Case Study, Chapter 55, Management of Patients With Urinary Disorders

1. Sue Meade, 22 years of age, presents to the clinic with complaints of burning, pain, and urgency when urinating. The patient has a fever of 100°F. The urine is strong in odor and cloudy with sediments. (Learning Objectives 1 and 2)

a. What questions should the nurse ask during the assessment to gain more information about the possible causes of the urinary tract infection?

b. What patient education should be provided?

2. John Lyons has undergone treatment for kidney stones three times in the last year. Today he calls this primary provider with complaints of acute, excruciating, colicky, pain that radiates down the thigh toward the genitalia. The pain started last night, and has become progressively more severe. He also complains of the urge to void but has little urine output, and it is blood tinged. Due to the pain, he has not taken any fluids or food in 24 hours. Mr. Lyons undergoes lithotripsy, and analysis of stone fragments to reveal calcium stones. (Learning Objective 6)

a. Mr. Lyons’ symptoms are most indicative of stones in what area of the renal system?

Mr. Lyons has the following orders:

· Morphine sulfate, 2 mg IVP every 2 hours as needed for severe pain

· Ibuprofen, 600 mg every 6 hours

· Normal saline at 200 mL/hr

b. What are the rationales for the above orders?

c. Based on the calcium composition of the stone, what dietary teaching should the nurse include in Mr. Lyons’ plan of care?

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