Urinary Tract Infection (ISK) - MInawati Dewi

8/9/2019 Urinary Tract Infection (ISK) - MInawati Dewi

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PART I

INTRODUCTION

A. Background

Urinary Tract Infection (UTI) or urinary tract Infection (UTI) is a state of the presence of

microorganisms in the urinary tract infasi (Agus Tessy, 2001).

Urinary Tract Infection (UTI) is a bacterial infection on the state of the urinary tract

(Enggram, arbara, 1!!"). Urinary tract infections can be on both men an# $omen of all

ages both in chil#ren, a#olescents, #$easa an# a#%ance# age. ut of the t$o se&es is

apparently $omen are more often affecte# than men by age population numbers

appro&imately '1'. Urinary tract infections in certain parts of the urinary tract cause# by

bacteria, especially scherichia coli* rtesi+o an# se%erity increase# $ith +on#iisi li+e

%esi+ouretral reflu&, urinary tract obstruction, urinary static, the use of ne$ urethral

instruments, septicemia. (usan -artin Tuc+er, et al, 1!!"). Urinary tract infection in men is

a result of the sprea# of infection from the urethra as $ell as in $omen. o$e%er, the length

of the urethra an# the #istance bet$een the urethra from the rectum in men an# their

bacterici#al in prostatic flui# to protect men from urinary tract infections. /onseuently UTIs

in men are rare, but $hen it happens this #isor#er sho$ abnormalities function an# structure

of the urinary tract.

Urinary Tract Infection cause# by the presence of pathogenic microorganisms in the urinary

tract. These microorganisms enter through* #irect contact from a nearby infection,

hematogenous, limfogen. There are t$o main lines of UTI, ascen#ing an# hematogenous. In

ascen#ing namely*

1) entry of microorganisms preformance bla##er, among others* anatomical factors $hich

$omen ha%e a shorter urethra than men so the higher inci#ence of UTI, urinary stress factors

#uring micturition, fecal contamination, installation of euipment into the urinary tract

(e&amination sistos+opi+ , the use of a catheter), the presence of an infecte# pressure sores.

2) The increase in the bacteria from the bla##er to the +i#neys* ematogenous namely* often

occurs in patients $hose immune systems are so lo$ that facilitate the sprea# of infection

hematogenous There are se%eral things that affect the structure an# function of the +i#neys,


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ma+ing it easier hematogenous sprea#, namely* the presence of the #am resulte# in total

urinary bla##er #istension, intrarenal #am #ue to scarring, etc.

B. Identification of the Problem

In this paper the authors $ill #iscuss the problem of Urinary Tract Infection (UTI). here the

#isease suffere# by many chil#ren to the el#erly.

C. Purpoe

To +no$ the #efinition, anatomy physiology, etiology, pathology an# ursing /are of

Urinary Tract Infection (UTI) itself.

D. !ethod of "riting

In con#ucting this stu#y, $e use# the metho# is the metho# of literature.

#. $%tematic "riting

C&APT#R I* Intro#uction ac+groun# containing, I#entification 3roblem, 4b5ecti%es,

-etho#s, an# ystematics.

C&APT#R II* /ontent $hich contains* The basic concept of #isease (anatomy an#

physiology of the urinary tract, glomerulonephritis un#erstan#ing, causes, pathophysiology,

clinical manifestations, #iagnostic e&aminations, an# management). As $ell as nursing care

(assessment, #iagnosis, planning an# e%aluation)

C&APT#R III* 3enutupyang contains /onclusions an# 6ecommen#ations


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C&APT#R II

R#'I#" O( TOR)

A. BA$IC CONC#PT$ O( DI$#A$#

*. Anatom% Ph%iolog% Urinar% $%tem

Urinary system consists of se%eral organs, namely the +i#ney, ureter, bla##er (bla##er), an#

urethra.

a. +i#ney

The +i#neys are organs berbetu+ t$obean $hich is locate# in the posterior part of the

ab#omen, one on each si#e of the %ertebral column thoracic 12th until the thir# lumbar

%ertebra, $here the right +i#ney usually lies slightly lo$er than the left +i#ney because of its

association $ith heart. (atson, 2002, hlm.7"8) .In +i#ney a#ults 1217 cm in length, $i#th 9

cm :i#ney %ital functions*

1) The secretion of urine an# e&pen#itures of the human bo#y.

2) As homeostasis.

7) E&pen#itures substances to&ins ; poisons

8) Treat the $ater balance of the atmosphere,

') -aintain aci#base balance of bo#y flui#s

9) -aintain a balance of salts an# other substances in the bo#y.

:i#ney #i%i#e# into e&ternal part calle# the corte& an# the internal parts are +no$n sebag ; ai

me#ulla. In humans, each +i#ney is compose# of appro&imately 1 million nefron.efron,

$hich is regar#e# as a functional unit of the +i#ney, consisting of a glomerulus an# a

tubulus.eperti as capillaries, glomerular capillary $all is compose# of layers of en#othelial

an# basement membrane. Epithelial cells locate# on one si#e of the basement membrane an#

en#othelial cells on the other si#e.


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into three parts* the pro&imal tubule, ansa enle, an# #istal tubules. =istal tubule

pengumpul.=u+tus unite# to form #ucts running through the renal corte& an# me#ulla to

empty its contents into the renal pel%is.an# $eighs bet$een 1201'0 grams.

Urine formation process begins $hen the bloo# flo$s through the glomerulus. hich is the

initial glomerular nephron structure, compose# of capillary tuft tuftrecei%ing bloo# from

%asa afferent an# bloo# flo$ through the %asa e%eren behin#. loo# pressure #etermines ho$

much pressure an# spee# of bloo# flo$ through the bloo# glomerulus.:eti+a $al+e# past this

structure, filtration occurs. ater an# small molecules $ill pass $hile large molecules are

retaine# in the bloo# stream. >lui# is filtere# through the $alls of the glomerular capillary

tuftfla+es an# enter the tubules. This liui# is +no$n as ?>itrat?.

In normal con#itions, less than 20 of the plasma that passes through the glomerulus are

filtere# into the nephron $ith the amount that reaches appro&imately 1"0 liters of filtrate per

#ay. The filtrate is %ery similar to bloo# plasma $ithout large molecules (proteins, re# bloo#

cells, $hite bloo# cells an# platelets) essentially consists of $ater, electrolytes, an# other

small molecules. In tubules, this substance selecti%ely partially re #iabsopsi other

#arah.ubstansi secrete# into the bloo# into the fitrat $hen fitrat flo$s along the tubule. >itrat

$ill be concentrate# in the #istal tubules an# collecting #ucts, an# then into the urine that

reaches the renal pel%is. As a substance, such as glucose, is normally entirely absorbe# bac+

into the tubules an# $ill not appear in the urine.

The process of reabsorption an# secretion in the tubules often inclu#e acti%e transportation

an# reuire the use of energy. @arious substances are normally filtere# by the glomerulus,

reabsorbe# by the tubules an# e&crete# into the urine inclu#e so#ium, chlori#e, bicarbonate,

potassium, glucose, urea, creatinine, an# uric aci#.

Urine is forme# in the +i#ney functional units calle# nephrons. Urine is forme# in this

nephron $ill flo$ into the renal tubules an# collecting #ucts are then fuse# to form the renal

pel%is. Each $ill form the pel%ic ureter. The ureter is a long tube $ith a $all that consists

mostly of muscle polos.4rgan connects each +i#ney to the bla##er an# ser%es as a pipe to

channel the urine.


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b. Ureter

/onsists of t$o pipelines each concatenate# from the +i#ney to the bla##er (bla##er) 2'70

cm in length $ith a cross section of 0.' cm. Ureter partially locate# $ithin the ab#ominal

ca%ity an# partially locate# in the pel%ic ca%ity.

Ureter $all layer consists of

1) The outer $all of connecti%e tissue (fibrous tissue)

2) The mi##le layer of smooth muscle

7) The ne&t layer in the mucosal layer.

Bining the $alls of the ureter causing peristaltic mo%ements once e%ery ' minutes that $ill

encourage the urine into the bla##er (bla##er).

Ureter runs almost %ertically #o$n$ar# along the psoas an# muscular fascia co%ere# by

pe#to#inium. arro$ing of the ureter occurs in a ureter left renal pel%is, bloo# %essels,

ner%es an# surroun#ing %essels ha%e sensory ner%es.

c. la##er (bla##er)

The bla##er is a hollo$ organ locate# 5ust behin# the anterior os.pubis. This organ berungsi

as a temporary container to hol# urine. -ost of the bla##er $all is compose# of smooth

muscle calle# muscle muscular #etrusor.:ontra+si mengososng+an primarily ser%es the

bla##er #uring urination (urinary). Urethra emerges from the bla##erC in males, the urethra

runs through the penis an# the $oman empties right anterior %aginal sebela. In the male

prostate glan# locate# 5ust belo$ the nec+ of the bla##er surroun#ing the urethra in posterior

an# been literally. Urinalysis e&ternal sphincter is a muscle %olunteers roun#e# to the initial

process control urination.

:i#ney #i%i#e# into e&ternal part calle# the corte& an# the internal parts are +no$n sebag ; ai

me#ulla. In humans, each +i#ney is compose# of appro&imately 1 million nefron.efron,

$hich is regar#e# as a functional unit of the +i#ney, consisting of a glomerulus an# a

tubulus.eperti as capillaries, glomerular capillary $all is compose# of layers of en#othelial

an# basement membrane. Epithelial cells locate# on one si#e of the basement membrane an#

en#othelial cells on the other si#e.


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pengumpul.=u+tus unite# to form #ucts running through the renal corte& an# me#ulla to

empty its contents into the renal pel%is.

Urine formation process begins $hen the bloo# flo$s through the glomerulus. hich is the

initial glomerular nephron structure, compose# of capillary tuft tuftrecei%ing bloo# from

%asa afferent an# bloo# flo$ through the %asa e%eren behin#. loo# pressure #etermines ho$

much pressure an# spee# of bloo# flo$ through the bloo# glomerulus.:eti+a $al+e# past this

structure, filtration occurs. ater an# small molecules $ill pass $hile large molecules are

retaine# in the bloo# stream. >lui# is filtere# through the $alls of the glomerular capillary

tuftfla+es an# enter the tubules. This liui# is +no$n as ?>itrat?.

In normal con#itions, less than 20 of the plasma that passes through the glomerulus are

filtere# into the nephron $ith the amount that reaches appro&imately 1"0 liters of filtrate per

#ay. The filtrate is %ery similar to bloo# plasma $ithout large molecules (proteins, re# bloo#

cells, $hite bloo# cells an# platelets) essentially consists of $ater, electrolytes, an# other

small molecules. In tubules, this substance selecti%ely partially re #iabsopsi other

#arah.ubstansi secrete# into the bloo# into the fitrat $hen fitrat flo$s along the tubule. >itrat

$ill be concentrate# in the #istal tubules an# collecting #ucts, an# then into the urine that

reaches the renal pel%is. As a substance, such as glucose, is normally entirely absorbe# bac+

into the tubules an# $ill not appear in the urine.

The process of reabsorption an# secretion in the tubules often inclu#e acti%e transportation

an# reuire the use of energy. @arious substances are normally filtere# by the glomerulus,

reabsorbe# by the tubules an# e&crete# into the urine inclu#e so#ium, chlori#e, bicarbonate,

potassium, glucose, urea, creatinine, an# uric aci#.

#. urethra

The urethra is a narro$ channel that originate in the bla##er that functions +emiih channel

$ater out.

In males consists of*

1) The urethra prostaria

2) membranous urethra

7) ca%ernous urethra.


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-ale urethral lining consists of a layer of the mucosa (innermost layer), an# the submucosal

layer. In a##ition to the channel e&cretion male urethra ser%es as the repro#ucti%e tract ($here

the #ischarge of sperm).

The urethra in $omen is locate# behin# the symphysis pubis, runs tilte# slightly up$ar#, 7

8 cm in length. Bining of the urethra in $omen consists of the tunica muscularis (outer) layer

spongeosa a ple&us of %eins, an# the mucosal layer (inner layer). >emale urethral opening is

locate# on the top of the %agina (bet$een clitoris an# %agina) an# urethra here only as a

channel e&cretion.

+. Undertanding Urinar% Tract Infection

Urinary Tract Infection (UTI) or urinary tract Infection (UTI) is a state of the presence of

microorganisms in the urinary tract infasi (Agus Tessy, 2001).




apparently $omen are more often affecte# than men by age population numbersappro&imately '1'. Urinary tract infections in certain parts of the urinary tract cause# by




a result of the sprea# of infection from the urethra as $ell as in $omen. o$e%er, the length

of the urethra an# the #istance bet$een the urethra from the rectum in men an# their

bacterici#al in prostatic flui# to protect men from urinary tract infections. /onseuently UTIs

in men are rare, but $hen it happens this #isor#er sho$ abnormalities function an# structure

of the urinary tract.

,. Pathoph%iolog% and Caue of Urinar% Tract Infection

Urinary Tract Infection cause# by the presence of pathogenic microorganisms in the urinary

tract. These microorganisms enter through* #irect contact from a nearby infection,

hematogenous, limfogen. There are t$o main lines of UTI, ascen#ing an# hematogenous. In

ascen#ing namely*


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1) entry of microorganisms preformance bla##er, among others* anatomical factors $hich

$omen ha%e a shorter urethra than men so the higher inci#ence of UTI, urinary stress factors

#uring micturition, fecal contamination,

installation of euipment into the urinary tract

(cystoscopy e&amination, catheter), the presence of an infecte# pressure sores.

2) The increase in the bacteria from the bla##er to the +i#neys

ematogenous ie* common in immunocompromise# patients system that facilitate the sprea#

of infection hematogenous There are se%eral things that affect the structure an# function of

the +i#neys, ma+ing it easier hematogenous sprea#, namely* the presence of the #am resulte#

in total urinary bla##er #istension, intrarenal #am #ue to scarring, etc.

At the a#%ance# age of UTI is often cause# #ue to*

1) The rest of the urine in the bla##er in#uce# increase bla##er emptying incomplete or

ineffecti%e.

2) -obility #ecrease#

7) utrients are often poorly

8) ystem imunnitas yng #ecrease#

') The e&istence of barriers in the urinary tract

9) The loss of bacterici#al effects of prostate secretion.

6esi#ual urine in the bla##er that increase# the lea# to e&cessi%e #istensii causing pain, this

situation results in a #ecrease in resistance to bacterial in%asion an# urinary resi#ue into

bacterial gro$th me#ia $hich in turn $ill lea# to impaire# renal function itself, then this state

of hematogenous sprea# to the urinary tract suluruh . In a##ition, some of the things that

pre#ispose to UTI, among others* obstruction of urine flo$ pro&imal mena+ibta+an

pressuriDe# flui# accumulation in the renal pel%is an# ureter calle# hi#ronefroses. /ommon

causes of obstruction are* renal scarring, stones, prostate hypertrophy neoplasms an# are

often foun# in men o%er the age of 90 years.


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a. The types of microorganisms that cause UTI, among others*

1) Escherichia coli* !0 cause of uncomplicate# UTI (simple)

2) 3seu#omonas, 3roteus, :lebsiella* causes of complicate# UTI

7) Enterobacter, epi#emi#is staphylococci, enterococci, an#other.

b. The pre%alence of the causes of UTI in the el#erly, among others*

1) The rest of the urine in the bla##er in#uce# increase bla##er emptying less effecti%e

2) -obility #ecrease#

7) utrients are often poorly

8) #ecrease# immune system, both cellular an# humoral

') The e&istence of barriers to the flo$ of urine

9) The loss of bacterici#al effects of prostate secretion.

-. $ign and $%mptom of Urinar% Tract Infection

a. ymptoms ymptoms of common +emihsecara tract infection often inclu#e*

1) The symptoms are %isible, freuent urge to urinate onset

2) urning an# stinging #uring urination

7) >reuent urination, but the urine in small amounts (oliguria)

8) The presence of re# bloo# cells in the urine (hematuria)

') Urine #ar+ an# mur+y, as $ell as the pungent o#or of urine

9) =iscomfort in the area of the renal pel%is

) 3ain in the area abo%e the pubic

") feeling #epresse# in the lo$er ab#omen

!) >e%er


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10) In ol#er $omen also sho$e# similar symptoms, yaiu fatigue, loss of strength, fe%er

11) >reuent urination at night

If the infection is left alone, the infection $ill sprea# from the bla##er to the +i#neys.

ymptoms symptoms of an infection of the +i#ney associate# $ith symptoms of cystitis,

fe%er, chills, bac+ pain, nausea, an# %omiting. /ystitis an# +i#ney infections, inclu#ing the

urinary tract infection.

ot e%eryone $ith a urinary tract infection can be seen signs signs an# symptoms, but

generally seen se%eral symptoms, inclu#ing*

1) a strong urge to urinate

2) burning sensation #uring urination

7) The freuency of urination is often the amount of urine (oliguria)

8) The presence of bloo# in the urine (hematuria)

b. ymptoms ymptoms of urinary tract infections are often specifically inclu#e*

1) acute pyelonephritis.

In this type, a +i#ney infection may occur after the sprea# of infections that occur in the

bla##er. Infection of the +i#neys can lea# to a sense of alit on the upper bac+ an# pel%is,

high fe%er, sha+ing from the col#, an# nausea or %omiting.

2) /ystitis.

Inflammation or infection of the bla##er may be able to cause #istress in the pel%is, lo$er

ab#ominal #iscomfort, pain #uring urination, an# the smell of urine mnyengat.

7) Urethritis.

Inflammation or infection of the urethra causing a burning sensation #uring urination. In men,

urethritis can cause interference on the penis.


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igns an# symptoms of a urinary tract infection base# on age ranges, inclu#ing*

a. ymptoms in infants an# young chil#ren is often the case, inclu#e*

1) The ten#ency for high fe%er of un+no$n origin, especially if associate# $ith a sign a sign

of a hungry baby an# illness such as fatigue an# lethargy.

2) The pain an# the smell of urine that is not ba#. (3arents are generally not able to i#entify

urinary tract infection urine 5ust by +issing her baby. Therefore, a me#ical e&amination is

reuire#).

7) Urine turbi#. (If urine is clear, it is 5ust similar to the #isease, although it can not be

%erifie# that the baby is free from urinary tract infections).

8) pain in the ab#omen an# bac+.

') %omiting an# pain in the ab#ominal area (in infants)

9) 5aun#ice (yello$ s+in an# eyes $hite) in infants, especially babies $ho set it eight #ays

ol#.

b. ymptoms of urinary tract infection in chil#ren chil#ren, inclu#e*

1) =iarrhea

2) /rying en#lessly that can not be stoppe# $ith a certain business (eg, fee#ing, an# carrying)

7) Boss of appetite

8) >e%er

') ausea an# %omiting

9) In chil#ren chil#ren, be#$etting also in#icates the symptoms of urinary tract infection.

) ea+

") The presence of pain #uring urination.


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c. >or chil#ren $ho are ol#er, the symptoms of $hich are sho$n in the form of*

1) pain in the pel%is an# lo$er bac+ ($ith a +i#ney infection)

2) freuent urination

7) inability mempro#u+asi urine in normal amounts, in other $or#s, the small amount of

urine (oliguria)

8) can not control spen#ing bla##er an# bo$els

') pain in the ab#omen an# pel%ic area

9) pain #uring urination (#ysuria)

) urine is clou#y an# has an o#or pungent

#. ymptoms of urinary tract infections in a#ults, inclu#e*

1) ymptoms that in#icate +emihringan tract infection (eg, cystitis, urethritis) inclu#es*

a) pain in the bac+

b) the presence of bloo# in the urine (hematuria)

c) the presence of protein in the urine (proteinuria)

#) urine clou#y

e) inability to urinate e%en though no or their urine out

f) fe%er

g) urge to urinate at night (nocturia)

h) no appetite

i) $ea+ an# lethargic (malaise)

5) pain #uring urination (#ysuria)

+) pain in the upper part of the pubic area (in $omen)


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l) #iscomfort in the area of the rectum (in men)

2) The symptoms that in#icate a more se%ere urinary tract infections (eg pyelonephritis)

inclu#es*

a) /hills

b) high fe%er an# sha+ing

c) nausea

#) %omiting (emesis)

e) pain un#er the ribs

f) pain in the area aroun# ab#ome

. Diagnotic #/amination

a. Urinalysis

1) Beu+osuria or pyuria* is one of the important e%i#ence of UTI. Beu+osuria positi%e if there

are more than ' leu+ocytes ; highpo$er fiel# (B3) urine se#iment

2) hematuria* hematuria positi%e $hen there is a '10 erythrocytes ; B3 urine se#iment.

aematuria cause# by %arious pathological states either glomerular #amage or urolithiasis.

b. acteriological

1) -icroscopic

2) bacterial cultures

c. Urine culture to i#entify any specific organism

#. /alculate the colony* colony count of about 100,000 colonies per milliliter of urine from

the urinary flo$ capacity of the specimens in the mi##le or catheter is consi#ere# as the main

criteria of infection.


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The use of common me#ications inclu#e* sulfiso&aDole (gastrisin), trimethoprim ;

sulfametho&aDole (T-3 ; -F, actrim, eptra), ampicillin or amo&icillin sometimes use#,

but E. coli $as resistant to these bacteria. 3yri#ium, a urinary analgesic in#igenous 5ug use#

to re#uce the #iscomfort cause# by infection.

The use of #rugs in the el#erly shoul# be consi#ere# the li+elihoo# is*

a. Impaire# absorption in the #igesti%e tract

b. Interansi #rug

c. i#e effects of #rugs

#. =isruption of #rug accumulation especially #rugs e&cretion through the +i#neys

The ris+ of #rug a#ministration in the el#erly in relation to renal physiology*

a. Effects of #rug nefrotosi+

b. Effects of #rug to&icity

The use of #rugs in the el#erly shoul# setiasp $hen e%aluate# their effecti%eness an# shoul#

al$ays ans$er the uestions as follo$s*

a. Are #rugs gi%en really useful ; necessaryG

b. Are #rugs gi%en cause things better or malh membahnaya+anG

c. Is a gi%en #rug $oul# still be appropriateG

#. /an some #i+uranngi #rug #osage or #iscontinue#G

B. NUR$IN1

1. Assessment

a. 3hysical e&amination* #one hea# to toe an# bo#y systems

b. istory or presence of ris+ factors*


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1) Is there any history of pre%ious infectionG

2) Is there any obstruction in the urinary tractG

c. The presence of factors that pre#ispose patients to nosocomial infections.

1) o$ #o the foley catheterG

2) ImmobiliDation in a long time.

7) hat happens urinary incontinenceG

#. Assessment of clinical manifestations of urinary tract infections

1) o$ #oes the pattern of the patient to urinateG to #etect the factors pre#isposing to UTI patients (impulse, freuency, an# amount)

2) Is there #ysuriaG

7) hat is the urgencyG

8) Is there hesitancyG

') Is there a pungent smell of urineG

9) o$ orine %olume output, color (grayish) an# the concentration of urineG

) Is thereusually suprapubic pain in the lo$er urinary tract infectionG

") Is there nyesi pangggul or $aistusually in the upper urinary tract infectionG

!) Increase# bo#y temperature is usually in the upper urinary tract infection.

e. Assessment of patient psychology*

1) o$ #i# the patient on treatment outcomes an# actions that ha%e been #oneG

2) A#a+a+an feelings of shame or fear of recurrence of the #isease.

+. Nuring Diagnoi

a. infection $ith the bacteria in the urinary tract.


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b. /hanges in urinary elimination pattern (#ysuria, encouragement, freuency, an# or

nocturia) associate# $ith UTI.

c. 3ain associate# $ith UTI.

#. Bac+ of +no$le#ge relate# to the lac+ of information about the #isease, pre%ention

metho#s, an# home care instructions.

,. Inter2ention 3Planning 4 Implementation5

3lan

a. Infections associate# $ith the presence of bacteria in the urinary tract

1) 3urpose*

After the act of nursing for 7 & 28 hours the patient sho$e# no signs of infection.

2) /riteria 6esults*

a) %ital signs $ithin normal limits

b) The %alue of a negati%e urine culture

c) Urine colore# translucent an# #o not smell

7) Inter%ention*

a) Assess the patientHs bo#y temperature e%ery 8 hours an# report if the temperature is abo%e

7".'0 /

6ational*

@ital signs in#icate a change in the bo#y

b) 6ecor# the characteristics of urine

6ational*

To fin# ; i#entify in#ications of progress or #e%iations from e&pecte# results.

c) Instruct the patient to #rin+ 27 liters if there are no contrain#ications


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6ational*

To pre%ent urinary stasis

#) -onitor ree&amination of urine +ultuur an# sensiti%ity to #etermine response to therapy.

6ational*

:no$ing ho$ far the effects of treatment on the circumstances of the patient.

e) Instruct the patient to empty the bla##er urinary +omlit e%ery time.

6ational*

To pre%ent bla##er #istension.

f) 3ro%i#e perineal care, +eep it clean an# #ry.

6ational*

To maintain cleanliness an# a%oi# bacteria that ma+e infection of the urethra

b. /hanges in urinary elimination pattern (#ysuria, encouragement, an# the freuency or

nocturia) associate# $ith UTI.

1) 3urpose*

After the act of nursing for 7 & 28 hour client can a#euately maintain the pattern of

elimination.


a) /lients can urinate e%ery 7 hours

b) The client no #ifficulty in micturition

c) /lients can A: an# micturition

7) Inter%ention*

a) -easure an# recor# the urine e%ery time urination

6ational*


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To #etermine the change in color an# to #etermine the input ; output

b) uggest to urinate e%ery 27 hours

6ational*

To pre%ent the buil#up of urine in the bla##er.

c) palpation of the bla##er e%ery 8 hours

6ational*

To facilitate :lian in urination.

#) Assist the client to the restroom, use a be#pan ; urinal.

6ational*

To facilitate the client to urinate.

e) Assist clients get comfortable poosisi urination.

6ational*

o that the client is not #ifficult to urinate.

c. 3ain associate# $ith UTI

1) 3urpose*

After the act of nursing for 7 & 28 hours the patient feel comfortable an# pain $as re#uce#.


a) 3atients say ; no complaints at the time of micturition

b) The bla##er is not straine#

c) 3assien seeme# calm

#) e&pression calm

7) Inter%ention*

a) Assess inensitas, location an# aggra%ating factors or relie%e pain.


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6ational*

e%ere pain in#icates infection.

b) 3ro%i#e a#euate rest perio#s an# the le%el of acti%ity that can be tolerant.

6ational*

/lients can rest in peace an# be able to rela& the muscles.

c) Encourage #rin+ing lots of 27 liters if no contra in#ications.

6ational*

To assist clients in urination.

#)


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In or#er for the client to ha%e passion an# $ant empathy for care an# treatment.

c)


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c. @oi#ing pattern changes, freuent urination, an# little by little, feeling the urge to pee

#ripping after urination.


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C&APT#R III

C7O$IN1

A. CONC7U$ION

In this chapter the authors to conclu#e, among others*

In the stu#y the authors conclu#e the #ata through $i#esprea# inci#ence of cases, inter%ie$,

physical e&amination, history or presence of ris+ factors, clinical manifestations of urinary

tract infections, the psychology of the patient, not because the authors #i# not assess #irectly

on the client, but the author only gets the #ata from the illustration case in the can.

=iagnose e&ist in theory but none of the cases $as a change in the pattern of elimination of

urine (#ysuria, encouragement, freuency, an# or ho+turia) relate# to mechanical obstruction

of the bla##er or urinary structures, etc., $hile the e&isting #iagnosis in theory an# in the case

of infections , impaire# sense of comfort pain an# lac+ of +no$le#ge.

In the planning of nursing authors a#5uste# for current clients e&tensi%ely stu#ie# an# ma#e it

a priority issue in accor#ance basic human nee#s accor#ing to -aslo$ an# the main nee#s of

clients.

In the implementation of the authors nursing nursing action base# on the plan of action that

has been ma#e.

In the e%aluation, the authors can conclu#e that all #iagnoses can be resol%e# an# nursing

goals achie%e#. ut the problem I can not seem to #ocument the #ata $ell so untu+membuat

e%aluation e&periencing #ifficulties, this is because penulishanya get #ata base# on the

gui#elines of cases.




apparently $omen are more often affecte# than men by age population numbers

appro&imately '1'. Urinary tract infections in certain parts of the urinary tract cause# by


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a result of the sprea# of infection from the urethra as $ell as in $omen.

. A=@I/E

>or rea#ers, colleagues an# $riters in or#er to prioritiDe problems accor#ing the basic human

nee#s of the client an# the main problem, although #ocumentation of #ata can not be #one

because the #ata obtaine# only by illustrati%e case e&tensi%ely but a plan of action can be

#one $ell. It is recommen#e# in or#er to #ocument all the #ata on the client #egan %erbal an#

ob5ecti%e so that it can ma+e a goo# e%aluation to support goo# #ocumentation.


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R#(#R#NC#$

=oenges, -arilyn E. (1!!!). ursing care plan* gui#elines for planning an# #ocumenting

patient care. Interpretation* I -a#e :ariasa, i ma#e umar$ati. E#ition* 7. Ja+rta* E


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TAB7# O( CONT#NT$

>46E46=

Ii TABE 4> /4TET

/A3TE6 I IT64=U/TI4

A. ac+groun#

. I#entification of 3roblem

/. 4b5ecti%e

=. -etho# of riting

E. ystematics riting

/A3TE6 II* 6E@IE 4> TE46K

A. AI/ /4/E3T 4> =IEAE

1. Anatomy 3hysiology

2. =efinition

7. 3athophysiology an# /auses of

8. igns an# ymptoms of

'. =iagnostic E&amination

9. -anagement of -e#ical

. U6I<

1. Assessment

2. ursing =iagnosis

7. Inter%ention (3lanning ; Implementation)

8. E%aluation

/A3TE6 III /B4I<

A. /onclusions

. 6ecommen#ations

6E>E6E/E


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PR#(AC#

-y gratitu#e are e&ten#e# to go# almighty one, because on his permission, I can finish a

paper entitle# ?Urinary Tract Infections? in accor#ance $ith the time. As for this paper I

create# as a test of English assignment $hich $ill be the sub5ect of %alue a##ition in the

English language.

Urinary tract infection is a #isease that causes the microorganisms. Urinary tract infections

can be on both men an# $omen of all ages both in chil#ren, a#olescents, #$easa an#

a#%ance# age. Urinary tract infections in certain parts of the urinary tract cause# by bacteria,

especially scherichia coli* rtesi+o an# se%erity increase# $ith +on#iisi li+e %esi+ouretral

reflu&, urinary tract obstruction, urinary static, the use of ne$ urethral instruments,

septicemia. then, $ill be #iscusse# more clearly in this paper.

Thus this paper I create# an# realiDe# the shortcomings in the use of language an# accuracy

in the preparation of the sentence, for that I as+ the a#%ice of criticism that $oul# be able to

buil# an# ma+e this paper is much better. I hope this paper can be useful for rea#ers, than+

you.


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A-A * -IAATI =EI

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PRO1RA! TIN11I I7!U 8#$#&ATAN

$TI8#$ D#7I&U$ADA D#7ITUA

TA&UN A9ARAN +:*4+:*0

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Urinary Tract Infection (ISK) - MInawati Dewi

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