Urinary Tract Infection

Question 1

urinary system

Answer 1

2 kidneys, 2 ureters, bladder, urethra & 2 sphincter muscles

Question 2

UTI

Answer 2

• infection that affects the urinary system, any part of the urinary tract can become infected
• classified as upper or lower UTI

Question 3

most common cause of UTI

Answer 3

• through the lower end of the urinary tract, the urethra. The opening of a man’s urethra at the tip of the penis or the opening of the woman’s urethra at the vulva.
• Infection ascends the urethra to the bladder & sometimes to the kidneys, or both

Question 4

how do bacteria enter the urinary tract

Answer 4

organisms enter the tract by one of 2 routes:
1. through urethra: infection ascends the urethra to the bladder & sometimes kidneys or both
2. through bloodstream, usually to the kidneys

Question 5

cystitis

Answer 5

• Infection/ inflammation of the bladder
• Usually caused by bacteria

Question 6

S/S of UTI

Answer 6

• changes in voiding
• frequent need to urinate
• dysuria
• urgency
• cloudy strong or foul urine
• hematuria
• lower back pain
• suprapubic pain
• fatigue
• abdominal distention
• nausea
• diarrhea
• fever

Question 7

causes- risks of UTI

Answer 7

• bacteria
• STI’s
• poor hygiene
• voiding problems (enlarged prostate, tumor, kidney stones)
• spermicides
• indwelling catheters
• personal care products
• diabetic patients
• honeymoon cystitis (bacteria in urinary tract following sex)
• urinary retention
• diabetes
• women

Question 8

testing for UTI

Answer 8

• urinalysis (dip stick) checks for WBC, blood & nitrates
• urinalysis routine & microscopic (chemical & microscopic tests show cells, cellular fragments, & bacteria in urine)
• urinalysis for C&S (Culture & Sensitivity)
• sterile specimen (clean catch/midstream or catheter specimen) identifies bacteria & the antibiotics sensitive or resistive to the bacteria

Question 9

nursing interventions for UTI

Answer 9

• education (complete full course of antibiotics)
• let dr know if symptoms dont improve
• have pt report side effects such as rash
• meds cause sun sensitivity (wear sunscreen)
• increase fluid intake (2L/day)
• avoid foods that irritate the bladder (caffeine, alcohol, tomatoes, spicy foods, chocolate)

Question 10

UTI medical management

Answer 10

• Patient will be prescribed the appropriate antibiotic
• Often Trimethoprim -sulfamethoxazole commonly called TMP-SMI (Septra, Bactrim), penicillins, cephalosporins, or Nitrofurantoin (Macrodantin)
• Phenazopyridine (Pyridium)-may be ordered for patient comfort to reduce pain, frequency & urgency. It has an analgesic effect (turns urine orange)

Question 11

complications of UTI medications

Answer 11

• broad spectrum antibiotics can cause significant side effects: c. dif, candidiasis, thrush, decreased effectiveness of oral birth control
• if infection travels up to the kidneys may cause pyelonephritis causing renal scarring & occasionally renal failure

Question 12

pyelonephritis

Answer 12

• bacterial infection of one or both kidneys
• Infection may spread up the urinary tract to the kidneys, or the kidneys may become infected through bacteria in the bloodstream

Question 13

S/S of pyelonephritis

Answer 13

• chills, fever, back pain, nausea, vomiting
• More common in women than men

Question 14

most common cause of pyelonephritis

Answer 14

E.coli
- causes about 90% of cases in people living in nursing homes or hospitalized

Question 15

treatment of pyelonephritis

Answer 15

• antibiotics
• hospitalization needed if: nausea & vomiting, dehydration, weak immune system, signs of severe infection, pain not controlled by oral meds

Question 16

treatment of pyelonephritis

Answer 16

• antibiotics
• hospitalization needed if: nausea & vomiting, dehydration, weak immune system, signs of severe infection, pain not controlled by oral meds

Question 17

cause of pyelonephritis

Answer 17

• usually caused by bacteria (E. coli)
• on rare occasions it is caused by fungal infections, TB or viruses
• Infections ascend from the genital area through the urethra to the bladder, then up the ureters into the kidneys
• In healthy urinary tracts the flow of urine washes out organisms and there is closure of the ureters at their entrance to the bladder;
• any obstruction to urine flow (structural abnormality, enlarged prostate, kidney stone, or back flow increases the likelihood of pyelonephritis
• risk increases during pregnancy as the enlarging uterus puts pressure on the ureters partially obstructing normal downward flow of urine

Question 18

Risk factors of pyelonephritis

Answer 18

• risk increases during pregnancy as the enlarging uterus puts pressure on the ureters partially obstructing normal downward flow of urine
• people with weakened immune systems and diabetes due to body inability to fight infection

Question 19

What signs and symptoms of an UTI may an Older Adult experience?

Answer 19

• confusion/delirium
• non localized abdominal discomfort

Question 20

What would a urine test strip test for?

Answer 20

WBC, Blood & Nitrates-if they are in the urine suspect infection