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Case study assignment 

 

Earl Green, 87 y/o male has been admitted to the Urology floor with the diagnosis of a complicated urinary tract infection (UTI) with urinary retention. An indwelling urinary catheter is inserted to temporarily relieve the retention.

PmHX: HTN, BPH, renal calculi

 

QUESTION 1

What are four signs and symptoms of a UTI that you will assess Mr. Green for? (2 marks)

 

QUESTION 2

Looking at Mr. Green’s history, what factor(s) may predispose him to develop UTIs and why? (4 marks)

 

QUESTION 3

List three specific lab or diagnostic test that you anticipate being ordered with a rationale for each order. (3 marks)

 

QUESTION 4

Discuss two pharmacological treatments that you anticipate Mr. Green to be ordered, their classification, and rationale. (3 marks)

 

QUESTION 5

Two days later, the physician orders for the indwelling catheter to be removed for a trial of voiding. Eight hours after the removal of the catheter, Mr. Green has not voided and is complaining of suprapubic pain. Bladder scan reveals retention of 500mL of urine in the bladder. The urology team comes to reassess Mr. Green and determines that his symptoms are a complication of his BPH. They determine that a TURP procedure will be most beneficial for Mr. Green.

The nurse anticipates physician orders for surgical preparation. List three of these orders and why they would be ordered (3 marks)

 

QUESTION 6

Earl had the TURP procedure. The PACU nurse has informed you the patient is returning with a CBI infusion due to small clots that were formed. The nurse states the patient is on an NS infusion @ 100 cc/hr and has infused 1L of fluid. The nurse has just emptied the patients foley for 1025cc of pink/red fluid with small amounts of clots. The patient is stating slight burning but no nausea.  Patient is A+O x3, VSS on 3L of O2.

What are four nursing priorities for Mr. Green postop? (2 marks)

 

QUESTION 7

As you are taking care of Mr. Green, you notice that the urine in the foley bag is bright red. What are your next steps and why? (1 mark)

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QUESTION 8 

At the end of your shift, you are assessing Earls intake and output. He has had a total of 800cc IV NS, 250 cc PO fluids, 4800cc irrigation fluid, and 4955 cc in the foley drainage bag. What is Earls intake and output for your shift? (1 mark)

 

 

QUESTION 9

You return back to the unit and Mr. Green is 3 days postop. His CBI infusion is slower as his foley drainage bag shows very light pink/clear drainage, with no clots. The patients IV is running@ 30cc/hr. The patient is tolerating his diet. What priority order do you anticipate and why? (1 mark)

 

QUESTION 10

What are four key areas you want to focus for your discharge teaching for this patient? Why? (4 marks)

 

SCIENCE
HEALTH SCIENCE
NURSING
HEALTHAGE 1AA3

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