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Urinary Tract Infection. JenniferLee DiBernardo Pathophysiology Project. OBJECTIVES. By the end of this presentation the learner should be able to identify: The basic structures and functions of the Urinary System. The most common microorganisms that cause Urinary Tract Infections.

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Urinary Tract Infection

JenniferLee DiBernardo

Pathophysiology Project

objectives
OBJECTIVES

By the end of this presentation the learner should be able to identify:

  • The basic structures and functions of the Urinary System.
  • The most common microorganisms that cause Urinary Tract Infections.
  • Risk factors for Urinary Tract Infections.
  • The most common laboratory tests in diagnosing Urinary Tract Infections.
  • Treatments and prevention measures for Urinary Tract Infections.
basic structures of the urinary system
Basic Structures of the Urinary System
  • The urinary system consists of:
    • two kidneys
    • two ureters
    • one urinary bladder
    • one urethra
functions of the basic structures of the urinary system
Functions of the Basic Structures of the Urinary System
  • Kidney– small, dark red kidney bean shaped structures. The kidneys are responsible for continuously cleansing the blood and adjusting its composition, urine formation, excretion of Nitrogen containing wastes, maintaining water and electrolyte balance of the blood, maintaining the acid – base balance of the blood and the formation of urine.
  • Ureters – slender tubes each 10 to 12 inches in long and ¼ inch in diameter. Each ureter runs from the kidney down to the urinary bladder and attaches itself to the posterior aspect of the bladder on a slight angle. The ureters are passageways to carry urine from the kidneys to the bladder.
  • Urinary Bladder – is a smooth, collapsible, muscular sac with 3 openings, the 2 ureter openings and the urethra opening. When the bladder is empty, it is collapsed and it is 2 to 3 inches long at most, when the bladder is moderately full about 500ml it is about 5 inches long. The bladder is able to hold twice that amount though. The main function of the urinary bladder is to provide a temporary storage tank for urine.
  • Urethra– is a thin walled tube that carries urine by peristalsis from the bladder to the outside of the body. The length and relative function of the urethra differs in both sexes.
functions of the urinary system
Functions of theUrinary System
  • The principal function of the urinary system is to maintain the volume and composition of body fluids within normal limits. One aspect of this function is to rid the body of waste products that accumulate as a result of cellular metabolism.
  • The urinary system maintains an appropriate fluid volume by regulating the amount of water that is excreted in the urine. Other aspects of its function include regulating the concentrations of various electrolytes in the body fluids and maintaining normal pH of the blood
  • In addition to maintaining fluid homeostasis in the body, the urinary system controls red blood cell production by secreting the hormone erythropoietin. The urinary system also plays a role in maintaining normal blood pressure by secreting the enzyme renin.
definition of urinary tract infection uti
Definition ofUrinary Tract Infection (UTI)
  • Is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract.
most common organisms which cause utis
Most Common Organisms Which CauseUTIs
  • Escherichia coli
  • Enterobacter
  • Pseudomas
  • Serratia
  • Staphylococcus saprophyticus
  • Candida
signs and symptoms of utis
Signs and Symptoms ofUTIs
  • Dysuria (burning pain upon urination)
  • Frequency
  • Urgency
  • Voiding in small amounts
  • Inability to void
  • Incomplete emptying of bladder
  • Low back / Suprapubic pain
assessment findings in utis
Assessment Findings in UTIs
  • Hematuria(bloody urine)
  • Cloudy urine
  • Flank pain
  • Abdominal pain
  • Fever
  • Nausea
  • Vomiting

chills

most common laboratory tests used in diagnosing utis
Most Common Laboratory Tests Used in DiagnosingUTIs
  • Urinalysis ( U/A )
    • Dip Stix
  • Culture and Sensitivity ( C & S )
urinalysis laboratory findings
Normal Findings

pH - 4.6 – 8.0

Appearance – clear

Color – pale yellow to amber yellow

Odor – aromatic

Specific Gravity – 1.005 – 1.030

Protein - none

Glucose – none

Ketones – none

Blood – none

Leukocyte esterase (WBCs) – none

Urinalysis Laboratory Findings

Abnormal Findings

  • pH – Alkaline ( increases)
  • Appearance – cloudy
  • Color - deep amber
  • Odor – foul smelling
  • Specific Gravity – may change
  • Protein – maybe present
  • Glucose – maybe present
  • Ketones - maybe present
  • Blood – maybe present
  • Leukocyte esterase (WBCs)- present
urinalysis laboratory findings microscopic examination
Normal Findings

Red Blood Cells (RBCs) – none

White Blood Cells (WBCs) – none

Casts – none

Crystals – none

Bacteria - none

Red Blood Cells (RBCs) – present

White Blood Cells (WBCs) – present

Casts – none

Crystals – present

Bacteria - present

Urinalysis Laboratory Findings Microscopic Examination

Abnormal Findings

culture sensitivity laboratory findings
Normal Findings

No bacteria present in urine.

Bacteria present in urine.

Culture & Sensitivity Laboratory Findings

Abnormal Findings

treatment of utis
Treatment ofUTIs
  • Antibiotics
  • Analgesics
  • Increase fluids (ex. Cranberry Juice)
  • Repeat urine culture and sensitivity after antibiotics are finished
risk factors in utis
Females

Sexual intercourse

poor fitting diaphragms

use of spericide

Pregnancy/Menopause

Clothing

tight jeans

wet bathing suits

pantyhose

synthetic underwear

Allergens/Irritants

feminine hygiene sprays

bubble baths

perfumed toilet paper / soap

sanitary napkins

Presence of indwelling catheter

Foley

Males

Age

Loss of bactericidal properties of prostatic secretions

sperm

Obstructive Uropathy

BPH

Presence of indwelling catheter

Foley

Risk Factors inUTIs
prevention of utis
Prevention ofUTIs
  • Encourage menopausal women to use estrogen vaginal creams to restore vaginal pH
  • Teach women to use water soluble lubricants for intercourse, especially after menopause
  • Maintain closed drainage system for hospitalized patients with an indwelling catheter and provide meticulous catheter care
  • Ensure that patients understand the importance of taking all antibiotics and having repeat culture and sensitivities done
  • Monitor older male patients, especially those with BPH, for the presence of infection
prevention of utis continued
Prevention ofUTIs Continued
  • Teach female patients good perineal hygiene
  • Teach women proper way to wipe after urination ( front to back )
  • Teach women to shower instead of bathing in tub.
  • Teach women to avoid using feminine hygiene sprays and other irritants
  • Teach women to wear cotton underwear
  • Avoid tight jeans, sitting around in wet bathing suits
  • Teach pregnant women to void every 2 hours
  • Teach patients the signs and symptoms of UTIs
references
References
  • Black, Joyce M.& Matassarin – Jacobs, Esther. (2001) Medical- Surgical Nursing: Clinical Management for Continuity of Care (5th ed.) W.B. Saunders Company
  • Christensen, Barbara & Kockrow, Elaine. (2000) Foundations of Nursing (2nd ed.) St. Louis: Mosby
  • Harkness, Gail A. & Dincher, Judith R. (2000) Medical –Surgical Nursing: Total Patient Care (9th ed.) St. Louis: Mosby
  • Marieb, Elaine N. (2001) Essentials of Human Anatomy & Physiology (4th ed.) Redwood City, California: The Benjamin/Cummings Publishing Company, Inc.
  • Pagana, Kathleen Deska & Pagana, Timothy James (2002) Diagnostic and Laboratory Test Reference (2nd ed.) St.Louis: Mosby
  • Timby, Barbara K. (2000) Fundamental Skills and Concepts in Patient Care (6th ed.) Philadelphia: Lippincott
  • All Images, www.google.com