emergency room report for patient with genitourinary tract infection

by Isabelle Pfeffer 8 min read

[Incidence of genitourinary pathology in the emergency

29 hours ago Age over 60 years, hospital admission as final resolution and infection/sepsis diagnosis were independent features for further waiting time in the Emergency Department. Persistent pain and symptoms of infection/sepsis behaved as independent features for hospital admission. >> Go To The Portal


What are genitourinary emergencies?

Abstract. Genitourinary emergencies are routinely seen and treated in the emergency department (ED). Most of the time they are minor problems that can be treated with medications. However, genitourinary problems, such as testicular torsion, can result in loss of the testicle(s) if untreated.

How will you assess a case of urinary tract infection?

Tests and procedures used to diagnose urinary tract infections include:Analyzing a urine sample. ... Growing urinary tract bacteria in a lab. ... Creating images of your urinary tract. ... Using a scope to see inside your bladder.

What key assessments do you look for in a patient with a UTI?

Your physical examination should include:▸vital signs, assessing specifically for fever, tachypnea, and tachycardia.▸CVA tenderness on palpation or percussion.▸suprapubic tenderness or flank pain or tenderness during deep abdominal palpation.▸urine abnormalities (cloudiness, sediment, foul odor, presence of blood)More items...

When should I go to the ER for a urinary tract infection?

Please go to an emergency department immediately for symptoms of a urinary tract infection along with any of the following: Fever with severe and sudden shaking (Rigors) Nausea, vomiting, and the inability to keep down clear fluids or medications. If you are pregnant.

How do you read a urine culture report?

What does the test result mean?Positive urine culture: Typically, the presence of a single type of bacteria growing at high colony counts is considered a positive urine culture.Negative urine culture: A culture that is reported as “no growth in 24 or 48 hours” usually indicates that there is no infection.More items...•

What is a nursing diagnosis for UTI?

Nursing Diagnosis: Hyperthermia related to urinary tract infection (UTI) as evidenced by temperature of 38.8 degrees Celsius, flushed skin, profuse sweating, and weak pulse. Desired Outcome: Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.

What are the priority nursing interventions for a patient experiencing a UTI?

Nursing ManagementAssess the symptoms of UTI.Encourage patient to drink fluids.Administer antibiotic as ordered.Encourage patient to void frequently.Educate patient on proper wiping (from front to the back)Educate patient on drinking acidic juices which help deter growth of bacteria.Take antibiotics as prescribed.More items...

What are nursing priorities for UTI?

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.

What are the priority nursing diagnosis related to urinary elimination?

A lit- erature search combined with clinical observation and review of anatomy and physiology helped to identify five specific nursing diagnoses. They are: urinary retention, stress incontinence, urge incontinence, reflex incontinence, and uncontrolled incontinence.

How do hospitals treat UTI?

At the hospital, you will receive fluids and antibiotics through a vein. Some people have UTIs that do not go away with treatment or keep coming back. These are called chronic UTIs. If you have a chronic UTI, you may need stronger antibiotics or to take medicine for a longer time.

What are signs of sepsis from UTI?

Severe sepsis symptoms include: Organ failure, such as kidney (renal) dysfunction resulting in less urine. Low platelet count. Changes in mental status....Symptoms and DiagnosisSudden and frequent urination.Pain in your lower abdomen.Blood in your urine ( hematuria)‌

How does a UTI lead to sepsis?

A urinary tract infection is generally treated with antibiotics. However, if the infection isn't identified and is left untreated, it can move to the kidneys and ureters and may cause sepsis and septic shock.

What is genital reconstruction?

Genital reconstruction for patients who have suffered a traumatic genital injury or have genital skin loss due to infection or other causes. Management of traumatic injuries to the kidney, ureter, bladder, scrotum/testicles and penis.

What is UCSF urethra?

UCSF is a national leader in urological care, including treatment for injuries to the kidneys, bladder, genitals, ureters (the tubes that carry urine from each kidney to the bladder) and urethra (the tube that allows the bladder to void urine).

What is the literature on UTI?

The literature spans the disciplines of emergency medicine, internal medicine, family practice, obstetrics and gynecology, urology, and infectious disease.

How many urinary tract infections are treated annually?

Urinary tract infections are a heterogeneous group of disorders, involving infection of all or part of the urinary tract, and are defined by bacteria in the urine with clinical symptoms that may be acute or chronic. Approximately 1 million urinary tract infections are treated every year in United States emergency departments. The female-to-male ratio is 6:1. Urinary tract infection s are categorized as upper versus lower tract involvement and as uncomplicated versus complicated. The emergency clinician must carefully categorize the infection and take into account patient host factors to optimally treat and disposition patients. A working knowledge of local or at least national susceptibil - ity patterns of the most likely pathogens is essential. A variety of special populations exist that require special management, including pregnant females, patients with anatomic abnormalities, and instrumented patients.

What is UTI management?

The diagnosis and management of urinary tract infection (UTI) seems, at first, like an ordinary task; however, effective management of the full spectrum of urinary tract conditions and their mimics presents a variety of challenges even for the most seasoned emergency clinician. Urinary tract symptoms are frequent presenting complaints, and knowing how to manage them properly will lower failures, bounce-backs, and complications. Knowing the atypical presentations and when to do a more extensive workup will maximize outcomes and minimize errors in management.

How can an emergency clinician reduce preventable returns?

The emergency clinician can reduce the preventable returns by reinforcing the need to take the full course of antibiotics, by prescribing according to local antibiotic stewardship programs and antibiograms, and by prescribing medications for pain and nausea control in addition to antibiotics at discharge.

Do you need to screen for sepsis if you have pyelonephritis?

“Fever and tachycardia are routine with pyelonephritis, and I only need to screen for sepsis if the patient looks septic.” The definition of sepsis has recently been defined much more broadly by the Surviving Sepsis Campaign guidelines. A patient needs only to have a source of infection and 2 of 24 criteria positive to meet the current definition for the diagnosis of sepsis. Fever and tachycardia, which are frequently present in pyelonephritis, qualify the patient as having sepsis by the Surviving Sepsis Campaign guidelines. Nonetheless, in our view, the criteria for sepsis cannot be interpreted to mean that every patient who presents febrile and tachycardic must be admitted. Rather, the presence of fever and tachycardia should serve as a trigger to treat the fever and tachycardia and to consider further workup for the presence of sepsis as a definite process. IV fluids are indicated as well as treatment of the fever. Further laboratory tests (such as a complete blood count, a basic metabolic profile, and a lactate level) can be considered to see if more criteria for sepsis are present. Select patients can be safely sent home on a case-by-case basis; the first dose of parenteral antibiotics prior to discharge and mandatory follow-up in 24 hours is warranted.

Can a pelvic abscess cause sterile pyuria?

With pelvic inflammatory disease or tuboovarian abscess, irritation of the bladder can also cause sterile pyuria. In women, the diagnosis of pelvic inflammatory disease or tubo-ovarian abscess should always be at least considered when lower abdominal pain and mild or minimal pyuria are present.

Can a fever workup be a UTI?

When performing a fever workup, it can be tempting to assume a diagnosis of UTI or pelvic inflammatory disease in a patient with a fever and trace or 1+ leukocytes. Particularly in the case of a patient with high fever, abnormal vital signs, or immunosuppression, it is important to consider other possibilities.