UTI and Pyelonephritis: NCLEX Priorities
UTI vs pyelonephritis: uncomplicated vs complicated, antibiotic choices, teaching.
UTI is one of the most common infections. NCLEX tests recognition, antibiotic selection, and teaching.
Uncomplicated UTI
Dysuria, frequency, urgency, suprapubic discomfort. Empiric: nitrofurantoin or fosfomycin (or Bactrim where resistance low). 3-7 days.
Pyelonephritis
Fever, flank pain, costovertebral angle tenderness, plus UTI symptoms. Often N/V. Ciprofloxacin or ceftriaxone. Hospital if severe.
Complicated UTI
Male, pregnant, immunocompromised, urinary tract abnormality, catheter, recurrent. Broader spectrum, longer course.
Teaching
Wipe front to back (women). Void after intercourse. Hydration. Cranberry products mixed evidence. Probiotics.
Frequently asked
Asymptomatic bacteriuria, treat?
Usually no, except in pregnancy and pre-urologic surgery.
Catheter-associated UTI prevention?
Use catheter only when necessary. Remove ASAP. Closed drainage system. Aseptic insertion.
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