Urinary Tract Infection (UTI) A bacterial infection that occurs when bacteria invade the urinary tract system.

. Risk Factors Women Poor hygiene Dysfunctional voiding patterns Presence of indwelling urethral catheters

Etiology Colonic bacteria - Most common: Escherichia coli - Others: Klebsiella, Proteus & Pseudomononas Clinical Manifestations Frequency - Voiding at close intervals. Usually every 5-15 minutes Urgency - Strong desire to void even with small amount of urine in the bladder Dysuria - Burning pain on urination Foul-smelling urine Suprapubic pain Malaise Fever & chills Nausea & vomiting Low back pain Diagnostic Procedure Routine urinalysis - Presence of RBC, pus & bacteria - Increased WBC Urine culture & sensitivity - Done to: 1. Find the cause of a urinary tract infection (UTI) 2. Make decisions about the best treatment for a UTI 3. Find out whether treatment for a UTI worked. Specimen: Clean-catch midstream urine. The first urine of the day is preferred because bacterial levels will be higher. Interpretation No bacteria or other organisms (such as fungi) grow in the culture. The culture result is negative.

Normal:

Organisms (usually bacteria) grow in the culture. The culture result is positive. A Abnormal: count of 100,000 or more bacteria per milliliter (mL) of urine may be caused by an infection.

RCdelaPea, RN, RM, MAN |UNP-CN 1

Nursing Management Increase OFI Give cranberry & prune juice Hot sitz bath Health Teachings - Practice 3 Ws 1. Wash hands before & after using the toilet 2. Wear cotton underwear 3. Wipe perineum from front to back Empty the bladder every 2-3 hours Empty the bladder before & immediately after sexual intercourse

Medical Management Administer the following medications as prescribed 1. Urinary Tract Analgesic - Pyridium (Phenazopyridine Hydrochloride) - It causes red-orange discoloration of urine - S/E: Nausea, headache, vertigo 2. Urinary Antiseptics - Furadantin, Macrodantin, Macrobid (Nitrofurantoin) - Causes brown urine. This is harmless 3. Mendalamine (Methanamine) Requires acidic urine with a pH of 5.5 or less to be effective Should not be combined with sulfonamides to prevent crystalluria Fluoroquinolones Cipro (Ciprofloxacin) Levaquin (Levofloxacin) Avelox (Moxifloxacin) Floxin (Ofloxacin) Administer Fluoroquinolones with a full glass of water & ensure adequate UO. To prevent crystalluria.

4. Sulfonamides - Bactrim (Trimethoprim-sulfa-methoxazole) Avoid exposure to sun. May cause rash fever & photosensitivity May cause Steven Johnson Syndrome (SJS) -Most severe hypersensitive response. Causes widespread lesions of the skin & mucous membranes, fever, malaise & toxemia Take medication on empty stomach with a full glass of water. Increase OFI to prevent crystalluria. 5. Cholinergic - Urecholine (Bethanecol Chloride) - To treat urinary retention. 6. Antispasmodics Ditropan (Oxybutynin) Pro Banthine (Propantheline Bromide) To treat urinary frequency. Do not administer in clients with glaucoma.

RCdelaPea, RN, RM, MAN |UNP-CN 2

RCdelaPea, RN, RM, MAN |UNP-CN 3