UTI Case Study

The assignment content discusses the connection between urinary tract infections (UTIs) and acute kidney disease (AKD). A UTI can cause AKD if left untreated, which can lead to permanent damage or even kidney failure. The symptoms of a UTI and AKD include flank pain, confusion, and cloudy urine. The article also explains how UTIs can be mistaken for dementia in older patients and highlights the importance of looking out for signs of UTI in seniors who may not exhibit typical symptoms. John's case study is presented, where his clinical signs have climbed beyond normal ranges due to a UTI infection.

Running head: UTI CASE STUDY
UTI Case Study
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UTI CASE STUDY 2
UTI Case Study
Provide a basis for the connection between urinary tract infections (UTIs) and acute kidney
disease (AKD).
A Urinary Tract Infection (UTI) occurs when bacteria in the bladder, urethra or kidneys
multiplies into the urinary tract. Acute kidney disease (AKD) occurs when the kidneys no longer
have the ability to get rid of excess fluids, salts and waste from the blood. The connection
between a UTI and Acute Kidney disease is that when the former is left untreated, it could lead
to acute kidney disease. This could in turn lead to the permanent damage of vital organs and
eventually lead to kidney failure. One of the symptoms of a UTI and acute kidney disease is
flank pain which was evident in the patient (Prakash & Ramasubramanian, 2016). This is pain
experienced on one side of the body between the hips and ribs or between the abdomen and the
back. Flank pain can be considered a sign of a kidney problem. Additionally, the patient showed
some signs of confusion and this is another symptom of acute kidney disease as well as UTI in
senior patients. Another symptom of UTI observed on the patient was the discharge of cloudy
and concentrated urine which had a foul smell (Allen, 2016).
Explain the clinical association or relationship between UTI and confusion in the
elderly.
A UTI can be the cause of confusion as well as other symptoms of dementia in senior
patients. This is sometimes mistaken for the very early stages of Alzheimer’s disease or
dementia.The symptom of confusion in a patient suffering from a UTI may be vague and can
mimic other health conditions.Since confusion is usually a vague and uncommon symptom of
UTIs, it makes it difficult to make a diagnosis in older patients (Nicolle, 2016). Thus, a simple

UTI CASE STUDY 3
urinalysis is conducted upon the suspicion of a UTI as in John’s case whose results showed that
he indeed had a UTI. When an older patient has the classic symptoms of a UTI, they may not be
in a position to inform their care givers. This is usually because of age-related issues such as
Alzheimer’s disease or dementia that bring about some confusion. Dementia also puts elderly
patients at the risk of contracting a UTI and it is sometimes termed as a risk factor. It is important
to look out for signs of confusion in senior adults because they may not exhibit the common
signs of a UTI (Balogun & Philbrick, 2014). This is because their immune systems are not
entirely capable of mounting a significant response to such an infection. Besides the absence of
noticeable signs in majority of the older individuals fail to or cannot express their levels of
discomfort to care providers (Mitchell, Fasugba, Beckingham, Bennett & Gardner, 2016).
Describe why John’s clinical signs have climbed now.
John’s clinical signs have climbed up beyond the normal vital sign ranges for an average
adult who is healthy because of the UTI infection. His temperature is at 400C which is above the
average 370C for a healthy adult. He was breathing at 26 breaths per minute while a healthy adult
breaths 12 to 18 breaths per minute. His pulse was at 102 bpm whilst the rate should be at 60 to
102 bpm. This can also be associated with his past medical history of asthma and congestive
heart failure. If at all the heart failure had gone untreated, it could have caused the complications
of kidney damage or failure. This is because heart failure reduces the flow of blood to the
kidneys and if left untreated, one suffers from kidney failure (Jarvis, Chan & Gottlieb, 2014). He
may have acquired these diseases from tobacco use when he smoked during his outdoor work.
Besides smoking, the asthma could have been caused by airborne substances like dust and pollen
or air irritants and pollutants such as smoke since he used to do an outdoor job at the city council.

UTI CASE STUDY 4
He is an Aboriginal who used to work and live alone and this could have triggered strong
emotions and stress that could have caused the asthma and now the rise of his vital signs that
show he has an infection.
What therapy is needed for John?
John should undergo antibiotic therapy as an inpatient since he has symptoms of a UTI.
UTI is common the elderly and if left untreated, it can lead to serious health implications. In this
case, as an elderly adult male, he should undergo a 10-14 days course antibiotic therapy, which
will help relieve his symptoms. However, it is always recommended that an antibiotic culture
should not be embarked on until a culture and sensitivity test is carried out (Rowe & Mehta,
2013). The results from the sample urine helps to avoid unnecessary use of broad courses of
antibiotic treatment. In this case, his vital signs are not stable and there could be no time to wait
for additional information. With the help of the urinalysis results, the best course of antibiotic
therapy could be prescribed, which can clear the symptoms of the infection. However, depending
on the nature of the infection, it is recommended that he first undergoes initial treatment by being
administered to intravenous (IV) antimicrobial therapy. This could be in the form of a
fluoroquinolone, a third-generation cephalosporin or an aminoglycoside as well as amoxicillin
(Jarvis, Chan & Gottlieb, 2014). Since the patient has a history of congestive heart failure which
could be a risk factor for acute kidney disease, the antimicrobial coverage ought to be broadened
and an agent such as antipseudomonal could be added. Additionally, the course of antibiotic
administered is influenced by the local resistance patterns (Jarvis, Chan & Gottlieb, 2014). The
antibiotic coverage could be readjusted later based on the results from the culture and

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sensitivities. Dietary considerations should also be taken with high regard including sufficient
fluids (Broom, Broom, Kirby & Adams, 2016).

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References
Allen, C. (2016). Education extra: Recurrent urinary tract infections. Australian Pharmacist
35(2), 36.
Balogun, S. A., &Philbrick, J. T. (2014). Delirium, a symptom of UTI IN the elderly: fact or
fable? A systematic review. Canadian Geriatrics Journal, 17(1), 22.
Broom., A., Broom J., Kirby, E., & Adams, J. (2016). The social dynamics of antibiotic use in an
Australian hospital. Journal of Sociology, 52(4), 824-839.
Jarvis, T. R., Chan, L., & Gottlieb, T. (2014). Assessment and management of lower urinary tract
infection in adults. Issues, 1.
Mitchell, B. G., Fasugba, O., Beckingham, W., Bennett, N., & Gardner, A. (2016). A point
prevalence study of healthcare associated urinary tract infections in Australian acute and
aged care facilities. Infection, Disease & Health, 21(1), 26-31.
Nicolle, L. E. (2016). Urinary tract infections in older adult. Clinics in geriatric medicine, 32(3),
523-538.
Prakash, K. C., &Ramasubramanian, V. (2016). Urinary Tract Infection. Manual Nephrology,
226.
Rowe, T. A., &Juthani-Mehta, M. (2013). Urinary tract infection in older adults. Aging health,
9(5), 519-528.