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UTI

all about UTI

QuestionAnswer
What are the 4 types of UTI Community Acquired, Catheter associated, Uncomplicated, Complicated
Uncomplicated UTI Infection occurs in normal urinary tract and usually only involves the bladder
Complicated Infections occur with coexisting presence of: Obstruction, stone, catheters, diabetes or neurologic disease, pregnancy- induced changes, and recurrent infection.
Those with complicated infection are at risk for what? pyelonephritis, urosepsis, and renal damage
Neurogenic Bladder Bladder is not functioning, not going to contract to allow urination. (stroke, paralysis, diabetes)
Problems with urine retained in bladder? cause infection, cause hedonecrosis, and other renal problems.
What is the most common pathogen of UTI? Ecoli
Indicate significant UTI Counts >100,000 organisms/ml
Lower tract Bladder/ urethra (cystitis/ Urethritis) NO SYSTEMIC MANIFESTATIONS
Upper Tract renal parenchyma/renal pelvis, ureters (Pyelonephritis)
Upper tract causes fever, chills, flank pain
Risk factors for UTI include (8 items) Female: short urethra Sexual activity BPH: obstruction increase risk in males Aging Invasive procedures Obstruction/functional disorders Exterrnal: bubble bath Anything that causes bacteria to enter
Clinical Manifestations of UTI Dysuria, Frequent urination (>q2hr) small amount, Urgency, suprapubic discomfort, Pyuria (cloudy), hematuria,
Progression to upper UTI (clinical manifestations) Flank pain, chills, and fever indicate infection of upper tract (pyelonephritis) Hematuria, foul smelling urine, tender, enlarged kidney Systemic systems: N/V, chills, malaise
Older adult UTI symptoms often absent, less likely to have a fever, superpubic discomfort, decreased appetite, cog. impairment, mental confusion, unexplained falls, sudden incontinence,
Only symptom older adult may have mental confusion
Complications of UTI Urosepsis- more common in elderly Acute renal failure
cystitis symptoms inflammation of bladder frequency, urgency, suprapubic pain, dysuria, hematuria, fever, confusion in older adults
urethritis inflammation of urethra
Urosepsis UTI that has spread into systemic circulation
diagnostic studies for UTI urinalysis Urine culture and sensitivity IVP or abdominal CT if obstruction suspected; renal ultra sound
Urinalysis provides 1st clues identifies nitrates, WBC, and leukocyte esterase microscopic confirmation
Urine culture and sensitivity clean catch preferred sensitivity determines susceptibility to antibiotics and guides treatment
What do you do before giving antibiotic for UTI? Get culture
Uncomplicated cystitis treatment short term course of antibiotics (1-3 days) Do well with less potent antibiotics (Nitro, Cipro) increase fluid intake prevention
Complicated UTI treatment long term treatment (7-14 days +) Cipro, Levaquin, Noroxin, Floxin, Tequin
Carbenicillin strongest med and highest concentration in urine
For patients who experience frequent UTI Prophylactic or suppressive antibiotics TMP/SMX administered daily to prevent recurrence
Pyridium Wont effect bacteria at all use with antibiotic Helps BURNING sensation stains urine reddish orange can be mistaken for blood & stain clothes
Unrised not used as much, turn urine blue or green
Nursing Diagnosis for UTI Impaired urinary elimination, Acute pain, knowledge deficit, Fluid volume deficit, Risk for sepsis/ renal damage/ impairment
Nursing interventions (Acute) give adequate fluids avg- 2-3 liters/day Drink cranberry juice, REST Avoid: caffeine, alcohol, spicy foods, any bladder irritants Apply warm compress to abdomen or lower back for pain Sitz bath &urinate in bath- relieve burning w/ urination
Nursing Interventions cont. Take full dose of meds until gone Complicated may come in for follow up -onset of flank pain or fever call MD Uncomplicated: no follow up, symptoms usually resolved
Complicated goals relief of pain normal temp no complications normal renal function no recurrence of symptoms
Uncomplicated goals relief from UTI lower tract: prevention of upper tract involvement Prevention of recurrence normal urinary elimination patterns Verbalize knowledge of treatment Adequate fluids
Teaching empty bladder regularly and completely Promote regular bowel activity WIPE FRONT TO BACK cotton panties DRINK FLUIDS Daily intake of cranberry juice will help Empty bladder before and after sex take showers not baths
Individuals at risk Debilitated persons, older adults, underlying diseases (HIV, DM), immunosuppressed
Infection control WASH HANDS before and after con Wear gloves for urinary care ROUTINE AND THROUGH PERI CARE for all pts NPSG prevention of CAUTIs -Avoid unnecessary cath -early removal of indwelling cath
CAUTI core preventions insert for only appropriate indications leave only as long as have to hand hygiene Aseptic technique and sterile equipment maintain closed drainage use ultrasound devices to see if urinary retention
use of indwelling catheters Acute urinary retention or obstruction peri operative use Assist healing of wounds in incontinent pts hospice, comfort care, palliative care Required immobilization for trauma or surgery Catheter in on admission Acute obstruction- BP
What do you do when placing catheter sticker on bag, chart date and placement of catheter, and purpose - **** DOCUMENT***
Pyelonephritis symptoms flank pain, dysuria, mild fatigue, Malaise, chills, fever, vomiting, pain at costovertebral angle, SAME S&S as Cystitis
Pyelonephritis goals May require hospitalization severe cases: IV antibiotics initially Monitor for Urosepsis to prevent septic shock
Created by: Jaycee420