Nurs 6501 Week ten Post.docx - Nurs 6501 Week Ten Discussion Main Post The Pathophysiology of Lower and Upper Urinary Tract Infections A Urinary tract

Nurs 6501 Week ten Post.docx - Nurs 6501 Week Ten...

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Nurs 6501 Week Ten Discussion Main Post The Pathophysiology of Lower and Upper Urinary Tract Infections A Urinary tract infection (UTI) is a condition whereby bacteria from the gut flora multiplies through the urinary epithelium (Huether & McCance, 2017). The urinary tract consists of the urethra, prostate, ureter, bladder and kidney. There are various causes and risk factors for UTI such as antibiotic use, prematurity of newborns, sexual intercourse, indwelling urinary catheter use, urinary obstruction amongst others. UTI can be complicated or uncomplicated, and they can either affect the lower urinary tract or upper urinary tract. Uncomplicated UTI refers to UTI that occurs is otherwise healthy individuals, while complicated UTI refers to the infections of the lower or upper urinary tract that is refractory to therapy, and linked to an underlying sequela (Najar, Saldanha, & Banday, 2009). Lower UTI (Acute Cystitis): Cystitis refers to the inflammation and infection of a portion or entirety of the lower urinary tract, which includes the bladder, urethra and kidneys. Common infecting microorganisms include E. coli, Staphylococcus, Pseudomonas and Klebsiella (McPhee & Hammer, 2014). It can be mild or more advanced, like in the case of ulcerative cystitis or gangrenous cystitis. Initial bacteremia is usually triggered by back flow of gram-negative bacilli into the urethra, which then travels through the urinary tract from the bladder, to the ureter and then the kidney (Huether & McCance, 2017). Furthermore, the type-1 fimbriae of the uropathic E. coli that are resistant to flushing during urination, binds to latex catheters and receptors of the uroepithelium.
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Upper UTI (Pyelonephritis): Pyelonephritis on the other hand refers to the infection of the upper urinary tract which involves the ureter, renal pelvis and interstitial space. It is commonly caused by an obstruction such as kidney stones, or retrograde flow of urine from the bladder. The ascension of the bacteria is can also be facilitated by conditions such as pregnancy and ureteral obstruction, as these conditions inhibit ureteral peristalsis ( Davis & Flood , 2011). Furthermore, bacteria that reach the renal pelvis can penetrate the renal parenchyma through the collecting ducts and disrupt the renal tubules, causing inflammation, or leading to abscess formation and necrosis of the tubules in severe acute cases. In chronic cases, there is recurrent infection and destruction of the tubules, leading to scarring of both kidneys.
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