Urinary Tract Infections (UTIs) Flashcards
Pathophysiology of a UTI
Bacteria introduced via the ascending route into the urinary tract from the urethra
What is the most common bacteria that causes UTIs?
E coli
Manifestations of UTIs
- Dysuria
- Frequency (voiding more than every two hours)
- Urgency
- Suprapubic discomfort/pressure
- Hematuria
- Sediment in the urine
- Cloudy appearance of urine
- Fever
- Chills
- Flank pain
Manifestations in the Elderly
- General abdominal discomfort
- Impaired cognition/confusion
- No fever
- Overall clinical deterioration
Risk Factors for UTIs
- Women (until after 50)
- Catheters
- Obesity/diabetes
- Kidney disease/stones
- Aging
- Pregnancy
- Sexual activity
- Poor hygiene habits
Assessments for UTI
- Past health/family history
- Current meds
- Symptoms
- Elimination patterns
- Hygiene practices
- Sexual activity
- Urine characteristics (color, clarity, odor, pH)
Labs & Diagnostic Tests
- Urinalysis/urine culture
- Imaging studies
- BUN/creatinine/GFR levels
Urinalysis (UA)
Analysis of urine by physical, chemical, and microscopic means to test for presence of disease
Why would you use imaging studies if someone has a UTI?
To look for abnormalities in your urinary tract; such as, inflammation, kidney stones, obstructions, etc.
What is BUN?
Blood urea nitrogen - reveals how well your kidneys are working
What is the normal range for BUN?
10-20mL/dL
Creatinine
Chemical compound left over from energy-producing processes in your muscles
What is the normal range for creatinine?
.5-12mg/dL
Glomerular Filtration Rate (GFR)
How much blood the nephrons filter every minute
What is a normal finding for a GFR level?
> 60
Nursing Interventions
- Regular catheter/peri care
- Answer call lights quickly
- Offer toilet/bedpan often
- Ensure adequate fluid intake
- Drug therapy
- Apply heat to suprapubic area
- Warm bath or shower
Medications
- Antibiotics
- Analgesics
- Antipyretics
Potential Complications
- Recurrent UTIs
- Kidney damage
- Urosepsis
Causes of Recurrent UTIs
- Bacterial resistance to antibiotics
- Patient uncompliant with antibiotics
- Multiple risk factors
Urosepsis
Bacteria getting into the bloodstream; life threatening
Signs of Urosepsis
- Elevated HR/RR
- Decreased BP
- Other organs shutting down
Patient Education
- Take antibiotics as prescribed for the entire course
- Side effects of medication
- Empty bladder before and after sex
- Don’t hold in urine, void regularly
- Drink 8-9, 8oz glasses of water a day
- Avoid harsh soaps, bubble bath, & sprays in the urethral area
- Report signs of recurrent UTI
- Vitamin C/cranberry juice to help bacteria not stick to bladder walls as easily
Cystitis
Inflammation of the bladder
Urethritis
Inflammation of the urethra
