1. APA FORMAT
2. CITE ALL REFERENCES
3. PLEASE COMPLETE ALL QUESTIONS. Late assignmentswill not be accepted!!!
Case Study: UrinaryTract Infection
You are working in an extended care facility whenM.Z.’s daughter brings her mother in for a week’s stay while shegoes on a planned vacation. M.Z. is an 89-year-old widow with a4-day history of non- localized abdominal pain, incontinence,new-onset mental confusion, and loose stools. Her most currentvital signs are 118/60, 88, 18, 98.4° F (37.4° C). The medicaldirector ordered a post void catheterization, which yielded 100mLof cloudy urine that had a strong odor, and several lab tests onadmission. Urine culture and sensitivity results are pending; theother results are shown in the chart.
Chart View Laboratory Test Results:
Complete metabolic panel: Within normal limits exceptfor 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 pointtoward?
Which assessment findings are typical of an olderadult with the condition in Question 1?
Considering her history and laboratory results, whatother condition is a possibility?
4.The medical director makes rounds and writes ordersto start an IV of D5 ½NS at 75mL/hr. and insert a Foley catheter togravity drainage. Because M.Z. is unable to take oral medications,the medical director orders ciprofloxacin (Cipro) 400mg q12h IVpiggyback (IVPB). Are the type of fluid and rate appropriate forM.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 insertthe Foley catheter and find that the nursing assistive 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 herwiping herself from back to front. What do you need to do at thistime?
Because M.Z. has been having diarrhea, what specialinstructions should you give the NAP assigned to give basic care toM.Z.?
Case StudyProgress:
The next day, you are the nurse assigned to M.Z.’scare. You notice that the NAP emptying the gravity drain is notwearing personal protection devices. You also observe that thedrainage port of the drainage bag was contaminated during theprocess because the NAP allowed it to touch the floor.
What issues need to be considered in protecting M.Z.’ssafety? Describe your actions in working with the nursingassistant.
As you assess M.Z., you notice that her cathetertubing is not secured. Why does the tubing need to be secured, andwhere is the correct place for the catheter tubing?
What changes, if any, will be made to the antibiotictherapy?
