Dysuria Case Studies

Mr. Hightower is a 52 year old male with a PMH Type 2 DM, Hyperlipidemia, and HTN. He is a new patient to your office stating he stopped his meds several months ago and he cannot remember what he took in the past. His BP is 150/90. HR 88, RR 20 BMI 35. HGB A1C is 9.6, Total chol 225, LDLs 183, HDL 35. CBC, CHem, LFTs are wnl except for glucose of 124. Discuss the focused pertinent physical exam for this patient as well as what further diagnostics are needed in providing evidenced based care. What medications are important to start for this patient to treat his co-morbidities. Include the follow-up for this gentleman along with pertinent diagnostics needed at

Increase the proportion of physician office visits made by patients with a diagnosis of cardiovascular disease, diabetes, or hyperlipidemia that include counseling or education related to diet or nutrition by encourage the residents to do primary care checking more prequent.

194-195). The fourth nursing diagnosis that pertains to her is anxiety related her inability to breath adequately without support, the unknown outcome, her inability to speak from intubation, a change in the environment, a change in health status, and her not having insurance, and this is evidenced by restlessness, being unable to sedate her, and her uncooperative behavior(Gulanick & Myers, 2014, p. 416). The last nursing diagnosis for this patient is risk for decreased cardiac output related to her mechanical ventilation (Gulanick & Myers, 2014, p.

The patient is a 45 year old man who had GI surgery 4 days ago.  He is NPO, has a nasogastric tube, and IV fluids of D51/2saline at 100 mL/hr.  The nursing physical assessment includes the following:  alert and oriented; fine crackles; capillary refill within normal limits; moving all extremities, complaining of abdominal pain, muscle aches, and "cottony" mouth; dry mucous membranes, bowel sounds hypoactive, last BM four days ago; skin turgor is poor; 200 mL of dark green substance has drained from NG tube in last 3 hours.  Voiding dark amber urine without difficulty.  Intake for last 24 hours is 2500mL.  Output is 2000mL including urine and NG drainage.  Febrile and diaphoretic; BP 130/80; pulse 88; urine specific gravity 1.035; serum

Patient C.B. is a 32 –year-old African American female, G2P2 who came to clinic with complaint of burning and frequency with urination and foul odor urine that she said began four days ago.

One group of nurses in a hospital in Canton Ohio has chosen to make this their project. The starting point involves analyzing and revamping the heart failure education booklet that is handed out on the coronary care unit. The book must be written at a level of understanding for the patient, some studies suggest a seventh grade level. The book must contain signs and symptoms as well as information to manage the heart failure (White, Kirschner, & Hamilton, 2014). The interventions that are included in the book are such things as obtaining daily weights, monitoring intake and output, low salt diet, exercise, and who and when to report signs and symptoms. Monitoring the patient’s daily weight is important, tele-monitoring is a consideration, as if the weight elevates more than two pounds in a day, and three pounds in a week the physician may want to adjust medications (Smith, 2013). The book on heart failure should be directed and shared with the patient’s family. The patient may count on family for emotional support, and the patient may also share meals with family which now need to be low salt (White et al., 2014). The book should also include information related to diuretics, which are generally used for the heart failure patient to assist in removing fluids from around the heart and lungs. In the medication category it should also be included to avoid NSAIDS because they may worsen the heart failure. Other medications that may be include in the book include ACE, ARBs, beta-blockers, Digoxin, and Potassium supplements, which may be included in the patient’s health regimen. New topic to the book may also include a section for the patient to record weights, and blood pressures, information specific to salt, tests that may be done to determine the patient’s

This patient is a 35 y/o young women with a new diagnosis of breast cancer. Problems are the diagnosis of breast cancer, dehydration, and depression. Her depression is affecting her nutritional intake which is causing her malnutrition and poor intake. As an RN, I would encourage her to increase her daily intake and encourage

Patients with chronic heart failure present with decreased exercise tolerance. It is important that a well-designed exercise prescription is followed at all times and the appropriate health care provider such as the cardiologist is in agreement with your treatment plan. Query the physician if there is any specific exercise precautions or guidelines that are distinct to the patient. Furthermore, these particular patient populations may sometimes overexert themselves. Symptoms such as dyspnea, dizziness or lightheadedness,

Nurses should take care to select the proper outcomes to ensure optimum care is provided to patients with CHF. The plan of care is dependent on the nursing diagnosis and the desired nurse-sensitive outcomes. The priority NOC outcome for the diagnosis of CHF is Fluid Balance and Fluid Overload Severity. Other related NOC outcomes are Knowledge: Cardiac Disease Management, Knowledge: Energy conservation, Knowledge: Medication, Knowledge: Prescribed Activity, Knowledge: Treatment, and Knowledge: Weight Management (Johnson et al., 2012). These are only a select few of the multiple outcomes available; care should be modified as the disease progresses through the problems which evolves over the lifetime of patients diagnoses with CHF. Once all these determinants are established, the nurse will be prepared to determine which level of NOC is essential to effectively manage the disease.

Hence, to improve oxygenation of the blood, preventing hypoxia and ischaemia, the student nurse must ensure that Sylvie is receiving adequate supply of oxygen by checking her oxygen therapy and pulse oximeter are delivering well. Sylvie must be placed in semi-fowler's position to increase chest expansion and improve ventilation by decreasing the labour of breathing (Lemone, et. al.,2014). Sylvie may have self-care deficits where there is an inability to undertake activities such as bathing, dressing or feeding oneself (O'Donovan ,2011). The student nurse must attend to them by assisting Sylvie, encouraging independence as much as possible, with her activities of daily living as needed. This will confirm that her care needs are met while reducing cardiac workload (Lemone, et. al.,2014). Moreover, nursing care must be organise to facilitate rest periods. Clustering activities together permits adequate time for Sylvie to regain energy and strength (Lemone, 2014). Furthermore, diet is an essential part in the management of heart failure to address fluid retention. The student nurse must be aware that excessive sodium retention by the kidneys has been shown to be a diagnostic of heart failure, which basically is the rationale for sodium restriction (Abraham, J., & Merrill, A., 2013) and

The patient is 65-year-old gentleman who presented to the emergency room with fever, urinary urgency, lower abdominal pain, no nausea no vomiting. The wife also reported that the patient had a leak from the Foley catheter. The patient this has a history of hypertension, dementia and enlarged prostate. He is been followed by urologist at St. Hackensack University Hospital and currently has a urinary retention with indwelling Foley catheter. He presents to our ED with a temp of 102.3, white count of 24.6 which goes up to 25.5 and the left shift. Urinalysis reveals him to be dehydrated with specific gravity greater than 1030, positive nitrates, positive large, leukoesterase, a large amount of blood and his cultures immediately grew Escherichia

The subjective data might include the patient telling the nurse of pelvic pain, painful menstruation, aching, cramping, a bearing down sensation in the pelvis or lower back dysparurina. This type of pain may indicate cysts that are about to rupture or an infected tissue. The patient may also reveal that she has amenorrhea (absence of a menstruation). The collective data may include noting signs of abnormal uterine bleeding and also signs of infertility.

QMHP encouraged Jackie to verbalize any health concerns since the last session. QMHP addressed Jackie’s health crisis. QMHP lectured Jackie about maintaining her health. QMHP lectured about the importance of maintaining a healthy lifestyle. QMHP inquired about Jackie’s medication intake. QMHP prompted Jackie to take her medication daily as prescribed to promote good health. QMHP increased Jackie’s awareness about the effects of not maintaining the proper diet and nutrition guidelines provided by her doctor. QMHP supported Jackie with her doctor’s appointment at Fort Norfolk Primary Care with doctor Gilbert. QMHP encouraged Jackie to verbalize her concerns to her doctor. QMHP helped Jackie to understand her medical diagnosis provided by

A 79 years old lady was admitted to ward via GP referral .She was admitted to ward because of ongoing abdominal pain that lasted more than week. She had BD package of care with two carers. She was given diagnosis of sepsis and was on active treatment of antibiotic. Additional to her new diagnosis she also had haemoptysis, COPD, obstructive

During the initial appointment it is imperative to gather information and make sure that the session is client focused. Information needed to gather during the initial appointment include: reason for counseling, past counseling, current diet including alcohol, living condition, diet history. This information is important because it helps dietitians accurately assess the patient and the initial goal-setting process. It also helps the dietitian and patient evaluate what worked and what did not work and how to successfully achieve their goal. In addition, the information gathered during the initial appointment will allow the RD to calculate energy needs, analyze their diet and complete their ADIME note. Without properly assessing and gathering the information from the initial appointment, adequate documentation may be lacking in addition to inadequate tracking of the patient’s goals and overall