Urinary Tract Symptoms: A Case Study

Urinary incontinence is loss of bladder control, which can happen to anyone, but it becomes more common with age. Symptoms of incontinence can range from mild leaking to uncontrollable wetting. If it is not managed on time, it can lead to embarrassment, stigmatization, and depression.

A visit note from Dr. Robert Hendren (Urology), dated 09/20/2017, indicated that the claimant continued to have urinary frequency, urgency, and urge incontinence that required her 2 pads per day. She had microscopic hematuria noted on 08/31/2017. She had 3+ blood on urinalysis during the visit, but she had been undergoing her menstrual period. She had complaints of pain in the stomach, left arm, right leg, and foot. Urinalysis showed moderate blood with 30+ protein. Her BMI was 32.12. She was diagnosed with urge incontinence and hematuria. Cystoscopy was recommended.

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.

Sign and symptoms of BPH are frequent urination or inability to urinate, incontinence/dribbling, pain when urinating, and unable to completely empty bladder. A short-term goal will be that the patient will not or experience less pain when urinating. The patient will not be dehydrated will be the long-term goal. These goals will be accomplished if patient follow medication regimen and the patient will report pain level to the nurse for pain management. By reducing the discomfort level of urinating, the patient will not be afraid of drinking more fluids. Teaching the patient, the importance of staying hydrated will also reduce the risk of getting an UTI. T.M. is Flomax for BPH. One of the teaching for Flomax is it “May cause sudden drop in BP, especially after first dose or when changing dose” Wolters Kluwer

Urinary System: Patient states that she urinates about 4 times a day without urgency. She denies having nocturia, dysuria, polyuria or oliguria, hesitancy or straining, narrowed stream, inconsistence, or pain in flank groin, suprapubic region, or low back. She states that her urine is clear, and it does not present hematuria. In order to avoid urinary tract infections, she states that she drinks about three liters of water every day. She had a UTI at age 18.

Benign prostatic hyperplasia (BPH) is an enlarged prostate. The prostate goes through two main growth periods. The first occurs early in puberty and the second begins around the age of 25 and continues during most of the man’s life ("Urology care foundation - What is benign prostatic hyperplasia (bph)?," 2016). BPH normally occurs during the second growth phase.

Patient reports urinary burning, urgency, and frequency for 2 days. He admits that he had similar symptoms 2 months ago, but he did not seek treatment because he was on vacation. States that he passes one kidney stone 1 week ago. Denies fever, chills, flank pain, and hematuria.

Urinary tract infections are among the most frequent infections not only in hospital or acute care setting, but also in residents of long-term care facilities for the elderly. (Blanck, Donahue, Brentlinger, Stinger, & Polito, 2014 Peasah, 2013). Wubay and I discussed how to reduce UTI and increase patient’s safety in acute and long term cares. Through our research we found that Foley catheter bundle/ high touch cleaning was effective to reduce CAUTI. We did our project on foley catheter bundle/high touch cleaning and agree to educate hospital wide team how to use high touch cleaning to reduce health care acquired infection and increase evidence based practice. We did this project because UTIs is affecting most of people in acute and long

The patient is a 41-year-old gentleman who was recently discharged from the hospital 2 days ago. He presented back to the ED complaining of nausea, vomiting, abdominal pain and he presented here instead of going to his regularly scheduled hemodialysis. He also stated that he thought he had blood in his stools. He was also complaining of abdominal pain and constipation and requesting IV Dilaudid and IV Benadryl. CAT scan of the abdomen showed wall thickening around the rectum and distal sigmoid, procto-colitis was not excluded. Initially the attending physician has hoped to keep the patient in outpatient status, however he was admitted inpatient. The case was discussed with Dr. Lasheen, it was decided in view of his multiplicity of comorbidities

Other symptoms consist of sharp stabbing pain in the lower back that can last up to an hour. If you experience nausea, vomiting, diarrhea, and noticed blood in your urine, then you may have a kidney stone. Some times you will have an urge to urinate and when you finally do you will feel a burning pain in the urethra.

The patient I Observed ,Ms Maggie, is a female patient in her 60s who has previously suffered a stroke, DVT and is currently taking a diuretic to prevent any further thrombi or emboli from forming. She presented complaining of a persistent urinary tract infection

Feline lower urinary tract disease is a general term used when there is a condition affecting a cat’s bladder or urethra. These problems can consist of: urinary stones or crystals that form in the urine and irritate the lining of the bladder, urethral plugs that form in the male cats’ urethra, causing a physical obstruction, spasm of the muscle in the wall of the urethra, stress and behavioral problems, and bacterial infections in the bladder (Understanding). Clinical signs of feline lower urinary tract disease include: straining to urinate, urinating small amounts, frequent and/or prolonged attempts to urinate, crying out while urinating, excessive licking of the genital area, urinating outside the litter box, and blood

Once it has been determined that further workup is needed there are certain labs and procedures that can be ordered. All patients will require a urinalysis and culture that can easily be performed to rule out infection and/ or hematuria. Cytoscopy, cystometry, and urethrography can be used to determine if there is presence of cystitis, bladder outlet obstruction, and cystocele.2 In males, prostate-specific antigen (PSA) level determination, ultrasonography, and prostate biopsy may be required to distinguish between benign prostatic hyperplasia and prostate

Nephrotoxins, acute interstitial nephritis, glomerular damage, and vascular damage also correlate with intrarenal acute renal failure (Singh, Levy, & Pusey, 2013). Postrenal acute renal failure is usually a result of a urinary tract obstruction that affects the kidneys bilaterally, which causes the intraluminal pressure upstream from the site of the obstruction to increase with a progressive decrease in the glomerular filtration rate (McCance, Huether, Brashers, & Rote, 2014). A pattern consisting of several hours of anuria with flank pain followed by polyuria is typically found in individuals with postrenal acute renal failure (McCance, Huether, Brashers, & Rote, 2014).

The patient’s symptoms indicate signs of advanced prostate cancer, “prostate cancer seldom produces signs and symptoms until it is advanced. Signs of advanced disease include a slow urinary stream…urinary hesitancy, incomplete bladder emptying…These symptoms are due to the obstruction caused by tumour progression.” Scott, W, pp421 (2011). The developmental stages of the cancer provide an understanding of the symptoms presented “T2b are diffuse, larger, or present in both lobes” Hamilton, W. (2004)