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NSG 326 Adult Health IUrinary Tract InfectionsUTIsUrinary Tract Infections [UTIs]Slide 5Slide 6Recurrent UTIs in WomenSlide 8UTI SymptomsSlide 10UTI DiagnosisSlide 12UTIs (cont.)UTIs & ObstructionSlide 15UTI & Indwelling CathetersSlide 17UTIs & ResearchSlide 19UTIs & Antibiotic TherapyUTI & TxUTIs & TxSlide 23Recurrent UTIs in WomenUTIs & MenUTIs & Kidney InfectionsPyelonephritisPyelonephritis: EtiologyClinical ManifestationsDiagnosticsTreatmentsNursing ManagementNursing InterventionsUrinary CalculiSlide 35Slide 36Etiology Urinary CalculiTypes of StonesSlide 39Slide 40How are they diagnosed?Slide 42Medical TreatmentsLithotripsyTreatmentsNursing DiagnosesInterventionsPatient TeachingSlide 49Prepared by Dr. K. A. EnnenNSG 326 Adult Health ISpring 2011Urinary Tract Infections [UTI] & Renal CalculiUrinary Tract InfectionsUTIs•The urinary system is structured in a way that helps ward off infection. The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladder helps wash bacteria out of the body. •In men, the prostate gland produces secretions that slow bacterial growth.•In both sexes, immune defenses also prevent infection. But despite these safeguards, infections still occur.Urinary Tract Infections [UTIs]•Urinary tract infections are a serious health problem affecting millions of people each year.•Infections of the urinary tract are the second most common type of infection in the body. •Urinary tract infections (UTIs) account for about 8.3 million doctor visits each year.• •UTIs•In adult women, though, the rate of UTIs gradually increases with age. Scientists are not sure why women have more urinary infections than men. •One factor may be that a woman's urethra is short, allowing bacteria quick access to the bladder. Also, a woman's urethral opening is near sources of bacteria from the anus and vagina. •For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.•According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. •Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.UTIs•Nearly 20 percent of women who have a UTI will have another, and 30 percent of those will have yet another. Of the last group, 80 percent will have recurrences.•Usually, the latest infection stems from a strain or type of bacteria that is different from the infection before it, indicating a separate infection.•Even when several UTIs in a row are due to E. coli, slight differences in the bacteria indicate distinct infections.Recurrent UTIs in Women•Women who have had three UTIs are likely to continue having them. •Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. •A woman who has frequent recurrences (three or more a year) can ask her doctor about one of the following treatment options:•Take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer.• If taken at bedtime, the drug remains in the bladder longer and may be more effective. •NIH-supported research at the University of Washington has shown this therapy to be effective without causing serious side effects.UTI Symptoms•Not everyone with a UTI has symptoms, but most people get at least some symptoms. •These may include •a frequent urge to urinate •a painful, burning feeling in the area of the bladder or urethra during urination. •It is not unusual to feel bad all over—tired, shaky, washed out—and to feel pain even when not urinating. •Often women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum. •It is common for a person with a urinary infection to complain that, despite the urge to urinate, only a small amount of urine is passed. •The urine itself may look milky or cloudy, even reddish if blood is present.•Normally, a UTI does not cause fever if it is in the bladder or urethra. •A fever may mean that the infection has reached the kidneys. •Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.UTIs•Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi but does contain fluids, salts, and waste products. •An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. •The urethra is the tube that carries urine from the bladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.UTI Diagnosis•To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria.• You will be asked to give a "clean catch" urine sample by washing the genital area and collecting a "midstream" sample of urine in a sterile container. •This method of collecting urine helps prevent bacteria around the genital area from getting into the sample and confusing the test results. Usually, the sample is sent to a laboratory, although some doctors' offices are equipped to do the testing.•In the urinalysis test, the urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria. This last step is called a sensitivity test.UTIs•Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in both men and women, but these infections tend to remain limited to the urethra and reproductive system. •Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.UTIs (cont.)•In many cases, bacteria first travel to the urethra.•When bacteria multiply, an infection can occur.•An infection limited to the urethra is called urethritis. •If bacteria move to the bladder and multiply, a bladder infection, called cystitis, results. •If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. •A kidney infection is called pyelonephritis.UTIs & Obstruction•Some people are more prone to getting a UTI than others. Any abnormality of the urinary tract that obstructs


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UNCW NSG 326 - NSG 326 AH I WK #11 UTI & Renal Calculi

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