Question

i need questions 2-6 answered please !!

PN 200 Fundamentals of Nursing II Urinary Tract Infection You are working in an extended care facility, when Marlo Zippo's daughter brings her mother in for a week stay while she goes on vacation. Ms. Zippo is an 89 year old widow with a 4 day history of dysuria, back pain, incontinency, severe mental confusion, and loose stools. Her physician has recently discontinued her hormone replacement therapy one month ago. Her most current vital signs are 118/60, 88, 18, 99.4. The medical director ordered several lab tests on admission. The results are as follows: WBC 11.000 complete metabolic profile is within normal limits. Post voiding catheterization yielded 100 mL and the urinalysis showed E coli 100,000+ HPF, RBC 3-6 bacteria rare. The urinary culture and sensitivity results are as follows: E colis 100,000 colonies, sensitive to ciprofloxacin, trimethoprim sulfamethoxazole, and nitrofuradantin. 1. State the abnormal lab values and what they could represent. The medical director makes rounds and writes to start an IV of D5 in.25 normal saline @ 75 ml/hr. and insert a retention catheter (Foley catheter) to straight drainage. Because Ms. Zippo is unable to take oral medications, the physician ordered ciprofloxacin 200mg, bid IVPB. 2. Is the type and rate of fluid appropriate for Ms. Zippo's age and condition? 3. What symptoms would you be looking for as to infiltration inflammation at the insertion site as well as over hydration? You enter the room to start the IV and insert the Foley catheter but find the aide has taken the patient to the bathroom for a bowel movement. You open the door and observe the patient wiping from back to front. This is a teaching moment and you take the aide aside to speak with her. 3. What is the association between Ms. Zippo's UTI and the organism found in her urine? The aide comes to you to report that Ms. Zippo is picking at her IV and asks if she can apply wrist restraints. 4. What will be your reply? 5. If Ms. Zippo should develop diarrhea, what special instructions should you give the nursing! assistant caring for the patient? You notice the nursing assistant emptying the urine drainage bag is not wearing personal protection devices. You also note that the spout becomes contaminated during the process . What issues need to be considered in protecting Ms. Zippo's safety?

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Answer 1

1. The abnormal values of lab tests show that elevated WBC level. The urine has shown the presence of bacteria E.coli. These show the patient has been infected with a bacterial infection that leads to UTI.

2. The type and rate of fluid show appropriate for the patient. Anyway, the correct rate should be calculated based on his actual weight. The normal rate is 25 - 30 mL/kg/day. The appropriate dose of ciprofloxacin is 6 - 10 mg/kg.

3. Symptoms of Infiltration

• slowing or stopping of IV infusion
• local edema
• Leakage at the puncture site.
• pain
• coolness of skin
• Skin blanching
• redness of the skin

4. No. The restraint can be applied only in case of uncontrolled behavior. We can apply restraint if she harms herself. She can also pull off if she feels pain or hurting at the injection site. We can explain to her in a better way first. If she continues then we can apply it without disrupting her.

5. Ms.Zippo has been infected with bacterial infection E.Coli. So the nurse should instruct the nursing assistant to use personal protective equipment of mask, gloves, and gown when comes to contact with feces to prevent cross-contamination of E.coli and to protect herself. E.coli is contagious and can easily spread through feces.

6. Contamination of spout may increase the chance of Zippo's complication and increases the transmission rate. she should instruct the nursing assistants to follow infection control practices and universal precautions to protect the safety of Zippo's, other patients, and health care workers.