Page 1854 - Saunders Comprehensive Review For NCLEX-RN

A. Description
1. Cystitis (urinary tract infection [UTI]) is an
inflammation of the bladder from an infection,
obstruction of the urethra, or other irritants (Box 54-
11).
2. The most common causative organisms are Escherichia
coli and Enterobacter, Pseudomonas, and Serratia
species.
3. Cystitis is more common in women, because women
have a shorter urethra than men and the urethra in
the woman is located close to the rectum.
4. Sexually active and pregnant women are most
vulnerable to cystitis.
B. Assessment
1. Frequency and urgency
2. Burning on urination
3. Voiding in small amounts
4. Inability to void
5. Incomplete emptying of the bladder
6. Lower abdominal discomfort or back discomfort;
bladder spasms
7. Cloudy, dark, foul-smelling urine
8. Hematuria
9. Malaise, chills, fever
3
9
10. WBC count greater than 11,000 mm (11.0 × 10 /L) on
urinalysis

Altered mentation is a sign of a UTI in older adults; frequency

and urgency may not be specific symptoms of UTI because of urinary
elimination changes that occur with aging.

C. Interventions

1. Before administering prescribed antibiotics, obtain a
urine specimen for culture and sensitivity, if
prescribed, to identify bacterial growth.
2. Encourage the client to increase fluids up to
3000 mL/day, especially if the client is taking a
sulfonamide; sulfonamides can form crystals in
concentrated urine.
3. Administer prescribed medications, which may
include analgesics, antiseptics, antispasmodics,
antibiotics, and antimicrobials.
4. Maintain an acid urine pH (5.5); instruct the client
about foods to consume to maintain acidic urine.
5. Provide heat to the abdomen or sitz baths for
complaints of discomfort.

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