Question

Please help

Case study:

Urinary Elimination

Ms. James is an obese 31-year-old female who comes into the primary care center with complaints of frequency, urgency, burning on urination, and lower abdominal pain rated as 7 on a 0-to-10 scale. Her vital signs are T 38.8° C (101.9° F), P 106 and regular, R18 and unlabored, and BP 110/70.

Significant assessment findings include a history of multiple and frequent bladder infections, occasional vaginal bleeding, right ovarian cyst removal 2 years ago, multiple sexual encounters with her partner in the past 3 weeks, and suprapubic tenderness on palpation. On the basis of diagnostic test results, Ms. James is prescribed an antibiotic, nitrofurantoin (100 mg PO q 6 hr), and the urinary tract analgesic phenazopyridine (2 tablets PO tid PRN) for a bladder infection and told to return to the clinic in a month for a follow-up appointment.

Question

1. Identify three assessment questions that the nurse should ask Ms. James to further investigate her chief complaint.

2. What diagnostic studies are most likely to be performed in evaluating Ms. James? Give the rationale for each study.

3. List a minimum of three topics that the nurse should discuss with Ms. James before discharging her from the clinic. Include content that the nurse should cover under each topic.

Answer 1

Answer: The three assessementquestions that the nurse should ask Ms. James about recently fever and bladder spasm. As this is the case of urinary tract infection where itching, burning sensation, pain is caused.

Analysis of the urine sample to check the blood cells, red blood cells or bacteria present in the urine. The accurate diagnosis can be done through ultrasound, a computerized tomography (CT) scan or magnetic resonance imaging (MRI). Moreover, diagnosis includes cystoscopy, using a long, thin tube with a lens (cystoscope) to see inside urethra and bladder. Drinking plenty of water, a decrease in sugar consumption as well as maintaining hygiene will help the patient to get well soon.