UTI

Question 1

CAUTI

Answer 1

catheter-acquired urinary tract infections

accounts for 31% of all HAIs

Question 2

upper UTI

Answer 2

involving parenchyma, pelvis or ureters

fever, chills, flank pain (CVA tenderness)

Question 3

lower UTI

Answer 3

no systemic manifestations

Question 4

pyelonephritis

Answer 4

inflammation (usually r/t infection) of renal parenchyma and collecting system

Question 5

cystitis

Answer 5

inflammation of bladder wall

Question 6

urosepsis

Answer 6

UTI that has spread to systemic circulation (life-threatening)

Question 7

what predisposes someone to a UTI?

Answer 7

neurogenic bladder
kidney stones
female urethra
aging
DM
constipation
pregnancy (hormones, baby pressing on bladder)
poor hygiene
habitual delay in urination

Question 8

pelvis

Answer 8

calculi
tumor

Question 9

ureter (extrinsic v. intrinsic)

Answer 9

extrinsic: pregnancy, tumor (ex. cervix)
intrinsic: calculi, tumor, clot, inflammation

Question 10

bladder

Answer 10

calculi
tumors
functional (neurogenic)

Question 11

prostate

Answer 11

hyperplasia (enlargement of prostate)
carcinoma

Question 12

above ______ is normally sterile

Answer 12

urethra

GI tube in stomach –> not sterile bc of acidic environment

Question 13

lower UTI symptoms

Answer 13

“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)

Question 14

UTI’s and women

Answer 14

most common bacterial infection in women
typically gram neg bacteria (e.coli most common)
organism originates in ascending route of urethra

Question 15

UTI’s and older adults

Answer 15

present as confused – not with classic symptoms

non localized abd discomfort
cognitive impairment
generalized clinical deterioration

Question 16

diagnosing a UTI

Answer 16

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

Question 17

a clean catch may be done if

Answer 17

complicated or nosocomial (hospital-acquired) UTI
frequent UTI
unresponsive to therapy
questionable diagnosis

Question 18

patient teaching about preventing UTIs

Answer 18

-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

Question 19

nosocomial/HAI UTI: risk factor reduction

Answer 19

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

Question 20

acute interventions for a UTI

Answer 20

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)