Urinary tract infections Flashcards
Escherichia coli (E.coli)
most common pathogen
if lower urinary infection, it’s called
cystitis
if upper urinary infection, it’s called
nephritis
lower UTI symptoms
inflammation of bladder, prostate, or urethra. pain.
upper UTI symptoms
fever, chills, flank pain. can seem like back pain.
Pyelonephritis: acute or chronic?
both
Urosepsis
UTI that has spread systemically. can lead to death.
who is at risk for UTI?
immunosuppressed
Diabetic
Have kidney problems
Have undergone multiple antibiotic courses
Have traveled to developing countries
exam will usually be
benign
who is at higher risk for UTI?
Alteration of defense mechanisms increases risk for contracting UTI
Compromising immune response factors
Age, HIV, diabetes
Predisposing factors
Factors increasing urinary stasis
BPH, tumor, neurogenic bladder
Foreign bodies
Catheters, calculi, instrumentation
Anatomic factors
Obesity, congenital defects, fistula
Functional disorders
Constipation
Other
Pregnancy, multiple sex partners (women)
older age - do kidneys get smaller?
kidney gets smaller, loss of muscle tone. decrease in bladder capacity.
UTI - Bladder storage - Nocturia and Nocturnal enuresis
Nocturia- waking up 2 or more times to void
Nocturnal enuresis- loss of urine during sleep
how many ppl have incontenence?
15 - 35% over 60
Older adults - UTI
Symptoms often absent
Non localized abdominal discomfort rather than dysuria
Cognitive impairment possible
Change in behavior, confusion or agitation possible
Fever less likely
Dipstick urinalysis (dip into the night with white and luke)
Identify presence of nitrites, WBCs, and leukocyte esterase
objective signs of UTI
fever
Hematuria, foul smelling urine, tender/enlarged kidney
Leukocytosis, + bacteria, WBCs, RBCs, pyuria, ultrasound, CT scan, IVP
