Place an order for your academic papers, assignments and study assistance. Our reliable paper writing service and research assignment help online ensures timely delivery of high-quality essays, answers, analysis and presentations, tailored to your specific course needs and requirements.
Posted: May 23rd, 2023
D4
Case 4
________________________________________
An 82-year-old man recently returned to the long-term care facility after hospitalization for open reduction internal fixation of the right hip. He has been divorced for over 50 years and has two adult children who visit him frequently in the nursing home. He has a 5-year history of mild to moderate dementia and known urinary tract infections. His last recorded mini mental state examination (MMSE) registered 18, which was 3 months ago. While in the hospital, he did have an indwelling catheter for 4 days. He has been incontinent since his return to the hospital but the staff their attributes this to the catheter and his deconditioned state following hospitalization. His medications include donepezil, memantine, and acetaminophen for pain and fever as needed. He has no other known medical problems except a history of multiple urinary tract infections throughout his lifetime that, according to his son, have required extensive antibiotic treatment. He enjoys drinking regular coffee throughout the day, says it is a habit he has had since his days in the service years ago. His family members and the nursing staff report that he has been very restless and has been unable to use the urinal on time the past couple of days.
Vital signs: T 99°F, HR 80, RR 18, BP 128/78, BMI 22.
Chief Complaint: Foul smelling urine, incontinence, restless
Discuss the following:
1) What additional subjective data are you seeking to include past medical history, social, and relevant family history?
2) What additional objective data will you be assessing for?
3) What are the differential diagnoses that you are considering?
4) What laboratory tests will help you rule out some of the differential diagnoses?
5) What radiological examinations or additional diagnostic studies would you order?
6) What treatment and specific information about the prescription that you will give this patient?
7) What are the potential complications from the treatment ordered?
8) What additional laboratory tests might you consider ordering?
9) What additional patient teaching may be needed?
10) Will you be looking for a consult?
Submission Instructions:
• Your initial post should be at least 500 words, formatted and cited in current APA Paper Writing Service by Expert Writers Pro Paper Help: Essay Writing Service Paper Writing Service by Essay Pro Paper Help: Essay Writing Service style with support from at least 2 academic sources. Your initial post is worth 8 points.
• Please post your initial response by 11:59 PM ET Thursday
Grading Rubric – Buy Custom College Essays Online: Pay for essay online
________________________________________
Your assignment will be graded according to the grading rubric.
Discussion Rubric – Buy Custom College Essays Online: Pay for essay online
Assignment Help & Best Dissertation Writing Services – Oxbridge Essays UK PhD Thesis Writing Ratings Points
Identification of Main Issues, Problems, and Concepts Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts. Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts. Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts. Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts. 5 points
Use of Citations, Writing Mechanics and APA Paper Writing Service by Expert Writers Pro Paper Help: Essay Writing Service Paper Writing Service by Essay Pro Paper Help: Essay Writing Service Formatting Write My Essay Today: No1 Essay Writing Service AU for Your Academic Papers – Guidelines Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA Paper Writing Service by Expert Writers Pro Paper Help: Essay Writing Service Paper Writing Service by Essay Pro Paper Help: Essay Writing Service precision and free of grammar and spelling errors. Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA Paper Writing Service by Expert Writers Pro Paper Help: Essay Writing Service Paper Writing Service by Essay Pro Paper Help: Essay Writing Service precision and free of grammar and spelling errors. Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA Paper Writing Service by Expert Writers Pro Paper Help: Essay Writing Service Paper Writing Service by Essay Pro Paper Help: Essay Writing Service style and writing mechanics need more precision and attention to detail. Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA Paper Writing Service by Expert Writers Pro Paper Help: Essay Writing Service Paper Writing Service by Essay Pro Paper Help: Essay Writing Service style and writing mechanics need serious attention. 3 points
D4 Case 4
Subjective Data
Chief Complaint: Foul smelling urine, incontinence, restless
Past Medical History: Mild to moderate dementia, multiple urinary tract infections, hip fracture
Social History: Divorced, two adult children
Family History: Unknown
Medications: Donepezil, memantine, acetaminophen
Allergies: None known
Objective Data
Vital signs: T 99°F, HR 80, RR 18, BP 128/78, BMI 22
Physical Exam: Genitourinary: Incontinent, foul smelling urine
Differential Diagnoses
Urinary tract infection
Bladder cancer
Prostate cancer
Renal calculi
Interstitial cystitis
Urethral stricture
Dehydration
Dementia
Delirium
Laboratory Tests
Urinalysis: Urine culture and sensitivity
Complete blood count (CBC)
Blood urea nitrogen (BUN) and creatinine
Electrolytes
Liver function tests
Radiological Examinations
Kidney, ureter, and bladder (KUB) X-ray
Renal ultrasound
Treatment
Antibiotics for urinary tract infection
Pain medication for pain
Fluid management for dehydration
Behavioral interventions for dementia
Environmental modifications for delirium
Potential Complications
Ascending infection
Pyelonephritis
Septicemia
Renal failure
Death
Additional Laboratory Tests
If the patient does not respond to antibiotics, additional laboratory tests may be ordered to rule out other causes of the infection, such as a kidney stone or prostatitis.
Additional Patient Teaching
The patient should be taught about the importance of drinking plenty of fluids, voiding regularly, and wiping from front to back after urination.
The patient should also be taught about the signs and symptoms of a urinary tract infection, such as foul smelling urine, pain or burning during urination, and frequent urination.
Consult
If the patient does not respond to treatment or has any complications, a consult with a urologist may be necessary.
References
Beers, M. H., Porter, R. S., Jones, T. V., & Kaplan, J. S. (2022). The Merck manual of diagnosis and therapy (19th ed.). Elsevier.
Fauci, A. S., Braunwald, E., Kasper, D. L., Hauser, S. L., Longo, D. L., Jameson, J. L., … & Fauci, A. S. (2022). Harrison’s principles of internal medicine (21st ed.). McGraw-Hill Education.
Place an order in 3 easy steps. Takes less than 5 mins.
Each Student Wants High Quality and That’s Our Focus
An online hub of writing bishops' experts. We select the best qualified writers to join our team. These writers are recruited based on their college graduation grades, exceptional writing skills and ability to convey complex ideas in a clear manner. They each have expertise in specific topic fields and background in academic writing. This expertise enables them to provide well-researched and informative content that meets the highest standards.
In appreciation of the fact that our clients are majorly college and university students, we offer the lowest possible pricing while still providing the best writers. This approach ensures that our clients receive high-quality content and best coursework grades without breaking the bank. Our costs are fair and reasonable compared to other custom writing services in the market. As a result of maintaining the balance between affordability and quality, we have established ourselves as a reliable choice in the industry.
You will never receive a final paper that contains any plagiarism or AI use similarity index. Our team of professional writers and editors is dedicated to ensuring the originality of all content. We scan every final draft before releasing it to be delivered to a customer for submission in safeassign and turnitin. This rigorous process guarantees that the work meets the highest standards of academic integrity.