A
List risk factors of UTIs
Female, pregnancy, catheterization, diabetes, sexual activity, increased age, immunosuppressed, incontinence, urinary retention, & gout
When should patient's void whilst sexually active?
Before & after intercourse
How will an older adult with a UTI present?
Atypical: confusion, vague abdominal pain, & new incontinence
Which drug is used to treat UTIs caused by E.coli?
Nitrofurantoin
SE of phenazopyridine
Stains urine reddish orange
Why are females at a higher risk of getting UTIs?
Shorter urethra
Pyelonephritis is an example of a ________ UTI
Upper
The spread of infection from the urinary tract to the bloodstream is called.....
Urosepsis
Which drug is used to treat uncomplicated UTIs, but is resistant to E.coli?
Sulfamethoxazole (or trimethoprim if sulfa allergy)
Patient educaiton to prevent UTIs
shower rather than bathe, wipe/clean from front to back, drink plenty of fluids, avoid coffe/tea/alcohol, void every 2-3 hours.
Systemic s/s are clinical manifestations of _______ UTI's.
Upper
Burning during urination, nocturia, and urinary frequency are a few clinical manifestations of _______ UTIs. What are some other clinical manifestations?
urinary urgency, incontinence, suprapubic or pelvic pain.
Which is an inappropriate indication for a catheter?
a.) acute urinary retention
b.) accurate I&Os during surgery
c.) patient has acute incontinence
d.) to improve comfort for end of life care
C. (this is a substitute for proper nursing care & is inappropriate)
What are uncomplicated UTIs in women usually caused by?
E.coli
What is the action of phenazopyridine?
Relieves Pain (urinary analgesic) (does NOT treat infection)
Examples of lower UTIs (list 3)
Urethritis, Prostatitis, & Cystitis
List s/s of upper UTIs
Fever, chills, n/v, leukocytosis, bacteriuria, pyuria (think systemic)
How can we prevent UTIs in our older adults?
Scheduled toileting every 2-3 hours, pericare, & make sure they are not constipated.
What populations may need hospitalization for longer medication or IV antibiotic course?
men, pregnant women, complicated UTI, & pyelonephritis
Patient teaching for a patient taking nitrofurantoin would include...
Avoiding the sun & using sunscreen and the drug may turn their urine brown.
Explain how UTIs are caused.
Microorganisms enter the ascending route of the urethra from the perineum. (often caused by E.coli from improper wiping)
What complications of an upper UTI should we be concerned about?
Sepsis, dehydration, kidney damage
Explain the management of urosepsis and expected clinical manifestations
S/S: low BP, high HR, tachypnea, increased tmeperature, LOC changes, SOB
Management: Monitor LOC, VS, labs (WBC), blood & urine cultures, antibiotics, IV fluids, Antipyretics (fever)
Treat source: if source is a catheter: REMOVE IT
Describe how a clean catch (midstream) urine specimen is obtained?
Wash hands, clean peri area with wipes, void a little into the toilet, then catch the rest into the container.
What labs will need to be monitored for a patient taking Sulfamethoxazole?
BUN, Cr, GFR, & K+ levels