URINARY

TRACT
INFECTION

BSN II- C (PM GROUP)

CHAPTER I
 GENERAL OBJECTIVE
The general objective of this case is to
be able to equip the level 2 student-
nurses of NEUST-CON to acquire
knowledge, skills and attitude in
providing care, utilizing the nursing
process and management of pediatric
patients experiencing Urinary Tract
Infection using the alternative learning
method for RLE.
 SPECIFIC OBJECTIVES
At the end of the clinical duty, the students will be able to:
1. Assess the client from head to toe, focusing on the parts affected by the
Urinary Tract Infection;
2. Obtain, document, and present a comprehensive medical history;
3. Explain the anatomy and physiology of Urinary System;
4. Define the Urinary Tract Infection, become familiar with the important
diagnostic/laboratory examinations that will be used in the confirmatory and
management of Urinary Tract Infection.
5. Understand the pathophysiology of Urinary Tract Infection
6. Recognize the different medications used, its action, side effect and its action
in the management of Urinary Tract Infection;
7. Understand the suggested medical management, employed to resolve
problems;
8. Formulate appropriate Nursing Care Plan utilizing the Nursing Process; and
9. Identify nursing priorities; provide prompt nursing intervention that would
help alleviate the condition of the client thus increasing their capacity to
function.
 INTRODUCTION
 Urinary tract infection (UTI) is a common and
potentially serious problem in children. The
overall prevalence is approximately 7% in
infants and young children, although there is
some variability based on age, gender, race, and
circumcision status (Shaikh, Morone, Bost, et al,
2008).

 UTI occurs more often in females than in males

at a rate of about 8% to 2% (Lum, 2008).
 INTRODUCTION
 A variety of organisms can be responsible for UTI.
Escherichia coli remains the most common uropathogen
overall, but the prevalence is higher in females (83%)
than males (50%) (Edlin, Shapiro, Hersh, et al, 2013).

 Because of the difficulty in distinguishing upper from

lower tract infection, particularly in young children, UTI
is often broadly defined. Upper UTIs or kidney
infections tend to present with fever and may lead to
renal scarring that may be associated with decreased
kidney function, hypertension, and renal disease over
time (Roberts, 2011).  
DEMOGRAPHIC PROFILE
Demographic Profile
1. Name: Patient X
2. Age: 8y/o
3. Birthdate: September 18, 2012
4. Gender: Female
5. Address: Talavera, Nueva Ecija
6. Civil Status: Single
7. Nationality: Filipino
8. Religion: Roman Catholic
9. Hospital: Eduardo L. Joson Hospital
10.Date of Admission: April 07, 2021
11.Date of Interview: April 07, 2021
12.Attending physician: Dr. X
 FAMILY HISTORY
The patient’s family health history
includes the patient’s father has
hypertension, her mother also has
diabetes and claimed that she often have
a UTI when she was a teenager. While
the immediate family members of the
patient do not signify any sign of illness
 HISTORY OF PAST ILLNESS

The patient’s mother stated that

her daughter has never been
hospitalized since she was born,
although she gets common cold and
cough every now and then that
lasted only for 1-2 days.
 ADMITTING HISTORY
On April 07, 2021 at around Admitting Vital
10:45AM, Patient X, an 8-year-old Signs:
girl was admitted in the Pediatric Temperature:
38.7°C
Ward of ELJH, accompanied by her
mother. Pulse Rate:
130bpm
Upon running some test, the
result shows that Patient X has a Respiratory Rate:
22c cpm
bacterial infection. The patient’s
final diagnosis is Urinary Tract Blood Pressure:
Infection. 90/60mmhg
 STATUS OF PRESENT ILLNESS

Patient X showed discomfort and pain on her back

and when urinating. The mother stated that whenever
the temperature of her child elevates, she will give her
a 250mg/5ml of paracetamol and she will prepare a
luke-warm, damp towel every night that she applies
on her daughter’s forehead. She also makes her drink
a lot of fluid since the patient has poor appetite. Since
the fever lasted longer than the usual and the patient
shows poor appetite and body weakness, the family
decided to seek for medical help.
 PHYSICAL ASSESSMENT
The table below shows the physical assessment of the client from head to toe.
Result
Body Part Normal Findings Actual Findings

Generally, round with the

prominence in the frontal to occipital. The patient’s skull is generally round and
Skull Normal
There are no nodules and masses has no tenderness upon palpation.
when palpated
The patient’s scalp has no lesion, neither
No lesions, no tenderness nor masses tenderness nor masses upon palpation.
Scalp Normal
on palpation
The patient’s hair is evenly distributed
Hair Evenly distributed, covers the scalp and covers the scalp. Normal

The patient’s eyes have clear pupils and

White sclera, pink conjunctiva. Clear reactive to light.
Eyes Normal
pupils and reactive to light.
 Facial grimace showing pain
Face Shape may be oval or rounded. Abnormal

The patient has clear hearing senses and

Ear color is the same with face. Clear has no abnormal discharge or wounds.
Ears & Hearing hearing senses. Absence of wounds Normal
and abnormal discharges.

The patient has no discharges, airways

No discharges, airways are patent. No are patent and no tenderness or lesions
Nose & Sinuses Normal
tenderness and lesions.
Body Part Normal Findings Actual Findings Result

Normal, lips are pinkish and The patient’s lips are pale and dry.
Mouth Abnormal
symmetrical.
The patient’s neck’s muscles are equal in
Muscles are equal in size, no inflamed
size, no inflamed nodule.
Neck nodules, and smooth movement with Normal
no discomfort.
The patient’s chest is symmetrical, right
Symmetrical, right and left shoulders and left shoulders are aligned with the
Chest are aligned with the right and left right and left hips. Normal
hips.
The patient’s abdomen is normal.
Abdomen is normally flat to round
Abdomen Normal
midline umbilicus
The patient’s both extremities are
No presence of bone deformities, normal, no presence of bone deformities,
tenderness and swelling. Normally tenderness and swelling. Normally firm
Extremities Normal
firm and movements should be and movements are coordinated.
coordinated.

The patient’s skin is pale and warm

The skin is normally uniform, whitish
pink or brown in color defending on Temp: 38.7 degree Celsius via axillary
Skin Abnormal
the race of client, should be moist and route
soft.

Normal. No cracks. Has good capillary The patient’s nails have no crack and are
Nails pale. Normal
refill.
The patient has unlaboured and is
Thorax Unlaboured and regular respiration regular in respiration. RR: Normal
22cpm
The patient is experiencing pain when
Female: Labia majora and labia
urinating
minora are pink and moist.
CHAPTER II
 DEFINITION OF THE CASE

Urinary tract infections are caused by

microbes such as bacteria overcoming the
body's defenses in the urinary tract. They can
affect the kidneys, bladder, and the tubes that
run between them. They are one of the most
common types of infection and account for
around 8.1 million visits to a doctor every
year (McIntosh, 2018)
ANATOMY AND PHYSIOLOGY
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
 MEDICAL MANAGEMENT
 Antispasmodic medications can help alleviate
bladder irritability, and analgesics and heat
therapy can help relieve pain and spasm.

 Antibacterial agents that eradicates bacteria

from the urinary tract with minimal effects on
fecal and vaginal flora.
 MEDICAL MANAGEMENT
Keflex belongs to a class of drugs called cephalosporin,
which are antibiotics. It is more often prescribed in its
generic version, called Cephalexin.  These drugs are
often given for the treatment of urinary tract infection,
respiratory tract infection, otitis media, and other
infections due to sensitive organisms.

Acetaminophen also known as Paracetamol. This is

not associated for the treatment of bacterial infection
but will help to make the client comfortable because it
can treat fever and pain experiencing by the client as a
symptom of UTI.
 NURSING MANAGEMENT
In all settings, nurses care for patients with urinary tract
infections.

The nurse should advise the parent to encourage the patient

to drink plenty of fluids in order to increase renal blood flow
and flush bacteria from the urinary tract.
Advise the mother to encourage the patient to void if she
feels the urge to urinate, as this will help to reduce urine
bacterial counts, reduce urinary stasis, and avoid reinfection.
Avoid urinary irritants such as coffee, tea, colas, and alcohol.
 CHAPTER III

LABORATORY RESULTS AND

INTERPRETATION
 COMPLETE BLOOD COUNT
04/07/2021 Result Normal Value Interpretation
Erythrocyte 4.9 4.6-5.2 Normal
Hematocrit 0.37 0.31-0.41 Normal
Hemoglobin 13 11.3-14.1 Normal
MCV 95 86-100 Normal
MCH 28 26-31 Normal
MCHC 35 31-37 Normal
Leukocyte 11.35 5-10 x 10/L Abnormal
Lymphocyte 9750 3000-9500 Abnormal
Platelets 325 140-340 x 10/L Normal
Neutrophils 8900 1500-8500 Abnormal
Eosinophil 0.01 0-0.05 Normal
 URINALYSIS

Physical Characteristics

Colour: Yellowish

Clarity: Cloudy
 CHEMICAL MEASUREMENTS
Findings

Specific gravity (1.010 – 1.006

1.030)
pH (5-9) pH 8.5
Protein Trace
Glucose Negative
Ketones Negative
Blood Negative
Bilirubin Negative
Urobilinogen Normal
Nitrate Positive
Leukocyte 2+
 MICROSCOPIC EXAMINATION

Notable Observation:
Presence of Bacteria
 CHAPTER IV

NURSING CARE PLAN

CHAPTER V

DRUG STUDY
 CHAPTER VI

EVALUATION AND FINDINGS

RECOMMENDATION
 EVALUATION AND FINDINGS
After conducting the study, the student-
nurses were able to understand the
importance of using the nursing process by
delivering clinical treatment and
management for the client. The client's health
issues were discovered by looking at the
results of laboratory tests and identifying the
potential causes of Urinary Tract Infection.
This study contributed in the efficiency of
nursing care and management for the client.
 EVALUATION AND FINDINGS
The study was presented by allowing uncovering the factors of
Urinary Tract Infection. The student-nurses understood that UTIs
are common, especially among girls and normally found in the
bowel, develops when microbes enter the urinary tract because of
poor toilet hygiene. Other factor presented in the study is the
increased salt intake which can alter sodium balance, causing the
kidneys to have reduced function and remove less water. The
student-nurses understood that this disease characterized by
discomfort and back pain, voiding symptoms such as burning
sensation with temperature elevation, voiding dysfunction
including urgency and urinary incontinence and urine have a strong
odor, appears cloudy, sometimes appears red, bright pink or cola-
colored as a sign of irritation to the urinary tract. Infection can
spread up the urinary tract to the kidneys which is more alarming
and could lead to sepsis if left untreated. Early diagnosis is the key
to its cure.
 EVALUATION AND FINDINGS
Antibiotics usually are the first line treatment
for urinary tract infections, the drugs used are
determined by the bacteria causing the disease.
And to help ease its symptoms, paracetamol is
given for reducing pain and elevated
temperature. This study provides the student-
nurses, a huge learning regarding on how well
they take care of their client in the real clinical
setting and teaches them to provide client’s care
more efficiently and competently to achieve an
effective and quality nursing care.
 RECOMMENDATION
Medications
Advise the mother to make her child take the entire course
of any prescribed medications. Medication must be continued
according to the doctor’s instruction specially it is an
Antibiotic.
Observe any reaction towards the given medications and
signs that needs to call the attention of the physician.

Environment
Encourage the mother to keep their environment clean.
Keeping the environment clean is an important way to prevent
infection. Dangerous bacteria can take up residence anywhere.
By keeping them to a minimum, it will reduce the chances of
developing an infection and may improve health.
 RECOMMENDATION
Treatment
Instruct the mother that the treatment regimen ordered by the
client’s doctor must be followed strictly and should not be stopped to
prevent the aggravation of the condition of the client.

Health Teaching
Instruct the mother to guide the client to:
 Increase fluid intake. Drink liberal amounts of fluids daily
to flush out bacteria.
 Avoid urinary tract irritants. Beverages such as coffee, tea,
colas, alcohol, and others contribute to UTI.
 Voiding habit. Advise the mother to encourage the patient
to void if she feels the urge to urinate
 Perineal hygiene. After each bowel movement, clean the
perineum and urethral meatus from front to back to reduce
concentrations of pathogens at the urethral opening.
 RECOMMENDATION
Outpatient
Instruct the patient’s mother to attend for follow up check-
up and encourage the mother to notify the physician
immediately if her child experiences any changes in her health
status.

Diet
Advise the mother to encourage her child to avoid food with
high in sodium such as canned or processed food and junk
foods, and teach her child to consume more in vegetables and
fruits.

Spiritual
Encourage the mother and also the client to seek guidance to
the Heavenly Father.
THANK YOU!