UTI Exemplar
- urethritis - prostatitis - cystitis
- infection of the lower urinary tract include __________ - inflammation of the prostate gland ____________ - inflammation of the urinary bladder
short-course therapy
- reduces treatment cost - increases compliance - has lower rate of side effects
cystitis
-is the most common UTI -inflammation of the urinary bladder
- encourage patients to maintain fluid intake of 2.0-2.5 liters per day - discuss the need to avoid voluntary urinary retention by emptying the bladder ever 3-4 ours - instruct women to cleanse the perineal area from front to back after voiding and defecating - teach clients to void and wash the perineal area before and after sexual intercourse - avoid bubble baths, feminine hygiene sprays, vaginal douches, wearing cotton briefs - drink two glasses of low-sugar cranberry juice daily, take vitamin C, and avoid excess intake of milk and milk products, other fruit juices, and baking soda
As the nurse, what can you teach your client to do to prevent UTIs?
- exposure of the urethra to bacteria in he feces in the diaper - predisposes the neonate to hyperbilirubinemia
How do newborns develop UTIs?
1. UTI in an infant less than 1 2. delay in diagnosis and effective antibacterial treatment for an upper UTI 3. Anatomical obstruction or nerve supply interruption 4. Recurrent episodes of upper UTIs
The risk of kidney damage increases what cases?
prostatic hypertrophy, bacterial prostatitis, anal intercourse
What are 3 risk factors of UTIs among males?
- dysuria (painful or difficult urination) - nocturia (voiding two or more times at night) - urine may have a foul odor and appear cloudy (pyuria) or bloody (hematuria) because of muscus - suprapubic pain and tenderness - chronic cystitis can lead to bladder stones
What are presenting symptoms of cystitis?
- pregnancy - urinary tract obstruction - congenital malformation - other: urinary tract trauma, scarring, calculi (stones), kidney disorders (polycystic or hypertensive kidney disease), chronic diseases (diabetes)
What are risk factors that contribute to pyelonephritis?
- unexplained fever - failure to thrive - poor feeding - vomiting & diarrhea - strong smelling urine - irritability
What are symptoms of a UTI in a newborn?
- assess pain - teach or provide comfort measures, such as warm sitz baths, warm packs or heating pads, and balanced rest and activity - increase fluid intake unless contraindicated - instruct the client to notify the primary care if pain and discomfort continue to intensify after therapy is initially altered
What nurse interventions can you do for a client experience pain?
- urinalysis (bacteria count greater than 10,000 per mL indicates infection) - nitrite dipstick - leukocyte esterase test - urine from urine collection bags may be used to screen for UTIs in infants, but cannot confirm a UTI - gram stain - urine culture and sensitivity tests - urine specimens - WBC count
What types of diagnostic tests can be done to test for UTIs?
- client's modesty in voiding - potential embarrassment - fear of changes in the body function
When caring for a client with a UTI, it is important for the nurse to consider what?
E.Coli
With cystitis, _________ is the organism responsible for 85% of the cases of acute pyelonephritis
acute pyelonephritis
a bacterial infection of the kidney
vesicoureteral reflux
a condition in which urine moves from the bladder back toward the kidney, is a common risk factor in children who develop pyelonephritis and also seen in adults when bladder outflow is obstructed
- chills and fever - malaise - vomiting - flank pain - costovertebral tenderness - urinary frequency
acute pyelonephritis is typically rapids with what accompanying symptoms?
vesicoureteral reflux
another cause of UTI which is the backflow of urine from the bladder into the ureters during voiding leading to pyelonephritis - prevents complete emptying of the bladder
rehydration and parenteral antibiotic treatment
children who appear ill and cannot tolerate antibiotics are often hospitalized because they need what?
prophylactic antibiotic therapy
clients who experience frequent symptomatic UTIs may be treated with what?
antibiotic therapy
most uncomplicated infections of the lower respiratory tract can be treated with short course of ________
chronic pyelonephritis
nonbacterial infections and inflammatory processes that can be metabolic, chemical, or immunological in origin
cystitis
occurs in females that wipe from back to front after urination which can transfer bacteria from the anorectal area to the urethra
hydronephrosis
renal scarring can result from ___________________(accumulation of urine in the renal pelvis as a result of obstructed outflow) or pyelonephritis
when anesthetic lubricating gels are inserted into the urethra prior to catheter insertion
research indicated that you can reduce the risk of catheter-associated UTI when what is inserted?
- preeclampsia - premature birth - asymptomatic bacteriuria - bacteria in the urine that actively multiple without clinical symptoms --> to kidney infection
the diagnosis of UTI in the pregnant client carries what risk for the mother and fetus?
the greater
the longer the catheter remains in place, the __________ risk for infection?
UTIs
the second most common infections in children, after otitis media
3
up to _____ UTIs annually are considered within normal limits?
- urinary tract obstruction by tumors or calculi - structural abnormalities such as strictures - impaired bladder innervation - bowel incontinence - constipation - diabetes mellitus - catherization or cryscopy - sexual activity - personal hygiene practices & voluntary urinary retention
what are congenital and acquire factors that contribute to the risk of infection?
- nocturia - incontinence - confusion - behavior change - lethargy - loss of appetite - "not feeling right" - change in behavior may be the only indicator of a UTI in patients in long-term care facilities
what are presenting symptoms in older adults of UTIs?
- aging - female's short urethra - urinary stasis - infrequent voiding - common in school- age children (incomplete emptying of bladder) - voluntarily suppressing
what are risk factors for developing UTI?
- urgency - frequency
what are the 2 presenting symptoms in younger adults with UTIs?
pyelonephritis
what is the most common upper urinary tract infection, involving inflammation of the kidney and renal pelvis
bacteria that have colonized the urethra
what is the usual source of infection with UTIs?
surgery
what may need to be done for recurrent UTI if diagnostic testing indicates calculi, structural anomalies, and strictures that contribute to the risk of infection?
- monitor color, clarity, and odor of urine - instruct clients with impaired urinary elimination to avoid caffeinated drinks, including coffee, tear, and cola; citrus juices, alcoholic beverages - use strict aseptic technique and a closed urinary drainage system when inserting a straight or indwelling catheter - use intermittent straight catherization to relieve urinary retention - maintain the closed urinary drainage system - provide perineal care regularly and follow defecation
what nursing interventions can you do for clients with impaired urinary elimination?
- administer prescribed meds. - promoting rehydration - assessing renal function - teaching client and family how to minimize future infection
what nursing role should you as the nurse focus on with a patient with a complicated UTI?
- enlarged prostate can impede urine flow and lead to incomplete bladder emptying and urinary stasis - diabetes mellitus - impaired immune response
what risk factors are seen in older men for developing UTIs?
ciprofloxacin (Cipro) & trimethoprim - sulfamethoxazole (TMP-SMZ)
what two antibiotics may be ordered?
asymptomatic UTI (e.g.,cather-associated UTI)
what type of UTI does not need treatment?
postpartal women
who is at an increased risk of developing urinary tract problems caused by normal postpartal diuretics, increased bladder capacity, and decreased bladder sensitivity from stretching or trauma
