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UTI
all about UTI
| Question | Answer |
|---|---|
| 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
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