Infections Of Urinary System ( UTI ) Flashcards by Brina Quintanilla Reyes

Urinary Tract infections are the most what ?

Most common HAI

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Urinary Tract infections are the second most common what for women?

Bacterial infection

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What is the most and second most common pathogen that causes UTI?

Escherichia C.oli
Candida Albicans

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From what can cause a UTI? (2)

Indwelling Catheter or asymptotic colonization

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Fungal and parasitic infections are rarely causing a urinary tract infection , however it can be seen more in which type of patients? (4)

Immunosupressed
Diabetics
Kidney problems
Multiple antibiotics

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How can we classify a urinary tract infection?

Either upper or lower

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We use specific terms in order to identify the location of an UTI. What are the 4 and define them ?

Pyelonephritis
- inflammation of the renal parenchyma & collecting systems
Cystitis
- inflammation of bladder
Urethritis
- inflammation of urethra
Urosepsis
- spread systematically

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We can also classify a UTI as what? (2)

Complicated vs uncomplicated

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What does complicated mean for UTI?
Give an example of this as well

Underlying disease or structural/functional problem in the UTI

Kidney transplant & stones

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What does uncomplicated UTI stand for?

Bladder only

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What term do we use to describe upper urinary tract infections
And which structures are included? (3)

Pyelnoephritis
Renal parenchyma
Pelvis
Ureters

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What term is used to describe lower urinary tract ? (2)
And define each

Cystitis ( bladder )
Urthritis ( Urethra )

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Etiology & Pathophysiology
The urinary tract above the urthra is normally what?

Sterile

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How is the urinary tract above the urthrea sterile?
What are the defense mechanisms that help maintain sterility ? (6)

Complete emptying with void
Ureterovesical junction competence
Ureteral Peristaltic Activity
( which helps move urine toward the bladder )
Acidic ph ( 6.0-7.5 )
High Urea
Glycoproteins & Peptides
( inhibit bacterial growth )

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Organisms that usually cause UTI originate in the what?

Perineum
( between anus & vulva/penis )

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How are organisms introduced into the Urethra?

Via the ascending route from the urthrea

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What are 4 most common factor contributing to ascending infection ?

Catherization
Cystoscopic examinations
Sexual intercourse
Hematogenous transmission

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How does Catherization and Cystoscopic examinations cause organism from the perineum ascend urthrea promote a UTI?

Allows bacteria to enter through opening

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How does sexual intrercourse cause organisms from perniuem to ascend into the urethra?

It promotes milking of bacteria

What does Hematogenous transmission mean for UTI?

Blood born bacteria invades kidneys, ureters or bladder from elsewhere in the body

CAUTIS are super dangerous why?

Because it’s extends hospital stay
Health cost
Mortality

What are the 3 clinical manifestations groups that fall under lower urinary tract infection?

Emptying symptoms
Storage symptoms
Hematuria/Cloudy appearance

What clinical manifestation would fall under emptying symptoms for a patient with a lower urinary tract infection? (5)

Hesitancy
Intermittency
Post void dribbling
Urinary retention/incomplete emptying
Dysuria ( painful pee )

What clinical manifestations fall under storage symptoms for lower urinary tract infections? (5)

Urinary frequency
Urgency
Incontinence
Nocturia
Noctural Enuresis

What are clinical manifestations for upper urinary tract infection are? (6)

Flank plan Chills Fever Fatigue Anorexia Asymptomatic

Older adults clinical manifestations For upper urinary tract infection 4

Non localized abdominal discomfort Cognitive impariment ( confused ) Generalized deterioration ( often aferible )

However: you want to remember that in older adults upper urinary tract infection are normally ?

Absent clinical manifestations

Sometimes people will have some bacteria colonization of bacteria in the bladder, however we want to treat and worry about this in which patients?

Pregnant women

Colonization of bacteria in bladder ; screen and test with pregnancy is called what?

Asymptomatic bacteriuria

What is a diagnostic studies we can do to help determine a UTI?

Dipstick urinalysis

The dipstick urinalysis can help determine what? (3) What do they indicate (2)

Presence of nitrites ( bacteriruia ) ( bacteria in urine ) Presence of white blood cells & leukocyte estesrase ( Pyuria ) ( pus in urine )

After we confirm bacteriuria & pyuria from the dipstick what other things will we do to help diagnosis?

Urine culture & sensitivity

What does urine culture & sensitivity mean? (2)

We collect urine by clean catch urine sample; which people pee into a cup at doctor And sensitivity is from that culture to see the specific bacteria to prescribe specific antibiotics

Urine culture/sensitivity are normally used in what? (4)

Recurring UTI (2-3 a year ) Complicated UTI ( structural/functional problem ) CAUTI & HAI UTI unresponsive to empiric therapy

Lastly, we’ve done a dipstick, urine culture, what is the last thing we can do to diagnostic studies on? (2)

Ultrasound or CT scan To see the urine

What is normal urine specific gravity?

1.005-1.030

Nursing assessment What are some things to ask for subjective data for UTI? (8)

Past history Medications Surgery Health perception Nutritional Elimination Cognitive Sexual

What are some objective data we will collect? (3)

General Urinary ( dipstick urinalysis ) Possible lab findings

What is the 3 nursing diagnosis for UTI?

Impaired urinary system function Acute pain Lack of knowledge

What are the 3 planning goals for the patient who has a UTI?

Relief from bothersome symptoms No upper urinary tract involvement No recurrence

Nursing Implementation What are we going to as nurses for the patient? (8)

Recognized those at risk of UTI Patient teach - empty bladder 3-4 daily - avoid vaginal sprays/douching - wipe front to back - adequate fluid intake - urinate after sex ( perineal hygiene hospital patients )

Who are most at risk that we can recognize for a UTI?

Immunocompromised ( cancer and diabetics ) Older adults

What are the 5 things we can do as nurses to help prevent CAUTI?

Avoid unnecessary Catherization Early removal Aseptic technique Hand hygiene Gloves

What are acute care we as nurses will do to help patients with UTI ( 5 ) For this one, think of the hospital, like what will we be saying to the patient and actually “grabbing” for them

Adquetae fluid ( helps dilute the urine & reduce irritation ) Avoid irritating fluids & foods ( coffee, alcohol, citrus juice, chocolate, spicy foods ) Heating pad to suprapubic & lower back ( help with discomfort ) Teach patient about drugs & side effects ( peridoum- orange pee ) Teach patient to what to look out for and report to HCP

What are we as nurses goin to help our patients with uti for Ambulatory care (6)?

Patient teaching Take anti microbes as ordered Adequate fluid intake Voiding regularly Stop using diaphragm Follow up date

Lastly, what would we want as a ending result The evaluation after treating and implementing our treatment for UTI? (3)

Have normal urinary elimination patterns Report relief of bothersome urinary tract symptoms State knowledge of treatment & plan