(5)
Empty drainage collection bags frequently.
(6) Document in the patient's clinical record. Record procedure, significant
nursing observations, and amount of fluid instilled and drained. Report same to
professional nurse.
Section IV. URINARY DISORDERS
2-24. URINARY TRACT INFECTIONS
a. Urinary tract infections (UTI) are caused by the presence of pathogenic
microorganisms in the urinary tract. In most urinary tract infections, bacteria enter
through the urethra and ascend to the bladder. Once established within the bladder, the
bacteria are able to ascend through the ureters to the kidneys. Contamination of the
urinary tract can occur in the following ways:
(1)
Reflux of urine from the bladder, into the urethra, and back up into the
bladder.
(2)
Reflux of urine from the bladder into the ureters.
(3)
(4)
Introduction of instruments for examination or catheterization.
b. Urinary tract infections may occur in the urethra (urethritis), the urinary
bladder (cystitis), the prostate gland (prostatitis), and the kidney (pyelonephritis).
(1) Cystitis is more common in females because the female urethra is short
and in close anatomical proximity to the vagina and rectum. The male urethra is longer,
and the prostatic secretions have an antibacterial property that discourages passage of
bacteria.
(2) Urethritis may be associated with cystitis, may occur as a result of
trauma from a catheter or cystoscope, or may be sexually transmitted. If urethral
discharge is present, with or without other symptoms, a urethral smear should be sent
to the laboratory for analysis along with the standard urine culture.
(3) Pyelonephritis is an infection of the kidney's renal pelvis, tubules, or
interstitial tissue. It may occur as an acute or chronic condition. Pyelonephritis can
result in renal insufficiency, which may lead to renal failure.
(4) Prostatitis is inflammation of the male prostate gland. Inflammation of
the prostate commonly occurs without the presence of infection. However, bacterial
invasion of the prostate may occur as a result of bacteria descending from the kidney or
bacteria ascending from the urethra.
MED918
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