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44 Cards in this Set
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What is the name of an upper uti:
Name of lower UTI is? |
pyelonephritis
cystitis urethritis prostatitis |
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Urinary antiseptics/antiinfectives have _______- effect when given in lower dasages.
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bacteriostatic
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Urinary antiseptics/antiinfectives have ___________ effect when given in higher dosages.
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bacteriacidal (think suicidal)
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What is acute cystitis commonly caused by:
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Escherichia coli, saprophyticus and gram-negative Klebsiella, Porteus and Pseudomonas.
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Symptoms of cystitis:
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pain, burning on urination and urinary frequency and urgency.
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Which bacteria most commonly causes Pyelonephritis.
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E Coli
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Symptoms of Pyelonephritis
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chills, high fever, flank pain, pain during urination, urinary frequency and urgency and pyuria
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What is the typical bacterial count in pyelonephritis
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100,000 bacteria/ml.
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What antibiotics might the pt receive to tx pyelonephritis in severe cases when pt has actually been hospitalized and receives thru IV
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amnioglycoside, ticarcillin/clavulanic acid or piperacillin/tazobactam.
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Drugs to tx UTI's
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nitrofurantoin
Bactrim Amoxillin Cephalosporins |
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What are the groups of urinary antiseptics/antiinfectives
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Nitrofuranoin
Methenamine Trimethoprim Fluoroquinolones |
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Nitrofurantoin (bacteriostatic and bactericida)
Effective against which bacteria |
gram - and gram + (especially e-coli). Used to tx acute and chronic UTIs. Absorbion is decreased with antacids.
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When is peak action with Nitrofurantoin
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30 minutes post absorbtion.
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Methenamine (Hiprex, Mandelamine) produces a bacteriocidal effect when the urinary ph is < what?
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5.5
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Methenamine is used for which kind of UTI
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chronic
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Do not take Methenamine with what?
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sulfonamides
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Trimethoprin can be used in conjunction with what to tx UTIs?
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sulfanamide
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What is the half-life of Trimethoprin
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9 to 11 hours. Although longer in pts with renal disease.
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What is the half-life of Fluoroquinolones
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2-4 hours (but prolonged in pts with renal dysfunction).
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What are the side effects of Nitrofurantoin (urinary antiseptic)
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GI disturbances such as anorexia, nausea, vomiting, diarrhea, ab. pain and pulmonary reactions such as dyspnea, chest pain, fever and cough.
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Methenamine side effects:
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GI including nausea, vomiting, diarrhea. Some allergic reactions to the dye in Hiprex. Bladder irritation and crystalluria (when taken in large doses may occur).
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Trimethoprim side effects:
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GI symptoms including nausea and vomiting, and skin problems such as rash and pruritus.
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Fluoroquinolones side-effects:
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headaches, dizziness, syncope (fainting), peripheral neuritis, visual disturbances and rash. Nausea, vomiting and diarrhea, headaches and visual disturbances can occur with cinoxacin and norfloxacin use. Photosensitivity.
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(drug to drug interation) Which med decreases nitrofurantoin absorption
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Antacids
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(drug to drug interation)
What inhibits the action of Methenamine. |
Sodium bicarbonate
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If a pt takes methenamine with sulfonamides what might they increase the risk of
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crystalluria
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Nalidixic acid enhances the effects of which anticoagulant
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Warfarin
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What type of drug is Phenazopyridine
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Urinary analgesic
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What does Phenazopyridine tx
(urinary analgesic) |
used to relieve pain, burning sensation and the frequency and urgency of urination that are symptomatic of lower UTIs.
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Side effects of Phenazopyrindine (urinary alalgesic)
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GI disturbances, hemolytic anemia, nephrotoxicity and hepatotoxicity. Urine becomes reddish/orange. Glucose levels need to be monitored because Phenazopyridine can alter the glucose urine test.
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What is a parasympathomimetic
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Drug used to stimulate micturition.
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Which parasympathomimetic drug is the drug of choice to stimulate micturiation
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Bethanechol chloride (Urecholine) also known as direct-acting parasympathomimetic.
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How does the parasympathomimetic drug Bethanechol chloride stimulate micturiation
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By increasing tone of the detrusor urinal muscle, which produces a contraction strong enough to stimulate urination.
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If a UT spasms are the result of infection or injury, which class of drug can help
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antispasmodics which have a direct action on the smooth muscles of the urinary tract.
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When are antispasmodics contraindicated
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if Gi obstruction is present or if the client has glaucoma.
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antispasmodics aka: dimethyl sulfoxide (aka DMSO), oxybutynin and flavoate is contraindicated with pts suffering from
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glaucoma and GI obstruction.
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antispasmodics/antimuscarinicsside effects are
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dry mouth
increased HR dizziness intestinal distention constipation |
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What other info. should the health care provide obtain from the client?
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Firstly, this drug is an antibacterial agent. Increased fluids highly recommended to prevent crystallization in the urine.
Nurse: check renal func. by checking urinary output should be >600ml/d, bun (8-25 mg/dl), creatinine (0.5 - 1.5 mg/d) If she has renal dysfunction she couldn't take sulfanomides. Oral antidiabetic drugs can increase likelyhood of hypoglycemic effect. Obtain CBC. |
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WHAT ELSE SHOULD THE HC PROVIDER DISCUSS WITH CLIENT IN REGARD TO TAKING THIS DRUG
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Side effects are anorexia, nausea, vomiting and diarrhea, stomatitis, crystalluria and photosensitivity.
Tell client to take drug with full glas of water. Urine output shoiuld be at least 1200 ml/d to decrease risk of crystallluria. Tell client not to take antacids because antacids decrease the absorbtion rate. |
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WHAT PREVENTATIVE MEASURES SHOULD BE TAKEN TO PREVENT FURTHER EPISODES OF UTIs
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xx
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xx
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xx
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WHAT IS THE RECOMMENDED FOLLOW UP CARE FOR F.I.
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Instruct client to report bruising or bleeding that could be a result of a drug-induced blood disorder. Advise client to have blood cell count monitored on a regular basis.
Avoid direct sunlight and wear sunblock due to photosensitivity. |
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xx
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xx
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R.M. TAKES COUMADIN 7.5 MG PER DAY. WHAT EFFECT DOES CO-TRIMOXAZOLE HAVE ON WARFARIN AND WHAT IS THE NURSING RESPONSIBILITY.
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It increases the anticoagulant effect. Meaning that the blood could get really thin. The nurse needs to obtain a full list of current drugs to find out if on Warfarin in particular.
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