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Urinary Tract Infection, (UTI) is an Infection of One Or

Urinary Tract Infection, (UTI) is an Infection of One Or

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Published by Lorebell

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Published by: Lorebell on Aug 15, 2009
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05/07/2013

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Urinary tract infection, (UTI) is an infection of one or more of the structures in the urinary tract.Most UTI’s happen from bowel organisms, (E-coli). Women are more prone to UTI’s because of theshortness of their urethra.
CYSTITIS
Infections of the lower urinary tract are called cystitis. This is an inflammation of the urinarybladder related to a superficial infection that doesn’t extend to the bladder mucosa, most often caused byascending infection from the urethra; it can also be caused by sexual intercourse.
Causes
o
Stagnation of urine in the bladder 
o
Obstruction of the urethra
o
Sexual intercourse
o
Incorrect aseptic technique during catheterization
o
Incorrect perineal care
o
Kidney infection
o
Radiation
o
Diabetes mellitus
o
Pregnancy
Other causes
o
Cystitis is usually due to a bacterial infection of the urine. Occasionally, in children it can becaused by a virus.
o
The infection is more common in women because a woman's anatomy is designed in such a waythat it makes it easier for bacteria to enter the bladder.
o
Sexual intercourse, using spermicidal creams, and using diaphragms all increase the risk of developing
.
o
People who have a catheter in their bladder or who have to periodically catheterize them have ahigher risk of developing bladder infection.
o
People with
s or abnormal connections between their bladder and intestines alsohave a higher risk of developing
.
Pathophysiology
Bacterial infection from a second source spreads to the bladder, causing an inflammatoryresponse.
Cell destruction from trauma to the bladder wall, particularly the trigone area, initiates an acuteinflammatory response.
Complications
Chronic cystitis (recurrent or persistent inflammation of the bladder)
Urethritis (inflammation of theurethra)
Pyelenophritis (Infections of the upper urinary tract)
Clinical manifestations
 
Any changes in the clients voiding habits should be assessed as a possible UTI. The mostcommon clinical manifestation of cystitis is burning pain of urination (dysuria), Frequency, urgency,voiding in small amount, inability to void, incomplete emptying of the bladder, cloudy urine and hematuria( blood in urine). Asymptomatic bacteriuria (bacteria in urine).
Nursing DiagnosisImpaired Urinary Elimination
. The primary diagnosis when a client is experiencing problems related tocystitis is Impaired Urinary Elimination related to irritation of the bladder mucosa.
Acute Pain
. Another common nursing diagnosis for clients with cystitis is Acute Pain related to irritationand inflammation of bladder and urethral mucosa.
How to diagnose
o
Often times, treatment may be based on the symptoms alone, without additional tests.
o
 (in which the urine is tested for the presence of an infection) is the most commonmethod of diagnosis.
o
Blood and
s may also be required.
o
In women with frequent infections (more than three a year), a full examination of the urinarytract (usually by a specialist) needs to be done. Also, it is sometimes recommended that allmen who develop any type of urinary infection, including
s, need to beseen by a specialist.
Diagnostic test findings
Urine culture and sensitivity: positive identification of organisms (Escherichia coli, Proteusvulgaris, Streptococcus faecalis)
Urine chemistry: hematuria, pyuria,; increased protein, leukocytes, specific gravity
Cytoscopy: obstruction or deformity
Assessment findings
Frequency of urination
Urgency of urination
Burning or pain on urination
Lower abdominal discomfort
Dark, odoriferous urine
Flank tenderness or suprapubic pain
Nocturia (need to get up during the nightin order to urinate, thus interruptingsleep)
Low-grade fever 
Urge to bear down during urination
Dysuria (refers to painfulurination)
Dribbling
Medical management
 
Diet: acid-ash diet with increased intakeof fluids and vitamin C
Activity: as tolerated
Monitoring: vital signs and intake andoutput
Laboratory studies: specific gravity,urine culture and sensitivity
Treatment: Sitz baths
Antibiotics: co- trimoxizole (Bactrim),cephalexin (Keflex)
Analgesic: oxycodone (Tylox)
Urinary antiseptic: Phenazopyridine(Pyridium)
Antipyretic: acetaminophen (Tylenol)
Nursing interventions
Maintain the patients diet
Encourage fluids (cranberry or orange juice) to 3qt (3L)/day
Assess renal status
Monitor and record vital signs, I/O,and laboratory studies
Administer medications, asprescribed
Allay patient’s anxiety
Maintain treatments: sitz baths,perineal care
Encourage voiding every 2 to 3 hours
Individualize home care instructions
o
Avoid coffee, tea, alcohol andcola
o
Increase fluid intake to 3 qt (3L)/day using orange juice andcranberry juice
o
Void every 2 to 3 hours andafter intercourse
o
Perform perineal care correctly
o
Avoid bubble baths, vaginaldeodorants ant tub baths

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