NURS 6501 Discussion Paper

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NURS 6501, N-21 Urinary tract infections (UTIs) are usually caused by bacteria and are common. Symptoms of both upper and lower infections are similar; therefore, it is important for advanced practice nurses (APNs) to be able to determine the pathophysiology of upper and lower UTIs. The purpose of this discussion is to evaluate the similarities and differences between upper and lower UTIs, clinical manifestations, treatments, and factors affecting all of these things. UTIs are infections that may occur anywhere in the urinary tract such as the urethra, bladder, ureters, and kidneys. Typically UTIs are caused by bacteria from the gut flora and are inflammation of the urinary epithelium. Because of the shorter length of the urethra, women are more susceptible to UTIs. Most infections are mild without complications (Huether, 2012, p. 747). UTIs are either in the lower or upper urinary tract. The lower tract consists of the bladder, whereas the upper tract is the ureter, renal pelvis, and interstitium. Acute cystitis is bladder inflammation and is the usual site of UTIs. Bacteria, fungus, and parasites may cause infections, however, acute cystitis is typically caused by Escherichia coli (E. coli) or Staphylococcus
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However, some doctors consider infections of the urethra and prostate to be lower (Iman, 2016). Upper UTIs usually consist of diseases of the ureters, renal pelvis, and interstitium. The differences are that upper infections can lead to kidney failure, and lower UTIs result in necrosis. E. Coli and Staphylococcus cause the lower infections, whereas the upper infections are usually due to Proteus, E. Coli, and Pseudomonas. Lower UTIs have symptoms frequency, urgency, dysuria, back pain, hematuria, cloudy urine, and flank pain, whereas upper infections have signs of frequency, urgency, dysuria, costovertebral tenderness, and hypertension (Huether, 2012, p.

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