UTI

Question 1

What intervention should you do for a pt presenting with symptoms of UTI to prevent escalation to sepsis?

Answer 1

Increase fluid intake to flush bacteria from urinary tract and dilute urine. This will also promote frequent urination which helps with the flushing part

Question 2

Risk factors r/t UTIs in older adults?

Answer 2

History of UTIs, neutropenia, neurogenic bladder, decreased cognition

Question 3

How to minimize risk of UTIs?

Answer 3

Practice good HH, urinate immediately after sexual intercourse to flush out bacteria introduced during sex, showers preferable to baths, avoid wearing tight fitting clothing to prevent moisture accumulation.

Question 4

Upper tract UTI?

Answer 4

Pyelonephritis (inflammation of renal parenchyma and collecting system). It’s more serious because the kidney is affected rather than the bladder. Location: renal parenchyma, pelvis, ureters. Symptoms are fever, chills, and flank pain.

Question 5

Lower tract UTI?

Answer 5

Urethritis and cystitis (inflammation of bladder wall). Symptoms are frequency and burning (dont have same symptoms as kidney one).

Question 6

True or false: UTI is most common infection in women

Answer 6

true

Question 7

What is the most common pathogen for UTI?

Answer 7

E. coli from the GI tract

Question 8

What does the virulence of the causative agent depend on?

Answer 8

Its ability to gain access/thrive in the urinary tract.

Question 9

Patients at risk for UTIs?

Answer 9

Diabetes, immunosuppressive, multiple course of antibiotic treatment, travelling to certain countries

Question 10

Uncomplicated and complicated UTIs?

Answer 10

U- occurs in otherwise normal urinary tract, involved only the bladder
C- UTIs with coexisting presence of obstructions, stones, catheter, diabetes/neurological disease, pregnancy changes, and recurrent infections

Question 11

Defence mechanisms to prevent UTIs?

Answer 11

Peristaltic activity, acidic pH of urine, high urea concentration, abundant glycoproteins, complete emptying of bladder when you go pee

Question 12

How are organisms introduced in UTIs?

Answer 12

Introduced via ascending route from urethra and they originate in perineum. Less common routes are bloodstream and lymphatic system.

Question 13

Risk factors for UTIs?

Answer 13

BPH, pregnant women, having multiple sex partners, obesity

Question 14

What is a catheter acquired UTI?

Answer 14

Bacterial biofilms develop on inner surface of the catheter

Question 15

S+S of UTIs?

Answer 15

Urinary frequency >every 2 hrs, urgency, incontinent, nocturia, nocturnal enuresis (bed wetting during night), dysuria, retention. Flank pain/fever/ chills indicate infection of upper tract.

Question 16

Symptoms of UTI in older adults?

Answer 16

Symptoms often absent. Can experience non localized abdominal discomfort, cognitive impairment, and less likely to have fever.

Question 17

Diagnostics for UTIs?

Answer 17

Urinalysis (nitrites, WBC, and leukocytes means there is bacteria in urine). Nitrates are normal in urine but they are converted to nitrites by bacteria. C+S tells us what drugs bacteria is sensitive to. X rays, CT scan, renal ultrasounds for recurrent UTIs.

Question 18

Cranberry juice and UTIs?

Answer 18

It may reduce certain UTIS

Question 19

Antibiotics for UTIs?

Answer 19

Uncomplicated cystitis will have short treatment of 1-3 days. Complicated UTIs require long term treatment for 7-14 days.

Question 20

Interventions for UTIs?

Answer 20

Emptying bladder regularly/compeltely, evacuate bowel regularly, wiping per area front to back, drinking adequate fluids, wash hands, wear gloves, regular toileting, routine perineal care.

Question 21

What foods to avoid?

Answer 21

Avoid caffeine, alcohol, citrus juice, chocolate, and highly spiced food. They could be potential bladder irritants.

Question 22

Urosepsis?

Answer 22

Systemic infection from a urological source. This is the most severe presentation of UTI.

Question 23

Why can females get UTIs easier?

Answer 23

Their urethra is short than males so it’s easier for bacteria to get into the bladder. The female urethra is closer to butthole which is the source of E. coli.