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Most UTI’s happen from bowel organisms, (E-coli). Women are more prone to UTI’s because of the
shortness of their urethra.
CYSTITIS
Infections of the lower urinary tract are called cystitis. This is an inflammation of the urinary
bladder related to a superficial infection that doesn’t extend to the bladder mucosa, most often caused by
ascending infection from the urethra; it can also be caused by sexual intercourse.
• Causes
• Other causes
o Cystitis is usually due to a bacterial infection of the urine. Occasionally, in children it can be
caused by a virus.
o The infection is more common in women because a woman's anatomy is designed in such a way
that it makes it easier for bacteria to enter the bladder.
o Sexual intercourse, using spermicidal creams, and using diaphragms all increase the risk of
developing Bladder Infection.
o People who have a catheter in their bladder or who have to periodically catheterize them have a
higher risk of developing bladder infection.
o People with Bladder Cancers or abnormal connections between their bladder and intestines also
have a higher risk of developing Bladder Infection.
• Pathophysiology
• Bacterial infection from a second source spreads to the bladder, causing an inflammatory
response.
• Cell destruction from trauma to the bladder wall, particularly the trigone area, initiates an acute
inflammatory response.
• Complications
• Clinical manifestations
Any changes in the clients voiding habits should be assessed as a possible UTI. The most
common clinical manifestation of cystitis is burning pain of urination (dysuria), Frequency, urgency,
voiding in small amount, inability to void, incomplete emptying of the bladder, cloudy urine and hematuria
( blood in urine). Asymptomatic bacteriuria (bacteria in urine).
• Nursing Diagnosis
Impaired Urinary Elimination. The primary diagnosis when a client is experiencing problems related to
cystitis is Impaired Urinary Elimination related to irritation of the bladder mucosa.
Acute Pain. Another common nursing diagnosis for clients with cystitis is Acute Pain related to irritation
and inflammation of bladder and urethral mucosa.
• How to diagnose
o Often times, treatment may be based on the symptoms alone, without additional tests.
o Urinalysis (in which the urine is tested for the presence of an infection) is the most common
method of diagnosis.
o Blood and Urine cultures may also be required.
o In women with frequent infections (more than three a year), a full examination of the urinary
tract (usually by a specialist) needs to be done. Also, it is sometimes recommended that all
men who develop any type of urinary infection, including Bladder Infections, need to be
seen by a specialist.
• Diagnostic test findings
Urine culture and sensitivity: positive identification of organisms (Escherichia coli, Proteus
vulgaris, Streptococcus faecalis)
• Assessment findings
• Medical management
Diet: acid-ash diet with increased intake Treatment: Sitz baths
of fluids and vitamin C
Antibiotics: co- trimoxizole (Bactrim),
Activity: as tolerated cephalexin (Keflex)
• Nursing interventions
Administer medications, as
prescribed
The client will have return of normal voiding habits within 3 days of starting antibiotic treatment as
evidenced by an absence of fever, pain, burning, frequency, and urgency.
The client will be able to urinate with minimal or no discomfort within 24 hours after treatment begins and
will return to normal voiding habits within 3 days, as evidenced by an absence of pain and burning on
urination.