Urinary tract infections (UTI) are caused by pathogenic microorganisms in the urinary tract (kidney, bladder, urethra). Most UTIs are caused by the bacterium Escherichia coli (E. coli), normally found in the digestive system. Usually, bacteria that enter the urinary tract system are removed by the body before they can cause symptoms. But, in some cases, bacteria overcome the natural defenses of the body, therefore causes infection. UTIs are usually classified as infections involving the upper or lower urinary tract. An infection in the urethra is called urethritis. A bladder infection is called cystitis. Bacteria may ascend to the ureters to multiply and cause the infection of the kidneys (pyelonephritis). Signs and symptoms of urinary tract infections include; fever, chills, a strong, persistent urge to urinate, burning sensation when urinating, cloudy, foul-smelling urine, and pelvic pain in women.
Nursing Care Plans
The focus of this nursing care plan for urinary tract infections includes nursing interventions to relieve pain and discomfort, increase the client’s knowledge about the preventive measures and treatment regimen, and manage potential complications.
- Acute Pain UPDATED
- Impaired Urinary Elimination UPDATED
- Hyperthermia UPDATED
- Deficient Knowledge UPDATED
- Other possible nursing care plans
May be related to
- Inflammation and infection of the urinary tract (e.g., urethra, bladder, and other urinary tract structures).
May be evidenced by
- Burning on urination.
- Facial grimace.
- Guarding behavior.
- Protective decreased physical activity.
- Spasm in the lower back and bladder area.
Desired goals and outcomes
- Client will use pharmacological and nonpharmacological pain relief strategies.
- Client will report satisfactory pain control at a level less than 3 to 4 on a scale of 0 to 10.
- Client will report absence of pain.
Nursing Assessment and Rationale
1. Assess the client’s description of pain, such as quality, nature, and severity of pain.
Pain associated with UTI is described as burning on urination, flank pain, lower abdominal or suprapubic pain (Gupta et al., 2017; Lee et al., 2007). In comparison, some clients with recurrent infections are asymptomatic. This information will help in determining the choice of intervention.
2. Assess for signs and symptoms of urinary tract infection.
Common signs and symptoms of UTI include dysuria (painful, burning sensation, or difficult urination), urinary frequency & urgency, and nocturia (voiding two or more times at bedtime). Additionally, pyuria (foul-smelling or cloudy urine) or hematuria (bloody urine) may also occur due to excess white cells in the urine and bleeding of the inflamed bladder wall (Flores-Mireles et al., 2019).
3. Assess for risk factors for UTI.
A history of sexually transmitted infections, catheter use, and previous surgeries of the genitourinary tract are at risk of developing UTI. Blockages of the urinary tract, such as those caused by a kidney stone or an enlarged prostate, can block urine flow and increase the risk of UTI. (Storme, Saucedo, Garcia-Mora, 2019).
4. Monitor laboratory and diagnostic studies, as indicated:
- 4.1. WBC count.
Increased WBC count is a systemic response to infection.
- 4.2. Urinalysis.
To assess for pyuria, bacteria, and blood cells in the urine that is associated with the inflammation process during an infection.
- 4.3. Bacteria in the urine.
Colony count of greater than 100,000 CFU/mL of urine during a clean-catch midstream or catheterized specimen indicates infection, although lower counts may also indicate UTI.
- 4.4. Urine culture and sensitivity.
Used to identify the infecting organism and to determine the most effective and suitable antibiotic. Additionally, test for sexually transmitted infections is performed if acute urethritis is suspected.
- 4.5. Computed tomography (CT scan).
Used for detecting renal calculi, pyelonephritis, and abscess.
- 4.6. Ultrasound and kidney scans.
Used for detecting obstruction, abscesses, tumors, and cysts.
Nursing Interventions and Rationales
1. Apply a heating pad to the suprapubic area or lower back.
The application of heat to the perineum help relieve pain and spasm.
2. Administer analgesics (e.g., acetaminophen) or antispasmodics (e.g., phenazopyridine), as indicated.
Antispasmodic and analgesic agents are useful in relieving bladder irritability, spasm, and pain.
3. Encourage the patient to increased oral fluid intake unless contraindicated.
Increasing fluid intake to 2 to 3 liters per day helps facilitate urine production, dilutes urine, reduces irritation of the inflamed bladder, promotes renal blood flow, and flushes bacteria from the urinary tract.
4. Instruct to avoid coffee, tea, spices, alcohol, and sodas.
These foods are considered urinary tract irritants and may irritate the urinary system.
5. Encouraged the client to void frequently.
Frequent voiding every 2 to 3 hours to completely empty the bladder is encouraged to prevent bladder distention, lower bacterial urine counts, reduce stasis of the urine, and prevent reinfection.
6. Use of non-pharmacological techniques for pain management as appropriate.
Alternative therapies such as relaxation, massage, guided imagery, or distraction may decrease pain and provide comfort.
7. Administer antibacterial agents as indicated.
Trimethoprim (TMP) or cephalexin are usually the first choices of antibiotics. Short-course therapy using a single antibiotic or a 3-day course reduces treatment cost, increases compliance to therapy, and a lower rate of side effects.
8. Stress the importance of completing the antibiotic therapy
Even if the symptoms disappear, the client should finish the prescribed duration of the antibiotic therapy. Unable to do so may result in reinfection.
Recommended nursing diagnosis and nursing care plan books and resources.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans and nursing diagnoses related to reproductive and urinary system disorders:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Renal Failure | 6 Care Plans
- Benign Prostatic Hyperplasia (BPH) | 5 Care Plans
- Chronic Renal Failure | 11 Care Plans
- Hemodialysis | 3 Care Plans
- Hysterectomy (TAHBSO) | 6 Care Plans
- Mastectomy | 14+ Care Plans
- Menopause | 6 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Peritoneal Dialysis | 6 Care Plans
- Prostatectomy | 6 Care Plans
- Urolithiasis (Renal Calculi) | 4 Care Plans
- Urinary Tract Infection | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
References and Sources
- Flores-Mireles, A., Hreha, T. N., & Hunstad, D. A. (2019). Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Topics in spinal cord injury rehabilitation, 25(3), 228-240.
- Gupta, K., Grigoryan, L., & Trautner, B. (2017). Urinary tract infection. Annals of internal medicine, 167(7), ITC49-ITC64.
- Lee, J. B., & Neild, G. H. (2007). Urinary tract infection. Medicine, 35(8), 423-428.
- Storme, O., Tiran Saucedo, J., Garcia-Mora, A., Dehesa-Dávila, M., & Naber, K. G. (2019). Risk factors and predisposing conditions for urinary tract infection. Therapeutic advances in urology, 11, 1756287218814382.