Author Question: A middle-aged man with diabetes reports that he must strain to urinate and that his urine stream is ... (Read 74 times)

theo · **on:** Jun 25, 2018

A middle-aged man with diabetes reports that he must strain to urinate and that his urine stream is weak and dribbling. He also reports feeling that his bladder never really empties.

The nurse knows that all of his complaints are likely caused by which of the following medical diagnoses?
A)
Detrusor muscle areflexia
B)
Detrusor-sphincter dyssynergia
C)
Uninhibited neurogenic bladder
D)
Bladder atony with dysfunction

Question 2

A 24-year-old college student has presented to the campus medical clinic with complaints of frequent, burning urination and has, subsequent to urinalysis, been diagnosed with an acute lower urinary tract infection (UTI) caused by E. coli.

What teaching will the clinician most likely provide to the student?
A)
This should likely resolve itself if you drink a lot of water and especially cranberry or blueberry juice.
B)
Unfortunately, the bacteria causing your infection is no longer responsive to antibiotics, but there are alternative treatments that we can use.
C)
Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe.
D)
This likely shows that you have some sort of obstruction in your urinary system, so when that is treated your UTI will likely resolve as well.

amy.lauersdorf90 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Ans:
D

Feedback:

Diabetes causes peripheral neuropathy, which can affect the sensory axons of the urinary bladder. Bladder atony with dysfunction is a frequent complication of diabetes mellitus.

Answer to Question 2

Ans:
C

Feedback:

Microbial resistance to TMP-SMX antibiotics is now common in the United States; however, other specific antibiotic options do exist. Cranberry and blueberry juice are more appropriate as preventative rather than curative measures (reduces bacterial adherence to the epithelial lining of the urinary tract), and the majority of uncomplicated UTIs in young women are not the result of urinary obstructions.