Question

NM122 Concept Map 8 Instructions Bladder Elimination

For this concept map, your main topic will be urinary tract infection (UTI).

Subtopics should include:

• Locate—list common assessment findings or observations associated with UTI
• Communicate—list questions you would ask the patient related to UTI
• Medicate—least expected treatments for UTI
• Educate—list pertinent patient education items related to UTI and/or its prevention
• Advocate—list items you would request from the physician or advocate for concern UTI

You are not limited to these subtopics, but these subtopics must all be included.

Each subtopic should include at least3-4supporting characteristics for that subtopic.

APA format is not required for this assignment, but correct spelling and grammar should be used.

Answer 1

1) COMMON ASSESSMENT FINDINGS:

• Hematuria Or Pyuria, dysuria with or without frequency, urgency
• New flank pain or supra public pain, or tenderness
• Older adults may initially present with generalised symptoms like lower abdominal pain, back pain and constipation

Diagnosis of UTI in community:

dipstick test , urinalysis for bacteruria , urine culture

Main Risk factors for UTI in community:

• age( reproductive -sexual activity)
• history of previous UTI
• medical comorbidities predisposing to hospitalisation, invasive procedures like urinary catheterisation , prosethetic devices
• diabetes or immunosuppressive conditions
• In post-menopausal women: history of urinary incontinence, cystocele
• In older men: prostrate hypertrophy causes urinary retention and high post-voidal residuals predisposes to UTI

Most common pathogen: E.Coli

Other organisms include Klebsiella, protein and Enterococcus

2) QUESTIONS To ASK when suspecting UTI:

• burning with urination
• frequency/ urgency of new onset
• foul smelling or cloudy urine
• fever
• new low back pain or bladder pain
• new or worsening incontinence
• history or previous UTI, or catheterizations
• current antibiotic use or immunosupressive therapy
• kidney stones or chronic urological disease
• history of urethral stricture or urethral reconstructive surgery
• pregnancy or history of contraceptive IUCD use

3) MEDICATION FOR UTI:

(least expected treatment)

In order of preference,

1. Bactrim DS 800/160 mg one tablet by mouth BID for 3 days for women and 7 days for men
2. if sulpha or bactrim allergy: Microbid 100 mg , one tablet by mouth, BID for 7 days for women only( not for men)
3. Ciprofloxacin 500 mg one tablet by mouth , BID , 3 days for women and 7 days for men
4. Amoxicillin 500 mg one tablet oral by mouth TID for 7 days

4) INSTRUCTIONS TO PATIENT:

• start antibiotic only after submitting the sample
• hold prophylactic antibiotic use for any other conditions
• encourage patient to maintain hydration

For Prevention of UTI :

• good perineal hygiene , wipe from front to back
• avoid potentially irritating products
• urinate promptly and empty bladder completely
• Empty bladder as soon as possible after intercourse , also drink a glass of water to help flush bacteria
• Drink plenty of fluids in general
• maintain healthy diet for good immune system and to prevent constipation

5) IN CASE OF COMPLICATED/CONCERN UTI:

• order urine analysis and culture
• send note to provider regarding allergies and Coumadin use
• send provider the most recent urine culture results
• check creatinine levels if history of poor renal function

Hope this helps you!

please provide feedback