upper/lower UTI
what does the upper uti affect
kidneys and ureters
taking all of the antibiotics so you don't get a superinfection
who is more at risk for a uti, men or women, and why
women, shorter urethra
factors increasing urinary stasis, foreign bodies, anatomic factors, compromising immune response factors
s/s in older adults
symptoms often absent, non localized abdominal discomfort rather than dysuria, *cognitive impairment possible*, fever less likely
are there any systemic manifestations for lower uti
no
how are antibiotics picked
depends on the results from sensitivity testing
what is the most common bacterial infection for uti
escherichia coli (E. coli)
factors increasing urinary stasis
BPH, tumor, neurogenic bladder
diagnostic studies for uti
history, physical, urinalysis (nitrates, WBCs, leukocyte esterase), urine culture, imaging studies, ultrasound, CT scan
is kidney infection something to worry about
YES, this is a big problem
what are some drugs that are given to patients with repeated UTIs
prophylactic or suppressive antibiotics
what are some potential problems from utis
cystitis (inflammation of the bladder), urethritis (inflammation of the urethra), pyelonephritis (kidney infection), urosepsis (uti that has spread systemically, life-threatening, needs treatment asap, can lead to septic shock and death)
foreign body examples
catheters, calculi, instrumentation
where are ureteral stents placed and why are they used
placed: within the ureter
used: maintain urine flow in patients with obstruction, divert urine, restore kidney function, promote healing, maintain the patency of the ureter after OR, temporary or permanent
s/s for lower uti
burning, frequent peeing
what is some teaching with phenazopyridine (pyridium) + other fun facts
it is a urinary alagesic
stains urine reddish orange (can be mistaken for blood and may stain clothing), avoid wearing contacts
provides soothing effect of urinary tract mucosa
used in combination with antibiotics
uncomplicated uti
occurs in otherwise normal urinary tract
usually only involves bladder
lower urinary tract
localized symptoms
dribbling, weak stream
fluids, antibiotic IV
anatomic factors
obesity, congenital defects, fistulas
nursing interventions for uti
acute care, adequate fluid intake, dilutes urine, making bladder less irritable, flushes out bacteria before they can colonize, ambulatory care, emphasize importance of compliance with drug regimen, maintain adequate fluids, regular voiding (Q3-4H), void after intercourse
s/s of upper uti
fever, chills, flank pain (from the kidney)
what are some other drugs you can take for uti
trimethoprim/sulfamethoxazole (inexpensive, take 2x a day)
nitrofurantoin (macrodantin, given 3-4x a day, long acting preparation (macrobid) is taken 2x a day
ampicillin, amoxicillin, cephalosporins (ceftriaxone)
fluoroquinolones (ciprofloxacin, cipro)
complicated uti
upper urinary tract (BUN, creatine)
obstruction or stones
*catheters #1 risk factor*
abnormal GU tract
diabetes/neurologic disease
resistance to antibiotics or recurrent infection
immunocompromised
pregnancy-induced changes
compromising immune response factors
age, HIV, DM