BSN Program Nursing Practice II
Knowledge Preparation on Presenting Health Challenges
Student__Rebekah Abebe__________
Date_January 25 2010____
Health Challenge/Diagnosis_Urinary Tract Infection____________
***Please note that this research is standardized for any client with this health challenge and as such, once
completed can be re-used with any other client with this specific health challenge. In future semesters, additional
knowledge including pathophysiology and diagnostic tests will be expected.
Description/Definition
(in your own words)
Clinical Manifestations
Collaborative Care
(Medical, Pharmacological, Surgical etc Treatments)
Urinary Tract
infection occurs when
bacteria trespasses
into the urinary tract.
Specifically bacterial
counts 10 by 5
colony-forming units
per millilitre or higher
typically indicate a
clinically significant
UTI.
-Dysuria
Frequent urination
(more often then every
2 hours), urgency, and suprapubic discomfort,
or pressure.
-The urine may contain
blood and sediment.
-Pain, chills and fever
indicate symptoms of
an upper urinary tract
infection. Suprapubic
pain.
-In older adults the
above symptoms
mentioned are not
often seen. Instead
older adults ten to
experience non
localized abdominal
discomfort.
-Older adults will also
have cognitive
impairment.
-Clients over 80 may
experience a slight
decline in
temperature.
-Some may have non
specific symptoms
such as fatigue and
anorexia.
For minor UTI’s antibiotics given for 1 to 3 days.
Example: Trimethoprim-sulfamethoxazole
(Bactrim, Septra)
For more complicated UTI’s antibiotics given for 7
to 14 days or even longer.
-Over the counter prescription drugs used to
reduce pain and improve comfort associated with
a UTI. Some of these medications can tint the
colour of urine reddish orange Example:
phenazopyridine (Pyridium) or bluish green.
Example: combination agent Urised
(methanamine, phenylsalicylate, atropine,
hyoscyamine).
-suppressive antibiotics are sometimes
administered to clients who experience repeated
UTI’s. Such therapy should only be short term, or
negative results will occur such as a higher risk for
a UTI due to a suppressed immune system caused
by antibiotics.
-Adequate fluid intake.
-Counselling about risk of recurrence and
reduction of risk factors.
-Repeat urine culture and sensitivity testing.
Sproule/Douglas/NPII/Student Clinical Prep
28/08/2010
Page 1 of 2
BSN Program Nursing Practice II
Nursing Management
Nursing
Assessment
Foci: Nursing
Diagnosis
Nursing Implementation
Nursing Interventions & Rationales
Symptoms
-Nausea, vomiting,
and anorexia; chills
-Lassitude, malaise
-Urinary frequency,
urgency, hesitancy;
nocturia
-Suprapubic or low
back pain, pressure
in bladder area,
costovertebral
tenderness; bladder
spasms, dysuria,
burning on urination,
sense of incomplete
emptying.
General
Fever
Urinary
-Hematuria;cloudy,
foul-smelling urine;
tender, enlarged
kidney.
1.)Impaired urinary
elimination related to
effects of urinary tract
infection (UTI) as
evidenced by pain and
burning or urination and
flank, suprapubic, and/
or lower back pain.
1.1 Perform a comprehensive assessment of pain to include
location, characteristics, onset and duration, frequency, quality,
intensity or severity, and precipitating factors to establish history
and baseline pain level.
1.2 Use of nonpharmacological techniques (e.g. heating pad to
suprapubic area or lower back, warm showers) along with other
relief measures to supplement pain medication and increase pain
relief.
2.)Impaired urinary
elimination related to
urinary tract infection
(UTI) as evidenced by
bothersome urgency,
daytime voiding
frequency, nocturia, or
hematuria and
verbalization of concern
over altered elimination
pattern.
2.1 Monitor urinary elimination including frequency, consistency,
odour, volume, and colour (as appropriate) to assess elimination
status.
2.2 If needed Obtain midstream voided specimen for urinalysis (as
appropriate) to determine pathogen causing UTI or to monitor
effectiveness of treatment.
2.4 Advise client and monitor for signs and symptoms of UTI to
monitor effectiveness of treatment and recognize symptoms of
recurrence.
2.4 Encourage client to drink 236 mL of liquid meals, between meals,
and in early evening to help prevent infection and dehydration.
3. Ineffective
Therapeutic regimen
management related to
lack of knowledge
regarding treatment
regimen and prevention
of recurrent infections as
evidenced by response
to questions regarding
therapeutic
management and
verbalization of desire to
manage treatment of
illness and prevent
infections.
3.1 Assess client’s current level of knowledge related to specific
disease process to plan individualized teaching.
3.2 Describe the reason behind non pharmacological therapy, to
promote compliance with treatment.
References: It is anticipated that the required textbook Medical-Surgical Nursing in Canada (Lewis et.al.,
2010) is used for this research. If other sources are used, please provide a brief list here.
Sproule/Douglas/NPII/Student Clinical Prep
28/08/2010
Page 2 of 2