Urinary tract infections are more common in pregnancy because hormones relax the urinary tract and the growing uterus presses on the bladder. Untreated infections can spread to the kidneys and raise the risk of preterm labor. Your priorities are finishing pregnancy-safe treatment, watching for kidney infection, and teaching prevention.
Each care plan below follows the nursing process (ADPIE).
Risk for Infection
- Urinary stasis from hormone changes and uterine pressure
- Untreated bacteria in the urine, even without symptoms
- Incomplete antibiotic course
- Client completes the full antibiotic course as ordered
- Repeat urine culture is negative after treatment
- Client has no kidney infection or preterm labor related to infection
- Temperature and vital signs
- Signs of kidney infection: fever, chills, flank pain, CVA tenderness, nausea and vomiting
- Urine culture results
- Signs of preterm labor such as contractions, cramping, or low back pain
- Fetal heart rate
| INTERVENTION | RATIONALE |
|---|---|
| Give pregnancy-safe antibiotics as ordered | Prompt treatment keeps the infection from spreading to the kidneys. |
| Teach the client to finish all antibiotics even when symptoms improve | Stopping early can leave bacteria behind and cause relapse. |
| Report fever, flank pain, or contractions right away | These can mean pyelonephritis or preterm labor, which need urgent care. |
| Make sure a follow-up urine culture is done as ordered | This confirms the infection is cleared. |
EVALUATION
- Client finishes the antibiotic course
- Follow-up culture is negative
- No fever, flank pain, or preterm labor signs
Impaired Urinary Elimination
- Bladder irritation from infection
- Burning with urination
- Urgency and frequency
- Lower abdominal or pelvic discomfort
- Cloudy or foul-smelling urine
- Client reports less burning and urgency within 48 to 72 hours of treatment
- Client returns to normal voiding patterns
- Urine color, clarity, and odor
- Voiding pattern and discomfort
- Intake and output
| INTERVENTION | RATIONALE |
|---|---|
| Encourage fluids, about 2 to 3 L per day unless restricted | Fluids flush bacteria out of the bladder. |
| Encourage emptying the bladder often and after intercourse | Frequent voiding reduces bacteria growth. |
| Teach front-to-back wiping and cotton underwear | These habits lower the chance of bacteria reaching the urethra. |
| Give comfort measures as ordered | Easing symptoms helps the client keep up with fluids and voiding. |
EVALUATION
- Client reports less burning and urgency
- Urine is clear
- Client describes prevention habits
Practice this in This vs That
Tell a simple bladder infection apart from pyelonephritis.
Play This vs ThatQuick answers
Why is bacteria in the urine treated in pregnancy even without symptoms?
Asymptomatic bacteriuria can progress to pyelonephritis in pregnancy and is linked to preterm labor and low birth weight.
A pregnant client with a UTI now has a fever and flank pain. What is the concern?
Pyelonephritis, a kidney infection. Report it right away, since it can lead to sepsis and preterm labor.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.