Urinary Tract Infections (UTIs) - Nursing Presentation PDF

Urinary Tract Infections (UTI’s) Dr. Sibi peter, PhD, RN,CCRN UTI and Classification Infection of the urinary tract due to either a bacteria, a fungus, or a parasite (bacteria is the most common)  More common in women than in men  More than 100,000 people are hospitalized annually for...

Urinary Tract Infections (UTI’s) Dr. Sibi peter, PhD, RN,CCRN UTI and Classification Infection of the urinary tract due to either a bacteria, a fungus, or a parasite (bacteria is the most common)  More common in women than in men  More than 100,000 people are hospitalized annually for UTI’s  Upper or lower depending on its location  Infections of the upper urinary tract typically cause fever, chills, and flank pain  Infections of the lower urinary tract usually don’t have systemic manifestations  Uncomplicated vs. Complicated  Pyelonephritis: inflammation of the renal parenchyma and collecting system Cystitis: inflammation of the bladder Classificatio n Urethritis: inflammation of the continued… urethra Urosepsis: UTI that has spread systemically, life-threatening and requires emergency treatment  Urinary tract above the urethra is normally sterile Etiology and Pathophysiology Mechanical and physiological defense mechanisms maintain sterility and prevent infection, a disruption in these mechanisms can increase the risk of developing a UTI Most organisms that cause UTI’s originate in the perineum and are introduced through the urethra (gram- negative bacilli) Risk Factors  Urologic instrumentation  Factors that increase urinary stasis  Sexual intercourse (may predispose women)  Poor personal hygiene  Fistula formation  Factors that decrease a person’s immune response  Menopause  Clinical Manifestations  Frequent urination  Dysuria  Urgency  Suprapubic discomfort  Hematuria/cloudy with sediment  Systemic manifestations (flank pain, fever, and chills) Diagnostic Tests  History & physical examination  Clean-catch urine sample  Urinalysis (nitrites, WBC’s and leukocyte esterase) -> microscopic urinalysis  Urine culture -> sensitivity testing  Computed tomography (CT) urogram or ultrasound may be indicated for patients who have a suspected obstruction in the urinary system or for patients that have severe reoccurring UTI’s Collaborative Care  Antibiotic therapy  First choice drugs for uncomplicated UTI’s: trimethoprim/sulfamethoxazole (TMP/SMX) (Bactrim, Septra, Macrodantin, and Monurol)  Other antibiotics for uncomplicated UTI’s: ampicillin, amoxicillin, and cephalosporins  Complicated UTI’s: fluroquinolones (Cipro, Levaquin, Noroxin, Floxin, and Tequin)  UTI’s due to a fungus: fluconazole (Diflucan)  Urinary analgesics for discomfort: oral phenazopyridine (Azo standard, Pyridium)  Nursing Management  Health history (allergies)  Physical Examination (elimination patterns)  Health management (urinary hygiene, sexuality, diet, etc.)  Medications  Diagnostic findings  Identify those at risk for UTI’s  Health promotion activities (emptying the bladder completely, wiping the perineal area from front to back, and drinking adequate liquids each day)  Promote daily intake of cranberry juice or cranberry tablets  Aseptic technique when dealing with catheterization, indwelling catheters should be removed as soon as possible!!  Perineal hygiene for hospitalized patients  Nursing Implementation Acute Intervention Ambulatory & Home care Adequate fluid intake Adhere to the prescribed drug regimen Avoidance of bladder irritants Adequate fluid intake accompanied (caffeine, alcohol, citrus juices, by regular voiding (do not hold urine) chocolate, spicy foods) Application of heat to the suprapubic Urinating before and after area or lower back intercourse Instruct patients to finish the full Follow up care if symptoms do not course of antibiotics subside  1) The client asks the nurse, "How did I get this urinary tract infection?" The nurse should explain that in most instances, cystitis is caused by: NCLEX A. Congenital strictures in the Questions urethra B. An infection elsewhere in the body C. Urinary stasis in the bladder D. An ascending infection from the urethra.  2) When assessing the patient who has a lower urinary tract infection (UTI), the nurse will initially ask about: NCLEX Questions A. Flank pain B. Pain with urination C. Poor urine output D. Nausea   3) The nurse is requested to NCLEX perform teaching to a client in the Emergency Department related to Question the diagnosis of a urinary tract infection. An intervention to be s followed by the client includes: A. Avoid tight-fitting pants or clothing B. Drink at least eight glasses of water a day C. I can discontinue use of my antibiotics when my symptoms go away D. I should urinate every 4-6 hours