Urinary Tract Infection and Osteoporosis in Women

Introduction

 Urinary tract infections, also called cystitis or infectious cystitis, is an acute infection that occurs within the upper, or the lower urinary tract. Women are at greater risk of developing urinary tract infections compared to the men. In women, the urinary tract infections are frequently caused by bacteria such as Escherichia coli, or Staph commonly found in bowel flora and may move through the urinary tract, causing infections in the bladder or the other components of urinary tract (Flores-Mireles et al., 2015). Osteoporosis is a chronic illness where the bones become weak and are more probable to break or fracture. Osteoporosis is characterized by the decreased bone mass with the disruption of the architecture of the bone that leads to augmented risks of the fragility fractures that are the major consequences of the illness. Women are at higher risks for osteoporosis after the menopause due to lower levels of the estrogen (Hiremath et al., 2018). This paper discusses urinary tract infections and osteoporosis in women. 

The Issue, Prevalence, and Significance

 Urinary tract infections (UTIs) are the most common, widespread infection in women since they have shorter urethras that permit bacteria fast access to the bladder. Urinary tract infections among women is associated with burning when urinating, pelvic pain, frequency of urination, and augmented urgency of urination (Flores-Mireles et al., 2015). The prevalence of the UTI is approximated to be about 150 million individuals each year across the world. Almost fifty percent of women reports having had a UTI during their lives. Urinary tract infections are the primary cause of morbidity and healthcare expenditures in women across the world. This type of infection is frequent in women and has adverse consequences (Flores-Mireles et al., 2015).

 There are an increasing number of women with osteoporosis worldwide, thus this disease is a main public health problem amongst women. Osteoporosis causes the bones to become weakened, abnormally thin and easily broken or fractured. Osteoporosis is linked to back pain and stooped posture along with bone fracture which take place much more effortless than anticipated (Stevenson, 2018). Osteoporosis causes over 8.9 million fractures yearly, leading to an osteoporotic fracture every three seconds in the world (Jeremiah et al., 2015). Osteoporosis is prevalent across the world and it is approximated that two hundred million women suffer from this disease. Around thirty percent of all the postmenopausal women have osteoporosis in the world. The significance of osteoporosis is that it results in the fracture of the hip, vertebrae, and wrist and these fractures happen with no or little trauma (Jeremiah et al., 2015).

 Some common risk factors include previous UTI’s, diabetes, pregnancy, poor hygiene, use of spermicides, recent antibiotic use, and sexual activity (Flores-Mireles et al., 2015). Whereas, some common risk factors include family history, Gonadal hormone deficiency, inadequate activity, age, low calcium and vitamin D intake, smoking, and of the Caucasian or Asian race (Aydin et al., 2014).

Health Promotion and the Screening for Urinary Tract Infections and Osteoporosis

 Strategies for health promotion for women with a urinary tract infection (UTI) include screening tests to detect the infection at an early stage and behavioral counseling intended to avoid or decrease the risk factors (Aydin et al., 2014). Screening for a urinary tract infection may involve a urine culture test to detect and identify yeast or bacteria in the urine that can be causing the infection (Aydin et al., 2014). Dipstick screening test for a UTI can be performed to check for acidity, protein, blood, and glucose in urine. A urine analysis can also be used to detect the existence of the nitrites that can be a sign of a UTI (Chu &Lowder, 2018).

 Conversely, health promotion for women with osteoporosis may include carrying out screening tests and offering behavioral counseling to minimize the risk factors. Screening test for osteoporosis may involve conducting a bone density test to diagnose the condition prior to the occurrence of a broken bone. Bone density test detects normal or low bone density (Hiremath et al., 2018).

Diagnostic Tests or the Laboratories Required for Urinary Tract Infections and Osteoporosis

 Diagnostic tests for urinary tract infections in women include ultrasound and cystoscopy. Ultrasound is conducted to check the bladder and the kidneys for irregularities which may necessitate treatment. A cystoscopy is carried out to diagnose the cause of the recurrent urinary tract infection and assist the doctor in examining the bladder for signs of infection, comprising irritation and to identify the causes of the symptoms of the infection (Chu &Lowder, 2018). Conversely, the diagnostic test for osteoporosis is bone densitometry, which rapidly and precisely measures the density of bone to assist in detecting the condition. Another diagnostic test for osteoporosis is dual X-ray absorptiometry (DEXA) to measure the bone density of the hip and spine to assist in gauging their risk of the fractures (Jeremiah et al., 2015).

Common Treatment and Management Modalities

 Not all UTI’s require treatment. An uncomplicated UTI may resolve on its own. If treatment is necessary, the first line antibiotic treatment will be dependent on the cause or specific type of bacteria that was found. First line treatment may include, fosfomycin 3g single oral dose, nitrofurantoin 100mg twice per day orally for five days, or sulfamethoxazole/trimethoprim 160/800twice each day orally for three days. The second line treatment may include ciprofloxacin 250mg orally twice daily for three days, levofloxacin 250mg orally once daily for 3 days, or amoxicillin/clavulanate 500mg twice a day orally for three days (Aydin et al., 2014). In contrast, the first line pharmacologic management of osteoporosis involves the utilization of bisphosphonates. There are pharmacological agents that are used for both prevention and treatment such as Fosamax 5mg orally a day or 35mg orally a week for prevention, or 10mg a day or 70mg a week for treatment. Raloxifene for both prevention and treatment is 60mg per day orally. For patients who are at high risk, teriparatide 20mcg daily subcutaneous for up to two years or denosumab 60mg a month for 6 months subcutaneous are productive option medications to avert osteoporotic fractures (Jeremiah et al., 2015).

 The management of UTIs among women requires good personal hygiene, getting plenty of vitamin C, drinking plenty water and changing sanitary pads and tampons throughout menstruation (Chu & Lowder, 2018). In contrast, the management of osteoporosis necessitates exercise and physical activity as well as the balanced diet that consists of calcium and vitamin D supplementation, counseling the patients to quit or avoid smoking and discouraging heavy consumption of alcohol (Jeremiah et al., 2015).

Patient Education and the Follow-Up

 Patient education in preventing urinary tract infection involves encouraging the patient to practice healthy habits that include good personal hygiene, drinking plenty water, getting plenty of vitamin C, understanding the causes of infection which should include changing sanitary pads and tampons often during the menstruation. The follow up for treatment along with management of urinary tract infections need to be conducted after two to three weeks to check the progress of treatment (Chu &Lowder, 2018). Conversely, patient education for osteoporosis should involve encouraging the patient to get regular exercise, eat a healthy diet and avoid smoking. The follow up for osteoporosis treatment should be performed after three to four weeks to check the productivity of the treatment plan and make necessary adjustments (Stevenson, 2018). 

Health Screening and Promotion Needs for Women across the Lifespan for UTI and Osteoporosis

 Health screening for urinary tract infection among women needs to involve testing a urine sample or a urinalysis. The urinalysis test is conducted to check for white blood cells, bacteria, red blood cells as well as the other chemicals including nitrites in the urine. The proper urinalysis may pinpoint the infection and the urine culture may assist the provider of healthcare to select the most appropriate antibiotic for the treatment of UTI (Gupta et al., 2017). A urinalysis and culture are carried out to see if the patient has an infection and if there is a need for further care. The urine culture and sensitivity test are the common diagnostic investigations intended to detect bacteria and to determine the kind of the antibacterial therapy required (Chu & Lowder, 2018).

 On the other hand, health screening for osteoporosis should involve a bone measurement test. Early screening can help avoid osteoporosis problems in women sixty-five years and older and help detect the fracture risk factors among post-menopausal women who are younger than sixty-five years and at risk for osteoporosis as established by the formal clinical risk’s evaluation apparatus (Curry et al., 2018). Health screening should also be included in perimenopausal women with the risk factors for osteoporosis including family history.

 Health promotion needs for women with the UTI should include staying hydrated, wiping from the front to the back when utilizing the bathroom, urinating often and keeping the genital area clean (Chu & Lowder, 2018). In contrast, health promotion requirements for women are engaging in physical activity and intake of calcium along with vitamin D (Curry et al., 2018).

Traditional and Nontraditional Treatment Options for Urinary Tract Infections and Osteoporosis

 Traditional treatment options for a UTI involve the utilization of antibiotics that have been discussed earlier. Conversely, the nontraditional treatment plans for UTIs involve drinking plenty of fluids such as water and pure cranberry juice, increasing the intake of Vitamin C and taking a probiotic (Chu &Lowder, 2018). Traditional treatment options for osteoporosis include the utilization of medications, for instance, Bisphosphonates, teriparatide, and raloxifene. The bisphosphonates that inhibit the breakdown of bone, preserve the bone mass and augment density of the bone in the hip and spine (Stevenson, 2018). On the contrary, the nontraditional treatment alternatives for osteoporosis include acupuncture that stimulates the various organs along with body functions and promotes healing and the use of red clover, which contains estrogen-like compounds that assist in protecting the bone (Stevenson, 2018). Both traditional as well as nontraditional treatment alternatives for urinary tract infections along with osteoporosis treats the symptoms, problems of some given region and focuses on the cause and the prevention (LaRosa et al., 2016).

Nurse Practitioner Collaboration with Other Healthcare Team for the Best Practice

 Interprofessional collaboration helps with offering safe and productive patient care, reduces medical errors and enhances the quality of care (Goldsberry, 2018). The nurse practitioner may collaborate with the other members of the healthcare team by sharing his or her knowledge and proficiency with others, caring for groups of patients autonomously and interdependently and supporting the other members of the team to fully utilize their distinct and shared skills (Goldsberry, 2018). 

Conclusion

 Both urinary tract infection and osteoporosis are widespread infections among women with numerous possible risks for complications. The appropriate diagnosis, as well as management of these illnesses, is essential to provide the best patient outcomes. The treatment of a UTI in women involves the use of antibiotics that include fosfomycin, nitrofurantoin, sulfamethoxazole / trimethoprim and ciprofloxacin. In contrast, the treatment of osteoporosis may involve the utilization of antibiotics that comprise bisphosphonates, Fosamax, Raloxifene, teriparatide and denosumab. The management of UTIs among women requires good personal hygiene, getting plenty of vitamin C, drinking plenty water, changing sanitary pads and tampons throughout menstruation. Conversely, the management of osteoporosis among women necessitates regular exercise, healthy eating and avoiding smoking. The risk factors for UTIs include diabetes, pregnancy, poor hygiene, use of spermicides, recent antibiotic use, and sexual activity. On the other hand, some widespread risk factors for osteoporosis are family history, inadequate activity, age, Gonadal hormone deficiency, low calcium and vitamin D intake, smoking, and of the Caucasian or Asian race. The collaboration between the nurse practitioner and other healthcare team helps in ensuring enhanced practice, the safety of the patients, high-quality care and enhances patients’ outcomes.

References

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