NU606 Week 11 Case Study

Use this case to answer questions 1–3.

Ms. G is a 28-year-old pregnant woman who comes into the hospital with back pain and fever. She has had two urinary tract infections (UTI) so far this pregnancy, with the last one being two weeks ago. The patient’s medical history is relevant for diabetes. She reports that she has had some dysuria and pressure for a few days but was trying to wait until her next OB appointment to be seen.

1. The patient is having some symptoms of a UTI and has had them in the past. Complete the following table for three risk factors specific to this patient and three additional risk factors.

Risk factors this specific patient has:   1. 2. 3.	Why each risk factors predisposes the person to UTI: 1. 2. 3.
Other risk factors:   1. 2. 3.	Why each risk factor predisposes the person to UTI: 1. 2. 3.

 

2. The patient is diagnosed with pyelonephritis. List three symptoms she is having consistent with pyelonephritis, and for each one state why it occurs.
3. Describe the pathophysiology for pyelonephritis.

Use this case to answer questions 4–6.

Mr. H is a 64-year-old male with a history of benign prostatic hypertrophy (BPH). He presents with low back pain, pelvic pressure, and a temperature of 100.6. He reports that he started feeling bad a few days ago, but just started with the fever today. When asked about urinary frequency, he reports that this is always an issue, so he hasn’t noticed much difference. He frequently feels like he has to urinate, but when he goes, he has a hard time initiating his stream.

4. Describe what benign prostatic hypertrophy is, and how it occurs.
5. What are complications of benign prostatic hypertrophy, and how do they occur?
6. Based on this case, what symptoms are associated with BPH, and what symptoms indicate that there might be another problem occurring?

For questions 7–10, answer each mini case.

7. Mrs. I is 62 years old. She has been married for 8 years and presents for an annual exam with concerns of painful intercourse that she believes is associated with menopause. She reports a small amount of discharge, but states that this is normal for her. Cultures are done during the exam and come back positive for trichomoniasis. She reports that she had this about 10 years ago, before she was with her current partner, and had treatment. Neither she nor her partner have been treated for STIs since they were together. She is wondering whether she could have had the infection the whole time. How will you respond to this?
8. Mr. J comes into the office with “a bump on his penis.” As an APRN, you know that this could be HSV, HPV, or primary syphilis. Your assessment will help to determine which of these is most likely. What would be the presentation for each of these?
9. Ms. K presents for her initial prenatal visit and is asking about the routine screening for STIs in pregnancy and why it is important. Choose two STIs and state why it is important to know the status of each in pregnancy.
10. You call Mrs. L to let her know that her Pap smear came back normal cytology but HPV position. She is concerned that this means she will have genital warts. How do you respond to her?