urologic problems: pyelonephritis Flashcards
lithos
stone
calculi
something accidental that doesn’t belong in body (ex: stone)
UTI: protective factors
acidic pH
presence of urea
urine is uni-directional
immune system
*men: prostatic secretions
*women: urethral gland secretions
why are women at higher risk than males for UTIs?
shorter urethra
urethral opening closer to anus (bacteria)
UTI: risk factors
-CAUTIs
-female; perineal irritation
-age
-pregnancy
-sex
-urinary obstruction or reflux
-immobility
-incontinence (urine+stool)
-decreased cognition
-bad personal hygiene
consideration with nursing homes relative to UTIs
50% have bacteriuria
*dont treat with abx
*expected finding
order of the spread of a UTI
(BOTTOM)
1. contaminated perineum
2. urethra
3. bladder (cystitis: bladder infection)
4. ureter
5. kidney (pyelonephritis)
(TOP)
*goes up in ascending pattern
upper UTI
pyelonephritis: inflammation/infection of kidney
inflammatory response –> kidney infection –> kidney failure
cause of pyelonephritis/upper UTI
ascending infection with E. coli
bloodstream infection
major risk factor of an upper UTI
pregnancy
fetus can block ureters, causing urinary stasis, thus infection occurs
upper UTI: clinical manifestations
sudden onset of fever, chills, CVA tenderness
lower UTI S/S
-dysuria
-frequency
-urgency
N/V, anorexia
complication of a UTI
urosepsis
untreated UTI spreads through urinary tract to kidney and causes sepsis
who is at risk for urosepsis?
serious systemic (inflammatory) response to a UTI
-elderly patients
-diabetics
-immunosuppressed patients
DEADLY, but treatable
UTI treatment depends on
upper vs. lower UTI
complications
pregnancy
culture and sensitivity
*upper is treated more aggressively than lower
types of abx for community-acquired infections
single dose
short course (3 days)
conventional (7-14) ** more for pt who have a reoccurrence of UTIs
