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Nursing Care Plan for Urinary Tract Infection (UTI)

Pathophysiology

The urine is normally sterile, but exposure to bacteria at the distal urethra (meatus) may lead to colonization of bacteria within the urinary tract. Infection may take place anywhere within the urinary tract, including the lower urinary tract (cystitis), or the upper urinary tract (pyelonephritis).  Cystitis refers to inflammation and infection of the bladder, Pyelonephritis refers to inflammation and infection of the kidneys.

Etiology

The bacteria associated with 80% – 90% of urinary tract infections is Escherichia coli. Other bacteria that commonly cause infections include klebsiella, Enterococcus and Staphylococcus. Bacteria may be introduced to the urinary tract through the use of indwelling catheters. Antibiotic use disrupts the normal flora of the vagina and allows bacteria to grow and spread to the urethra, as does  frequent or recent sexual intercourse. Difficulty voiding and inability to empty the bladder are also causes for the development of bacterial infections in the urinary tract.

Desired Outome

Patient will be free from pain and symptoms of UTI and will be free of infection.

Urinary tract infection (UTI) Nursing Care Plan

Subjective Data:

  • Lower back pain
  • Dysuria
  • Frequent urination
  • Urethral discharge (primarily in men)
  • Nocturia
  • Suprapubic pain
  • Nausea / vomiting

Objective Data:

  • Hematuria (may be microscopic)
  • Fever / chills
  • Oliguria
  • Foul smelling urine

Nursing Interventions and Rationales:

  1. Monitor vital signs for infection
    • Symptoms that indicate worsening infection or progression of disease include :
      Tachycardia
      Fever / chills
      Elevated blood pressure
  2. Assess / palpate the bladder every 4 hours
    • Assess for bladder distention to determine if there is urinary retention.
  3. Assess hydration status and encourage increased fluids
    • Increasing fluid intake will help the kidneys to flush excess waste and increase blood flow. This will also prevent dehydration with can complicate UTI.
  4. Administer medications to treat: Infection, Pain, Fever
    • Infection- Most UTIs can be treated with common antibiotics such as nitrofurantoin, cephalexin and sulfamethoxazole/trimethoprim, depending on urine culture & sensitivity test results.

      Pain- Analgesics for urinary pain include phenazopyridine, which is a dye that helps numb the pain within the urinary tract.

      Fever- Ibuprofen or acetaminophen may be given in case of fever and chills per facility protocol
  5. Provide education regarding hygiene and prevention of future infections
    • Wipe from front to back when urinating and defecating to prevent bacteria being introduced to the vagina and urethra

      Avoid scented hygiene sprays, douches and bath products to prevent infection and irritation

      Cleanse genital area before and after sex

      Empty bladder frequently and completely to avoid build up of toxins in the bladder

      Drink lots of water

      Wear cotton underwear and avoid tight fitting clothing
  6. Apply heating pad for comfort
    • Application of heat to lower back or abdomen may help relieve pain and cramping. Avoid prolonged exposure to heating pad, using only 15 minutes per session with at least 15-30 minutes in between to prevent burns.

References

Date Published - May 15, 2017
Date Modified - Oct 30, 2018