Urinary tract infections (UTIs): Nursing process (ADPIE)

Alejandra Ramirez is a 38-year-old female who presents to urgent care reporting that she has been experiencing painful urination, and has needed to urinate more frequently and urgently than normal over the past two days.

Ms. Ramirez has a history of type 2 diabetes mellitus.

She is sexually active with no history of sexually transmitted infections.

A urinary tract infection, or UTI, happens when the urinary tract which is made up of upper urinary tract, consisting of the kidneys and the ureters, and the lower urinary tract, bladder, prostate, and the urethra, becomes infected by pathogenic microorganisms.

UTIs are most often caused by an ascending bacterial infection.

Esherichia coli, or E. coli accounts for 75 to 95 percent of all urinary tract infections while other bacteria such as Klebsiella pneumoniae, Staphylococcus saprophyticus, or Proteus mirabilis are also common causes of infection.

Once the bacteria enter the urinary tract, they multiply and colonize the urinary tract, causing inflammation.

Inflammation of the urethra, or urethritis, results in dysuria, which is a symptom of pain or burning during urination.

Inflammation of the bladder, or cystitis, leads to edema of the bladder wall, which can result in suprapubic pain, which is pain felt in the lower abdomen near the bladder, a feeling of bladder fullness, and a need to urinate frequently and urgently.

Bacteria in the urine, or bacteriuria, often results in cloudy, foul smelling urine, while damage to the bladder mucosa can cause blood in the urine, referred to as hematuria.