Medical-surgical Nursing Demystified

(Sean Pound) #1

(^392) Medical-Surgical Nursing Demystified
NURSING INTERVENTIONS



  • Monitor vital signs.

  • Monitor intake and output.

  • Assess patient’s coping abilities.

  • Teach patient testicular self-exam.


Urinary Tract Infection


WHAT WENT WRONG?


Urinary tract infection occurs when an infecting organism, typically a gram negative
bacteria such as E. coli, enters the urinary tract. Inflammation of the local area
occurs, followed by infection as the organism reproduces. Often the bacteria is pres-
ent on the skin in the genital area and enters the urinary tract through the urethral
opening. The organism can also be introduced during sexual contact. The infection
occurs as an uncomplicated, community-acquired infection in this setting. Patients
with a urinary catheter in place may also develop an infection due to the presence
of the catheter which allows a pathway for the bacteria to enter the bladder.
Instrumentation of the urinary tract, e.g. cystoscopy, also allows a pathway for bac-
teria to enter the bladder. Some of the instruments are not completely sterilized
between patients; they are treated with a high-level disinfectant due to fiberoptics
and lenses within because they would not withstand the high temperatures needed
to sterilize. These infections would be considered nosocomial.

PROGNOSIS


Urinary tract infections that are identified are typically treated and resolve. Some bac-
teria have become resistant to certain antibiotics, so testing the urine to be sure the
infection has cleared after treatment is a good idea. Infections that are left untreated
can progress and travel upward through the urinary tract to involve the kidneys or
become a systemic infection or sepsis, especially in elderly or infirm patients.

HALLMARK SIGNS AND SYMPTOMS



  • Frequency due to irritation of bladder muscles

  • Urgency due to irritation of bladder muscles


10

Free download pdf