Specific Nursing Care









The Urinary Tract

Cystitis is an infection of the urinary bladder.  It occurs when bacteria travel up the urethra (the passage which the urine passes from the bladder to the outside), infect the urine and inflame the bladder lining.  It is the most common type of urinary tract infection, particularly in women.  This is because of their short urethra and its positioning; the urethra lies close to the anus and vagina which allows bacteria from these areas to easily migrate and travel up the urethra into the bladder.  There is always the danger that the infection may ascend via the ureters into the kidneys causing pyelonephritis (kidney infection).





Common Causes of Cystitis


Poor toilet hygiene.  In female, wiping the bottom from back to front after passing stool or urine brings bacteria from the anal or vagina to enter the urethra.


Obstruction of the urethra which prevent all of the urine to be emptied from the bladder.  The remaining urine in the bladder provides a bleeding ground from bacteria.  Causes of urethra obstruction may be due to narrowing urethra or enlarge prostate (in men).


Inadequate emptying of bladder may also due to the effect of some drugs (example, antidepressants), immobility, abnormal bladder control and constipation.


Fail to observe proper hygiene and catheter care for people who are using urinary catheter.


Tight-fitting clothes such as underwear or pants, which trap heat and moisture, making the genital area conducive to bacteria growth.


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Symptoms of Cystitis


Frequent urge to urinate with small amount.


Pain or burning sensations during urination.


Concentrated, cloudy and foul-smelling urine because of the presence of bacteria.


Discomfort or ache in the lower abdomen (above the pubic bone) and lower back.


May have blood stains in the urine.


Fever and chills.


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Homecare Tips and How to Prevent Further Attacks


Drink sufficiently.  This can help to flush out the bacteria from the bladder through urination.


Avoid foods or drinks that can irritate the bladder.  These include coffee, soft drinks with caffeine, alcohol, citrus juices and spicy foods.


Pass urine as soon as the urge is felt.  Retaining urine in the bladder allows bacteria to thrive.


When using a sitting toilet, to facilitate a complete emptying of bladder, the correct posture is to place yourself backwards on the toilet, so you lean against the wall.  It is a bad habit to sit on the toilet, bent forward and reading while urinating.


Practice proper toilet hygiene.  In female, after passing stool or urine, always wipe from front to back (urethra to anus), to avoid carrying bacteria from the bowel to the bladder.


Wash the genital area well before and after sexual intercourse.


The woman should urinate immediately after intercourse to wash away bacteria that may have entered the urethra.


Women should change their sanitary pads frequently because bacteria thrive in blood.


Avoid tight-fitting underwear or pants which trap heat and moisture. This makes the genital area conducive to bacteria growth.  Wear cotton rather than nylon underwear.


Do not use perfumed soaps, talcum powder or any type of deodorant around the genitals.


Studies have shown that cranberry juice may decrease the incident of urinary tract infections.  It works by preventing common bacteria from ‘sticking’ to the walls of the bladder.  Consult your doctor prior to taking cranberry juice as it can alter the effectiveness of some antibiotics.


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Emergency Alerts


Pain below the ribs including the abdomen may indicate that the infection has spread to the kidneys.  In extreme cases, it causes vomiting and high fever.  If untreated, it may cause permanently damage to the kidneys.


People who experience frequent episodes of cystitis should consult their doctors for close evaluation to establish the underlying problem.


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