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members may be a way to screen for the need for genetic testing; since up to 30% of children who acquire pyelonephritis have significant renal scaring after the infection clears, they are a group who especially need genetic testing if appropriate (Godaly et al., 2014).Huether (2017) noted half of all women will have a lower UTI at some time in their life. You mention in your post, “the patients should be examined for abnormalities in the urinary system by carrying out urinalysis, ultrasound, and intravenous pyelography. The physician should look at the clinicalsymptoms of the patient and request for a urine culture to identify the specific type of bacteria causing the disease.” What criteria will you use for choosing what care situations to apply this to? Most uncomplicated lower UTIs are diagnosed using a dipstick testing of the urine and treated with a 3-day course of antibiotics (Arcangelo, 2017). By the time the culture is completed in these situations, the course of antibiotics will be completed. It is recommended cultures be collected in complicated UTI presentation (such as men, children or post-menopausal women); these clients should also be treated for seven days rather than three (Arcangelo, 2017). With symptoms of pyelonephritis, a culture is completed and treatment is extended to 10-14 days (Arcangelo, 2017). I would agree with you in cases where the client fails therapy or repeated infections occur there is a need for further testing such as ultrasound or pyelography, but it would be a small minority of clients. Generally, if a client has progressed to that point I would be referring them to urology for management.ReferencesArcangelo, V. P. (2017). Urinary tract infection. In V. P. Arcangelo, A. M. Peterson, V. Wilbur, & J. A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice (4th ed., pp. 519-526).Philadelphia: Wolters Kluwer.Godaly, G., Ambite, I., & Svanborg, C. (2015). Innate immunity and genetic determinants of urinary tract infection susceptibility.Current Opinion in Infectious Diseases,28(1), 88–96. doi:10.1097/QCO.0000000000000127Huether, S. E. (2017). Alterations of renal and urinary tract function function. In S. E. Huether & K. L. McCance, (Eds.), Understanding pathophysiology(6th ed., pp. 747-769). St. Louis, MO: Mosby.Urinary Tract Infections
A urinary tract infection (UTI) is a general term used to describe an infection of the urethra, prostate, bladder, or kidneys (Arcangelo, 2017).The cause of the infection is often the result of a pathogen that has traveled from the rectal or perineal area into the urethra and bladder and may ascendthe ureters and occasionally continue to the kidney. Bacteria or other causative organisms can be commonly introduced through sexual intercourse which may force periurethral or urethral bacteria into the bladder (Arcangelo, 2017). Organisms can also be introduced through urethrovesical reflux caused bystraining or coughing that can cause urine in the urethra to be pulled back into the bladder, bringing contaminates with it (Hooten, 2012). For infection to occur, the organism must be significantly virulent and in high enough numbers to bypass several host-protect defense mechanisms. These include the