Question

PN 200 Fundamentals of Nursing STUDY: URINARY TRACT INFECTION You are working in an extended licy when Maria A a week stay while she at Mrs Zippo is a 69 year history of dysuria, back pain, incont physician had Wascian had recently discontinued her hemone replacement therapy on most current vital signs are 1860, 88, 18. 99.4 F. The on admission. The results were as follows: WBC 11,000 CMP all values were within normal limits Maria Zippo's daughter brings her mother in Incontinency, severe mental confusion, and loose stools. He Mrs Zippo is a 69 year-old widow with a 4 day mone replacement therapy one (1) month ago. Her The medical director ordered several lab tests Post-voiding catheterization vielded 100 mL and urinalysis showed: WBC +100 under HPF (high power field) RBC 3-6 Bacteria-rare Urinary culture and sensitivity results are as follows: E.coli >100,000 colonies: sensitive to ciprofloxacin, trimethoprim- sulfamethoxazole, and nitrofurantoin. #1. What role does hormone replacement therapy play in the prevention of U in the prevention of UTI's? S #2. Explain the pathophysiology of the symptoms the patient displayed. 3. Which of the above laboratory values are abnormal: what are the normal values # 4. What is the significance of the post-voiding catheterization? What is the normal amount of urine in the bladder to be expected? The medical director makes rounds and writes the order to start an IV of D/5 0.9%NS at 75 mL/hr. and insert a Foley retention catheter to straight drainage. Because Mrs. Zippo is unable to take oral medications, the physician orders ciprofloxacin 200mg twice daily IVPB. #5. Is the type of fluid and rate appropriate for Mrs. Zippo and condition? Explain your rationale. #6. What type of adverse effects would you look for in a patient receiving IV ciprofloxacin?

Answer 1

1. Hormone replacement therapy is indicated in post menopausal women to prevent urinary tract infections. Low estrogen levels is correlated with frequent UTI. Researcher found that estrogen induces  production of natural antimicrobial substances in the bladder. This hormone make the urinary tract tissue stronger by closing the gaps to prevent bacteria entering into bladder wall.

2. Uropathogenic microbes ènable adeherence on the host cells and grow and hampers host immune mechanism. UTI debelops like the above. infections in the kidneys lead to upper back pain. infection in the bladder causes painful urination.

3. E coli in urine culture more than 1 lakh count is abnomal.

WBC , RBC, CMP is normal within limits.

4. Post voidal catheterization is the procedure to find put any residual volume of urine in bladder after voiding. It is a diagnostic tool. It is used to identify any disease such as UTI, mechanical obstruction, cauda equina syndrome etc. Normal expected amount is 50 ml is adequate emptying