NURS MISC Urosepsis Case Study Jean Kelly age 82,100% CORRECT
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NURS MISC Urosepsis Case Study
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NURS MISC Urosepsis Case Study
NURS MISC Urosepsis Case Study Jean Kelly age 82
Jean Kelly is an 82-year-old woman who has been feeling more fatigued the last three days and has had a fever the last twenty-four hours. She reports a painful, burning sensation when she urinates as well as frequency of urination the last week. H...
Jean Kelly is an 82-year-old woman who has been feeling more fatigued the last three days and
has had a fever the last twenty-four hours. She reports a painful, burning sensation when she
urinates as well as frequency of urination the last week. Her daughter became concerned and
brought her to the emergency department (ED) when she did not know what day it was. She is
mentally alert with no history of confusion. While taking her bath today, she was weak and
unable to get out of the tub and used her personal life alert button to call for medical assistance.
Personal/Social History:
Jean lives independently in a senior apartment retirement community. She is widowed and has
two daughters who are active and involved in her life.
What data from the histories are important and RELEVANT and have clinical significance for
the nurse?
RELEVANT Data from Present Clinical Significance:
Problem:
Progressively worsening fatigue, Clinically significant symptoms of urinary tract
fever, and painful, burning, and infection prompting request for an order for a
frequent urination. urinalysis.
Sudden onset of confusion (change Confusion is a common presentation of UTI in the
in mental status) with no prior elderly, and change in mental status from baseline
history should always be fully investigated.
RELEVANT Data from Social Clinical Significance:
History:
Lives in a senior retirement Jean has a strong support system and a safe place to
community with daughters who are return to after discharge that will provide support. Her
actively involved in her life and life alert button provides the security she needs in the
wears a life alert button event of an emergency since she lives alone.
What is the RELATIONSHIP of your patient’s past medical history (PMH) and
current meds? (Which medications treat which conditions-indicate with numbers
or some form that I can identify
PMH: Home Meds: Pharm. Expected Outcome:
Classification:
Diabetes 1. Allopurinol 100 1. Antigout agent 1. Decreased
type 2 mg PO
Hyperlipide bid production of uric
mia
,Hypertension 2. ASA 81 mg PO acid to reduce gout
(HTN) Gout daily 3. 2. Antiplatelet/salicyl flares
Pioglitazone 15 mg ate 2. Reduce platelet
PO daily aggregation and
4. Simvastatin 20 clumping to prevent
mg PO daily clotting
3. Thiazolidinedion
5. Metoprolol 25 mg 3. Reduces and
PO bid 6. Lisinopril 10 e/anti diabetic controls blood
4. Antihyperlipidemic
mg PO daily 7. glucose levels
Furosemide 20 mg PO 5. Beta blocker 4. Reduces
daily cholesterol/ blood
8. Potassium chloride 20 lipid levels
mEq PO daily 5. Reduces blood
6. Ace inhibitor pressure
6. Reduces blood
7. Loop diuretic pressure
8. K supplement 7. Reduces BP
through diuresis
8. Replaces K in the
body lost through
diuresis
, One disease process often influences the development of other illnesses. Based on your
knowledge of pathophysiology, (if applicable), which disease likely developed FIRST
that then initiated a “domino effect” in their life?
● Circle what PMH problem started FIRST
• DMII
● Underline what PMH problem(s) FOLLOWED as dominoes
• HTN, HLD (probably coexisted), Gout
• Wasn’t exactly sure when Gout could have happened as it not
necessarily linked to her other comorbidities
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 101.8 F/38.8 C Provoking/Palliati Nothing/Nothing
(oral) ve:
P: 110 (regular) Quality: Ache
R: 24 (regular) Region/Radiation: Right flank
BP: 102/50 Severity: 5/10
O2 sat: 98% room air Timing: Continuous
The nurse recognizes the need to validate his/her concern of fluid volume deficit and performs a
set of orthostatic VS and obtains the following:
What VS data are RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
Temp of 101.8F Indicative of fever, systemic sign of infection
Pulse of 110 Tachycardia, heart is beating faster - could be sign of
anxiety or compensation of some sort
Respirations of 24 Tachypnea could also be a sign of anxiety or
compensation
BP 102/50 In combination with tachycardia, probably indicative of
fluid volume deficit in which heart beats faster to
maintain pressure with the decreased blood volume
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