- A UTI is indicated by more than 105 bacterial colonies/mL of urine in two consecutive clan, voided, mistream specimens.
- Two common types of UTIs are cystitis, inflammation of the urinary bladder, and pyelonephritis, inflammation of the renal pelvis.
- UTIs occur in about 5% of postpartum women; they occur in 15% of women who have undergone postpartum catheterization.
- Ascending bacterial infections account for most UTIs.
- Another cause of UTIs is retention and residual urine due to overdistention and incomplete emptying of the bladder.
- Temporary urine retention may be due to decreased perception of the urge to void, resulting from perineal trauma and the effects of analgesia, or anesthesia.
- Urinary stasis and residual urine provide a medium for bacterial growth, predisposing the client to cystitis and pyelonephritis.
- Causative organisms in cystitis and pyelonephritis include E. coli (most common), Proteus, Pseudomonas, S. aureus, and Streptococcocus faecalis.
- Consequences of not recognizing early symptoms of UTI include the extension of the infection upward with subsequent permanent loss of kidney function.
Clinical manifestations depend on the type of infection.
- Clinical manifestations include frequency, urgency, dysuria, hematuria, nocturia, temperature elevation, and suprapubic pain.
- Pyelonephritis manifestations include high fever, chills, flank pain, nausea, and vomiting.
Recognize signs of infection and prevent the development of further complications.
- Determine if symptoms are present and if the woman had difficulty urinating after delivery.
- Obtain specimens, report findings, and administer antibiotics and medications as prescribed.
- Describe self-care related to regular emptying of bladder, proper perineal cleansing, and the need for increased fluids.
- Insert intermittent or indwelling catheter as needed.
- Observe and record the response to treatment.