Urinary Tract Infection : Nursing Management

Nursing Management

    • Nursing Assessment
      • Subjective Data
        • Important Health Information
          • Past health history:
            • Previous urinary tract infection.
            • Urinary calculi, reflux, strictures, or retention.
            • Neurogenic bladder, pregnancy, benign prostatic hyperplasia, bladder cancer, sexually transmitted infection.
          • Medications: Antibiotics, anticholinergics, antispasmodics
          • Surgery or other treatments:
            • Recent urologic instrumentation (catheterization, cystoscopy)
        • Functional Health Patterns
          • Health perception–health management:
            • Urinary hygiene practices.
          • Lassitude, malaise
          • Nutritional-metabolic:
            • Nausea, vomiting, anorexia. Chills
          • Elimination:
            • Urinary frequency, urgency, hesitancy. Dysuria, nocturia
          • Cognitive-perceptual:
            • Suprapubic or low back pain, costovertebral tenderness, bladder spasms, dysuria, burning on urination
          • Sexuality-reproductive: Multiple sex partners (women), use of spermicidal agents or contraceptive diaphragm (women)
      • Objective Data
        • General
          • Fever, chills, dysuria
          • Atypical presentation in older adults: afebrile, absence of dysuria, loss of appetite, altered mental status
        • Urinary
          • Hematuria. Cloudy, foul-smelling urine. Tender, enlarged kidney
        • Possible Diagnostic Findings
          • Leukocytosis. UA positive for bacteria, pyuria, RBCs, WBCs, and nitrites. Positive urine culture. Ultrasound, CT scan (CT urogram), VCUG, and cystoscopy indicating urinary tract abnormalities
    • Nursing Diagnoses
      • Impaired urinary elimination related to the effects of UTI
      • Infection
      • Risk for urge urinary incontinence
      • Acute pain: dysuria related to inflammatory process in bladder
      • Readiness for enhanced health management
    • Nursing Planning
      • Patient will have
        • Relief from lower urinary tract symptoms (LUTS)
        • No upper urinary tract involvement
        • No recurrence
    • Nursing implementation
      • Health Promotion
        • Recognize individuals at risk
          • Debilitated persons
          • Older adults
          • Underlying diseases (HIV, diabetes)
          • Taking immunosuppressive drug or corticosteroids
        • Emptying bladder regularly and completely
          • Evacuating bowel regularly
          • Wiping perineal area front to back
          • Drinking adequate fluids (person’s weight in pounds/2)
            • 20% of fluid comes from food
        • Cranberry juice or cranberry tablets may reduce number of UTIs
        • Avoid unnecessary catheterization and early removal of indwelling catheters
        • Aseptic technique must be followed during instrumentation procedures
        • Routine and thorough perineal care for all hospitalized patients
        • Answer call lights and offer bedpan or urinal at frequent intervals
      • Prevention of CAUTI
        • Avoidance of unnecessary catheterization
        • Early removal of indwelling catheters
        • Follow aseptic technique for procedures
        • Handwashing before and after patient contact
        • Wear gloves for care of urinary catheters

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