Which patient is most at risk for developing a urinary tract infection?
a. Teenage comatose patient on a ventilator lying supine
b. Middle-age adult after abdominal surgery sitting in a chair
c. Elderly adult with Alzheimer disease who is wandering at night
d. Middle-age adult postcardiac catheterization being discharged home
A
The patient most at risk is the teenage comatose patient on a ventilator lying supine. When the patient is in bed, the kidneys and ureters move toward a more level plane, and urine tries to move from the kidney to the bladder against gravity. Because the peristaltic contractions of the ureters are not strong enough to overcome gravity when the patient is reclining, the renal pelvis fills before urine enters the ureters, which increases the patient's risk for urinary tract infection (UTI) and renal calculi. The elderly adult with Alzheimer and the middle-age adult post cardiac catheterization are both upright, which decreases chance for UTI. The middle-age adult after abdominal surgery is sitting in a chair, which decreases chance for UTI because gravity is helping the ureters drain.
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