Urinary Tract Infection
A client is admitted to the emergency department for possible acute pyelonephritis. Which manifestations are associated with this disorder?
1. Diarrhea 2. Vomiting 3. Flank tenderness 4. Urinary frequency
What are the clinical manifestations of pyelonephritis?
1. Fever 2. Vomiting 3. Flank Pain Clinical manifestations that occur with pyelonephritis include fever, vomiting, and flank pain. Enuresiss and dysuria occur with cystitis.
The nurse is caring for a client diagnosed with a urinary tract infection (UTI). Which assessment findings support this diagnosis?
1. Flank pain 2. Burning sensation upon urination 3. Abdominal pain
Which topics are important to include in the home care teaching for a client with a urinary tract infection (UTI)? (Select all that apply.)
1. Good hygiene methods 2. Proper nutrition 3. Adequate fluid consumption
A client has a history of repeated urinary tract infections caused by several different factors. What clinical situation would be least likely to cause a UTI?
Increase in urinary motility A decrease, not an increase, in urinary motility can cause a UTI. Urinary stasis, trauma to the urinary tract, and a blockage in the urinary tract can cause a UTI.
Ms. Rodriquez is a 20-year-old woman who has had several urinary tract infections during the past 2 years. She returned to the healthcare provider's office for a follow-up visit and is speaking to you regarding treatment. She tells you that she realizes that she must complete the prescribed course of antibiotics. She is concerned that because she has taken antibiotics several times during the past few years, she will develop problems. Ms. Rodriguez is asking if there are foods that she can avoid to prevent the urinary tract infections from recurring. What is your best response?
"you should avoid alcoholic beverages, as consumption has been liked to increasing the risks for UTIS" The nurse would educate the client to avoid alcoholic beverages as these have been linked to UTIs. The client would be encouraged to drink cranberry juice and to avoid artificial sweeteners as part of the teaching associated with decreasing the risk for UTIs.
The client wants to know what fluids to avoid, in light of repeated urinary tract infections. What fluids would you educate the client about?
1. Citrus juices 2. Alcoholic beverages 3. Coffee Avoiding citrus juices, alcoholic beverages, and coffee can help prevent urinary infections. Increasing the intake of cranberry juice, not avoiding it, can help prevent urinary infections. Milk intake has no known effect in preventing urinary infections.
What are the causes of urinary tract infections?
1. Structural deviations 2. Renal scaring 3. Vesicoureteral reflux The causes of urinary tract infections include structural deviations, renal scaring, and vesicoureteral reflux. Excessive oral fluid intake or use of antibiotics does not cause urinary tract infections.
A 5-year-old client arrives at the community health clinic exhibiting signs of a urinary tract infection (UTI), including fever of 101 ºF, strong-smelling urine, and irritability. A urine culture and sensitivity have been ordered. Which causative agent does the nurse expect, based on this diagnostic test?
A gram-negative enteric bacterium The majority of UTIs are caused by gram-negative enteric bacterium such as Escherichia coli. The culture and sensitivity will verify the causative agent and allow the healthcare provider to prescribe the most appropriate treatment. Glucose, protein, and ketones are tested by a urine dipstick, not a urine culture.
The client asks the nurse, "How did I get this urinary tract infection (UTI)?" The nurse bases the response on which common causative factor?
An ascending infection from the urethra The most common cause of a UTI is an ascending infection from the urethra. Congenital strictures and urinary retention can lead to infection, but these are not the most common causes. Systemic infections are rarely causes of UTIs.
What physiologic changes occur with pyelonephritis?
An inflammatory response occurs in the pelvis and in the parenchyma within the affected kidney. Pyelonephritis occurs due to an inflammation of the pelvis and parenchyma of the kidney. The other choices describe other types of urinary tract infections.
The nurse is caring for a client complaining of loss of appetite, feeling confused and lethargic, and painful urination. Based on these symptoms, what diagnosis does the nurse expect?
Cystitis The combination of anorexia, confusion (in the elderly), lethargy, and dysuria are symptoms of cystitis. Symptoms are different for urethritis, pyelonephritis, and prostatitis.
Why is a urine culture and sensitivity used in the diagnosis and treatment of urinary tract infection (UTI)?
It helps the provider choose the most effective antibiotic A urine culture and sensitivity is a diagnostic test that helps the healthcare provider choose the most effective antibiotic to treat the UTI. A urinalysis tests for bacteria and blood cells in the urine. A white blood cell count identifies characteristic changes associated with the infection. An intravenous pyelography evaluates structure and excretory function.
Which nursing intervention is appropriate for a client with the nursing diagnosis of impaired urinary elimination?
Measuring intake and output The client experiencing the nursing diagnosis of impaired urinary elimination would benefit most from the nurse measuring intake and output. The client with the nursing diagnosis of pain would benefit from a pain assessment, analgesic administration, and recommending a warm sitz bath.
The parent of a child with repeated urinary tract infections (UTIs) is worried because her child has not been progressing like other children of the same age. Which nursing diagnosis would be the most appropriate for this client?
Potential for growth retardation While all these diagnoses are appropriate for clients with a history of UTIs, the most appropriate for this client based on the concern of the parent is potential for growth retardation.
The nurse is caring for a client in the emergency department (ED) who has been diagnosed with a urinary tract infection (UTI) and is complaining of pain. The nurse teaches the client to expect which medication for the treatment of pain?
Pygidium Pyridium is a medication that is used to treat the painful spasms that are associated with UTIs. Sulfamethoxazole-trimethoprim and amoxicillin clavulante are antibiotics that are commonly used in the treatment of UTIs, but they would not be prescribed for the treatment of pain. Vancomycin is an antibiotic and would not be appropriate in the treatment of pain.
A nurse is caring for a client diagnosed with a urinary tract infection. When providing education to this client, which topic should not be included as a bladder irritant?
Smoking Caffeinated beverages, citrus juices, alcohol, and artificial sweeteners are considered bladder irritants; therefore, the client should be educated to avoid them. Smoking is not considered a bladder irritant.
What is the purpose of phenazopyridine (Pyridium) in the treatment of urinary tract infections?
TO relieve symptoms associated with Urinary Tract infections Phenazopyridine (Pyridium) is used to relieve dysuria, urinary frequency, and urgency that are associated with urinary tract infections. The medication is a urinary analgesic, not an antibiotic, which would decrease bacterial growth. Nitrofurantoin (Furadantin, Macrodantin) may be prescribed to prevent urinary tract infections for clients who experience frequent infections. Phenazopyridine does not alter the urinary pH.
You are a nurse manager planning a presentation for the staff nurses regarding urinary health. Several members of your staff have recently been diagnosed with urinary tract infections. One of these nurses came to you stating, "We are so busy that we don't stop to void during our shifts." Which topic is appropriate for you to include in the presentation?
The importance of not ignoring the urge to eliminate. Many nurses ignore this urge, placing themselves at risk for development of a urinary tract infection. It is important to remind the nursing staff that they should not ignore the urge to void as this increases the risk of a urinary tract infection. The staff would be reminded to decrease caffeinated beverages, increase fluid consumption, and add cranberry juice to their fluid regimen as ways of decreasing UTIs.
The nurse is caring for a client who is diagnosed with a urinary tract infection (UTI). Which diagnostic test does the nurse anticipate will be ordered for the client to determine appropriate treatment?
Urine culture and sensitivity The client suspected of having a urinary tract infection would have a urine culture and sensitivity ordered to determine the best course of pharmacological treatment. A client with renal calculi would require an intravenous pyelogram for diagnosis. A pelvic examination is useful to assess structural changes of the urinary tract. A voiding cystourethrography is useful when determining the cause of urinary inflammation.
Ms. Boyer is an 82-year-old woman who had a total knee replacement yesterday. Although her pain has been adequately managed during rest, when she gets up to use the bedside commode, she rates her pain very high. Consequently, she is reluctant to drink and holds her urine so she does not have to get up often. Her daughter explains her mother's situation, states her surprise that her mother does not have a urinary catheter in place, and asks why this is so. What is your best response to Ms. Boyer's daughter?
"Having a urinary catheter in place would increase your mother's risk of developing a urinary tract infection. Bacteria could enter the bladder from the catheter and from urine in the drainage bag and tubing." Insertion of a urinary catheter increases the risk of developing a urinary tract infection. This occurs because the flushing action of the voiding process is no longer present, and bacteria from the perineal area can ascend on the catheter sides farther up the urethra and closer to the bladder. Although client movement is encouraged postoperatively, it is important to offer the most specific response when teaching clients and family members. Referencing the potential development of complications is very general. Insertion of a urinary catheter does not reduce the client's need to void; it may contribute to urinary retention over a prolonged period because the bladder muscle is not contracting when a urinary catheter is in place. Having a urinary catheter in place increases the risk for cystitis; this could ascend and develop into a kidney infection but is a less frequent occurrence.
The student health center nurse is talking to a college student who had symptoms of a urinary tract infection (UTI). The student bought over-the-counter Pyridium and no longer has symptoms. The student feels "cured." What is the nurse's best response?
"Pyridium is an analgesic, so it helps the pain, but it does not treat the infection. An antibiotic is needed." Pyridium is an analgesic, so it helps the pain, but it does not treat the infection. An antibiotic is needed to treat the infection. Easing the pain is worthwhile, but not if it delays active treatment of the infection. The client does not need to stop the analgesic; the client does not need to make a return visit for treatment. The client needs a prescription for an antibiotic to treat the infection.
