URINARY TRACT INFECTIONS
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INTRODUCTION
Urinary tract infections (UTIs) are an infection in the urinary system (what makes and gets rid of pee) caused by germs (for example bacterial, fungal, or yeasts). UTIs are a very common infection in people who live in nursing homes or have recently been in the hospital.
Women and men with a catheter {kath-i-ter} (a tube inserted into the bladder to get rid of your pee) are at a very high risk for UTIs because germs can easily travel along the catheter tube and cause an infection in the bladder (which stores the urine/pee) and the kidneys (which filter the blood to make urine/pee).
UTIs are more common in women than in men because women have a short urethra (the tube that connects the bladder
to the outside of the body) allowing bacteria to easily get into the bladder. Women
are at higher risk for UTIs if they are in menopause due to hormone changes.
UTIs in men, however, can be more serious. Men are at higher risk for UTIs if they have prostate
enlargement, as this can get in the way of the bladder emptying completely when going pee. There is a risk that
bacteria in the urinary system will not get flushed out and instead spread, causing
frequent UTIs.
As a caregiver, you can be proactive (hands-on) in preventing your care recipient from having a UTI or having to go to an emergency room and/or be admitted to the hospital. Consider the following information.
WHAT I SHOULD KNOW
- If your care recipient has one of the following conditions he or she has a higher
risk for UTIs:
- Renal (kidney) stones and/or bladder stones, which are small, hard crystal deposits in these organs.
- A narrow urethra, which is the tube that connects the bladder to the outside of the body.
- An inability to completely empty the bladder when going to the bathroom.
- Chemotherapy treatment, which causes a weakened immune system making it more difficult for the body to fight off infection.
- A urinary catheter to go to the bathroom.
- Antibiotic treatment should not be started unless there are signs and symptoms of
a UTI present. Unnecessary use of antibiotic drugs can harm you by causing:
- Drug allergies.
- Interactions between drugs.
- Increased antibiotic resistance. This is where the bacteria, virus or yeasts become super bugs and are not killed by the medicine any longer.
- Nausea and vomiting.
UTIs can affect your care recipient’s physical, mental, and emotional health, as well as his or her social life.
WHAT I CAN DO
Encourage Fluids:
- Encourage your care recipient to drink 6 to 8 glasses of water daily if this is OK with his/her health care provider, as this will allow the urinary tract to be regularly flushed.
- Remind your care recipient to avoid drinks that irritate the bladder like alcohol, coffee, tea, spices, citrus juices (orange juice, lemonade) and carbonated beverages (Coke, Pepsi, 7UP). See this website for a more complete list: http://my.clevelandclinic.org/health/diseases_conditions/hic_Bladder_Irritating_Foods
- Offer the person you care for two glasses of cranberry juice a day (unsweetened to reduce sugar). He or she can also take concentrated cranberry extract as a powder, chew, or pill, which you can find at a drug store. Do not have your care recipient drink cranberry juice or concentrated extract if he or she has a family history of kidney stones.
Encourage Urination:
- Try to get the one you care for to the bathroom to urinate/pee every 3 hours while he/she is awake. Set a timer as a reminder.
- Change adult diapers (briefs, depends) as soon as they become soiled or wet.
- Women should always wipe from front to back, to prevent bacteria from entering the vagina or urethra.
- If your care recipient is female, have her use sanitary pads instead of tampons and change them with each use of the bathroom.
- Do not use douches or other feminine hygiene sprays since they can irritate the urethra
by changing the normal bacterial environment and make an infection more likely.
Encourage Good Hygiene:
- Have your care recipient take showers instead of baths to help prevent bacteria from entering the urethra and causing a UTI.
Have him or her wear cotton-cloth underwear which are more breathable and keep you
dryer. Bacteria grow better in a moist environment. - Practice even safer sex by using the bathroom to empty the bladder and clean the genital and anal areas before and after sexual intercourse.
- You and your care recipient should practice good hand washing with soap and water before and after urination/peeing for 20 seconds.
- Want to know more? This is the same time it takes to sing the Happy Birthday Song.
See the steps in this video: http://www.youtube.com/watch?v=KY6kahdQ5_0.
WHAT I NEED TO WATCH FOR
As family members and/or caregivers you are in a perfect position to help prevent a UTI, recognize early signs and symptoms, and get early treatment for your care recipient.
Your care recipient with a UTI may be:
- Going to the bathroom every 1 or 2 hours.
- Getting up to go to the bathroom in the middle of the night.
- Dribbling urine/pee (mainly in men).
- Having new or more confusion.
WHAT I NEED TO REPORT
Report bloody urine/pee immediately to your health care provider.
- Also report if you care recipient is having:
- Cloudy pee.
- Strong or bad smelling pee.
- A frequent or urgent need to pee.
- Pain or burning with peeing.
- Pain or pressure in the lower abdomen, lower back, or side (particularly pain on one side).
- Shakes or chills.
- A fever greater than 101○F.
- Nausea or vomiting.
- Confusion.
- Tiredness, restlessness, or is moving slower (seen in patients with catheters).
- If your care recipient has a simple UTI with common signs and symptoms, his/her health
care provider may give him/her an antibiotic to take at home for 3 to 14 days.
- It is very important to have your care recipient take the medication as prescribed (as order by the health care provider) and to take all the medication, even after the signs and symptoms are gone, to prevent the infection from returning.
- If his/her symptoms are serious or he/she cannot take the medicine or drink enough fluids, your care recipient may need to go into the hospital.
I WANT A QUICK REVIEW
Click on this link to listen to a review of this material for Urinary Tract Infections:
http://hscms.utoledo.edu/Mediasite/Play/5b5250bb37da4356a92e59cf3753ce721d
Running time = 05:09 minutes
WHAT I HAVE LEARNED
Click on this link to assess Test questions
I NEED MORE INFORMATION
There are other OPTIONAL websites which can assist you with learning more about UTIs. Click on these sites for more information.
- Information on urinary tract infection in adults, its causes, symptoms, and treatment:
The U.S. National Library of Medicine, The National Institute of Health, Medline Plus
- Prevention of UTIs: Mayo Clinic
- Information on urinary catheters: The U.S. National Library of Medicine, The National Institute of Health, Medline Plus
REFERENCES
Bass-Ware, A., Weed, D., Johnson, T., & Spurlock, A. (2014). Evaluation of the effect of cranberry juice on symptoms associated with a urinary tract infection. Urologic Nursing, 34 (3), 121-127. ISSN: 1053-816X PMID: 25112018
DeVito, M. (2014). Management of urinary tract infection (UTI) in the community. Journal of Community Nursing, 28(3), 18-26. ISSN: 0263-4465
Eriksson, L., Olofsson, B., Gustafson, Y., & Fagerstrom, L. (2014). Older women's experiences of suffering from urinary tract infections. Journal of Clinical Nursing, 23, 1385-1394. doi: 10.1111/jocn.12422
MacKenzie, K., & Aning, J. (2016). Managing lower urinary tract symptoms in men. Practitioner, 260(1792), 11-6.
Schneeberger, C., Geerlings, S.E., Middleton, P., & Crowther, C.A. (2012). Interventions for preventing recurrent urinary tract infection during pregnancy (Review). The Cochran Collaboration. The Cochrane Library, 11. John Wiley & Sons, Ltd.