Urinary elimination depends on the function of the kidneys, ureters, bladder and urethra. Urinary tract infection is the term given to any infection of part of the urinary system. The urinary system consists of the kidneys, the bladder, the ureters (tubes that connect the kidneys to the bladder) and the urethra (tube connecting the bladder to the outside world), and is responsible for excreting some liquid wastes from the body. The kidneys act as filtration units to remove some of the body’s wastes from the blood, such as urea and ammonia, which are then passed from the kidney as urine.
The urine passes through the ureters into the bladder and then leaves the body through the urethra. Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi but does contain fluids, salts, and waste products. An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.
In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection can occur. An infection limited to the urethra is called urethritis. If bacteria move to the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis. Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in both men and women. The urinary system is structured in a way that helps ward off infection.
The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladder helps wash bacteria out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. But despite these safeguards, infections still occur. Recurrent UTI in this patient lead to renal calculi and therefore had permanent indwelling catheter IDC. Due to renal calculi his urine was haematuric. Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection.
An enlarged prostate gland also can slow the flow of urine, thus raising the risk of infection. A common source of infection is catheters, or tubes, placed in the urethra and bladder. A person who cannot void or who is unconscious or critically ill often needs a catheter that stays in place for a long time. Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life. Bacteria on the catheter can infect the bladder, so hospital staff takes special care to keep the catheter clean and remove it as soon as possible.
Pain control is one of the nurse’s responsibilities in patient with UTI. A nurse performs a comprehensive assessment of pain including location characteristics onset, duration, frequency, quality, intensity or severity and precipitating factors. A nurse provides optimum pain relief by administering urinary alkalinisers as ordered to promote comfort. Monitoring for urinary elimination including frequency, consistency odour, colour as appropriate to assess elimination status. Administer antimicrobial drugs as ordered to eliminate symptoms by inhibiting bacterial growth.
Residents with UTI should be assessed every shift by trained nursing staff for signs and symptoms suggesting progression of infection and/or worsening of overall condition like rigours (indicate ongoing bacterial sepsis) ongoing dysuria, frequency or haematuria, fever, and dehydration. Conclusion Nursing care for elderly patients with Parkinson disease can be very challenging. Parkinson’s disease can result into various complications that can aggravate and worsen the situation. Like in this patient, complications like dysphagia and UTI make the medical situation and treatment more complex.
If the patients appear thin or malnourished because of dysphagia a dietician for example can order a calorie count and suggest lab tests, such as prealbumin level to determine his nutritional status (Smith, 2003) Additionally, wearing off can also occur after a few years using levodopa to treat Parkinson’s disease. Parkinson disease is a slowly progressive disease, so the symptoms they experience will change and evolve over time. Nursing care should manage wearing-off by changing the treatments. Patients with Parkinson’s disease require detailed attention to their speech, nutrition, drug therapies, physical capabilities and complications.
Nursing care involved listening carefully to their speech and other needs. By using the best nursing care plan one can advise the medical staff about the best way to treat and help their patients.
References
“Living With Parkinson’s Disease” (2007) Parkinson’s Disease Information. Retrieved October 8, 2008, from http://www. parkinsons. org/ “Parkinson’s Disease. ” (2007). Health Encyclopedia. Retrieved October 8, 2008, from http://www. uphs. upenn. edu/ “Parkinson’s Disease Facts, Disease Prevention and Treatment Strategies. ” (2002). Personal Health Lifestyles, Inc. Retrieved October 8, 2008, from