Nanda Nursing Diagnosis for Urinary tract infections (UTIs)

Urinary tract infections (UTIs) are common in women. Due to the shorter female urethra, contaminant bacteria pass more easily through the pathway to the bladder. Other factors at play are the tendency to retain urine as well as irritation of the skin of the urethral opening.
Urinary tract infections cause symptoms of frequent pain and burning sensation when urinating, spasm in the bladder area, hematuria, back pain may occur, fever, chills, pelvic and low back pain, pain when urinating, malaise, nausea and vomiting resulting in disturbances urinary elimination.

According to WHO in 2011, urinary tract infections were among the most common infections acquired by patients receiving treatment in health services
(health care-associated infection). In fact, urinary tract infections were recorded as the second most common (23.9%) in developing countries after surgical wound infections (29.1%) as the most common infections obtained by patients in health facilities. UTI is a significant cause of morbidity and mortality. Urinary tract infections are also more common in women than men.

Urinary tract infections are caused by various kinds of bacteria including E. coli, klebsiella sp, proteus sp, providensiac, citrobacter, P. aeruginosa, acinetobacter, enterococu faecali, and staphylococcus saprophyticus, however, about 90% of UTIs are generally caused by E. coli (Sjahjurachman, 2004).

Urinary Tract Infection Disease (UTI), the most important management in patients is to maintain urinary tract function and improve the quality of life of patients with immediate handling of urination so that urinary elimination disorders do not occur. (Jennyver 2012).

Independent interventions that are carried out to overcome this problem include: Providing a comfortable position for the patient so that it can reduce pain. Palpate the bladder every 4 hours for distention. Teach deep breathing relaxation techniques, Give
drinking intake of 2 – 2.5 liters per day (Kiran, et al 2013). The role of nurses that can be given to UTI patients is to help teach how to excrete urine, so that urinary tract infections do not occur (Ronald 2013).


Nanda Nursing Diagnosis : Impaired Urinary Elimination

Definition: urinary elimination dysfunction

Related factors:

1. Sensory motor disorders
2. Urinary tract infection
3. Anatomical obstruction
4. Multiple causes

Defining characteristics:

1. Dysuria
2. Urge to urinate
3. Urinary incontinence
4. Nocturia
5. Urinary retention
6. Frequent urination

NOC

Urinary Elimination Disorder

Urinary elimination:

1. Elimination pattern
2. Urine smell
3. Amount of urine
4. Color of urine
5. Urine clarity
6. Fluid intake
7. Empty the bladder completely
8. Recognize desire to urinate
9. Urine particles are visible
10. Blood is visible in urine
11. Pain when urinating
12. Burning sensation when urinating
13. Hesitating to urinate
14. Frequency to urinate
15. Urgent urge to urinate
16. Urinary retention
17. Nocturia
18. Urinary incontinence
19. Stress incontinence
20. Incontinence urinate
21. Incontinence functional

NIC

Urinary Elimination Disorder

Infection control:

1. Allocate appropriate space per patient, as indicated by the Centers for Disease Control and Prevention guidelines.
2. Clean the environment well after each use for each patient.
3. Change patient care equipment according to institutional protocol.
4. Isolation of people affected by infectious diseases.
5. Maintain appropriate isolation techniques.
6. Limit the number of visitors.
7. Teach hand washing for health workers.
8. Instruct patient on proper hand washing technique.
9. Encourage visitors to wash their hands when entering and leaving the patient's room.
10. Use antimicrobial soap for proper hand washing.
11. Wash hands before and after patient care activities.
12. Take universal precautions.
13. Wear gloves as recommended by the universal precautions policy.
14. Wear a change of clothes or a robe when handling infectious materials.
15. Wear sterile gloves properly.
16. Rub the patient's skin with an appropriate bacterial agent.
17. Shave and prepare the area for preparation for invasive procedures or surgery as indicated.

Pain management

1. Perform a comprehensive pain assessment that includes; location, characteristics, onset/duration, frequency, quality, intensity or severity of pain and precipitating factors.
2. Observe for non-verbal clues about discomfort, especially in those who cannot communicate effectively.
3. Ensure that analgesic treatment for the patient is carried out under close monitoring.
4. Use therapeutic communication strategies to identify pain experiences and convey patient acceptance of pain.
5. Assess the patient's knowledge and beliefs about pain.
6. Consider the influence of culture on pain response.
7. Determine the impact of the experience of pain on quality of life (eg sleep, appetite, understanding, feelings, relationships, work performance and role responsibilities).
8. Assess with the patient factors that can reduce or aggravate pain.
9. Evaluation of past pain experiences including individual or family history of chronic pain or pain that causes disability / disability / disability appropriately.