UTI
- a guideline for nursesAim
- To diagnose and treat an uncomplicated urinary tract infection. To be aware of differential diagnoses and what further investigations may be necessary.
- To refer on when necessary.
History of presenting complaint
- Dysuria
- Duration
- Frequency of micturition
- Fever
- Haematuria
- Urgency
- Abdo/loin pain
History
- Age – child; post menopause
- Sex
- Sexual History – contraception, ?pregnant ?recent change of partner
- Vaginal discharge
- Well being, other diagnoses (diabetes), weight change
- Medication.
- Allergies
Investigations
- Dipstick for blood (not significant if menstruating), nitrites, luekocytes, protein, ?sugar
- UTI in children - consider UTI in febrile child with malaise, without urinary symptoms.
- Risk of pregnancy or pregnant – Trimethoprim teratogenic DO NOT USE.
- If recurrent – follow up with GP. If high fever or loin pain, could be pyelonephritis. Male, UTI not usual in males, more likely to be STI.
- If uncomplicated UTI, routine MSU to lab not necessary. Consider triple swabs; bloods.
Treatment
Child
|
Female
|
Adult Male
|
Education
- Usually E-coli – fluid, voiding, hygiene, cranberry juice.
Differential diagnoses
- Renal calculi; STI; thrush; pyelonephritis; bladder tumour; atrophic vaginitis; prostatitis;