Question

Please help

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

2. 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

1. The diagnostic tests for urinary tract infection are :-

Mainly we do the urine analysis .

- urine culture =to detect the microorganisms causing the infection .

- urine dip stick test = to detect nitrates.

- urine leukocyte esterase test =to detect leukocytes ,it indicates the presence of infection .

- pyuria = on assessment of urine , presence of pus is a sign of infection.

- hematuria =presence of blood in urine is also a sign of infection in 30%of patients with urinary tract infection.

- Basic blood investigations =complete blood count in which increased WBC count is a sign of infection.

2. The topics nurse should discuss with Ms .James before discharge are :-

- Drink plenty of liquids especially water ,water helps to dilute urine and ensure you urinate more frequently . It flushes out the bacteria from urinary tract and dose not allow time to accumulate and cause infection.

- Drink Canberra juice , research has showed drinking canberry jjuice prevents urinary tract infection.

- Wipe from front to back after urinating and bowel movement prevents bacteria in the anal region from spreading to urethra.

- Empty your bladder after intercourse and have a glass of water ,it will flush the bacteria .

- Avoid potentially irritating feminine products.

- Change your birth control methods , sometimes these products continuous use cause urinary tract infection.

- Use cotton cloth undergarments and change them every day ,and avoid moisture accumulation.

- Take the medicine prescribed at correct time and maintain compliance to avoid drug resistance.