Patient
Shadow Health patient 2 was Makayla Henderson. She is a 21year old biracial female who presented
with frequency, painful urination, brown/cloudy urine, and lower abdominal cramping for a few days.
She rated her pain a 7/10 with urination. LMP was 2.5weeks ago. She admitted to being sexua...
Patient
Shadow Health patient 2 was Makayla Henderson. She is a 21year old biracial female who presented
with frequency, painful urination, brown/cloudy urine, and lower abdominal cramping for a few days.
She rated her pain a 7/10 with urination. LMP was 2.5weeks ago. She admitted to being sexually active,
but is on birth control pills and uses spermicidal condoms. Ms. Henderson has a hypersensitive allergy to
Penicillin which causes her to have a rash. Urinalysis confirmed UTI, as well as being positive for
leukocytes and bacteria in the sample. She was prescribed Macrobid and Pyridium to treat the
infection. Education was given at time of discharge.
Pathophysiology
A urinary tract infection (UTI) is an infection in your urinary system. This could include an infection in the
kidneys, ureters, urethra, or bladder. Most infections involve the lower urinary tract which are the
bladder and the urethra. Women have an increased risk for UTI's in comparison to men. This increased
risk is primarily due to the anatomy. It is important to treat a UTI as soon as possible so that the
infection does not spread to your kidneys, which would require admission with IV antibiotics (Urinary
Tract Infection (UTI), 2020).
The most common bacteria associated with UTI's is E-Coli. When the bacteria enters the urethra, it
begins to multiply and travel up the urinary system into the bladder. Urethritis is an infection of the
urethra, while cystitis is an infection of the bladder. If a UTI is not caught and treated soon enough, the
infection moves up the urinary system into the kidneys causing pyelonephritis(Urinary Tract Infection
(UTI), 2020).
Being a sexually active female, menopause, birth control use, urinary catheters, recent urinary
procedures, suppressed immune system, or urinary system abnormalities all put you at risk for UTI's.
Signs/Symptoms
As with Ms. Henderson, frequency, painful urination, and cloudy urine are all signs of UTI. Some of the
other signs include: strong smelling urine, pelvic pain, fever, red or pink urine, small amounts of urine at
one time, and in older patients altered mental status. Once the infection moves up the urinary system
into the bladder, low back pain, nausea, vomiting and chills can occur (Urinary Tract Infection (UTI),
2020).
Diagnostics
A urinalysis from a clean catch specimen is the primary tool used in diagnosing UTI's. The test looks for
evidence of infection such as bacteria or white blood cells in the urine. If nitrate is present in the urine
(the leukocyte esterase test being positive) it confirms the UTI diagnosis (Urinary Tract Infection (UTI),
2020). The urine is sent off for culture and within 48-72hrs the physician will know the type of bacteria
causing the infection. He will also know from the sensitivity report if you antibiotic will be effective.
Treatment
Antibiotics are the treatment of choice for urinary tract infections as they kill the bacteria responsible for
the infection. Commonly prescribed antibiotics include Macrobid, Bactrim, Keflex, Septra, and
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