Case Study on Disease Process of Urinary Tract Infection

Pathophysiology/etiology of Urinary Tract

Unitary tract infection is referred to as asymptomatic bacterial infection in the urinary tract. The issue includes lower urinary tract infection that is known as cystitis and the upper Unitary tract infection that is known as acute pyelonephritis. The cystitis is symptomatic bladder infection and acute pyelonephritis is the kidney infection. The classification of Unitary tract infection is based on the symptoms and the area suggested by the terminology. Asymptomatic bacteriuria is identified mainly in patients having two consecutive urine cultures showing > 100,000 CFU/, L urine but it is not simple as compared to UTI. It is treated in a single way that is before the urological operation, immunocompromised patients and women. Unitary tract infection may become complicated if the symptoms emerge with pyelonephritis. Expect the distal urethra, the tract becomes normally sterile because of the host defenses against bacterial colonization (Lima & Manzoni, 2014).

Etiology of Urinary Tract

Etiology is an issue that occurs (80-90%) due to infection of Escherichia coli species. The other usual causes include Proteus mirabilis, Klebsiella, Staphylococcus saprophyticus and Enterococcus. Periurethral colonization is carried out by the pathogen that appears on the initial steps of the cascade that event leads to UTI. In the causative organisms, the natural GI tract process is considered that act as the natural reservoir for the UTI. Risk factors include iatrogenic, behavioral, genetic and anatomic issues  (Mulvey, Klumpp, & Stapleton, 2017).

Pathophysiology of Urinary Tract

Pathogenesis of the urinary tract infection includes several considerations including acute kidney injury, pyelonephritis, ascension, uroepithelium penetration, and colonization. Acute kidney injury is due to inflammatory cascade, tubular obstruction, and interstitial edema. The pyelonephritis is the infection of renal parenchyma that cause pyelonephritis. Ascension is the bacterial colonization that occurs due to bacteria in the kidney. Uroepithelium penetration is due to fimbria that allows bladder for penetration and replication (Pathophys. org, 2019).    

Prevalence / Statistics of the Disease Worldwide/ within the GCC or Saudi Arabia, or in JHAH of Urinary Tract

According to the statistical analysis, the appropriateness and urinary tract infection treatment are measured in the emergency department of Saudi Arabia. In Saudi Arabia, urinary tract infection (UTI) is becoming a serious health issue and it induces an impact on the millions of people every year. The overall prevalence of urinary tract infection is 9.9%. The analysis showed 1,449 diagnosed patients with UTI including pediatric (18.6%), elderly (22.2%) and adult (59.2%). In this situation, three main types of antibiotics were prescribed including fluoroquinolone (22%), penicillin (26%), and cephalosporin (39%)  (Alanazi, 2018). There are two types of Unitary tract defense mechanisms including urine and mucosal immunity.   

 Signs and symptoms  (300)

There is a number of symptoms of urinary tract infections that don’t always cause issues urinary system (Mayoclinic. org, 2019). The major symptoms are listed below,

1.      Burning sensation during urinating

2.      The persistent urge in urinating

3.      Smalls and frequent amounts of urine

4.      Cloudy urine

5.      Muscle aches

6.      Abdominal pains

7.      Urine that appears the cola-colored, bright pink and red color sign

8.      Pelvic pain particularly in women

9.      Strong smelling urine

Prevention of Urinary Tract

There are several steps to reduce the risk of urinary tract infections.

1.   Drink plenty of water and liquid

Drinking more water can help in reducing and diluting the urine and then ensure you are urinating frequently. This process will remove bacteria from the body  (Lima & Manzoni, 2014).

2.   Empty bladder of Urinary Tract

Keep the bladder empty that will remove bacteria from the body.

3.    Drink cranberry juice of Urinary Tract

Some studies and researches concluded that cranberry juice prevents urinary tract infection UTI.

Diagnostic procedures/tests of Urinary Tract

Different testing and diagnostic method can be used to reduce the problem and the main focus of these methods and procedures is to diagnose urinary tract infection.

1.   Blood sample analysis

The doctor and expert can ask for the urine samples to be analyzed in the labs. The analysis considers the number of white blood cells, bacteria, and red blood cells. The analysis can be used to prevent the potential combination of samples with the other samples. In the process, the doctors ask to wipe the genital area by using an antiseptic pad to collect to the midstream urine (Mulvey, Klumpp, & Stapleton, 2017).

2.  Growth of bacteria

In this lab analysis, urine is used to be considered in the urine culture. The test analysis reveals the type of bacteria that can cause infection and medication in a proper way is the most effective method to overcome the issue.

3.  CT scan and MRI

To identify the issue and solution of the issue it is important to find the location. The computer can be used to design the outcomes of the test. The doctor can analyze reasons for abnormality in the urinary tract by using ultrasound, computerized tomography scan and magnetic resonance imaging (MRI).  The doctor can use a contrast dye to highlight the structure of the urinary tract (Healthline. com, 2017).

4.  Ultrasound

A device of ultrasound that is called transducer is passed over the abdomen and it generates ultrasound waves to generate the image of urinary tract organs and it is displayed on the monitor.

5.  Intravenous pyelogram (IVP)

This treatment involves injecting dye into the body and the dye pass through the urinary tract and X-ray analysis of the abdomen is carried out to highlight the urinary tract.

6. Cystoscope

In the case of recurrent UTIs, the doctor recommends performing the cystoscopy. The process uses a thin tube lens to see inside the urethra and bladder. The cystoscope is inserted in the urethra and then passes through the bladder to check the level of the issue in the body.  

Medical treatment/management (200)

1)      Simple infection of Urinary Tract

The first treatment method deals with antibiotics to overcome urinary tract infections. The drugs prescribed in the treatment depend on age, health condition, and illness type. The drugs recommended in the simple type of urinary tract infection include Fosfomycin (Monurol), Ceftriaxone, Trimethoprim/sulfamethoxazole (Bactrim, Septra, others), Nitrofurantoin (Macrodantin, Macrobid), and Cephalexin (Keflex). Another group of antibiotics is called fluoroquinolones that include levofloxacin (Levaquin) and ciprofloxacin (Cipro). These methods have outweighed benefits (Mulvey, Klumpp, & Stapleton, 2017).

2)      Frequent infection of Urinary Tract

If a patient undergoes frequent Urinary tract infection (UTI) then doctors recommend some other solutions. The use of low dose antibiotics is the first treatment step that remains to continue for the six months and sometimes more than six months. The treatment and self-diagnosis is another strategy to remain in touch with the doctors. Vaginal estrogen therapy is used in the case of post-menopausal (Lima & Manzoni, 2014).

3)      Severe infection of Urinary Tract

In the case of the severe stage of Urinary tract infection (UTI) the doctors recommend continuous treatment in hospital with intravenous antibiotics used in the hospitals.

When comparing to the international best practice guidelines provided to the doctors the best strategy is to measure the issue and then have complete treatment (Naber & Johansen, 2018). The doctors measure the level of seriousness and which organism is causing the infection from the results of the initial test and then use the reports. In most of the causes, the main issue is bacteria that can be treated by using antibiotics. In some other cases, viruses and fungi can also cause Urinary tract infection (UTI). The viral type of Urinary tract infection (UTI) is treated by proper medication that is called antivirals. Most often, the antiviral cidofovir is the only choice to treat viral UTIs. The antifungals are used to treat the Urinary tract infection (UTI) that is caused by fungi  (Pathophys. org, 2019).     

Compare to International Best Practice Guidelines, e.g. NICE / CDC guidelines

Patient Presentation

 Patient information 

Description of disease/condition

Comparison to a textbook case

Contrast to a textbook case

Expected prognosis

Nursing Assessment:

Related to ADL’s (activities of daily living)

….this can be done separately or included in your ADL boxes

Relate findings to the disease process

….this can be done separately or included in your ADL boxes

Nursing Care Plan

Three nursing diagnosis

This can be done either with 1 diagnosis, goal or evaluation per page or as a table (see below)

A.     Prioritize nursing diagnosis

B.      Nursing Care Plan 

                                                              i.      Diagnosis

                                                            ii.      Goal/s

                                                          iii.      Interventions 

Evaluation/Outcomes

Conclusion of Urinary Tract:

Summarize of current condition 

Summing up all the discussion from above, it is concluded that urinary track injection is extremely important for the patients

 that are struggling with a particular disease. In this paper, there is complete information about the symptoms of this disease. The classification of Unitary tract infection is based on the symptoms and the area suggested by the terminology.

Unitary tract infection may become complicated if the symptoms emerge with pyelonephritis. Expect the distal urethra, the tract becomes normally sterile because of the host defenses against the bacterial colonization

Etiology is an issue that occurs (80-90%) due to infection of Escherichia coli species. The other usual causes include Proteus mirabilis, Klebsiella, Staphylococcus saprophytic us and Enterococcus. Periurethral colonization is carried out by the pathogen that appears on the initial steps of the cascade that event leads to UTI. In the causative organisms, the natural GI tract process is considered that act as the natural reservoir for the UTI.

The pyelonephritis is the infection of renal parenchyma that cause pyelonephritis. Ascension is the bacterial colonization that occurs due to bacteria in the kidney.

 In Saudi Arabia, urinary tract infection (UTI) is becoming a serious health issue and it induces an impact on the millions of people every year. The overall prevalence of urinary tract infection is 9.9%. Then after this, there is comprehensive information about the diagnosis procedure in detail.

Patient & family teaching of Urinary Tract:

This is what you teach the patient; include any patient handout or PTR’s you used during the patient's stay. As it has been discussed in the above section that how dangerous this disease is for the patients for that case, the family of the patients has to take a proper look on the recommendations for the patients. This is an extremely harmful disease and the patient has to be extremely careful while dealing with such disease.

The parents of the patients and other family members have to follow all kinds of instructions related to the disease. The doctor will provide proper information about the medicine schedule and the members of the family have to provide proper information about the condition of the patient.

Patient & family response to teachings:

The response of the family must be positive according to the teachings of the doctor. The family member must have to stay positive and deal with the condition in an efficient way. Moreover, if there is a need for any kind of injection so they must have to provide him according to the recommendation of the patient. If the family member will stay completely positive then it will be extremely easy for them to overcome such disease in less time.

Furthermore, the family has to give proper information about the regular condition and situation of the patient. This is because through analyzing these conditions he will give them proper recommendations about what they have to do for the future. The next thing is that the family members also have to follow all recommendations inefficient way for the welfare of the patient.

How you assessed their understanding?

This is one of the most difficult tasks to assess their understanding. But it can be done easily by just following the recommendation and details given by the doctor. If you have any kind of misunderstanding just consult the doctor immediately without any hesitation. The main reason is that it is an extremely sworn condition and the family member are not able to take any kind of risk regarding the main problem. This is the reason why it is extremely important to gain proper knowledge about the condition of the patient.

Expectations after discharge of Urinary Tract:

Discharge home and follow up appointment- this is only the basics.

You must include information regarding returning to work/school, driving a car, having more pregnancies, lifting, bending, further education or counseling required, etc.

 It can be noted that the family members must have to keep positive expectations after the discharge. Then after this, the doctor will give a proper recommendation about future appointments. The family members of the patients must have to stay positive and check your patients regularly according to the recommendation of the doctor. 

The classification of Unitary tract infection is based on the symptoms and the area suggested by the terminology. Asymptomatic bacteriuria is identified mainly in patients having two consecutive urine cultures showing > 100,000 CFU/, L urine but it is not simple as compared to UTI. This disease is extremely critical. In that case, the doctor has to give him special medicine in case of any problem to the patients.

After discharging the patient, the doctor will give a proper recommendation about the treatment and regular checkup of the patient. Through this, it will become extremely easy to check the main problem in the health of the patient. The doctor will provide proper information about the medicine schedule and the members of the family have to provide proper information about the condition of the patient. Then after this, it is the main duty of the doctor to check the patient and also give him proper medication according to the demand.

References of Urinary Tract:

Alanazi, M. (2018). An evaluation of community-acquired urinary tract infection and appropriateness of treatment in an emergency department in Saudi Arabia. Therapeutics and Clinical Risk Management, 14(01), 01-10.

Healthline. com. (2017). Everything You Need to Know About Urinary Tract Infection. Retrieved from www.healthline.com: https://www.healthline.com/health/urinary-tract-infection-adults#risks-for-women

Lima, M., & Manzoni, G. (2014). Pediatric Urology: Contemporary Strategies from Fetal Life to Adolescence. Springer.

Mayoclinic. org. (2019). Urinary tract infection (UTI). Retrieved from www.mayoclinic.org: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447

Mulvey, M. A., Klumpp, D. J., & Stapleton, A. E. (2017). Urinary Tract Infections: Molecular Pathogenesis and Clinical Management. Wiley.

Naber, K. G., & Johansen, T. E. (2018). Antibiotics and Urinary Tract Infections. Multidisciplinary Digital Publishing Institute.

Pathophys. org. (2019). URINARY TRACT INFECTION (UTI) » PATHOGENESIS OF URINARY TRACT INFECTION. Retrieved from www.pathophys.org: http://www.pathophys.org/uti/uti-patho/