Urinary Tract Infection with Sepsis
Added on 2022-12-22
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Running head: URINARY TRACT INFECTION WITH SEPSIS
1
Urinary tract infection with sepsis
Name:
Institution:
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1
Urinary tract infection with sepsis
Name:
Institution:
Tutor:
Date:
URINARY TRACT INFECTIONS WITH SEPSIS
2
Introduction
In this case study, Kirkmann a 75 year old man presented at the ED and was admitted
later after diagnosis with urinary tract infection that got worse after 24 hours to sepsis. Sepsis
according to the World Health Organization is the overall effect as the immune system fight back
against an infection like UTIs. Since urinary tract infection with sepsis is lethal, it is important
to comprehend the pathogenesis of the condition in order to come up with effective nursing
strategies. Within this essay, there will a discussion on pathogenesis, appropriate nursing strategy
and arterial blood gases in relation to urinary tract infection with sepsis of Mr. Kirkmann.
Pathogenesis
Studies indicate that the genitourinary tract is responsible for 20-30% of sepsis. The
World Health Organization and the Centre for Disease Control define a urinary tract infection as
any medical condition that affects the urinary system which is comprised of the bladder, kidneys
and ureters. However, the body or rather the urinary system is made in a manner that makes it
hard for any bacteria to colonize the urinary system (Abraham, 2016). It only happens in extreme
conditions such as after sexual intercourse or unhygienic insertion of catheters. Once the bacteria
attack the bladder and start replicating, the patient will experience burning sensation during
urinating and abdominal pain that radiate from the right flank (Sprung & Reinhart, 2016). If the
Urinary tract infection is not treated on time and effectively by antibiotics, it leads to sepsis like
the case of Mr.Kirkmann. Sepsis is a condition in which the body responds to an infection and in
the end injures its own tissues and organs and might to death or significant morbidity. In the case
study, Mr.Kirkmann was diagnosed with Urinary Tract Infection with sepsis.
2
Introduction
In this case study, Kirkmann a 75 year old man presented at the ED and was admitted
later after diagnosis with urinary tract infection that got worse after 24 hours to sepsis. Sepsis
according to the World Health Organization is the overall effect as the immune system fight back
against an infection like UTIs. Since urinary tract infection with sepsis is lethal, it is important
to comprehend the pathogenesis of the condition in order to come up with effective nursing
strategies. Within this essay, there will a discussion on pathogenesis, appropriate nursing strategy
and arterial blood gases in relation to urinary tract infection with sepsis of Mr. Kirkmann.
Pathogenesis
Studies indicate that the genitourinary tract is responsible for 20-30% of sepsis. The
World Health Organization and the Centre for Disease Control define a urinary tract infection as
any medical condition that affects the urinary system which is comprised of the bladder, kidneys
and ureters. However, the body or rather the urinary system is made in a manner that makes it
hard for any bacteria to colonize the urinary system (Abraham, 2016). It only happens in extreme
conditions such as after sexual intercourse or unhygienic insertion of catheters. Once the bacteria
attack the bladder and start replicating, the patient will experience burning sensation during
urinating and abdominal pain that radiate from the right flank (Sprung & Reinhart, 2016). If the
Urinary tract infection is not treated on time and effectively by antibiotics, it leads to sepsis like
the case of Mr.Kirkmann. Sepsis is a condition in which the body responds to an infection and in
the end injures its own tissues and organs and might to death or significant morbidity. In the case
study, Mr.Kirkmann was diagnosed with Urinary Tract Infection with sepsis.
URINARY TRACT INFECTIONS WITH SEPSIS
3
Gram negative bacteria that are responsible for urinary tract infections have endotoxins in
their cell walls. The most common bacteria responsible include E.coli, proteus spp, Klebsiella
spp, Enterobacter, P aeruginosa and finally staphylococcus aureus. A good example of the
endotoxin is Lipopolysaccharides (Tandogdu, Bjerklund Johansen, Bartoletti, & Wagenlehner,
2016). They are the lipopolysaccharides that mediate the manifestation of urinary tract infection
with sepsis. Randomized controlled trials from different studies have established that the
endotoxins normally activates the different components of the immune system such as the
inflammatory, coagulation and complement systems. Furthermore, the endotoxins have also
shown to stimulate the actions of monocytes, macrophages, neutrophils and dendritic cells
(Deutschman & Singer, 2016). The monocytes mediate clinical sepsis besides the production of
tumor necrosis alpha as well as the interleukin 1.Studies indicate that they are normally produced
at the concentration of between 25 and 50 pg and Ml. Further studies have also found out that the
endotoxins normally bind receptors in the endothelial cell membranes and this has also shown to
enhance pro-inflammatory mediators (Singer et al., 2016). It is the rate at which the endotoxins
are released into blood stream that determines the severity of the sepsis. The sepsis leads to
respiratory failure thus the patient experience variations in blood arterial gases as well as low
blood pressure, high heart and respiratory rate and low blood pressure like in the case of
Mr.Kirkmann.
Appropriate Nursing strategy
According to the ABCDE framework of nursing survey, Mr.Kirkmann is experiencing
difficulties in breathing due to sepsis that causes venodilation thus he experiences hypovolemia.
The appropriate nursing strategy according to studies in this case is fluid therapy. The rationale
of this nursing strategy is to increase the volume of fluids that will in return facilitate the delivery
3
Gram negative bacteria that are responsible for urinary tract infections have endotoxins in
their cell walls. The most common bacteria responsible include E.coli, proteus spp, Klebsiella
spp, Enterobacter, P aeruginosa and finally staphylococcus aureus. A good example of the
endotoxin is Lipopolysaccharides (Tandogdu, Bjerklund Johansen, Bartoletti, & Wagenlehner,
2016). They are the lipopolysaccharides that mediate the manifestation of urinary tract infection
with sepsis. Randomized controlled trials from different studies have established that the
endotoxins normally activates the different components of the immune system such as the
inflammatory, coagulation and complement systems. Furthermore, the endotoxins have also
shown to stimulate the actions of monocytes, macrophages, neutrophils and dendritic cells
(Deutschman & Singer, 2016). The monocytes mediate clinical sepsis besides the production of
tumor necrosis alpha as well as the interleukin 1.Studies indicate that they are normally produced
at the concentration of between 25 and 50 pg and Ml. Further studies have also found out that the
endotoxins normally bind receptors in the endothelial cell membranes and this has also shown to
enhance pro-inflammatory mediators (Singer et al., 2016). It is the rate at which the endotoxins
are released into blood stream that determines the severity of the sepsis. The sepsis leads to
respiratory failure thus the patient experience variations in blood arterial gases as well as low
blood pressure, high heart and respiratory rate and low blood pressure like in the case of
Mr.Kirkmann.
Appropriate Nursing strategy
According to the ABCDE framework of nursing survey, Mr.Kirkmann is experiencing
difficulties in breathing due to sepsis that causes venodilation thus he experiences hypovolemia.
The appropriate nursing strategy according to studies in this case is fluid therapy. The rationale
of this nursing strategy is to increase the volume of fluids that will in return facilitate the delivery
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