Nursing Management: UTI
What is the recommended fluid intake per person over 24 hours?
- (person's weight in pounds)/2 = # of fluid oz. person should have per day - 20% of fluids will be obtained from foods
What are the most effective means for reducing HAI UTIs?
- avoid unnecessary catherization - early removal of indwelling catheters - follow aseptic technique - wash hands before and after contact w/patient - wear gloves - answer call lights quickly, offer bedpans/urinals to bedridden patients at frequent intervals
What types of fruit juice could potentially reduce UTIs?
- cranberry juice, tablets or capsules - juice is more effective vs. tablets or capsules - enzymes found in cranberries inhibits attachment of urinary pathogens to bladder wall
Who is at risk for UTIs?
- debilitated persons - immunocompromised, i.e. cancer, HIV, diabetes mellitus - immunosuppressive drugs, corticosteroids
What are health promotion activities in preventing UTIs?
- emptying bladder regularly and completely - evacuating bowel regularly - wiping perineal area from front to back after urination and defecation - drinking adequate amount of liquids each day
What are acute interventions for a patient with a UTI?
- ensure adequate fluid intake - application of local heat to suprapubic area or lower back to relieve discomfort: use heating pad at lowest setting OR warm shower/sitting in tub of warm water filled above waist - instruct to take full course of ABx - instruct to watch for signs of improvement: cloudy urine becomes clear, etc.
What should you teach patients about adequate fluid intake?
- increase frequency - dilute urine making bladder less irritable - flush out bacteria before they have a chance to colonize in bladder - caffeine, alcohol, citrus juices, chocolate, highly spiced foods or beverages are potential bladder irritants and should be avoided
What happens if patients complete treatment and symptoms are still present?
- patient should get follow-up care - symptoms may still occur 1-2 weeks after completion of therapy
What are overall goals for a patient with a UTI?
- relief from bothersome LUTS - prevention of upper urinary tract involvement - prevention of recurrence
What should you teach patients about UTIs?
1. take all ABx as prescribed 2. practice appropriate hygiene: carefully clean perineal region by separating the labia when cleansing, wipe from front to back after urinating, cleanse with warm soapy water after each bowel movement 3. empty bladder before and after sex 4. urinate regularly, approx. every 3-4 hours during the day 5. maintain adequate fluid intake 6. avoid vaginal douches and harsh soaps, bubble baths, powders, sprays in the perineal area 7. report to HCP symptoms or signs of recurrent UTI, i.e. fever, cloudy urine, dysuria, urgency, frequency 8. consider drinking unsweetened cranberry juice (8 oz. 3x per day) or taking cranberry extract tablets 300-400 mg/day for UTI prevention 9. temporarily discontinue diaphragm
