urinary tract infection

Urinary Tract Infection UTI Nursing Care Plans

Nursing Diagnosis for Urinary Tract Infection Nursing Care Plans for UTI

5 Nursing Care Plans for Urinary Tract Infection

Urinary tract infection (UTI) is a medical condition that results from the invasion and multiplication of pathogens in the urinary tract. The urinary tract system involves the kidneys, bladder, and urethra.

The most common pathogen that causes UTI is Escherichia coli that is part of the normal gut flora. UTI is more common in women than in men due to the anatomical positions of urethra and anus.

The signs and symptoms of UTI include fever, burning sensation in the urine, cloudy and foul-smelling urine, bladder and/or pelvic pain, and increased urine frequency.

Below are 5 most effective nursing care plans to be used in the care of a patient with UTI.

  1. Nursing Diagnosis: Infection related to urinary retention as evidenced by presence of leukocytes and nitrates in the urine upon urinalysis, positive bacteria urine culture result, foul-smelling urine, burning sensation when passing urine, temperature of 38.9 degrees Celsius, and increased white blood cell count

Desired Outcome: The patient will be able to avoid the development of an infection.

InterventionsRationales
Assess vital signs and monitor the signs of infection.To establish baseline observations and check the progress of the infection as the patient receives medical treatment.
Administer the prescribed antibiotic for UTI. The antibiotic choice is based on the result of the urine culture and sensitivity test. The usual course of antibiotics for UTI runs for 7 to 10 days.To treat the underlying infection. Trimethoprim / sulfamethoxazole, nitrofurantoin, and Augmentin are the most commonly used antibiotics for UTI.
Obtain a urine sample for urinalysis once the antibiotic therapy has been completed.To confirm that the infection has been completely treated, or if there is a need to continue the same antibiotic therapy or shift to a different treatment.
Teach the patient some lifestyle changes related to UTI prevention., including proper perineal hygiene, adequate oral hydration (at least 2 liters of fluids per day, if not contraindicated), and avoidance of undergarments that have non-breathing materials or are constricting/ tight-fitting.Wiping the perineal area from front to back rather than back to front can prevent the travel of normal flora of the anus to the urethra where they become UTI-causing pathogens. Good oral hydration results to more urine production leading to flushing of bacteria from the bladder once the urine is eliminated. Undergarments that are made of non-breathing materials or are tight-fitting promote moisture formation. This encourages bacterial growth.  
UTI Nursing Care Plan 1
  • Nursing Diagnosis: Impaired Urinary Elimination related to frequent urination and urgency as evidenced by dysuria and urinary frequency

Desired Outcome: The patient will be able to achieve normal pattern of urinary elimination.

InterventionsRationales
Assess the patient’s current pattern of elimination and compare with his/her normal pattern (i.e. prior to UTI).To establish baseline data on urinary elimination pattern.
Administer the prescribed antibiotic for UTI. The antibiotic choice is based on the result of the urine culture and sensitivity test. The usual course of antibiotics for UTI runs for 7 to 10 days.To treat the underlying infection. Trimethoprim / sulfamethoxazole, nitrofurantoin, and Augmentin are the most commonly used antibiotics for UTI.
Palpate the bladder and observe for bladder distention.To check for bladder distention and bladder retention.
Encourage the patient to void every 2 to 3 hours.To facilitate flushing of bacteria from the bladder and avoid urine accumulation.
Teach the patient some lifestyle changes related to UTI prevention. including proper perineal hygiene, adequate oral hydration (at least 2 liters of fluids per day, if not contraindicated), and avoidance of undergarments that have non-breathing materials or are constricting/ tight-fitting.Wiping the perineal area from front to back rather than back to front can prevent the travel of normal flora of the anus to the urethra where they become UTI-causing pathogens. Good oral hydration results to more urine production leading to flushing of bacteria from the bladder once the urine is eliminated. Undergarments that are made of non-breathing materials or are tight-fitting promote moisture formation. This encourages bacterial growth.  
UTI Nursing Care Plan 2
  • Nursing Diagnosis: Disturbed Sleep Pattern related to nocturia and acute pain due to UTI as evidenced by verbalization of inability to sleep, delayed sleep onset, bladder pain or discomfort, frequent urination, restlessness, and irritability

Desired Outcome: The patient will report an improved rest/sleep pattern and verbalize feeling well-rested.

InterventionsRationales
Assess the patient’s current pattern of sleep and rest and compare with his/her normal pattern (i.e. prior to UTI).To establish baseline data on rest/sleep pattern.
Administer the prescribed antibiotic for UTI. The antibiotic choice is based on the result of the urine culture and sensitivity test. The usual course of antibiotics for UTI runs for 7 to 10 days.       Administer pain relief medication.To treat the underlying infection. Trimethoprim / sulfamethoxazole, nitrofurantoin, and augmentin are the most commonly used antibiotics for UTI.   To help alleviate bladder pain.
Encourage the patient to limit oral hydration during night time. Advise the patient to avoid caffeine-containing drinks in the evening.To reduce urinary frequency during bed time. Caffeine blocks sleep-inducing chemicals produced in the brain, thereby increasing level of alertness.
Reduce sleep disturbance in the environment such as room temperature, noise and light. Provide comfort measures such as back rub, warm bath, and relaxation techniques.To provide a sleep-conducive environment.  
UTI Nursing Care Plan 3
  • Nursing Diagnosis: Hyperthermia related to urinary tract infection (UTI) as evidenced by temperature of 38.8 degrees Celsius, flushed skin, profuse sweating, and weak pulse.

Desired Outcome: Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.

InterventionsRationales
Assess the patient’s vital signs at least every 4 hours.To assist in creating an accurate diagnosis and monitor effectiveness of medical treatment, particularly the antibiotics and fever-reducing drugs (e.g. Paracetamol or Tylenol) administered.
Remove excessive clothing, blankets and linens. Adjust the room temperature.To regulate the temperature of the environment and make it more comfortable for the patient.
Administer the prescribed antibiotic and anti-pyretic medications.Use the antibiotic to treat bacterial infection, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature.
Offer a tepid sponge bath.To facilitate the body in cooling down and to provide comfort.
Encourage the patient to drink at least 2 liters of fluids per day, if not contraindicated.To reduce the risk for dehydration related to hyperthermia episode.
UTI Nursing Care Plan 4

5. Nursing Diagnosis: Deficient Knowledge related to new diagnosis of UTI as evidenced by patient’s verbalization of “I want to know more about my new diagnosis and care”

Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of UTI and its management.

InterventionsRationales
Assess the patient’s readiness to learn, misconceptions, and blocks to learning (e.g. poor memory or poor lifestyle habits).To address the patient’s cognition and mental status towards the new diagnosis of UTI and to help the patient overcome blocks to learning.
Explain what UTI is, its cause, prevention, and management. Avoid using medical jargons and explain in layman’s terms.To provide information on UTI and its pathophysiology and treatment in the simplest way possible.
Educate the patient about how to determine and report any recurrence of UTI signs and symptoms.To empower the patient to manager his/her own urinary health and to allow early detection of UTI recurrence. UTI signs and symptoms usually recur within 1 to 2 weeks after completion of antibiotic therapy.  
Inform the patient the details about the prescribed medications (e.g. drug class, use, benefits, side effects, and risks) to treat UTI. Ask the patient to repeat or demonstrate the self-administration details to you.To inform the patient of each prescribed drug and to ensure that the patient fully understands the purpose, possible side effects, adverse events, and self-administration details.
Educate the patient about some lifestyle changes related to UTI prevention. Proper perineal hygiene: Wiping properly after urinary elimination or bowel movement, choosing showering over bath tub use, and performing frequent bladder emptying. Oral hydration: Encourage the patient to drink at least 2 liters of fluids per day, if not contraindicated.Clothing: Avoid undergarments that have non-breathing materials or are constricting/ tight-fitting. Choose cotton-made and slightly loose undergarments.Wiping the perineal area from front to back rather than back to front can prevent the travel of normal flora of the anus to the urethra where they become UTI-causing pathogens.         Good oral hydration results to more urine production leading to flushing of bacteria from the bladder once the urine is eliminated. Undergarments that are made of non-breathing materials or are tight-fitting promote moisture formation. This encourages bacterial growth.
UTI Nursing Care Plan 5

With proper nursing and medical management, a patient with UTI will be treated effectively and will be able to prevent the recurrence of infection, and to re-establish a normal sleep/rest pattern and urinary elimination pattern.

References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.     

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.

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