NUR 505 Chamberlain University GU Case Study

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A 28 year old G0 calls the office with complaints of lower abdominal pressure and urinary frequency. She has been in the office four times over this past year for dysuria and has been treated for UTI. She is sexually active on Apri for contraception. She has a negative GYN history. She feels her UTI symptoms seem to be occurring within 12 hours of intercourse.

Medications – Loestrin 1/20, Mvi, Omega 3
Allergies – Ciprofloxacin

Vitals: T=98.4, B/P=118/72, Pulse = 84

Color, Urine yellow
Clarity, Urine Turbid
pH, Urine 5.5
Glucose, Urine Negative
Protein, Urine 100 mgdL
Ketones, Urine Negative
Blood, Urine Large
Nitrite Positive
Leukocytes Urine Large
Specific Gravity, Urine 1.020
White Blood Cells, Urine 818
Red Blood Cells, Urine >900
Bacteria, Urine Many
Hyaline Casts <=10

Culture results with >100,000 CFU/ML Escherichia coli

Escherichia coli Not Specified
Ampicillin <=8 ug/ml Sensitive
Ampicillin + Sulbactam <=1/.5 ug/ml Sensitive
Cefazolin <=2 ug/ml Sensitive
Cefepime <=2 ug/ml Sensitive
Ceftriaxone <=1 ug/ml Sensitive
Ciprofloxacin <=1 ug/ml Sensitive
Gentamicin <=1 ug/ml Sensitive
Nitrofurantoin <=32 ug/ml Sensitive
Tobramycin <=1 ug/ml Sensitive
Trimethoprim + Sulfamethoxazole <=2/38 ug/ml Sensitive
  1. What would you include in your focused physical exam?
  2. What diagnostic tests would you include today?
  3. What is your interpretation of these results?
  4. Would you select to treat this patient?
  5. What does MIC mean? How does it influence choosing a treatment?
  6. Explain your reasoning for selecting the treatment you chose.
  7. What would your choice be if she was pregnant?
  8. Explain why women are at higher risk for urinary tract infections.
  9. As you finish your visit she asks, “What can I do to prevent this from happening?” How do you answer this question, and what can she do to prevent them from happening in conjunction with sexual relations?

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