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Author Name f.abraham@student.ciu.ac.ug

Title COURSE ASSIGNMENT 2 FOR MEDICAL NURSING 1 (BNS TU II & DIR II
-AUG 2023)
Paper/Submission ID 1124917
Submitted by fgithinji@ciu.ac.ug
Submission Date 2023-11-22 23:17:02
Total Pages 10
Document type Assignment

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Registration NO.: 2022BNSFT-F03
Course unit: Medical Nursing 1
Course lecturer: Kimara Agnes
Assignment 2
 4
A) Urinary tract infections (UTIs) are infections that occur in any part of
the urinary system, which includes the kidneys, bladder, ureters
(tubes connecting the kidneys to the bladder), and urethra (tube
through which urine is expelled from the body). UTIs are most
3
commonly caused by bacteria entering the urinary tract through the
urethra and multiplying in the urinary system.

B) Etiology
Acute uncomplicated UTI:
UTI without underlying disease
Escherichia coli: causes 80% of UTI
Gram(-) enteric bacteria{ klebsiella, proteus}
Gram(+) cocci { streptococcus faecalis, staphylococcus saprophyticus-
infections to young sexually active women}

Complicated UTI
UTI with an underlying structural, medical or neurologic disease
Pseudomonas aeruginosa , enterobacter and serratia
They are isolated inhospital acquired infections and catheter associated
UTI
The predisposing factors of UTI are;
2
 Aging : as people get older , changes occur in the urinary system that
increase the risk of UTI. Changes like reduced bladder capacity,
weakened muscle bladder and decreased hormonal support. Health
condition such as urinary retention urinary incontinence or presences
of urinary catheters can make them more susceptible. Indivduals with
diabetic mellitus are more prone to UTIS. There is impaired immune
11
function as the body becomes weak to fight off infections. Elevated
blood sugar levels can promote bacterias to grow especially high
blood pressure.
  In females- shorter urethra- the bacteria have a shorter distance to
travel to reach yhe bladder making them easier for them to infect.
Female have shorter urethra than men.
 Sexual intercourse, bacteria from the genital ares can be introduced
3
into the urethra and then travel to bladder
 Contacceptives, certain contraceptives like diaphrams or spermicides
can increase the risk of UTIS. It changes the balance in the vagina and
urethra.
 Incomplete bladder emptying with age, as women there si decrease in
strength and coordination of the muscles involving the bladder
making the bacteria have and environment where it can multiply and
infect.
 In males, prostatic hypertrophy, as men age the prostatic gland can
enlarge and obstruct the normal flow of urin and make it difficult to
completely empty the bladder .
 Bacterial prostatitis, prostatitis in an inflammation of the prostatic
gland, it can recruit UTIS
3) Bacteria can enter the UT in 4 routes
1. ascending infection; most common route, bacteria ascend throught
urethra into bladder
2)Haemogenous spread; blood borne spread to kidney, it occurs
3)lymphatogenous spread; for men through rectal and colonic lymphatic
vessels to prostate and bladder. For women, through periuterine
lymphatics to urinary tract
4) direct extraction from other organs- pelivic inflammatory diseases ,
genitourinary tract fistulas
5) the organisms virulence factors:
Escherichia coli; fimbriae, toxic production, production of urease
enzyme , resistance to serum bactericidal activity
The clinical features depending on the sit of infection and age of patients
a) On the site
Urethritis: Discomfort in voiding , dysuria , urgency , frequency
Cystitis ; pelvic discomfort, dysuria, pyuria, abdominal pain
Hemorrhagic cystitis :visible blood in urine, irritating voiding symptoms
Pyelonephritis; invasive nature , fever and chills, WBC casts in urine, back
pain, nausea and vomiting
Also sepsis, septic shock, death
B)ON age:
Babies and infants : Failure to thrive , diarrhea, fever,
Children, adult : dysuria, haematuria, vomiting, acute abdominal pain
Adults: LUTIs- dysuria, haematuria
UUTIs- fever, rigor, symptoms of lower UTIs
Elderly :asymptomatic
4)Upper UTIs
Shock
Death
Sepsis
Recurrent UTI
Pyelonephritis
Kidney damage
5)
Diagnosis Interventions Rational Evaluation
Acute Pain 1. Assess and - Pain assessment - The patient's
1
related to document the helps in pain level
inflammation patient's pain determining the should be
and infection of level using a intensity of the decreased or
the urinary tract. pain scale. pain and relieved.
2. Administer evaluating the - The patient
prescribed pain effectiveness of demonstrates
medications as interventions. understanding
ordered by the - Pain medications of pain
provide analgesia
 healthcare to relieve management
provider. discomfort. strategies.
3. Apply heat - Heat application - The patient
therapy to the helps to reduce reports relief
lower abdomen pain and muscle from pain and
or perineal area, spasm by improved
as appropriate, promoting comfort.
to alleviate pain vasodilation and
and promote increasing blood
comfort. flow.
4. Encourage the - Increased fluid
patient to drink intake promotes
plenty of fluids urinary flow,
to promote dilutes the urine,
urinary flow and and aids in
help flush out bacterial
bacteria. clearance.
5. Provide a - A comfortable
comfortable and environment can
supportive contribute to the
environment patient's overall
that promotes well-being and
rest and help reduce pain
relaxation. perception.
6. Educate the - Education about
patient about completing the
the importance antibiotic course
of completing promotes
the full course of adherence to
prescribed treatment,
antibiotics to preventing the
ensure effective spread of infection
treatment and and recurrence.
pain relief.

Risk for 1. Monitor the - Close monitoring - The patient

Imbalanced patient's fluid of fluid intake and maintains
Fluid Volume intake and output helps adequate
related to output closely, identify hydration, as
increased including urine imbalances and evidenced by
urinary color, volume, guides appropriate normal fluid
frequency and and frequency. interventions. intake and
potential 2. Encourage the - Adequate fluid output.
dehydration patient to drink intake maintains - Signs of
adequate fluids, urinary flow, dehydration
such as water or dilutes urine, and are absent or
cranberry juice, helps flush out resolved.
to maintain bacteria, reducing - The patient
hydration and the risk of demonstrates
promote urinary infection. understanding
flushing. - Individual of the
3. Collaborate adjustment of importance of
with the fluid intake hydration and
healthcare ensures optimal signs of
provider to hydration while dehydration
adjust the considering the
patient's fluid patient's specific
intake based on needs.
individual needs - Prompt
and identification and
comorbidities treatment of
(e.g., heart or dehydration
kidney disease). prevent
4. Assess for complications and
signs of promote overall
dehydration, well-being.
8
such as dry - Intravenous
mucous fluids may be
membranes, necessary to
decreased skin restore fluid
turgor, and balance in severe
increased thirst, cases or when oral
and report intake is
findings insufficient.
promptly. - Patient
5. Administer education
1
intravenous empowers the
fluids as patient to actively
prescribed in participate in
cases of severe maintaining
 dehydration or hydration and
inability to recognizing signs
tolerate oral of dehydration.
intake.
6. Educate the
patient about
the importance
of maintaining
adequate
hydration and
2
the signs and
symptoms of
dehydration.
Risk for Urinary 1. Assess the - Assessing the - The patient
Incontinence patient's current patient's demonstrates
related to urinary continence status improved
urinary tract continence helps identify the bladder control
infection and status and any risk for urinary and reduced
increased factors that may incontinence and risk of urinary
urinary contribute to guides appropriate incontinence.
frequency urinary interventions. - The patient
incontinence. - Addressing the verbalizes
2. Encourage the patient's concerns understanding
patient to and anxieties of strategies to
verbalize any promotes open manage
concerns or communication urinary
anxieties related and reduces incontinence.
to urinary psychological - The patient
incontinence. distress. reports
3. Provide - Timely toileting decreased
regular toileting and scheduled episodes of
assistance and voiding minimize urinary
scheduled the risk of incontinence
bathroom accidents and and increased
breaks to ensure provide a confidence in
timely voiding structured managing
and minimize approach to bladder
the risk of managing urinary function.
accidents. frequency. - The patient
expresses
 6
4. Teach the - Pelvic floor reduced
patient pelvic muscle exercises embarrassment
floor muscle strengthen the or self-esteem
exercises (Kegel muscles that issues related
exercises) to control bladder to urinary
improve bladder function, incontinence.
control and enhancing urinary
prevent urinary control and
incontinence. reducing the risk
5. Educate the of incontinence.
5
patient about - Dietary
9
dietary modifications can
modifications help reduce
that may help urinary urgency
reduce urinary and frequency,
urgency and improving bladder
frequency, such control.
as avoiding - Protective
bladder irritants measures provide
like caffeine and a sense of security
spicy foods. and help manage
6. Offer and any episodes of
assist the patient urinary
with the use of incontinence.
protective - Collaboration
measures, such with the
as absorbent healthcare
pads or adult provider ensures
diapers, to appropriate
manage any medication
episodes of management to
urinary address urinary
incontinence. incontinence
7. Collaborate caused by the
with the urinary tract
healthcare infection.
provider to - Emotional
determine if support and
medication reassurance are
adjustments are essential in
 necessary to addressing the
address urinary psychosocial
incontinence impact of urinary
caused by the incontinence.
urinary tract
infection.
8. Provide
emotional
support and
reassurance to
the patient,
addressing any
embarrassment
or self-esteem
issues related to
urinary
incontinence
6) 1. Definition and Causes:
- Explain that a UTI is an infection that occurs in any part of the urinary
3
system, including the kidneys, bladder, ureters, and urethra.
- Describe that UTIs are commonly caused by bacteria, with Escherichia
coli (E. coli) being the most common culprit. Other factors such as poor
15
hygiene, urinary retention, sexual activity, and certain medical conditions
can also contribute to UTIs.
2. Signs and Symptoms:
- Educate about common signs and symptoms of UTIs, including frequent
urination, burning or pain during urination, cloudy or foul-smelling urine,
urgency to urinate, and lower abdominal pain.
- Highlight that some individuals, particularly older adults, may experience
non-specific symptoms such as confusion, lethargy, or worsening of pre-
existing conditions.
3. Prevention Strategies:
- Emphasize the importance of good hygiene practices, including regular
washing of hands and proper wiping technique (front to back) after using
the toilet, to prevent the spread of bacteria.
- Encourage maintaining adequate hydration by drinking plenty of fluids,
7
as this helps flush out bacteria from the urinary system.
- Discuss the benefits of urinating regularly and completely, as holding
3
urine for prolonged periods can increase the risk of UTIs.
14
- Encourage individuals who are sexually active to urinate before and after
12 16
sexual activity to help flush out any bacteria that may have entered the
urinary tract.
5. Lifestyle Modifications:
- Discuss the impact of certain lifestyle factors on UTI risk, such as avoiding
prolonged use of irritating feminine hygiene products, wearing breathable
cotton underwear, and avoiding tight-fitting clothing that can trap
moisture.
- Encourage individuals to maintain a healthy immune system through
regular exercise, a balanced diet, adequate sleep, and stress management,
13
as a strong immune system can help prevent infections.
6. Awareness of UTIs:
2
- Raise awareness about UTIs as a common infection and the importance of
discussing symptoms and seeking appropriate medical care.
- Highlight that UTIs can affect individuals of all ages, including children
10
and older adults, and that early recognition and treatment are crucial for
optimal outcomes
Reference :
https://www.nursetogether.com/urinary-tract-infection-nursing-
diagnosis-care-plan/#deficient-fluid-volume
chrome-
extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.med.umich.
edu/1libr/NursingUnits/UTIPrevention.pdf
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-
health/5-tips-to-prevent-a-urinary-tract-infection