URINARY

TRACT
INFECTION IN
PREGNANCY
 Scenario 1:
A 26-YEAR-OLD WOMAN COMES TO THE CLINIC BECAUSE
OF A 3-DAY HISTORY OF LOWER ABDOMINAL PAIN. SHE IS
18 WEEKS PREGNANT BY DATES. THE PATIENT DESCRIBES
THE PAIN AS SHARP, STEADY, AND RADIATING ACROSS
HER LOWER ABDOMEN BILATERALLY. LAST NIGHT SHE
DEVELOPED NEW NAUSEA AND VOMITING. SHE HAS NOT
BEEN ABLE TO KEEP DOWN ANY FOOD OR DRINK THIS
MORNING. SHE HAD A NORMAL BOWEL MOVEMENT
YESTERDAY. SHE SAYS SHE FELT COLD AND SHIVERING
THIS MORNING, FOLLOWED BY FEELING WARM;
HOWEVER, SHE DID NOT CHECK HER TEMPERATURE. SHE
DENIES VAGINAL BLEEDING.
ETIOLOGY
- The set of cause or manner of causation
of a disease or condition
 ETIOLOGY
" URINARY TRACT INFECTION " (UTI)

MODIFIABLE RISK NON-MODIFIABLE

FACTORS RISK FACTORS
Food Intake ESCHERICHIA COLI FEMALE
Sexual Activities ANATOMICAL
The disease is caused by
Dehydration STRUCTURE
pathogens usually – bacteria – that
FAMILY HISTORY
Hygiene enters the urethra and travel to the
bladder via patient stool, causing
inflammation and infection due to
gram negative organisms, mostly
are the Escherichia coli.

ANATOMY &
PHYSIOLOGY
- Anatomy refers to the internal and external structures of the
body and their physical relationships, whereas physiology
refers to the study of the functions of those structures
URINARY SYSTEM
The urninary system,
also known as the
renal system or urinary
tract, consist of the
kidneys, ureters,
bladder and tye
urethra.
 KIDNEY NEPHRONS
The word nephron is derived
from the Greek word –
nephrons, meaning
kidney. There are
about millions of
nephrons in each
human kidney

A nephron is the basic structural and

functional unit of the kidney. They are
the microscopic structure composed
of a renal corpuscle and a renal tubule.
URINARY
BLADDER
The urinary bladder is an
organ in the body
resembling a pouch into
which urine passes from the
kidneys and is temporarily
stored until discharged
from the body.
PATHOPHYSIOLOGY

-The disordered physiological processes

associated with disease or injury.
URINARY TRACT
INFECTION

CAUSATIVE AGENTS

BACTERIA
Uropathogenic Escherichia Coli (UPEC)
Proteus Mirabilis
Klebsiella Pneumoniae
Staphylococcus Saprophyticus
Enterococcus Faecalis
Neisseria Gonorrhea
Mycoplasma
Chlamydia Trachomatis
Serratia
 PRECIPITATING FACTOR

Increased urinary excretion

Difficulty with hygiene of glucose and amino acids Dilation of the ureters and renal
due to a distended favors the growth of pelvis. The weight of the fetus can put
pregnant belly. bacteria. pressure on the bladder and urinary

tract and these traps bacteria.

Contamination

Colonization In Urethra
and Bladder
LOWER URINARY

TRACT

Inflammatory Response
Cystitis Neutrophil Infiltration

Prostatitis

Urethritis

Bacteria Multiply and

Immune System Evasion
(Virulence)

Ascension to the kidney

UPPER URINARY
Colonization Of Kidney TRACT

Bacteremia Pyelonephritis

 CLIENT
BASED

DIAGNOSTIC TEST
PHYSICAL ASSESSMENT Urine Culture Test
OBSERVATION The client stated all of these Complete Blood
CLIENT symptoms together with the Count
Urinalysis test Result or
STATEMENT Renal Panel
Examination that denotes of
having a high possibility of infection
in Urinary Tract System URINALYSIS RESULT
CLIENT STATEMENT
Sharp pain across lower Leukocytes esterase
abdomen URINARY TRACT Blood
Nausea Cold INFECTION Ketones Nitrites
Vomiting Shivering Bacteria Protein
 If UTI is untreated the infection may
spread from the bladder to one or
both kidneys. That can cause damage
and reduce kidney function

PYELONEPHRITIS

Acute pyelonephritis is a sudden and

severe kidney infection. It causes the
kidneys to swell and may permanently
damage them. Pyelonephritis can be
life-threatening.
 MEDICAL
DIAGNOSIS

Infection
Urinary Tract
MEDICAL AND SURGICAL
MANAGEMENT
CLINICAL
MANIFESTATION Initially treated with
FEVER & CHILLS antibiotics such as
NAUSEA
cephalexin, amoxicillin,
VOMITING
nitrofurantoin, or
LOWER
ABDOMINAL PAIN DIAGNOSTIC TEST trimethoprim/
sulfamethoxazole.
KUB Utrasound
Phenazopyridine
CBC
(AZO)
Urinalysis
STD Test
SIGNIFICANCE/PERTINENT
FINDINGS
WBC - 30-50
Leukocyte esterase (+)
Blood (+) Ketones (+) NURSING DIAGNOSIS
Bacteria (+) Nitrites (+)
Acute pain related to infection of the
Protein (-) Urine
urinary tract as evidenced by lower
Gonorrhea/Chlamydia/
abdominal pain, nausea and vomiting,
Trichomoniasis (-)
presence of leukocytes and nitrates
upon urinalysis, positive bacteria urine
culture result, temperature of 38.8
degrees celcius, and increased white
blood cell count.
TREATMENT & MANAGEMENT
DRUG STUDY
- Study drug information which can be accessed online and
outlines precautions, side effects, interactions, dosage
instructions, potential diagnoses a nurse can make and
teachings for patients and carers.
 NCP

NURSING CARE PLAN

-Is a formal process that correctly identifies

existing needs and recognizes potential
needs or risks.
DISCHARGE PLANNING

-is the process of identifying and preparing for a

patient's anticipated health care needs
after they leave the hospital.
 MEDICATION
Teach the patient, family members,
or significant other the proper
dosage, right time, and right route
in taking the prescribed medication.
Inform and discuss the possible side
effects and adverse effects of the
medications and seek medical attention
immediately if any of these arise.
Emphasize the importance of
taking the prescribed medications
as instructed by the physician,
ensuring no missed doses.
Avoid the use of OTC medications
that are not prescribed. Inform the
physician before taking any OTC
medications
 ENVIRONMENT
Appropriate hand hygiene
Maintain a clean and safe (handwashing or use of alcohol-
environment around the pregnant based hand rubs). Hand hygiene is
woman. important to prevent the spread of
microorganisms.

Reducing stress is important.

Pregnant women should avoid
stressful situations as much as they
can. Recruit your loved ones to help
you manage stress in your life.
 EXERCISE
A Probiotics are good live
microorganism that can increase good Make sure to clean your genitals from
front to back using the bathroom.
gut bacteria. It has Lactobacilli strains
Because, rectum is a main source of E.
that could associate with less frequent
Coli. This habit decreases the risk of
UTI diseases. They also promote growth
bringing E. Coli from the anus to the
of goodnbacteria in the urinary tract.
urethra.

Avoiding holding your urine or pee, this

could encourage bacterial growth. Be Drink plenty fluids. Staying hydrated
throughout the day will make you pee
mindful and try not to wait more than 3 to
more frequently, which flushes bacteria
4 hours to pee, and completely empty
out of our urinary tract to the body. Aim
your bladder each time. This could put a
to drink 6 to 8 glasses of water a day and
person at greater risk especially if she is
avoiding caffeinated drinks.
pregnant.
TREATMENT
 Amoxicillin and ampicillin are part of
UTIs can be safely treated with
the penicillin family of antibiotics.
antibiotics during pregnancy. Doctors They’re first-choice antibiotics for
usually prescribe a 3-7 day course of UTIs during pregnancy. Amoxicillin is
antibiotics that is safe for you and the much more commonly used because
baby. many bacteria are resistant to
During pregnancy, you may be ampicillin.
screened for urinary tract
Sometimes, healthcare providers may
infections (UTIs). Even if you
prescribe a combination of amoxicillin
don't have symptoms, you'll likely
and clavulanic acid. Clavulanic acid is a
be prescribed an antibiotic to
medication that can help make
treat it such as Amoxicillin and
amoxicillin more effective against
cephalexin(Keflex) are usually the
UTI bacteria. Amoxicillin/clavulanic
first-choice antibiotics for a UTI
acid (Augmentin) is generally
during pregnancy.
Considered safe in pregnancy.
SELF
TREATMENT

Drink 6-8 glasses of water each day
and unsweetened cranberry juice
regularly.
Eliminate refined foods, fruit juices,
caffeine, alcohol, and sugar.
Take Vitamin C (250 to 500 mg),
Beta-carotene (25,000 to
50,000 IU per day) and Zinc (30-
50 mg per day) to help fight
infection
Develop a habit of urinating as
soon as the need is felt and empty
your bladder completely when
you urinate
Urinate before and after intercourse.
Avoid intercourse while you are
being treated for a UTI.
After urinating, blot dry (do not rub),
and keep your genital area clean.
Make sure you wipe from the front
toward the back.
Avoid using strong soaps, douches,
antiseptic creams, feminine hygiene
sprays, and powders.
Change underwear and pantyhose every
day. - Avoid wearing tight-fitting pants.
Wear all-cotton or cotton-crotch
underwear and pantyhose.
HEALTH TEACHING
 Do not drink alcohol.
Explain how follow-up care is a key Urinate often. Try to empty your
part of their treatment and safety.
bladder each time.
Tell the patient their antibiotics as
Urinate when you first have the
directed. Do not stop taking them
urge.
just because they feel better.
Urinate right after you have sex.
Explain to them the need of taking
This is the best way for women to
the full course of antibiotics.
avoid UTIs.
Encourage them to drink extra
After using the toilet, wipe from
water and other fluids for the next
front to back to keep bacteria
day or two. This will help wash out
from entering the vagina or
the bacteria causing the infection. If
urethra. postpartum period.
you have kidney, heart, or liver
After 2 to 4 weeks following
disease and have to limit fluids, talk
completion of treatment, urine
with your doctor before you
culture should be obtained to
increase the amount of fluids you
assure that reinfection has not
drink
occurred.
OUT PATIENT FOLLOW-UP
Return for follow-up schedule after 1-2 weeks after
completion of treatment as indicated by the physician.

Inform family or significant others to report any abnormalities

as soon as possible to prevent further complications.
 Pregnant women will usually attend a
screening to check for UTIs in their early
pregnancy.

What to Drink for a UTI – Cranberry Juice

- The explanation for the infamous
cranberry juice remedy is complicated.
Consuming pure cranberry juice,
DIET cranberry extracts, or cranberry
supplements may help lower the
incidence of recurring UTIs, according to
several clinical trials (mostly on women).
However, there isn't much to gain from
cranberry juice for a UTI.
 The greatest beverage for someone with a UTI is water,
without a doubt. While you have an infection, drinking at
least 12 8-ounce cups of water a day will assist eliminate
the bacteria from your body and has the potential to
hasten the healing process.

Foods to Eat for a UTI - Berries. Although

researchers are still studying their
effectiveness, it’s believed that eating
DIET cranberries, blueberries, and raspberries
can help fight off a UTI. They contain
proanthocyanidin, which has been shown
to prevent infection-causing bacteria from
adhering to the lining of the urinary tract.
 Probiotic - rich foods. Try incorporating
foods like plain Greek yogurt, pickles, and
sauerkraut into your diet, since they contain
good bacteria that can help combat an
infection.

High-fiber foods. Foods that are high in

DIET fiber—such as bananas, beans, lentils, nuts,
oats, and other whole grains—can help
remove harmful bacteria from your body.
They also encourage regular bowel
movements, which can help relieve some
bladder pressure.
 Salmon. Cold-water fish
contain omega-3 fatty acids,
which can help reduce
inflammation caused by a
UTI. Fish oil supplements are
DIET another great alternative for
individuals who don’t eat
fish; always consult your
doctor before adding any
supplements to your diet.
 SPIRITUALITY
1. Listen to their fears and concerns
without going into your own stuff.
Simply giving the, empathy to
understand their thoughts, feelings
and emotion without giving them any
harm and your own interest.
2. Encourage the patient and his or
her family if they would like to pray.
This could help them to improve
their health, improve their relaxation
response and call for spiritual
strength during their stay at the
hospital.

3. Share and give positive and

encouraging bible verses to the
patient.
 Presented
BSN 2 - YA - 25
by:

GROUP 1 GROUP 2
John Paul Bugarin Carrie Anne Francisco
Maria Luisa Bernardez Denzyl Dela Peña
Daniella Balmera Emmanuel Giron
Kyla Nomabilis Balila Gio Lajato
Eunice Damian Mira Francisco
Karlyn Ann Dacleson Nej Jethro Fabricante
Omayah Cali Roniel Costimiano Din
Vincent Gerald Cañas Jewel Nathan Inoferio
Kathrina Armendi Andrea Mirando Dela Cruz
Catherine Almario Sarah Gangan
Aubrey Rayo
Thank you for
listening!
Don't hesitate to ask any questions!