.M. is an 81-year-old female who lives in a nursing home. She had a stroke 2 years ago and has residual right-sided weakness. She also has gastroesophageal reflux disease, hypertension, and stress incontinence. She currently takes the following medications: Omeprazole 20 mg PO daily before breakfast Captopril 50 mg PO BID Furesomide 20 mg PO daily Today she tells the nursing assistant that she has a lot of pain when she urinates. The charge nurse completes a physical exam and notifies the provider of the exam findings and patient’s painful urination. A urinalysis is ordered. Subjective Data Pain with urination began 2 days ago States she usually doesn’t drink much because of the stress incontinence and not wanting to have “accidents,” and now she is drinking even less because doesn’t want to have to urinate due to the pain and burning Wearing feminine hygiene pads she had in her closet since the painful urination started because her stress incontinence “is worse” Objective Data Physical Examination Temperature 99.7° F, pulse 78, respirations 18, blood pressure 162/80 Left flank tenderness Diagnostic Studies Urinalysis Color: Dark, smoky color Odor: Foul smelling Protein: Trace Glucose: None Ketones: None Bilirubin: None Specific gravity: 1.034 pH: 8.2 RBCs: 8/hpf WBCs: 12/hpf Casts: Present Discussion Questions Based on L.M.’s presentation, what do you suspect is occurring and what assessment data led you to this conclusion? You need to obtain a clean-catch urine sample from L.M. to send for urinalysis. To collect this specimen, what instructions do you give L.M.? Describe how to assess for flank tenderness. What is the significance of L.M.’s left flank tenderness?

.M. is an 81-year-old female who lives in a nursing home. She had a stroke 2 years ago and has residual right-sided weakness. She also has gastroesophageal reflux disease, hypertension, and stress incontinence. She currently takes the following medications: Omeprazole 20 mg PO daily before breakfast Captopril 50 mg PO BID Furesomide 20 mg PO daily Today she tells the nursing assistant that she has a lot of pain when she urinates. The charge nurse completes a physical exam and notifies the provider of the exam findings and patient’s painful urination. A urinalysis is ordered. Subjective Data Pain with urination began 2 days ago States she usually doesn’t drink much because of the stress incontinence and not wanting to have “accidents,” and now she is drinking even less because doesn’t want to have to urinate due to the pain and burning Wearing feminine hygiene pads she had in her closet since the painful urination started because her stress incontinence “is worse” Objective Data Physical Examination Temperature 99.7° F, pulse 78, respirations 18, blood pressure 162/80 Left flank tenderness Diagnostic Studies Urinalysis Color: Dark, smoky color Odor: Foul smelling Protein: Trace Glucose: None Ketones: None Bilirubin: None Specific gravity: 1.034 pH: 8.2 RBCs: 8/hpf WBCs: 12/hpf Casts: Present Discussion Questions Based on L.M.’s presentation, what do you suspect is occurring and what assessment data led you to this conclusion? You need to obtain a clean-catch urine sample from L.M. to send for urinalysis. To collect this specimen, what instructions do you give L.M.? Describe how to assess for flank tenderness. What is the significance of L.M.’s left flank tenderness?

Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)

6th Edition

ISBN:9781305964792

Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Chapter22: The Patient History And Documentation

Section: Chapter Questions

Problem 2CR

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Related questions

Question

L.M. is an 81-year-old female who lives in a nursing home. She had a stroke 2 years ago and has residual right-sided weakness. She also has gastroesophageal reflux disease, hypertension, and stress incontinence. She currently takes the following medications:

Omeprazole 20 mg PO daily before breakfast
Captopril 50 mg PO BID
Furesomide 20 mg PO daily

Today she tells the nursing assistant that she has a lot of pain when she urinates. The charge nurse completes a physical exam and notifies the provider of the exam findings and patient’s painful urination. A urinalysis is ordered.

Subjective Data

Pain with urination began 2 days ago
States she usually doesn’t drink much because of the stress incontinence and not wanting to have “accidents,” and now she is drinking even less because doesn’t want to have to urinate due to the pain and burning
Wearing feminine hygiene pads she had in her closet since the painful urination started because her stress incontinence “is worse”

Objective Data

Physical Examination

Temperature 99.7° F, pulse 78, respirations 18, blood pressure 162/80
Left flank tenderness

Diagnostic Studies

Urinalysis

Color: Dark, smoky color
Odor: Foul smelling
Protein: Trace
Glucose: None
Ketones: None
Bilirubin: None
Specific gravity: 1.034
pH: 8.2
RBCs: 8/hpf
WBCs: 12/hpf
Casts: Present

Discussion Questions

Based on L.M.’s presentation, what do you suspect is occurring and what assessment data led you to this conclusion?

You need to obtain a clean-catch urine sample from L.M. to send for urinalysis. To collect this specimen, what instructions do you give L.M.?

Describe how to assess for flank tenderness. What is the significance of L.M.’s left flank tenderness?

What are L.M.’s risk factors for developing a urinary tract infection?

What diagnostic test would be needed to determine the best medication to treat L.M.’s urinary tract infection?

What are some important measures to teach L.M. to prevent recurrence of a urinary tract infection (UTI)?

Definition Definition Organic compounds that have a carbonyl group, C = O, as their functional group. The carbonyl group in ketones is placed somewhere in the middle of the molecular structure, which means, the C=O is attached to two alkyl groups or benzene rings. Just like all other homologous series, the naming of ketones is done using a common suffix “-one”. The general molecular formula is C n H 2n O. Functional group of a ketone

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