What should be included when assessing a patient with suspected upper UTI?

In assessing a patient with suspected upper urinary tract infection (UTI), obtaining a urinalysis (UA) and urine culture is essential. The urinalysis provides valuable information about the presence of nitrites, leukocyte esterase, blood, and the overall urine characteristics, which can indicate infection. A urine culture is crucial for identifying the specific bacteria causing the infection and determining their susceptibility to antibiotics. This ensures that the treatment administered is effective against the infecting organism, particularly in cases of pyelonephritis or severe UTIs where antibiotic resistance may be a concern.

The approach of advising oral antibiotics without confirming an infection through testing may not ensure the appropriateness of the medication prescribed. A pelvic examination might not be necessary for diagnosing a UTI, as the assessment can often be made with a UA and urine culture. Monitoring vital signs alone is insufficient for diagnosis or management, as it does not provide specific information regarding the urinary tract infection. Thus, obtaining UA and urine culture is the most comprehensive and effective strategy for assessing a patient with a suspected upper UTI.