UTI Flashcards
CAUTI
catheter-acquired urinary tract infections
accounts for 31% of all HAIs
upper UTI
involving parenchyma, pelvis or ureters
fever, chills, flank pain (CVA tenderness)
lower UTI
no systemic manifestations
pyelonephritis
inflammation (usually r/t infection) of renal parenchyma and collecting system
cystitis
inflammation of bladder wall
urosepsis
UTI that has spread to systemic circulation (life-threatening)
what predisposes someone to a UTI?
neurogenic bladder
kidney stones
female urethra
aging
DM
constipation
pregnancy (hormones, baby pressing on bladder)
poor hygiene
habitual delay in urination
pelvis
calculi
tumor
ureter (extrinsic v. intrinsic)
extrinsic: pregnancy, tumor (ex. cervix)
intrinsic: calculi, tumor, clot, inflammation
bladder
calculi
tumors
functional (neurogenic)
prostate
hyperplasia (enlargement of prostate)
carcinoma
above ______ is normally sterile
urethra
GI tube in stomach –> not sterile bc of acidic environment
lower UTI symptoms
“emptying” symptoms:
hesitancy, intermittency, post-void dribbling, urinary retention/incomplete emptying, dysuria
“storage” symptoms:
urinary frequency, urgency, incontinence, nocturia (peeing a lot at night), nocturnal enuresis (bed wetting at night)
UTI’s and women
most common bacterial infection in women
typically gram neg bacteria (e.coli most common)
organism originates in ascending route of urethra
UTI’s and older adults
present as confused – not with classic symptoms
non localized abd discomfort
cognitive impairment
generalized clinical deterioration
diagnosing a UTI
goal: confirm bacteriuria and pyuria (pus in urine)
urinalysis –>
first, quick dipstick:
+ nitrites (indicating bacteriuria)
increase WBC (“pyuria”)
+ leukocyte esterase (enzyme present in WBCs - pyuria)
then, confirm with microscopic urinalysis
a clean catch may be done if
complicated or nosocomial (hospital-acquired) UTI
frequent UTI
unresponsive to therapy
questionable diagnosis
patient teaching about preventing UTIs
-empty bladder regularly and completely
-wipe perineal area front to back following urination/BM
-drink adequate amounts of fluid daily (2-3 liters daily)
-cranberry juice or tablets
-sexually active females –> urinate before and after sex
nosocomial/HAI UTI: risk factor reduction
avoid or remove urinary catheterization early
careful aseptic/sterile technique with UTI instrumentation
excellent hand washing & glove wearing when giving perineal care
avoid incontinence episodes
acute interventions for a UTI
adequate fluid intake (unless contraindicated) - water
-AVOID caffeine, alcohol, citrus juices, chocolate, spicy foods
pain relief:
-warm bath or shower
-local heat to area
(^soothing)
