Wk 5 UTI Flashcards
What 3 things does an upper UTI involve?
Parenchyma
Pelvis
Uterus
What are 3 symptoms of an upper UTI?
Fever
Chills
Flank pain (CVA tenderness)
A lower UTI has no __ manifestations
Systemic
What is the definition of pyelonephritis?
Inflammation, usually associated with infection, or renal parenchyma and collecting system
What is cystitis?
Inflammation of the bladder
What is urosepsis?
UTI that has spread to systemic circulation
Urosepsis is…
life-threatening
Anyone who has urinary __ is predisposed to a UTI
stasis
What is a good example of someone who has urinary stasis?
Neurogenic bladder
What are two immune system risk factors for UTIs?
Aging
Diabetes
What is a functional disorder that may cause a UTI?
Constipation
How does constipation cause a UTI?
Can impeded urine outflow
What is a “nurse’s bladder”?
A habitual delay in urinating that can lead to UTI
What else can cause a UTI?
Calculi
What can cause a blockage of the ureter that can lead to a UTI? (2)
Pregnancy
Tumors
What are 4 things that can cause an obstruction of the ureter?
Calculi
Tumors
Clots
Inflammation
3 things that can cause UTI concerning below the bladder?
Prostate hyperplasia
Carcinoma
Urethral strictures
What are symptoms of LOWER UTIs?
Bladder emptying symptoms
Bladder storage symptoms
What are bladder emptying symptoms? (5)
Hesitancy Intermittency Post-void dribbling Urinary retention Dysuria
What are bladder storage symptoms? (5)
Urinary frequency Urgency Incontinence Nocturia Nocturnal enuresis
Urinary frequency Urgency Incontinence Nocturia Nocturnal enuresis
What type of symptoms are these?
Bladder storage symptoms
Hesitancy Intermittency Post-void dribbling Urinary retention Dysuria
What type of symptoms are these?
Bladder emptying symptoms
Bladder emptying and storage symptoms are for __ UTIs
Lower
What is nocturnal enuresis?
Bed wetting
UTIs are the most common bacterial infection in…
women
A UTI in women is typically a gram-__ infection
negative
What bacteria is responsible for most UTIs?
E. coli
What is the most common classic symptom in an elderly patient with a UTI?
Confusion
What is often the first sign an elderly patient has a UTI?
Confusion
What are 3 symptoms for the elderly that they may be experiencing a UTI?
Non-localized abdominal discomfort
Cognitive impairment
Generalized clinical deterioration
What are 2 things we look for in urine to diagnose a UTI?
Bacteriuria and pyuria
What is pyuria?
Pus in the urine
What are 3 chemstrip indications that a patient had a UTI?
Positive for nitrates
Increased WBC
Positive for leukocyte esterase
What 2 tests on a chemstrip indicated a patient has pyuria?
Increased WBC
Positive for leukocyte esterase
What is leukocyte esterase?
An enzyme in white blood cells
What do nitrates in urine indicate?
Bacteriuria
List 4 reasons a clean catch urine culture may be done
Complicated or nosocomial UTI
Frequent UTI
Unresponsive to therapy
Questionable diagnosis
Patient teaching on emptying
Empty the bladder regularly and completely, don’t rush the process
Patient teaching on wiping
Wipe perineal area from front to back following urination and bowel movement
Patient teaching on PO fluid intake
Drink adequate amounts of fluid daily (2-3 liters)
There is no evidence that what prevents UTIs?
Cranberries
Patient teaching on sexual activity
If female urinate before and after sex
UTI risk factor reduction for catheterization:
Avoid putting them in or remove asap
UTI risk factor reduction for instrumentation?
Careful aseptic technique
UTI risk factor reduction for perineal care
Excellent hand washing, gloves wearing
UTI risk factor reduction for incontinent patients
Avoid incontinence episodes, clean up asap
What types of fluids/foods are bladder irritants? (5)
Caffeine Alcohol Citrus juices Chocolate Spicy foods
What should you NOT do if a patient has a UTI?
Don’t put them in a bubble bath
What are good non-pharmacologic techniques for UTI pain? (2)
Warm bath or shower
Local heat to the area
What are 2 teaching points for pharmacologic treatment of UTI for patients?
Take full course of antibiotics
Seek follow-up care if symptoms do not resolve
How soon should a patient with a UTI start to see symptoms subside if they are on antibiotics?
A couple days
If a patient doesn’t see symptoms of UTI subside within a couple days of antibiotic treatment they should do what?
Contact HCP
