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Urinary Tract Infection Case

The patient has foul-smelling urine, incontinence, and is agitated. Urinary tract infections (UTIs) are extremely frequent, affecting millions of Americans each year. UTIs are ascending infections that, if not treated promptly, can be fatal (Hubert & VanMeter, 2018).

It is necessary to start by inquiring about the symptoms. Inquire about the patient’s urination problems, such as hesitation, dribbling, or nocturia. Inquire about the patient’s sexual history, both past, and present. Next, find out the past medical history to see whether the patient has any prostate troubles (Kennedy-Malone et al., 2019). I’d also investigate whether he had bladder training before the foley was removed from the hospital.

Palpating the lower abdomen for bladder distension or soreness would be another objective data point. I would also perform a bladder scan on the patient if possible. This is a quick and easy approach to detect how much urine is held in the bladder and whether there is retention. A urogenital exam, if the patient agrees, may reveal lesions, edema, hernias, or lymphadenopathy (Kennedy-Malone et al., 2019). Pyelonephritis can also be detected by palpating the patient’s flank area or by lower back pain. Finally, look for symptoms of infection such as malaise, nausea, and leukocytosis.

Dysuria, cystitis, urethritis, pyelonephritis, urinary incontinence, and lower urinary tract infection are all differential diagnoses to explore. Underlying problems such as a lower urinary tract infection and the use of certain drugs can induce dysuria. Involuntary bladder function is impaired, resulting in urinary incontinence (Dunphy et al., 2019).

Uranalysis is a quick, painless, and inexpensive approach to diagnose a urinary tract infection and associated problems. A patient’s white blood cell count (WBC) can be determined through blood tests, which will be higher if an infection is present. Blood tests can also be used to assess kidney function (Dunphy et al., 2019). E. coli, Klebsiella, Staphylococcus, and Enterobacteria are common bacteria linked to urinary tract infections (Hubert and VanMeter, 2018). A CT scan of the abdomen and a renal ultrasound are two radiological tests that should be considered. This would reveal any form of blockage or mass.

I would consider giving an antibiotic sensitive to the bacteria discovered in the urine based on the results of the urinalysis and lab testing. When prescribing antibiotics, I would inform the patient and his caregivers about possible side effects, such as nausea, diarrhea, and dizziness. To counteract the antibiotic’s effects, I would advise the patient to take a probiotic two hours before or after taking the antibiotic. An allergy or sensitivity to the antibiotics, as well as treatment resistance, could be side effects of the medication.

Nutritional counseling may be required as additional patient education. Caffeine should be avoided throughout the day by the patient. Caffeine is a diuretic, which means it can make you dehydrated (Kennedy-Malone et al., 2019). To enhance renal profusion and appropriate hydration, the patient should consume enough water. Cranberry juice can be consumed by the patient because it has been demonstrated to prevent E. coli from adhering to the bladder wall (Hubert & VanMeter, 2018).

I would consider giving an antibiotic sensitive to the bacteria discovered in the urine based on the results of the urinalysis and lab testing. If the symptoms persist, a visit to a nephrologist may be necessary, especially if the patient has a history of this happening frequently. Finally, I would seek advice from the patient’s neurologist. According to the study, the patient is taking memantine and donepezil, two drugs that can help with dementia management. Memantine, on the other hand, can build up in the body and create side effects. It’s also not a good idea for people who have kidney problems or have poor kidney function to take that medication (Kennedy-Malone et al., 2019). If lab tests reveal this, it may be best to stop taking the drug or reduce the amount slightly. On this matter, consulting with a neurologist and a nephrologist is the recommended course of action.

References

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary care: The art and science of advanced practice nursing – an interprofessional approach. F.A. Davis Company.

Hubert, R. J., & VanMeter, K. (2018). Gould’s pathophysiology for the health professions. Elsevier.

Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older adults. F.A. Davis Company.