2. INTRODUCTION
A urinary tract infection (UTI) in children is a fairly common
condition. Bacteria that enter the urethra are usually flushed
out through urination. However, when bacteria aren’t expelled
out of the urethra, they may grow within the urinary tract. This
causes an infection.
3. DEFINITION
1. A urinary tract infection (UTI) is an infection that affects any
part of the urinary tract, including the kidneys, ureters,
bladder or urethra
2. UTI is invasion of the urothelium that results in an
inflammatory response.
4. INCIDENCE
The incidence of UTI in children aged 1-2 years is 8.1% in girls
and 1.9% in boys. Studies from Sweden have indicated that at
least 3% of girls and 1% of boys have a symptomatic UTI by age
11 years
5. Classification
Upper UTI
1. Acute pyleonephritis
2. Chronic pyleonephritis
3. Interstitial pyleonephritis
4. Renal abscess
5. Perirenal abscess
Lower UTI
1. Cystitis
2. Prostatitis
3. Urethritis
Both upper & lower UTI are further divided
into complicated and uncomplicated.
6. ETIOLOGY & risk factors
The most common cause of UTIs is E. coli Bacteria
a structural deformity or blockage in one of the organs of the
urinary tract
abnormal function of the urinary tract
vesicoureteral reflux, a birth defect that results in the
abnormal backward flow of urine
the use of bubbles in baths (for girls)
7. CONTI...
tight-fitting clothes (for girls)
wiping from back to front after a bowel movement
poor toilet and hygiene habits
Uncircumcised boys under 1 year old also have a slightly
higher risk of UTIs
8. PATHOPHYSIOLOGY
Due to etiological factors
bacteria ascends the urethra
Lining of urinary tract becomes inflammed
Micturition reflex triggered
Clinical manifestations
9. cLINICAL MANIFESTATION
Symptoms of a UTI can vary depending on the degree of
infection and your child’s age. Infants and very young children
may not experience any symptoms.
fever
poor appetite
vomiting
diarrhea
irritability
overall feeling of illness
10. CONTI...
Additional symptoms vary depending on the part of the urinary
tract that’s infected. If your child has a bladder infection,
symptoms may include
blood in the urine
cloudy urine
foul-smelling urine
pain, stinging, or burning with urination
pressure or pain in the lower pelvis or lower back, below the navel
11. CONTI...
frequent urination
waking from sleep to urinate
feeling the need to urinate with minimal urine output
urine accidents after the age of toilet training
If the infection has traveled to the kidneys, the condition is more
serious. Your child may experience more intense symptoms, such as:
irritability
12. CONTI...
chills with shaking
high fever
skin that’s flushed or warm
nausea and vomiting
side or back pain
severe abdominal pain
severe fatigue
13. DIAGNOSTIC EVALUATION
Urinalysis.
Urine culture.
Urine collection bag
Catheterized urine collection.
kidney and bladder
ultrasound
voiding cystourethrogram
(VCUG)
nuclear medicine renal scan
(DMSA)
CT scan or MRI of the
kidneys and bladder
16. CONTI...
cephalosporins
doxycycline, but only in children over age 8
nitrofurantoin
sulfamethoxazole-trimethoprim
Pain medication to alleviate severe discomfort during
urination also may be prescribed.
17. CONTI...
NON PHARMACOLOGICAL MANAGEMENT
Take child’s temperature if they seem to have a fever.
Monitor child’s urination frequency.
drinks plenty of fluids.
Change diapers frequently in children.
Encourage child to use the bathroom frequently rather than
holding in urine.
18. SURGICAL MANAGEMENT
1. Surgical removal of renal calculi,bladder calculi
2. Ureteroplasty
3. Reimplatation of ureters if VUR present
19. NURSING MANAGEMENT
Assessment
1. A history of signs and symptoms related to UTI is obtained from the
child with a suspected UTI.
2. Assess changes in urinary pattern such as frequency, urgency, or
hesitancy.
3. Assess the characteristics of the child urine such as the color,
concentration, odor, volume, and cloudiness.
20. Nursing Diagnosis
Impaired urinary elimination related to frequent urination as
evidenced By Dysuria
Infection related to Improper toilecting as evidenced by
Bacteriuria.
Acute pain slated to Inflammation and Infection of the urethra,
bladder and other urinary tract structures evidenced by Guarding
as behavior.
21. CONTI...
Disturbed sleep pattern related to pain as evidenced by
restlessness/irritability
Hyperthermia related to inflammation as evidenced by
increae body temperature above normal range
22. Nursing Intervention
Monitor Vital signs
Encourage increased fluid intake ( 3 - 4 liters a day if tolerated)
Maintain an acid environment of the bladder by the use of agent
Monitor laboratory findings
Apply a heating pad to the suprapubic area or lower back
Maintain bed rest
Administer anti-pyretic drugs and analgesics
23. Prevention
Don’t give female children bubble baths. They can allow bacteria
and soap to enter the urethra.
Avoid tight-fitting clothing and underwear for your child, especially
girls.
Ensure that your child drinks enough fluids.
Avoid allowing your child to have caffeine, which can cause bladder
irritation.
Change diapers frequently in younger children.
24. CONTI...
Encourage your child to use the bathroom frequently rather
than holding in urine.
Teach your child safe wiping techniques, especially after bowel
movements. Wiping from front to back reduces the likelihood
that bacteria from the anus will get transferred into the
urethra.
25. Complication
• UTIs that are not treated promptly
could spread in the entire urinary
system and become the cause of renal
failure.
Renal failure.
• The bacteria may invade the urinary
system and result in sepsis.Urosepsis
26. conclusion
Urinary Tract Infection (UTI) is one of the most common
bacterial infections in childhood. The infection may affect the
upper urinary tract or the lower urinary tract . Unfortunately,
it may be difficult, if not impossible, to distinguish
pyelonephritis from cystitis based on clinical symptoms and
signs, especially in infants and young children.
