Question

In: Nursing

A 22- year-old woman presents to the ED with complaints of bladder fullness , incomplete bladder...

A 22- year-old woman presents to the ED with complaints of bladder fullness , incomplete bladder emptying , and severe pain in her right flank. She rates the pain a 9 on a 0-10 numeric pain scale. Patient states she has a history of kidney stones . She also states when she is able to void, it burns and has a foul odor . Vital signs: HR 85 , BP 120/80 , RR 16, SPO2 98% on RA, temp 100.9 (oral). Pt takes the following medications : Hydrochlorothiazide (HCTZ ) 25 mg PO daily , Detrol LA 2 mg PO daily Lab results : CBC : WBC 26 Urinalysis : WBC (too many to count), Bacteria (5+, large), Leukoesterase (+) Positive , Protein (-) negative , Ketones (-) negative.
Assessment? Diagnosis? Evaluation ? Implementation ? Planning?

Solutions

Expert Solution

Assessment-subjective data includes fever,right flank pain,bladder fullness,incomplete bladder emptying,burning micturation and foul odour in urine.

Objective data-pain score 9,oral temperature 100.9F,elevated wbc in blood(26) and wbc as well as bacteria in urine.

The reason might be kidney stones as it is one of the cause for UTI.

Diagnosis-urinary tract infection.

Planning-withhold hydrochlorothiazide because it is a diuretic ,as patient has delayed bladder emptying it will worst the condition.

Detrol also should withhold as it is used to treat an overactive bladder.As patient has delayed emptying it will also affect patient condition.

Analgesics and antipyretic can be given as adviced by doctor,example paracetamol which has both effects.As pain score is 9 intravenous therapy is better.Asses the pattern of voiding and its frequency.provide comfortable position.Encourage to pass urine.Asses bladder .Administer antibiotics as adviced by doctor.Can arrange for a cystoscopy or ultrasound to identify for any stones.Give more fluids.

Implementation-provide comfortable position.provide privacy.Encourage to pass urine.Administer medications as per order.provide psychological support.Provide cold application to encourage urination.Maintain proper hygiene.

Evaluation-Reduced pain and temperature. Can pass urine without pain.wbc is reduced in urine and blood.

Nightingale answered 1 hour ago
Next > < Previous

Related Solutions

A 22 year old black woman present with complaints of burning and frequency of urination for...
A 22 year old black woman present with complaints of burning and frequency of urination for the past 2 to 3 days. It is getting worse. She feels she has to void, rushes to the bathroom and then is only able to void a small amount. it is painful. There is no sign of blood in the urine. She denies fever, chills, diarrhea, nausea, vomiting or vaginal discharge. " I have to rush to the bathroom, and it hurts when...
A 22 year old black woman present with complaints of burning and frequency of urination for...
A 22 year old black woman present with complaints of burning and frequency of urination for the past 2 to 3 days. It is getting worse. She feels she has to void, rushes to the bathroom and then is only able to void a small amount. it is painful. There is no sign of blood in the urine. She denies fever, chills, diarrhea, nausea, vomiting or vaginal discharge. " I have to rush to the bathroom, and it hurts when...
A 25-year-old previously well woman presents to doctor’s office with complaints of episodic shortness of breath...
A 25-year-old previously well woman presents to doctor’s office with complaints of episodic shortness of breath and chest tightness. She has had the symptoms on and off for about 2 years but states that the have worsened lately, occurring two to three times a month. She notes that the symptoms are worse during the spring months. She has no exercise-induced or nocturnal symptoms. The family history is notable for a father with asthma. She is single and works as an...
Your patient is a 42-year-old female that arrives in the ED with complaints of fever and...
Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with scant amount of dark, foul smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28. She is allergic to penicillin and Sulfa. What type of shock is she experiencing? What interventions do you anticipate the doctor will order? What can you...
A 36 year old caucasian, obese, female presents to the ED with a complaint of epigastric...
A 36 year old caucasian, obese, female presents to the ED with a complaint of epigastric pain for the last 2 days. THe pain radiates through to her back, is consistant, sharp in nature and relieved with sitting up. Associated symptoms includes nausea and non-bloody emesis. Eating make the pain worse and therefore she has not eaten for the last 24 hrs. He is married and has two children. She denies any alcohol and drug use. One assessment she is...
A 36 year old caucasian, obese, female presents to the ED with a complaint of epigastric...
A 36 year old caucasian, obese, female presents to the ED with a complaint of epigastric pain for the last 2 days. THe pain radiates through to her back, is consistant, sharp in nature and relieved with sitting up. Associated symptoms includes nausea and non-bloody emesis. Eating make the pain worse and therefore she has not eaten for the last 24 hrs. He is married and has two children. She denies any alcohol and drug use. One assessment she is...
A 72 year old woman went into a walk-in clinic with complaints of coughing and shortness...
A 72 year old woman went into a walk-in clinic with complaints of coughing and shortness of breath. She was diagnosed with acute bronchitis and was given a prescription for antibiotics. She was told to return to the clinic if her symptoms did not respond to the antibiotics. The patient returned, the following week. She had similar complaints and was given a chest x-ray, which was normal. The patient was diagnosed with respiratory illness and was referred to a pulmonologist....
A 42 year old woman was introduced to the Emergency Room with complaints of abdominal pain...
A 42 year old woman was introduced to the Emergency Room with complaints of abdominal pain for the past few days. She was also reported her stools have been black and sticky. She suspected to have GI (gastro-intestinal) bleeding. According to her medical history, she was transfused with 2 units washed packed RBCs 6 months ago for the same symptoms. The CBC results were: WBCs: 5.7 X 103/µl RBCs: 2.95 X 106/µl HGB: 6.3g/dL Hematocrit: 19.8% According to her anemic...
A 57 year-old male with history of HTN and HLP presents to your office with complaints...
A 57 year-old male with history of HTN and HLP presents to your office with complaints of transient chest pain during exertion. He denies associated nausea, diaphoresis however does complain of increase shortness of breath and dyspnea on exertion. His chest pain is substernal and does not radiate and seems to alleviate after 5-10 minutes with rest. The last occurrence of pain was one week ago. Pt denies palpitations, near syncope or syncopal episodes. 1. How would you classify the...
QUESTION 12 A 76-year-old male presents to the OP surgical suite for investigation of suspected bladder...
QUESTION 12 A 76-year-old male presents to the OP surgical suite for investigation of suspected bladder tumors. A diagnostic cystoscopy is performed, revealing a normal urethra. However, two bladder tumors of approximately 1.5 cm were identified. At that time, a cystoscopicfulguration of the tumors was accomplished. Prior to fulgeration, a biopsy of the tumors was taken and sent to pathology. The surgeon's operative report lists a post-operative diagnosis of "suspected bladder cancer." The pathology report indicates transitional cell carcinoma in...
ADVERTISEMENT
Subjects
ADVERTISEMENT
Latest Questions
ADVERTISEMENT