Urinary Tract Infection: Health Promotion, Chronic, and Acute Illness

Introduction

Health promotion involves implementing measures that facilitate timely disease diagnosis, treatment, and prevention. Healthcare providers play an important role in promoting health in the community through patient education. This paper describes the diagnosis, treatment, and health promotion of urinary tract infection as an acute disease and cervical cancer as a chronic illness in women. A comparison of common versus non-traditional treatment modalities is also done.

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Urinary Tract Infection

Urinary tract infection (UTI) is an acute disorder that is marked by bacterial infections in the urinary tract, which consists of the bladder, ureter, kidneys, and urethra. The precise region of the urinary tract that is affected determines the name of the infection (Smith et al., 2018). Pyelonephritis happens when the infection is in the kidneys and is usually associated with indications such as chills, fever, and back pains. Conversely, urethritis happens when the infection is in the urethra and may be accompanied by the production of vaginal discharge. Cystitis occurs when the affected area is the bladder.

UTIs occur in men and women. However, women are more susceptible to the disorder than men because women have a shorter urinary tract compared to men. Generally, predisposition to UTIs increases as a woman advances in age. The lifetime incidence of UTIs in adult women is 50 to 60% (Medina & Castillo-Pino, 2019). Therefore, UTIs are common infections in outpatients in the United States. Its treatment takes a significant fraction of health care expenditure for outpatients.

Diagnostic Tests

UTIs can be diagnosed in four different ways. The most commonly used test is a urinalysis, which involves checking urine for bacteria, leucocytes, and erythrocytes. The presence of leucocytes is an indication of infection and gives a positive test for UTI. The second test is a urine culture, which involves growing a urine sample on growth media to identify the infecting microorganism and its response to treatment. The third diagnostic approach is taking images of the urinary tract via a computerized tomography scan or magnetic resonance imaging. This method reveals any abnormalities in the urinary tract, especially in cases of recurrent UTIs (Smith et al., 2018). The fourth method is cystoscopy, which entails the visualization of the urinary tract using a cystoscope.

Treatment and Management Modalities

The first-line treatment of UTI is antibiotics. The precise type of drug is determined by the antibiotic susceptibility exhibited by the urine culture. The region of the urinary tract that is affected influences the drug form. For instance, contagions of the lower tract are often managed with oral antibiotics, whereas infections in the upper tract are treated with intravenous drugs. Commonly used antibiotics in the treatment of UTIs include trimethoprim/sulfamethoxazole, cephalexin, nitrofurantoin, Fosfomycin, and ceftriaxone. Antibiotics are the traditional treatment options for UTIs. Unconventional treatments for UTIs include home remedies such as the intake of cranberry juice (Luís, Domingues, & Pereira, 2017). However, this remedy is ineffective for an active case of UTI. It can only prevent the recurrence of future infections by precluding the attachment of infectious pathogens to the bladder lining.

Health Promotion and Screening

UTIs can be prevented by practicing healthy behaviors. For instance, taking at least six glasses of water daily is recommended. One should avoid holding urine for protracted durations. Complete emptying of the bladder is advisable. Topical estrogens have demonstrated the ability to prevent UTIs in post-menopausal women (Luís, Domingues, & Pereira, 2017). Regular screening does not yield any benefits. Therefore, there are no set guidelines for the screening of UTIs.

Patient Education and Follow-Up

Patients should complete their antibiotics course to treat the disorder fully and prevent the development of drug resistance. The patient should return to the hospital for additional testing after completing the treatment. Recurrent cases of UTIs should be evaluated to determine any abnormalities in the urinary tract. Patients should be informed about their risk factors for UTI, for example, diabetes, pregnancy, suppressed immunity, birth control methods such as diaphragms, and poor bathroom hygiene. Wiping from front to back helps to prevent UTIs. Patients should also be advised to don cotton underwear and pass urine after sexual activity.

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Collaboration with Other Members of the Healthcare Team for Best Practice

The diagnosis and management of UTIs require the interprofessional collaboration of different health care service providers. A physician is needed to take the patient’s history and request for laboratory tests, diagnose, and prescribe drugs. Lab technologists are responsible for specimen collection and conducting tests to diagnose the disorder. The role of pharmacists is to dispense medications. Nurses are needed for bedside care, patient education, and administration of intravenous drugs.

Cervical Cancer

Cervical cancer is a form of malignancy that is characterized by the aberrant growth of cells that form the cervix, which is a passage that links the vagina and uterus. Cervical cancer can disseminate to other tissues in the body, for example, vagina, bladder, liver, lungs, or rectum. The main cause of cervical cancer is the human papillomavirus (HPV) which is sexually transmitted. Cervical cancer ranks fourth in malignancies that affect women, with an approximate incidence of 570,000 cases in 2018 (World Health Organization, 2020). This figure accounted for 6.6% of all cancers affecting women. The risk of cervical cancer increases with advancing age.

Health Promotion and Screening

Cervical cancer is a preventable disease. Early vaccination against the HPV virus with the Gardasil 9 can prevent the transmission of the virus and subsequent development of the disease. Vaccination should start at the age of 9 to 12 years. Two shots given at 6-month intervals are required between 9 and 14 years. At the ages of 15 to 45, three shots of the vaccine should be given with the second and third shots being taken after 2 and 6 months of the first shot. In adulthood, regular screening through Pap smears can help in the timely diagnosis of disease, which is crucial for effective treatment.

Health Screening and Promotion Needs for Women Across the Lifespan

Prevention of cervical cancer starts at the age of 9 years through the administration of the HPV vaccine. The U.S. Preventive Services Task Force stipulates that women between the ages of 21 and 29 years should be screened for cervical cancer with a Pap test at three-year intervals. Women aged between 30 and 65 years should undergo the pap smear test every three years or have the high-risk HPV test every five years. Another screening option is a Pap smear and HPV test every five years (Curry et al., 2018).

Diagnostic Tests

The diagnosis of cervical cancer is done using a Pap smear test that checks the morphology of cervical cells for any abnormality. A swab of cervical tissue is usually taken and examined microscopically. Visualization of abnormal cells is followed up by a colposcopy, which is the visualization of the cervix through the vagina to check or cervical lesions. The presence of lesions indicates precursors of cervical carcinomas.

Treatment and Management Modalities

Cervical cancer can be treated through surgery, radiation therapy, chemotherapy, or targeted therapy. Surgery aims at eliminating cancerous tissues while radiation therapy uses high-energy x-rays to destroy malignant cells. The radiations can be conveyed externally outside the body or internally via a metal tube inserted into the vagina. Chemotherapy involves the administration of chemical agents that kill cancerous cells. It is often done in cycles to allow the body time to recuperate. Targeted therapy works by selectively preventing the growth of cancerous cells. The drug Bevacizumab works by inhibiting the vascularization of malignant tumors, thus depriving them of oxygen and nutrients (Tewari et al., 2017). These forms of treatment constitute the traditional treatment of cervical cancer.

Nontraditional treatment options for cervical cancer include herbal remedies such as ginkgo, ginseng, and Echinacea. Dietary supplements such as glucosamine sulfate and selenium are thought to boost immunity. Another option is vaginal suppositories made of curcumin or green tea that are thought to work by drawing infection out of the cervical cells.

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Patient Education and Follow-Up

Patient education entails increasing awareness about the importance of regular Pap smear tests based on the screening recommendations. Patients should be advised to receive HPV vaccines. However, it should be clarified that vaccination does not substitute screening. Patients should also practice safe sex because HPV, a sexually transmitted infection is the main cause of cervical cancer. Follow-up involves monitoring patients’ response to treatment (Curry et al., 2018).

Collaboration with Other Members of the Healthcare Team for Best Practice

The diagnosis and treatment of cervical cancer need the collaboration of several professionals. Laboratory technologists facilitate the diagnosis process. Reproductive specialists guide treatments in cases where the preservation of fertility is desired. Oncologists are responsible for the treatment of cervical cancer.

Conclusion

Health promotion entails the simultaneous implementation of several activities. Some of the commonly used techniques include medical intervention, patient education, behavioral change, and patient engagement in healthy activities. Screening aids the prompt diagnosis and treatment of chronic diseases such as cancers, whereas patient education empowers patients to be responsible for their health. Therefore, healthcare professionals should ensure that patients are well-informed about their role in health promotion.

References

Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W.,… Landefeld, C. S. (2018). Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA, 320(7), 674-686.

Luís, Â., Domingues, F., & Pereira, L. (2017). Can cranberries contribute to reduce the incidence of urinary tract infections? A systematic review with meta-analysis and trial sequential analysis of clinical trials. The Journal of Urology, 198(3), 614-621.

Medina, M., & Castillo-Pino, E. (2019). An introduction to the epidemiology and burden of urinary tract infections. Therapeutic Advances in Urology, 11, 1756287219832172. Web.

Smith, A. L., Brown, J., Wyman, J. F., Berry, A., Newman, D. K., & Stapleton, A. E. (2018). Treatment and prevention of recurrent lower urinary tract infections in women: A rapid review with practice recommendations. The Journal of Urology, 200(6), 1174-1191.

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Tewari, K. S., Sill, M. W., Penson, R. T., Huang, H., Ramondetta, L. M., Landrum, L. M.,… DiSaia, P. J. (2017). Bevacizumab for advanced cervical cancer: Final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240). The Lancet, 390(10103), 1654-1663.

World Health Organization. (2020). Cervical cancer. Web.

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