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SECTION 9 Problems of Urinary Function

NURSING CARE PLAN 46-1


Patient with a Urinary Tract Infection
NURSING DIAGNOSIS
PATIENT GOALS

Impaired urinary elimination related to effects of urinary tract infection (UTI) as evidenced by pain and burning on urination;
flank, suprapubic, and/or lower back pain; urgency; frequency; nocturia; or hematuria
1. Experiences normal urinary elimination patterns
2. Reports relief of bothersome urinary tract symptoms

OUTCOMES (NOC)
Urinary Elimination

INTERVENTIONS (NIC) AND RATIONALES


Urinary Elimination Management

Monitor urinary elimination including frequency, consistency, odor, volume, and color to evaluate
elimination status.
Obtain midstream voided specimen for urinalysis (as appropriate) to determine pathogen causing UTI or
to monitor effectiveness of treatment.
Teach patient to obtain midstream urine specimens at first sign of return of infection signs and symptoms
to obtain early treatment of recurrence.
Teach patient to drink 8 oz of liquid with meals, between meals, and in early evening to prevent dehydration, relieve bladder irritability, and decrease bacterial colonization.

Pain with urination _____


Burning with urination _____
Urinary frequency _____
Urgency with urination _____
Nocturia _____
Visible blood in urine _____

Measurement Scale
1 = Severe
2 = Substantial
3 = Moderate
4 = Mild
5 = None

Pain Management
Perform a comprehensive assessment of pain to include location, characteristics, onset/duration,
frequency, quality, intensity or severity, and precipitating factors to establish history and baseline pain
level.
Provide the patient optimal pain relief with prescribed analgesics.
Teach the use of nonpharmacologic techniques (e.g., heating pad to suprapubic area or lower back, warm
showers) along with other relief measures to supplement pain medication and increase pain relief.

NURSING DIAGNOSIS
PATIENT GOALS

Readiness for enhanced self-health management as evidenced by verbalization of desire to manage treatment of illness
and prevent recurrence
1. Verbalizes knowledge of treatment regimen
2. Expresses intent to carry out treatment regimen

OUTCOMES (NOC)
Knowledge: Treatment Regimen

INTERVENTIONS (NIC) AND RATIONALES


Teaching: Disease Process

Specific disease process _____


Rationale for treatment regimen _____
Self-care responsibilities for ongoing
treatment _____
Expected effects of treatment _____
Prescribed medication regimen _____

Appraise patients current level of knowledge related to specific disease process to plan individualized
teaching.
Explain pathophysiology of the disease and how it relates to anatomy and physiology.
Describe rationale behind management/therapy/treatment recommendations to promote compliance
with treatment.
Describe possible chronic complications to emphasize the need for completion of treatment.

Measurement Scale

Teaching: Prescribed Medication

1 = No knowledge
2 = Limited knowledge
3 = Moderate knowledge
4 = Substantial knowledge
5 = Extensive knowledge

Instruct patient on the purpose and action of each medication.


Instruct patient on possible adverse effects of each medication so patient can identify problems.
Instruct patient on appropriate actions to take if side effects occur to prevent serious problems.

COLLABORATIVE PROBLEM
POTENTIAL COMPLICATION
NURSING GOALS

Urosepsis (bacteriuria and bacteremia) related to systemic extension of UTI

Anticipate potential for urosepsis in


patients at risk.
Report deviations from acceptable
parameters.
Carry out appropriate medical and
nursing interventions.

INTERVENTIONS (NIC) AND RATIONALES


Monitor vital signs and watch for changes in mental status in patients at risk (immunocompromised,
elderly, those with frequent urinary system instrumentation or anatomic abnormalities) to detect inadequate tissue perfusion.
Report abnormalities such as hyperthermia or hypothermia; decreasing blood pressure; rapid pulse and
respirations; and warm, flushed skin as indicators of septic shock resulting from urosepsis.
Monitor platelet levels and coagulation function tests because alterations indicate bleeding tendencies.