The specific diagnosis of a urinary tract infection (UTI) needs the isolation of merely one uropathogen from the urine culture. Urine sample should be performed before any antimicrobial therapy is initiated. The urine sample can be obtained in various methods. The simplest method is via a bagged specimen, which includes connecting a plastic bag to the perineum.
• Urine Sampling
There are four different procedures to collect urine sample with variable contamination rate and invasiveness in newborns, toddler & non-toilet-trained children.
The technique used most often in daily routine is, a plastic bag is attached to the cleaned genitalia. It is useful when the urine culture result is negative. Urinary tract infection (UTI) can be denied
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This is suggested for the confirmation of urinary tract infection (UTI) in teenagers who are badly or extremely sick.
If urine sample cannot be cultured within four hours of collection, it should be refrigerated.
Fig. Algorithm for urine testing in children with suspected urinary tract infection (UTI). National Collaborating Centre for Women’s and Chil¬dren’s Health. Urinary tract infection in children. Diag¬nosis, treatment and long-term management. August 2007. London, United Kindom: Royal College of Obste¬tricians and Gynaecologists; 2007
➢ Imaging Studies: Imaging procedures for further more assessment of urinary tract infection (UTI) in children are with the highest ratings from American College of Radiology are.
• Renal and bladder ultrasound.
• Voiding cystourethrography
• Nuclear cystogram
• Renal scan
• Computed tomography (CT)
➢ Ultrasound: During ultrasound a gel is applied on the abdomen and a transducer is placed on the skin. Sound waves are transmitted through the skin to the inner organs. An image is obtained which provides excellent information about the shape and size of the kidneys, ureters, and
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This test has less anatomical details in the image so it is rarely used.
➢ Renal Scan: This test gives the information about the scars of the kidneys, urinary blockage and the comparison about the function of both kidneys. It gives important information when a blockage is observed in ultrasound or when multiple kidney infections have resulted scaring. The test is done by placing an intravenous catheter (IV) for the isotope, and a bladder catheter to drain the urine. The isotope is run intravenously IV. Then a medicine called furosemide (Lasix) is given at a specified time to increase the flow of urine. The uptake and excretion of the isotope are the measured. European Society for Pediatric Urology
Temperature in most office rooms are kept within 69°F to 73°F which is far too cold for an acceptable sample. A sample with a temperature out of the normal range may be immediately received with suspicion because urine will hold temperature in this range as long as it is received in 4 minutes or less.
Kidneys play an important role in the unary tract. They are located on each side of the spine, just below the ribcage. Each kidney is connected to the bladder by ureters. The kidneys have many functions, but the most common functions are to clean waste, control chemicals, and regulate fluid in the body which makes up the urine. Urine collects in the kidney before entering the ureters and as time passes more materials are added. When calcium and oxalate or phosphates are combined in the kidney tiny stones are formed called nephrolithiasis, commonly known as kidney stones. These stones can be very painful and “increases risks for diabetes, high blood pressure, and osteoporosis” (Goldfarb, 2009). About ten percent of all people will have kidney stones in their lifetime. Kidney stones are most frequently found in white men over the age of forty, relatives of kidney stone patients, and people who have formerly had kidney stones.
The procedure of the test is simple hence patients will then be asked to remove their clothes and wrap and cover with a paper cloth around the waist before the Pap test. Patients will then be asked to lie back on the examine table with their legs spread open .Knees have to be bent and feet sitting on rest position. The clinician or gynecologist will insert the lubricated instrument called speculum into the patient’s vagina in a way that will hold open to see the cervix clearly. The clinician will examine to see if there is any visible problem and will gently scrape the surface of the cervix with the help of wooden scraper or spatula to obtain the sample of the cells. The liquid sample will then be smeared on a glass slides and will be brought to a laboratory to analyze where microscope slides will be ready for the test. The clinicians will have to repeat the test if the result is abnormal .Cells abnormalities are divided as follows ASC atypical squamous cells ,AGC,AIS,LSIL.
Lasix is known as the “water pill” it’s a diuretic administrated orally.(1) The active ingredient of Lasix is furosemide, but also includes a number of inactive ingredients including lactose monohydrate NF, magnesium stearate NF, starch NF, talc USP, and colloidal silicon dioxide NF. (1) The peak effects of furosemide are typically seen within the first hour of two after a dose of the medication. (1). Lasix is prescribed for individuals to treat edema that may arise from congestive heart failure, liver cirrhosis or renal disease. (1) In adults, furosemide may also be taken to treat hypertension itself.(1) Furosemide comes in 20, 40, and 80mg tablets as well as oral suspensions.(2) Furosemide is absorbed rapidly from oral suspension at 50 minutes, and from tablets at 87 minutes.(2) Food may slow down the absorption of the drug and alter the bioavalibitly.(1) Furosemide binds to plasma proteins, albumin being the main plasma protein that furosemide binds to, at 91-99%, and peak plasma concentrations increase with the increase of a single dose.(2) Furosemide is excreted through the urine and the remainder is excreted in the feces. (2) The half-life for furosemide is approximately 2 hours but the diuretic effects last 6-8 hours. (2)
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
(5) NIH Publication No. 03–4241. Your Kidneys and How They Work. National Kidney and Urologic Diseases Information Clearinghouse, 2003. http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/
The follwong are the major kidneys tests that are performed on the patient. The first one is the glomerular filtration rate, which is performed to deduce the number of functioning nephrons, which aid in ascertaining the magnitude of kidney impairment in the individual. According to the National Kidney Foundation (2016), the glomerular filtration rate is estimated by measuring the creatinine level in the blood stream and using the results to compute the estimated GFR level. Collecting of urine samples in a 24 hour period and measuring the creatinine concentration also aid s in kidney function
nephrostomy tube because it involves assessment of the tube, the area of skin and assessment of
Handbook of Laboratory and Diagnostic Tests with Nursing Implications (3rd edition). Philadelphia: F.A. Davis Company.
In general, ultrasound waves produced by an instrument called transducer are sent into a patient. Some of the waves are absorbed, but the other portion of these waves are reflected when tissue and organ boundaries are encountered. The echoes produced by the reflected waves are then picked up by the transducer and translated in a visible picture often referred to as ultrasound. In the paragraphs that follow, the physics of how the transducer functions, what the ultrasound waves do, and how the image is formed will be explained.
George Whitesides presentation is focused on how, in a world dominated by money, you can mass produce some type of way to test for diseases in poor areas of the world without sending in a doctor or having a lab. Well his solution was a small urine test, about the size of a postage stamp. These tests are small, lightweight, made of paper and carpet tape and cost close to nothing to produce. The paper wicks bodily fluids, urine for example, and the paper changes color to provide diagnostic information, such as showing how much glucose or protein is present. His goal is to distribute these simple paper diagnostic systems to developing countries, where people with basic training can administer tests and send results to distant doctors with a cellphone. (http://www.ted.com/speakers/george_whitesides.html)
Bacteria can be found in healthy urine, so usually a doctor bases it off symptoms and the lab tests. For the people with reappearing UTIs, and for patients in the hospital, the urine may be seriously infected and civilized. The experiment is resolved by placing part of the urine in a test tube with a certain substance that makes the bacteria multiply, after this process is finished, they can be identified. Another test that can be taken is the sensitivity test, the test tests for sensitivity to different medicines and antibiotics to see which medication is best for treating the persons severe infection. If a person has recurrent UTIs, the doctor may order some extra exams to determine if the person’s urinary tract can get back to being
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
Urinalysis is the analyzing of urine for the diagnosis of diseases. It involves the elimination of the urine using chemical methods, physically or even microscopically. Urinalysis is one of the most common medical laboratory procedures performed because the composition of the urine reflects the status of many different body functions. For instance, diabetic mellitus is often due to sugar present in the urine because the excess sugar in the blood is filtered out by the kidney and being excreted out in the urine. Additionally, urinalysis can predict early stages of kidney failure, a common disease affecting millions each year Fortunately, each person has two kidneys.
Rumack, C. M., Wilson, S. R., & Charboneau, J. W. (2005). Diagnostic ultrasound (3rd ed.). St. Louis: Elsevier Mosby.