Uti,

UTI

1. URINARY TRACT INFECTION (UTI)

2. INTRODUCTION A urinary tract infection (UTI) in children is a fairly common condition. Bacteria that enter the urethra are usually flushed out through urination. However, when bacteria aren’t expelled out of the urethra, they may grow within the urinary tract. This causes an infection .

3. DEFINITION A urinary tract infection (UTI) is an infection that affects any part of the urinary tract, including the kidneys, ureters, bladder or urethra UTI is invasion of the urothelium that results in an inflammatory response.

4. INCIDENCE The incidence of UTI in children aged 1-2 years is 8.1% in girls and 1.9% in boys. Studies from Sweden have indicated that at least 3% of girls and 1% of boys have a symptomatic UTI by age 11 years

5. Classification Upper UTI Acute pyleonephritis Chronic pyleonephritis Interstitial pyleonephritis Renal abscess Perirenal abscess Lower UTI Cystitis Prostatitis Urethritis Both upper & lower UTI are further divided into complicated and uncomplicated.

6. ETIOLOGY & risk factors The most common cause of UTIs is E. coli Bacteria a structural deformity or blockage in one of the organs of the urinary tract abnormal function of the urinary tract vesicoureteral reflux, a birth defect that results in the abnormal backward flow of urine the use of bubbles in baths (for girls)

7. CONTI... tight-fitting clothes (for girls) wiping from back to front after a bowel movement poor toilet and hygiene habits Uncircumcised boys under 1 year old also have a slightly higher risk of UTIs

8. PATHOPHYSIOLOGY Micturition reflex triggered Clinical manifestations

9. cLINICAL MANIFESTATION Symptoms of a UTI can vary depending on the degree of infection and your child’s age. Infants and very young children may not experience any symptoms . fever poor appetite vomiting diarrhea irritability overall feeling of illness

10. CONTI... Additional symptoms vary depending on the part of the urinary tract that’s infected. If your child has a bladder infection, symptoms may include blood in the urine cloudy urine foul-smelling urine pain, stinging, or burning with urination pressure or pain in the lower pelvis or lower back, below the navel

11. CONTI... frequent urination waking from sleep to urinate feeling the need to urinate with minimal urine output urine accidents after the age of toilet training If the infection has traveled to the kidneys, the condition is more serious. Your child may experience more intense symptoms, such as: irritability

12. CONTI... chills with shaking high fever skin that’s flushed or warm nausea and vomiting side or back pain severe abdominal pain severe fatigue

13. DIAGNOSTIC EVALUATION Urinalysis. Urine culture. Urine collection bag Catheterized urine collection. kidney and bladder ultrasound voiding cystourethrogram (VCUG) nuclear medicine renal scan (DMSA) CT scan or MRI of the kidneys and bladder

14. MANAGEMENT

15. MEDICAL MANAGEMENT PHARMACOLOGICAL MANAGEMENT The most common antibiotics used for treatment of UTIs in children are: amoxicillin amoxicillin and clavulanic acid

16. CONTI... cephalosporins doxycycline, but only in children over age 8 nitrofurantoin sulfamethoxazole-trimethoprim Pain medication to alleviate severe discomfort during urination also may be prescribed.

17. CONTI... NON PHARMACOLOGICAL MANAGEMENT Take child’s temperature if they seem to have a fever. Monitor child’s urination frequency. drinks plenty of fluids. Change diapers frequently in children. Encourage child to use the bathroom frequently rather than holding in urine.

18. SURGICAL MANAGEMENT Surgical removal of renal calculi,bladder calculi Ureteroplasty Reimplatation of ureters if VUR present

19. NURSING MANAGEMENT Assessment A history of signs and symptoms related to UTI is obtained from the child with a suspected UTI. Assess changes in urinary pattern such as frequency, urgency, or hesitancy. Assess the characteristics of the child urine such as the color, concentration, odor, volume, and cloudiness.

20. Nursing Diagnosis Impaired urinary elimination related to frequent urination as evidenced By Dysuria Infection related to Improper toilecting as evidenced by Bacteriuria. Acute pain slated to Inflammation and Infection of the urethra, bladder and other urinary tract structures evidenced by Guarding as behavior.

21. CONTI... Disturbed sleep pattern related to pain as evidenced by restlessness/irritability Hyperthermia related to inflammation as evidenced by increae body temperature above normal range

22. Nursing Intervention Monitor Vital signs Encourage increased fluid intake ( 3 - 4 liters a day if tolerated) Maintain an acid environment of the bladder by the use of agent Monitor laboratory findings Apply a heating pad to the suprapubic area or lower back Maintain bed rest Administer anti-pyretic drugs and analgesics

23. Prevention Don’t give female children bubble baths. They can allow bacteria and soap to enter the urethra. Avoid tight-fitting clothing and underwear for your child, especially girls. Ensure that your child drinks enough fluids. Avoid allowing your child to have caffeine, which can cause bladder irritation. Change diapers frequently in younger children.

24. CONTI... Encourage your child to use the bathroom frequently rather than holding in urine. Teach your child safe wiping techniques, especially after bowel movements. Wiping from front to back reduces the likelihood that bacteria from the anus will get transferred into the urethra.

25. Complication

26. conclusion Urinary Tract Infection (UTI) is one of the most common bacterial infections in childhood. The infection may affect the upper urinary tract or the lower urinary tract . Unfortunately, it may be difficult, if not impossible, to distinguish pyelonephritis from cystitis based on clinical symptoms and signs, especially in infants and young children.