Course material

1. Nursing Case Study: Urinary Tract Infection
Case Study: Urinary Tract InfectionYou 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.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/LWhite blood cell count 11,000/mm3Urinalysis Appearance Cloudy Odor Foul pH
6.9 Protein Negative Nitrites Positive Crystals NegativeWBCs 6 per low-power field RBCs
3What 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. 5. While the IVPB ciprofloxacin is being
administered, which adverse effects might occur?6. You enter the room to start the IV
infusion and insert the 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 her wiping herself from back to front. What do you need to do at
this time?7. Because M.Z. has been having diarrhea, what special instructions should you
give the NAP assigned to give basic care to M.Z.?Case Study Progress: The next day, you are
the nurse assigned to M.Z.’s care. You notice that the NAP emptying the gravity drain is not
wearing personal protection devices. You also observe that the drainage port of the
drainage bag was contaminated during the process because the NAP allowed it to touch the
floor.8. What issues need to be considered in protecting M.Z.’s safety? Describe your actions
in working with the nursing assistant.9. As you assess M.Z., you notice that her catheter
tubing is not secured. Why does the tubing need to be secured, and where is the correct
place for the catheter tubing?10. What changes, if any, will be made to the antibiotic
therapy?