Urinary Tract Infection (UTI) Assessment

Study Notes

Urinary tract infection (UTI) is an infection involving the kidneys, ureters, bladder, or urethra.

Assessment involves identifying signs and symptoms indicative of a UTI.
Pain is a common symptom, which can manifest as abdominal, flank, or suprapubic pain.
Fever suggests the presence of an infection.
Vomiting may occur, particularly in younger children.
Failure to thrive (FTT) in infants can be a subtle sign of underlying UTI.

Diagnostic procedures are essential to confirm the presence of a UTI and identify the causative organism.
Urinalysis (UA) is a preliminary test to detect signs of infection.
- It looks for the presence of bacteria (bacteriuria).
- It looks for white blood cells (pyuria).
- It looks for nitrites (produced by bacteria).
- It looks for leukocyte esterase (an enzyme released by white blood cells).
Urine culture (Cx) is the gold standard for diagnosing UTI.
- In urine culture it identifies the specific bacteria causing the infection.
- In urine culture it determines the antibiotic sensitivities.
Renal ultrasound (U/S) is an imaging study.
- It is used to evaluate the kidneys and urinary tract for abnormalities.
- It is used to identify structural issues.
- It is used to identify stones.
- It is used to identify abscesses.
Voiding cystourethrogram (VCUG) is a specialized X-ray.
- It is used to assess the bladder and urethra.
- It is used to visualize urine flow.
- It is used to detect vesicoureteral reflux (VUR).
- VUR is the backflow of urine from the bladder into the ureters and kidneys.

Intervention involves stabilizing the patient.
Intervention involves administering appropriate treatment.
Stabilization is the initial step in managing a patient with a UTI.
Ensure adequate hydration to support kidney function and facilitate the excretion of bacteria.
Manage fever with antipyretics to improve patient comfort.
Address pain with appropriate analgesics.
Administer antibiotics to eradicate the bacterial infection.
Antibiotic choice depends on the patient's age, severity of illness, and local antibiotic resistance patterns.
Antibiotics can be administered intravenously or orally, depending on the patient's condition.

Prevention strategies aim to reduce the risk of recurrent UTIs.
Encourage frequent and complete bladder emptying to prevent urinary stasis.
Promote adequate hydration to dilute urine and flush out bacteria.
Teach proper hygiene practices, such as wiping from front to back after toileting, especially in females.
Consider prophylactic antibiotics in patients with recurrent UTIs or VUR, as recommended by a healthcare provider.
Address and manage any underlying conditions that may contribute to UTIs, such as constipation or bladder dysfunction.