Case Study: Urinary Tract Infection.
You are working in an extended care facility when M.Z.’s daughter brings her mother in for a week’s stay while she goes on a planned vacation. M.Z. is an 89-year-old widow with a 4-day history of non- localized abdominal pain, incontinence, new-onset mental confusion, and loose stools. Her most current vital signs are 118/60, 88, 18, 98.4° F (37.4° C). The medical director ordered a post void catheterization, which yielded 100mL of cloudy urine that had a strong odor, and several lab tests on admission. Urine culture and sensitivity results are pending; the other results are shown in the chart.
ORDER CUSTOM, PLAGIARISM-FREE PAPER
Chart View Laboratory Test Results:
Complete metabolic panel: Within normal limits except for the following results:
BUN 25mg/dL Sodium 131mEq/L
Potassium 3.2mEq/L
White blood cell count 11,000/mm3
Urinalysis Appearance Cloudy Odor Foul
pH 6.9
Protein Negative
Nitrites Positive
Crystals Negative
WBCs 6 per low-power field
RBCs 3
What condition do the lab reports point toward
Which assessment findings are typical of an older adult with the condition in Question 1?
Considering her history and laboratory results, what other condition is a possibility?
4.The medical director makes rounds and writes orders to start an IV of D5 ½NS at 75mL/hr. and insert a Foley catheter to gravity drainage. Because M.Z. is unable to take oral medications, the medical director orders ciprofloxacin (Cipro) 400mg q12h IV piggyback (IVPB). Are the type of fluid and rate appropriate for M.Z.’s age and condition? Explain.
While the IVPB ciprofloxacin is being administered, which adverse effects might occur?
You enter the room to start the IV infusion and insert the Foley catheter and find that the nursing Helpive personnel (NAP) has taken M.Z. to the bathroom for a bowel movement. M.Z. asks you to help her, and, as you open the door, you observe her wiping herself from back to front. What do you need to do at this time?
Because M.Z. has been having diarrhea, what special instructions should you give the NAP assigned to give basic care to M.Z.?
