Urinary Tract Infections

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Urinary tract infections (UTI’s) present a significant problem in the older population affecting 8% of women over age 70 and 20% of women over age 80. UTI’s are often misdiagnosed and over-treated both in the hospital setting and long term care facilities. Educating patients is thought to help prevent UTI’s in as much as 20% of acute cases.
An older patient coming into the hospital may have many underlying conditions. It is important to ask questions regarding predisposing conditions such as diabetes, sexual activity, immobility, disease process that have altered the patients immunity, fluid intake, and use of antibiotics. If you suspect your patient has an altered mental status, obtaining a detailed history from family or a caregiver helps the provider launch the best treatment plan for the individual patient. Equally important is assessing the patient for signs of a UTI including fever, pain on palpitation, nausea & vomiting. This information along with diagnostic urine test are essential in determining if the UTI is acute or chronic in nature.
Urine is a sterile body fluid in most healthy adults. A clean catch urine will show if the urine is positive for bacteria. The most common bacteria present in UTI’s is E. Coli however a culture and sensitivity test should be done to accurately determine which bacteria is responsible for the infection. The results will allow the provider to prescribe more specific antibiotic treatments. With the increase in microbial resistant

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