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URINARY TRACT INFECTION SAMMARY URINARY TRACT INFECTION Course Outline UTI DURING PREGNANCY ASSESSMENT FOR PREGNANT WOMEN WITH UTI THERAPEUTIC MANAGEMENT FOR UTI PREGNANCY UTI DURING PREGNANCY 4% to 10% of nonpregnant women have asymptomatic bacteriuria. In pregnant women, because of progesterone, stasis of urine can occur. There is also minimal presence of glycosuria that also occurs with pregnancy provides an ideal medium for growth of any organism present. Asymptomatic infections are potentially dangerous because they can progress to the kidneys [pyelonephritis] and are associated with preterm labor and premature ruptured of membrane. Women with vesicoureteral reflux can develop UTIs or pyelonephritis.

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URINARY TRACT INFECTION



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,  Urine culture: over 100,000 organisms per milliliter of
URINARY TRACT urine.


INFECTION THERAPEUTIC MANAGEMENT

Course Outline  Urine culture and sensitivity
 Antibiotics: amoxicillin, ampicillin, and cephalosporins
UTI DURING PREGNANCY  Sulfonamides: safe in early pregnancy however in near
ASSESSMENT FOR PREGNANT WOMEN WITH UTI term it can interfere with protein binding bilirubin that
THERAPEUTIC MANAGEMENT FOR UTI PREGNANCY leads to hyperbilirubinemia.
 Tetracyclines: contraindicated because it can cause bone
UTI DURING PREGNANCY growth retardation and staining of deciduous teeth.
 Promote increased amount of fluid [3 to 4L/day] to flush
4% to 10% of nonpregnant women have asymptomatic out infection.
bacteriuria. In pregnant women, because of progesterone,  Promote urine drainage by knee-chest position for 15
stasis of urine can occur. There is also minimal presence of minutes morning & evening,
glycosuria that also occurs with pregnancy provides an ideal
 Pyelonephritis: 24-48 hours IV antibiotics, nitrofurantoin
medium for growth of any organism present.
for the remainder of her pregnancy, ascorbic acid.
Asymptomatic infections are potentially dangerous because  After birth UTI. Ultrasound to detect urinary tract
they can progress to the kidneys [pyelonephritis] and are abnormality such as vesicoureteral reflux to prevent future
associated with preterm labor and premature ruptured of infections.
membrane. Women with vesicoureteral reflux can develop UTIs
or pyelonephritis. BACKGROUND

Escherichia coli are bacteria that is responsible for UTI that is an Urinary tract infection is common and painful human illness
ascending infection, while descending infection can also occur. that is responsive to modern antibiotic therapy. The most
It begins in the kidneys from the filtration of organisms present common manifestation of UTI is acute cystitis because it is more
from other body infections. prevalent among women.

If streptococcus B is detected, vaginal cultures should be DEFINITIONS OF UTI
obtained because it is associated with pneumonia in newborns.
UTI may be asymptomatic [subclinical infection] or symptomatic
[disease].
ASSESSMENT FOR PREGNANT WOMEN WITH UTI

 Frequent urine and dysuria. ▪ Asymptomatic bacteriuria [ASB] occurs in the absence
of symptoms and usually does not require treatment.
 Pain in lumbar region especially on the right side that
radiates downward [pyelonephritis]. ▪ Cystitis – symptomatic infection of the bladder.
 The RLR is tender to palpate. ▪ Urethritis – inflammation of ureter.
 May have accompanying nausea and vomiting, malaise, ▪ Pyelonephritis – symptomatic infection of the kidneys.
pain, and frequency of urination. ▪ Uncomplicated urinary tract infection – acute cystitis or
 Temperature may be slightly elevated or 39 degrees to 40 pyelonephritis without anatomic abnormalities or
degree Celsius. instrumentation of urinary tract.

 Infection is usually on the right because there’s greater ▪ Complicated UTI – encompasses all other types of UTI
compression & urinary stasis on the right ureter from the ▪ Recurrent UTI – not necessarily complicated; individual
uterus being pushed that way by the large bulk of intestine episodes and can be uncomplicated and treated as
on the left side. such.
▪ Catheter-associated bacteriuria

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