Assessment and Nursing Diagnosis for UTI

Urinary Tract Infection

Urinary tract infection is the development of microorganisms in the urinary tract, but under normal circumstances does not contain bacteria, viruses, or other microorganisms. Urinary tract infections can occur anywhere, from the urethra, uterus bladder, ureters (fibromuskuler channel that drains urine from the kidney to the urinary contents) or kidney.

Symptoms of Urinary Tract Infection

• Frequent urination along with the feeling of need to urinate even though there may be a little urine to pass.
• Nocturia: Need to urinate at night.
• Urethritis: Discomfort, irritation or pain in meatus or a burning sensation along anyway urethra with urination (dysuria).
• Pain in the midline suprapubic region.
• Pyuria: Pus in urine or urethral discharge.
• Hematuria: Blood in the urine (not always visible to the eye, but often revealed during urine tests).
• Pyrexia: Mild fever
• Cloudy and foul-smelling urine

Nursing Assessment of Urinary Tract Infection

1. Physical examination : do head to toe
2. History or presence of risk factors :

• Is there a history of previous infections ?
• Is there a history of obstruction of the urinary tract ?

3. The presence of factors predisposing patients to nosocomial infections .

• What about mounting folley catheter ?
• Immobilization in a long time ?
• Is urinary incontinence occurs ?

4. Assessment of clinical manifestations of urinary tract infections

• How voiding pattern ? to detect the occurrence of UTI predisposing factors (encouragement, frequency, and amount)
• Is there dysuria ?
• Is there urgency ?
• Is there hesitancy ?
• Is there a pungent smell of urine ?
• How orine output of volume, color ( grayish ) and the concentration of urine ?
• Is there a suprapubic pain - usually on lower urinary tract infection ?
• Are there any pelvic pain or waist - usually the upper urinary tract infection ?
• Increased body temperature is usually in the upper urinary tract infections.

5. Psychological assessment of patients :
How feelings toward patients and treatment outcome measures that have been done ?
Is there any sense of shame or fear of recurrence of the disease.


Nursing Diagnosis of Urinary Tract Infection

1. Impaired sense of comfort: Acute Pain related to inflammation and infection of the urethra, bladder and other urinary tract structures.

2. Altered Urinary Elimination related to mechanical obstruction of the bladder or other urinary tract structures.

3. Deficient Knowledge: about condition, prognosis, and treatment needs related to lack of resources.

Geriatric Nursing - Alzheimer's Disease Assessment

Assessment in Alzheimer's disease

1 . Activity / rest
Symptoms : Feeling tired
Signs : Day / night restless , helpless , disruption of sleep patterns
lethargy : decreased interest or concern in usual activities , hobbies , inability restates what is read / follow event television programs .
Motor skills disorder , inability to do normal things that have been done , the movement is very useful .

2 . Circulation
Symptoms: History of cerebral vascular disease / systemic . hypertension , embolic episodes ( a predisposing factor ) .

3 . Ego integrity
Symptoms : Suspicious or fear of the situation / person fantasies , misperceptions about the environment , identification of objects and faults of people , hoarding objects : objects that one believes that placement has been stolen , lost multiple , changes in body image and self-esteem perceived .
Signs : Hiding disability ( many reasons are unable to perform an obligation , it may also open the hand without reading the book yet ) , sit and watch the others , the first activity may accumulate objects are not moving and emotionally stable , repetitive movements ( folded unfolded folded cloth ) , hide stuff , or take a walk .

4 . Elimination
Symptoms : Encouragement urination
Signs : Incontinence of urine / feaces , tend to constipation .

5 . Food / fluid
Symptoms : History of hypoglycemia episodes ( a predisposing factor ) changes in taste , appetite , weight loss , denying the hunger / need to eat .
Symptoms: Loss of ability to chew , avoiding / refusing to eat ( probably trying to hide skill ) . and looking increasingly thin ( advanced stage ) .

6. Hiygene
Symptoms: Need help / dependent people
Signs: not able to maintain the appearance, personal habits are lacking, poor cleaning habits, forgetting to go to the bathroom, forget the steps for waste water, unable to find a bathroom, and less interested in or have forgotten at meal time: dependent on others for over the kitchen to cook and prepare food, eat, use cutlery.

7. Neuro-sensory
Symptoms: The denial of the presenting symptoms, especially cognitive changes, and blurred or picture, hypochondria complaints about fatigue, dizziness or headache sometimes. Complaints in cognitive abilities, decision-making, given the pass, drop behavior (observed by nearby). Loss of sensation of proprioception (body position or a certain part of the body in space), and a history of cerebral vascular disease / systemic embolism or hypoxia that lasted periodically (as a predisposing factor) as well as seizure activity (secondary to the brain damage).
Symptoms: Damage communication: aphasia and dysphasia; difficulty in finding the right words (especially nouns); asked repeatedly or conversations with the substance of the word that has no meaning; fragmented, or speech not audible. Lose the ability to read and write stages (loss of fine motor skills).

8. Comfort
Symptoms: A history of serious head trauma (may be a predisposing factor or acceleration factor), traumatic accidents (falls, burns, and so on).
Sign: ecchymoses, lacerations and hostile / attack others.

9. Social interaction
Symptoms: Feeling lost power. psychosocial factors previously; influence of personal and individual that appears to change patterns of behavior that emerge.
Symptoms: Loss of social control, the behavior was not appropriate.

Nursing Assessment for Malignant Lymphoma (Signs and Symptoms)

Nursing Assessment for malignant lymphoma by Doenges, (1999) obtained the following data:

1. Activity / rest

• Symptoms: fatigue, weakness, or general malaise, loss of productivity and decreased exercise tolerance.
• Signs: decreased strength, shoulders slumped, slow road, and other signs that show fatigue.

2. Circulation

• Symptoms: palpitations, angina / chest pain.
• Signs: tachycardia, dysrhythmias, cyanosis face and neck (venous drainage obstruction due to enlarged lymph nodes is a rare occurrence), sclera jaundice and jaundice common in connection with damage to the liver and bile duct obstruction by enlarged lymph nodes, pallor (anemia), diaphoresis, perspiration evening.

3. Ego integrity

• Symptoms: stress factor, fear / anxiety in connection with the diagnosis and possible fear of death, diagnostic tests and treatment modalities (chemotherapy and radiation therapy).
• Signs: various behaviors, such as withdrawing angry, passive.

4. Elimination

• Symptoms: changes in urine and stool characteristics, history of intussusception obstruction, or malabsorption syndrome (infiltration of retro-peritoneal lymph nodes)
• Signs: tenderness in the right upper quadrant on palpation and enlargement (hepatomegaly), tenderness in the left upper quadrant on palpation and enlargement (splenomegaly), decreased urine output, dark urine, anuria (urethral obstruction / renal failure), bowel dysfunction and bladder.

5. Food / fluid

• Symptoms: anorexia / loss of appetite, dysphagia (esophageal pressure) weight loss.
• Signs: swelling of the face, neck, jaw, or right hand (secondary to superior vena cava compensated by enlarged lymph nodes), lower extremity edema in relation to the inferior vena cava obstruction of intra-abdominal lymph node enlargement (non-Hodgkin), ascites (obstruction in the inferior vena cava, in connection with intra-abdominal lymph node enlargement)

6. Neuro-sensory

• Symptoms: nerve pain (neuralgia) indicates nerve root compression by enlarged lymph nodes in the brachial, lumbar, and sacral plexus, muscle weakness, paresthesias.
• Signs: mental status; lethargy, withdrawal, lack of interest in the general vicinity, paraplegia (spinal rod compression of the vertebral body, disc involvement in compression / degeneration or compression of the blood supply to the spinal rod).

7. Pain / comfort

• Symptoms: tenderness / pain on the affected lymph nodes, eg at about mediastinum, chest pain, back pain (vertebral compression) general bone pain (bone involvement limfomatus), pain in the affected area immediately after drinking alcohol.
• Signs: focus on yourself, cautious behavior.

8. Breathing

• Symptoms: dyspnea at work or rest; chest pain
• Symptoms: dyspnea; tachycardia, dry non-productive cough, respiratory distress signal; increased respiratory rate and depth, use of accessory muscles, stridor, cyanosis, husky / laryngeal paralysis (pressure of enlarged nodes in laryngeal nerve).

9. Security

• Symptoms: a history of frequent / infection, mononukleus history, history of ulcer / perforation gastric bleeding, fever, night sweats without chills, redness / general pruritus.
• Symptoms: fever settled without any symptoms of infection, lymph node symmetric, no pain, swollen / enlarged, enlarged tonsils, general pruritus, most areas of melanin pigmentation loss (vitilago).

10. Sexuality

• Symptoms: problem about fertility / pregnancy (while the disease does not affect, but affect treatment), decreased libido.