Tuesday, August 26, 2014

Practice Guidelines: Urinary Tract Infections

***Please know that I'm a student midwife and my education is every growing. This is my current Practice Guidelines for Urinary Tract Guidelines. I cannot say it is definite or complete. Please seek care from your provider of choice.***

Urinary Tract Infections (UTI)
 
Urinary Tract Infections (UTI) are the most common bacterial infection in adult women. They are 14 times more common in women than they are men. By age 24 approximately 1/3 of women have been diagnosed with a UTI and prescribed antibiotics by a doctor. UTI’s are more common in pregnancy. 5-10% of UTI’s are asymptomatic. They are caused by bacteria entering your system. The most common ways bacteria enter your system is improper wiping, sexual intercourse and holding your urine.
Signs and Symptoms:
      *        Sub- or suprapubic aching pain
      *        Burning upon urination
      *        Cramps
      *        Fever or low grade fever
      *        General fatigue (common if the infection is well established)
      *        Lower backache (may indicate kidney involvement)
      *        Frequent urination
      *        Small amount of urine output
      *        Incontinence
      *        Cloudy and/or unusual smelling urine
 If it spreads to your kidneys:
      *        Chills/shaking/night sweats
      *        Fatigue/general ill feeling
      *        Fever of 101°F or more
      *        Flushed, warm or reddened
      *        Mental changes (confusion in elderly is common
      *        Nausea and vomiting
 
Complications of a UTI:
      *        Miscarriage
      *        Kidney infections
      *        Preterm labor
      *        Preterm ROM
      *        Preterm birth
      *        Uterine infections
Conditions That May Mimic a UTI:
       *        Early sign of an ectopic pregnancy
       *        Premature labor
       *        Torsion of the pregnant uterus (rare)
       *        Incarceration or sacculation of the uterus (rare)
 
Diagnosis and Treatment:
 
Diagnosis: When you do all prenatal care you should test a woman’s urine at every visit. You can observe it for clarity, color and smell. When you read the urine test analysis strip, make sure you have first let it set for the specific time it needs to rest before being read.
When reading the test strip you will find that the leukocytes and nitrites will be elevated. The best urine for getting an accurate reading is after not having urinated for several hours. The reason these are elevated is because leukocytes (or White Blood Cells) are produced in relation to an infection. Certain bacteria (like the one that causes the UTI) change nitrates to nitrites. If the test is positive for both it means there is bacteria present in your urine likely causing an infection.
 More than 500mg of Vitamin C in the past 24 hours may give a false positive for nitrites. And tetracycline may cause a false positive for leukocytes.
 
Prevention and Treatment: The best treatment for any type of illness is prevention. To help prevent a UTI make sure to wipe properly (front to back), urinate before and after any sexual contact, watch your diet and lifestyle, wear cotton undergarments and urinate when you feel the urge to, never hold it.
 Traditional Treatment Methods:
*        Antibiotics- Common ones are: trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline and fluoroquinolones.
*        Increase water intake
Alternative/Holistic Methods:
*        ¼ tsp baking soda in water 3x daily for 3 days.
*        Cranberry pills
*        Hydration and frequently empty the bladder
*        Uva-ursi- 2 capsules 4x a day for 3-5 days then recheck urine
*        Rinse with a vinegar and water mix
 
Reasons Why Women Have More UTIs:
Common reasons that women have more UTI’s in general are:
*        Relatively short urethra
*        External 3rd of the urethra is close to the rectum
*        Friction during sex allows bacteria into the urethra easier
*        Pregnancy hormones cause the urethra to be a bit more open than normal, which also alters the tone    and movement of it
*        Sugar in the urine and bladder compression because of the growing fundus
 
 
 
 


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