cystitis

Cystitis Nursing Diagnosis Care Plan

Cystitis Nursing Diagnosis Care Plan Pathology and NCLEX Review

Cystitis is a medical condition that involves the inflammation and/or infection of the bladder.

Escherichia coli are the most common bacteria that cause cystitis. However, foreign body objects, drugs, and radiation therapy may also cause non-infectious cystitis.

Most cases of cystitis are mild, but it can turn into a serious health issue if left untreated and starts to affect the kidneys.

Signs and Symptoms of Cystitis

  • Fever( usually low grade)
  • Urinary frequency and urgency and passing small amounts of urine
  • A burning sensation upon urinating
  • Blood in the urine (hematuria)
  • Passing cloudy or strong-smelling urine
  • Pelvic discomfort
  • Pain when urinating
  • A feeling of pressure in the lower abdomen
  • Cloudy and/or smelly urine

Causes of Cystitis

Bacterial cystitis is usually caused by E.coli bacteria. E.coli are actually a part of the normal gut flora. In the intestines and anus, E.coli are harmless.

However, improper wiping (back to front instead of front to back) especially in women may cause the E.coli to enter the urinary tract. Sexual intercourse can also cause bacterial cystitis.

Some cases of cystitis are non-infectious, which means that they are caused by agents other than microbes.

Cystitis can be caused by drugs (such as chemotherapy agents ifosfamide and cyclophosphamide), radiation therapy, foreign body (such as long-term catheter use), and chemicals that may cause an allergic reaction in the bladder (such as feminine hygiene soaps or sprays, bubble bath, and spermicidal jellies).

It may also be a complication of other serious diseases, such as kidney stones, enlarged prostate, spinal cord problems, and diabetes.

Complications

  1. Pyelonephritis. If left untreated, bacteria in the bladder can spread to the kidneys and cause a more serious infection. The patient with pyelonephritis is at high risk for permanent kidney damage.
  2. Hematuria. An infection in the bladder may cause inflammation and minor bleeding, which is evidenced by the presence of blood in the urine. This is rarely seen in bacterial cystitis. Chemotherapy and/or radiation therapy-induced cystitis are more likely to result to hematuria.

Diagnostic

  • Urinalysis – mid-stream urine sample is required to perform a quick urine dipstick
  • Urine Culture and Sensitivity –if there is a presence of blood and/or WBCs in the urine, the doctor may ask to send the sample to the lab for culture
  • Cystoscopy – insertion of a thin tube with camera and light into the bladder to view the urinary tract; some tissues may be collected for further analysis (biopsy)

Treatment

  1. Antibiotics. The most important management for cystitis is to give a course of appropriate antibiotics to which the causative bacteria is sensitive. The course usually lasts from 3 days to a week and this depends on how severe the infection is.
  2. Drink plenty of water. It is recommended to drink plenty of fluids, especially water, before a chemotherapy or radiotherapy session (if not contraindicated). It is also advisable to drink a full glass of water and empty the bladder after sexual intercourse.

Nursing Care Plans for Cystitis

  1. Nursing Diagnosis: Impaired Urinary Elimination secondary to the disease process of cystitis as evidenced by frequent urination, burning sensation upon elimination, pelvic discomfort, cloudy and fishy urine

Desired outcome: The patient will re-establish a normal urine elimination pattern, odour-free and clear urine, and maintain a balanced input and output.

InterventionsRationale
Assess the patient’s vital signs and monitor input and output. Collect a urine sample, and send for urinalysis and culture.To assist in creating an accurate diagnosis and monitor effectiveness of medical treatment.
Advice the patient to drink plenty of fluids, especially water.To flush the bacteria out of the bladder.
Administer prescribed antibiotics for cystitis.To treat the underlying infection.
If the patient has an indwelling catheter, assess for any signs of infection, placement, and kinking of the tubes. Review the need for continuous use of catheter.  To check if the cystitis is caused by long-term use and/or an infected catheter. The patient may benefit from bladder retraining instead of unnecessary continued use of catheter.  
Cystitis Care Plan 1
  • Nursing Diagnosis: Acute Pain secondary to the disease process of cystitis, as evidenced by pain score of 8 out 10 when urinating with burning sensation and bladder discomfort

Desired Outcome: The patient will demonstrate relief of pain as evidenced by a pain score of 0 out of 10 and verbalization of a more comfortable elimination.

InterventionsRationale
Administer prescribed painkillers.To alleviate pain and discomfort
Assess the patient’s vital signs and characteristics of pain at least 30 minutes after administration of medication.To assess and monitor the effectiveness of pain relief medication.  
If the patient has an indwelling catheter, assess for placement and kinking of the tubes. Review the need for continuous use of catheter.Tube kinking and wrong catheter placement prevent the urine to flow from the bladder to the urine bag via gravity, causing the urine to pool in the bladder which then results to bladder distention and discomfort.
Encourage the patient to have a warm sitz bath.Warm sitz bath soothes the pelvic and urinary tract muscles, providing more comfort to the patient.
Cystitis Nursing Care Plan 2

Other nursing diagnoses:

  • Fever
  • Deficient Knowledge
  • Risk for Recurrent Infection
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