Question

Max Replies Unlimited Assessment of urinary tract infection by Lee Gilbert-about a month ago Dashboard Info Patient Profile LM.is an 81-year-old female who lives in a nursing home. She had astroke 2 years ago and has residual right-sided weakness. She also has gastroesophageal reflux disease, hypertension, and stress incontinence. She currently takes the following medications: Assignments Lessons Discussions Omeprazole 20mg PO daily before breakfast Captopril 50 mg POBID Furesomide 20 mg PO daily Calendar Roster Today she tells the nursing assistant that she has a lot of pain when she urinates. The charge nurse completes a physical exam and notifies the provider of the exam findings and patient's painful urination A urinalysis is ordered Subjective Data Pain with urination began 2 days ago States she usually doesn't drink much because of the stress incontinence and not wanting to have "accidents," and now she is drinking even less because doesn't want to have to urinate due to the pain and burning Wearing feminine hygiene pads she had in her closet since the painful urination started because her stress incontinence "is worse Objective Data Physical Examination Temperature 99.7 F, pulse 78, respirations 18, blood pressure 162/80 Left flank tendeness Diagnostic Studies Urinalysis Color: Dark smoky color Odor: Foul smelling Protein: Trace Glucose: None Ketones: None Bilirubin: None Specific gravity: 1.034 pH:82 RBCs 8/hpf WBCs: 12/hpf Casts: Present Discussion Questions 1 Based on LM's presentation, what do you suspect is occurring and what assessment data led you to this conclusion? 2 You need to obtain a clean-catch urine sample from LM. to send for urinalysis. To collect this specimen, what instructions do you give LM? 3 Describe how to assess for flank tenderness. What is the significance of LMs left flank tenderness? 4 What are LM's risk factors for developing a urinary tract infection? 5What diagnostic test would be needed to determine the best medication to treat LM's urinary tract infection? 6 What are some important measures to teach LM. to prevent recurrence of a urinary tract infection (UTI You can edit the discussion topic until a comment is posted

please do answer all questions and cite any references if used thanks for all the help

Answer 1

1. LM is suspect of urinary tract infection. A detailed history and focused renal and urinary assessment helps to conclude the diagnosis. Increased specific gravity indicates the concentrated urine, and the presence of RBCs, WBCs shows the kidney infection.

2. Advise LM first to urinate some amount into the toilet bowl. Then to collect the midstream of urine in the sample cup and closed it properly. Then, urinate remaining into the toilet bowl.

3. place the patient in a prone or sitting position. At the costovertebral angle of twelfth rib, do percussion by placing one hand and percussive thump by the other hand. A positive murphy's sign could be identified. L.M left flank tenderness indicates the patient has a kidney infection.

4. The risk factors for developing urinary tract infections are increased age, incomplete bladder emptying, immunosuppression, adverse effects of drugs.

5. The diagnostic test must include

• Complete urinalysis
• Urine culture to identify the causative agent
• cystoscopy

6. Health educate LM

• To empty the bladder frequently and completely.
• Drink plenty of fluids.
• Take antibiotics as advised by the physician.
• Monitor intake and output.
• Follow hygienic measures.