Infections of the Urinary Tract

Which conditions may put a patient at risk for developing a fungal urinary tract infection (UTI)?

AIDS diagnosis AIDS leads to compromised immunity and can increase the risk for fungal UTI. Renal failure Renal failure increases the risk for fungal UTI because of impaired immunity and prophylactic antibiotic therapy. Chronic bacterial infections Chronic bacterial infections can lead to fungal UTI because repeated antibiotic therapy kills normal flora, allowing fungi to overgrow.

A patient presents with a fever of 102° F, fatigue, nausea, and urinary urgency. On percussion during physical examination, the nurse notes costovertebral tenderness on the left side. Urinalysis indicates bacteriuria. Which provider order would the nurse implement first?

Administer intravenous (IV) ampicillin. The patient's symptoms indicate pyelonephritis. The nurse would administer a broad-spectrum IV antibiotic.

A patient presents with urinary pain and urgency but no systemic symptoms. Urinalysis indicates a bacteria count of 103 CFU/mL. The patient's chart indicates no coexisting obstruction or health concern. However, the patient has been seen for urinary tract infections (UTIs) five times in the last year. Which antibiotic should the nurse expect the provider to prescribe for this patient?

Ciprofloxacin Ciprofloxacin is used to treat complicated UTIs and for patients with frequently recurring UTIs.

The nurse is caring for a patient being treated with ciprofloxacin for a catheter-associated urinary tract infection (UTI). Which assessment finding would be most concerning to the nurse?

Costovertebral angle (CVA) tenderness CVA tenderness indicates kidney involvement and worsening infection. This finding would be concerning to the nurse.

A patient presents with suprapubic pain, fever, and chills. The nurse notes heart rate of 112 beats/min, blood pressure of 146/88 mm Hg, and oxygen saturation of 100%. Which assessment findings would be most concerning?

Elevated white blood cell (WBC) count An elevated WBC count indicates infection and would be most concerning to the nurse.

Which urinary symptoms would indicate to the nurse that a urinary tract infection (UTI) has progressed to renal failure?

Oliguria Oliguria is decreased production of urine and can indicate renal failure. Flank pain Flank pain would indicate that damage to the kidneys has occurred and the UTI may have progressed to renal failure.

The nurse is caring for an older adult patient who complains of cloudy urine. Urinalysis indicates a bacteria count of 5 × 102 CFU/mL. The nurse understands that which treatment is most appropriate for this patient?

Oral nitrofurantoin therapy Oral antibiotics should be administered to patients with uncomplicated urinary tract infections.

A patient who is 5'5" and 180 lb is diagnosed with a urinary tract infection (UTI). The patient reports drinking 50 ounces of water a day and regular bowel movements and urination throughout the day. Which additional information should the nurse provide to the patient to help prevent future infections?

Tell patient to increase water intake to 90 ounces per day. The patient should be taught to increase fluid intake to at least 90 ounces per day.

Which infections of the urinary tract may manifest systemically as symptoms of fever, chills, and flank pain?

Upper urinary tract infection (UTI) Upper UTIs involve the kidneys and often present with fevers, chills and flank pain. Acute pyelonephritis Acute pyelonephritis is often caused by infection and is accompanied by fever, chills, and flank pain.