Ch 46: Urination - UTI's and Catheters Flashcards
What is the most common hospital-acquired infection in the United States?
UTI
A lower UTI affects the:
urethra and bladder
An upper UTI affects
The ureter and kidneys
What is the baterium that causes UTIs?
e. coli
When E. coli colonizes and ascends up the urethra and into the bladder, it causes…
cystitis
What is cystitis?
Inflammation of the urinary bladder. It is often caused by UTI and is usually accompanied by frequent painful urination.
If a UTI continues to ascend into the ureters and up into the kidneys, it causes…
pyelonephritis
What is pyelonephritis?
Inflammation of the substance of the kidney as a result of bacterial infection (UTI).
What are the UTI stats for sexually active young women?
25-35% will get at least 1 UTI a year
What are the UTI stats for older adult women in nursing homes?
30-50% have bacteria at any given time
What are the symtpoms of Cystitis
- Dysuria
- Urgency
- Frequency
- Pyuria
- Bacteriuria
- Suprapubic discomfort
What are the symptoms of Pyelonephritis?
Same as Cystitis with the addition of:
- fever
- chills
- severe flank pain
How is mild pyelonephritis treated?
Can be treated at home with oral antibiotics
How is severe pyelonephritis treated?
Treatment will require hospitalization and IV antibiotics
What are the main risk factors of UTIs?
- Gender: Female
- Age
- Indwelling catheter
- Certain Conditions
- Diabetes
- Suppressed immune system – either through disease or medications
- Urinary tract obstruction
What Objective data indicates a UTI?
- Bladder discomfort on palpation
- Abnormal urinalysis results (presence of pathogen, occult, or gross hematuria possible)
What Subjective data indicates a UTI?
Patient reports:
- Dysuria
- Urgency
- Frequency
- Nocturia
- Cloudy urine or hematuria
- Urinary hesitancy may be present
- Perineal itching
What are the three types of catheterization?
- Intermittent
- Short-term indwelling
- Long-term indwelling
When is Intermittent Catheterization used?
- Relief off discomfort of bladder distension (Decompression)
- Obtain a sterile urine specimen when clen-catch specimen is unubtainable
- Assessment of residual urine after urination
- Long-term management of clients with
- spinal cord injuries
- neuromuscular degeneration
- incompetent bladders
When is Short-term Indwelling Catheterization used?
- When their is an obstruction to urin outflow (prostate enlargement)
- Surical repair of bladder, urethra and surround structures
- Prevention of urethral obstruction from blood clots after genito-urinary surgery
- Measurement of urinary output in critically ill clients
- Continuous or intermittent bladder irrigations
When is Long-term Indwelling Catheterization used?
- Severe urinary retention with episodes of UTI
- Skin rashes, ulcers or wounds irrigated by contact with urine
- Terminal illness when bed linen changes are painful for client
What are the four types of “invasive” catheters?
- Straight
- Foley
- Coude´
- Triple-lumen
Description and Use
Straight Catheter
- Description
- Single-lumen catheter
- Use
- Intermittent urine drainage
- Single use (“in-and-out”) catheterization, or short-term
- Urine specimen collection
- Catheter is usually removed as soon as the bladder is drained or specimen obtained
Description and Use
Foley Catheter
- Description
- Two-lumen indwelling catheter
- Anchoring balloon present
- Lumen 1: balloon inflation
- Lumen 2: urine drainage
- Use
- Continuous drainage of urine
Description and Use
Coude´Catheter
- Description
- Two forms: single-lumen or two-lumen (same as Foley)
- Catheter is bent at the tip and slightly stiff
- A metal introducer wire may be inserted inside the catheter lumen to facilitate passage of tube (performed by primary care provider or urologist)
- Use
- Facilitates bladder access when urethra is partially constricted
- Commonly used with prostate enlargement or benign prostatic hyperplasia (BPH)
Description and Use
Triple Catheter
- Description
- Lumens 1 and 2: same as Foley
- Lumen 3: used to instill sterile irrigation solution or antibiotics, and drain blood and clots
- Use
- Post-urologic surgery or diagnostic procedure
