Urinary Tract/Bladder Infection FINAL

Question 1

Cause

Answer 1

Bacteria, viruses, fungi, and parasites

Question 2

S/Sx

Answer 2

• Increased frequency or urgency in voiding
• Urgency and pain or discomfort on urination
• Change in urine color, clarity, or odor; presence of pus (WBCs) or blood (RBCs)
• Abdominal or back pain
• Bladder distention
• Feelings of incomplete bladder emptying
• Voiding in small amounts or inability to urinate
• Difficulty in initiating urination
• Urinary meatus inflammation
• Prostate gland changes or tenderness

Question 3

S/sx in older adults

Answer 3

• The symptoms of UTI may be as vague as increasing mental confusion or unexplained falls
• Sudden onset of or worsening of incontinence may be an early symptom
• Fever, tachycardia, tachypnea, and hypotension even without any urinary symptoms may be signs of urosepsis
• Loss of appetite, nocturia, and dysuria are common symptoms

Question 4

Risk factors

Answer 4

• Female – short urethra
• Older Adult Clients – decreased estrogen promotes atrophy of the urethral opening
• Sexual intercourse
• Frequent use of feminine hygiene products
• Poorly fitted diaphragm
• Synthetic underwear and pantyhose
• Wet bathing suits
• Frequent submersion into baths or hot tubs
• Catheters, diabetes

Question 5

Urinalysis for positive UTI

Answer 5

Color: yellow, hazy
Specific gravity: 1.005
pH: 7
Blood: 1+
Protein: Neg
Nitrite: 1+
Leukocyte esterase: 3+
Bacteria: 3+
White blood cells: 40-100/hpf
Red blood cells: 2/hpf
Epithelial cells: 0-5/lpf

Question 6

Why is it important to review culture & sensitivity (bacteria in urine)?

Answer 6

Allows you to identify what antibiotic the organism s susceptible to and ensure the patient is on the correct antibiotic

Question 7

Nursing Care/Interventions

Answer 7

-Teach pt to self-administer drugs & complete all of the prescribed antibiotics/antimicrobial agents
-Expect changes in color of urine w/ some treatments
-Use appropriate techniques to prevent discomfort w/ sexual activities and how to prevent postcoital infections. Empty bladder before and after intercourse. Wash genitals before and after sex.
-Consume liberal fluid intake to maintain urine color as clear or light yellow.
-Clean perineum after urination
-Empty bladder as soon as urge is felt
-Avoid known irritants- caffeine, carbonated beverages, tomato products, bubble baths, vaginal washes, and scented toilet tissue
-Seek prompt medical care if sx reoccur

Question 8

Why do pregnant women with cystitis require prompt and aggressive antibiotic treatment because

Answer 8

this infection can lead to preterm labor and premature birth

Question 9

Meds

Answer 9

• Antibiotics: In uncomplicated UTIs (also called acute bacterial cystitis), a 3-day course of oral antibiotic treatment is recommended
  o TMP-SMX, Nitrofurantoin, & Fosfomycin
• Analgesics (phenazopyridine) or antipyretics may be used to promote comfort. Urine may turn orange.
• Antispasmodics may be used to decrease bladder spasm and promote complete bladder emptying in certain chronic conditions or with recurrent UTI.
• Antifungal agents such as amphotericin B in daily bladder instillations and ketoconazole (Nizoral) in oral form may be used if the infecting microbe is fungal

Question 10

Clean catch urine sample

Answer 10

Self clean before voiding
Initiate voiding after cleaning then stop. Resume voiding into container. No part of pt’s anatomy should touch the container. Only 1 ounce (30mL) is needed.