Exam (elaborations) NR 511 WEEK 5 SNAPPS WRITTEN ASSIGNMENT TEMPLATE

Exam (elaborations) NR 511 WEEK 5 SNAPPS WRITTEN ASSIGNMENT TEMPLATE What is the self-directed learning issue that was identified in your oral presentation? Management of Recurrent Urinary Tract Infection in Women Research the self-directed learning issue and provide a summary of your findings which is fully supported by appropriate, scholarly, EBM references. According to Al-Badr and Al-Shaikh (2015), "Urinary tract infections (UTIs) are one of the most frequent clinical bacterial infections in women, accounting for nearly 25 percent of all infections. Around 50 to 60 percent of women will develop UTI in their lifetimes and approximately 20 to 30 percent of women with UTI will have a recurrence (p.4)." Escherichia coli is considered to be the primary pathogen that causes UTIs in most patients. Even though antimicrobial is the initial treatment therapy for urinary tract infection, there are many different types of prophylactic regimens that are available to help reduce the overuse of antibiotics (Al-Badr & Al-Shaikh, 2015, p. 4). Recurrent UTI can reduce the quality of life and increase healthcare costs associated with outpatient visits, diagnostic tests and prescriptions. Gupta, Nag, Garg (2017), stated "Recurrent UTI can be defined as at least three episodes of UTI in one year or two episodes in six months (p. 1)." There are many antibiotics available to help in the treatment of UTIs, but recurrent infections continue to affect many women. It necessitates to explore other alternative antimicrobial therapy. Since Escherichia coli is the primary cause of UTI which spreads from the rectum to vagina and then ascends the sterile urinary tract, it is important to improve the gut or vaginal flora with the right remedy; thus will impact the urinary tract. According to Gupta et al. (2017), "Probiotics have been shown to be effective in varied clinical trials for long-term preventions of recurrent UTI (p. 3)." This study source was downloaded by from CourseH on :34:19 GMT -05:00 This study resource was shared via CourseH NR 511 WEEK 5 SNAPPS WRITTEN ASSIGNMENT TEMPLATE It is crucial that clinicians obtain a complete patient history and perform a pelvic examination in women presenting with recurrent urinary tract infection. According to Gupta, et al. (2017), "Women with recurrent UTI need to be properly investigated by urinalysis, urine cultures and other radiological techniques in order to rule out causes of recurrence, as well as to assess possible anatomical or functional urinary tract abnormalities (p.2)." Antimicrobial therapy is the standard therapy for UTI; however, according to Bushman, and Le (2016), "There are many alternative options that are available to help reduce the use of antibiotics which include cranberry juice, vaginal estrogens for women in post-menopausal, also methenamine hippurate salt (p.3)." Bushman, and Le (2016), also stated "Peri– and post– menopausal women with recurrent UTIs could benefit from vaginal estrogen therapy to reduce the risk of future UTI unless there are contraindications to estrogen therapy (p.4)." Continuous use of prophylaxis antibiotics, postcoital prophylaxis, and acute self-treatment are costeffective treatment strategies for reducing the number of recurrent UTI in some patients. Sihra, Goodman, Zakri, Sahai, and Malde (2018), stated that "Many recurrences of UTI may actually be caused by an underlying bladder infection that came about due to ineffective initial treatment. Treating UTI might not be difficult but preventing UTI recurrence sometimes might be very troublesome for both patients and doctors (p. 4)." There are many strategies to prevent recurrent UTI in young women which include education about the disease itself, frequency of sexual intercourse and the usage of spermicide-containing products. According to Nazarko (2014), "Continuous prophylaxis with low-dose antimicrobials or intermittent selftreatment with antimicrobials has all been demonstrated to be effective in managing recurrent This study source was downloaded by from CourseH on :34:19 GMT -05:00 This study resource was shared via CourseH uncomplicated UTIs in women (p. 2)." Bergamin and Kiosoglous (2017) said "Patients with recurrent UTI are often complex and difficult to manage. The long-term management options in women are multimodal and should focus on prevention of relapse and recurrence. Behavioral factors include adequate hydration, care with sexual hygiene, reducing one’s body mass index (BMI) and post-void residual (PVR) volume (p. 1)." In conclusion, the long-term management of recurrent UTI