Assignment
Develop a VoiceThread presentation that includes a PowerPoint you would share with colleagues. Answer the following questions in regards to the case studies provided. Review the grading rubric prior to beginning the assignment.
Case Study I
Ms. R. is a 35-year-old female patient who presents to the clinic with a chief complaint of "burning when I pee". Upon taking a history you uncover that she is experiencing burning and pain during urination, urgency, and frequency. Her past medical history includes three pregnancies, Caesarian section, right ACL repair and a Motor vehicle accident that resulted in a pelvic fracture 5 years ago. She is currently sexually active.She is also allergic to all Sulfa containing medications. She has not tried anything for her symptoms and reports that she has never experienced this feeling before. As the advanced practice nurse you order a Urinalysis and it comes back positive for leukocyte esterase and nitrite. Urine culture shows more than 105CFU/mL of a single organism.
A. Analyze the common pathogens that can cause uncomplicated community-acquired urinary tract infections (UTIs) in women
B. What are the indications for the use of antimicrobial therapy in the treatment of UTIs?
C. Discuss the first-line antimicrobial drugs for UTIs and discuss which medication would be best for this patient specifically. Also, describe the mechanism of action and the main adverse effects of the medication you would prescribe.
D. If the patient is suspected of pregnancy, what would be the treatment of choice for antimicrobial therapy of UTIs?
Case Study II
B.G. is a 70 y.o. African American female patient that presents to the clinic today with a productive cough with green sputum and with wheezing for the past 7 days. The claimant has been taking over the counter "cold" medicine, as she believed that she had a cold, but her symptoms have not improved, but in fact, have worsened. Today, she reports an increase in shortness of breath and orthopnea.
Physical examination findings:
1) General: Patient appears in mild distress from persistent cough with some chest congestion. Appears fatigued. Overall healthy, except for her respiratory symptoms over the last week.
2) Lungs: Chest expansion symmetrical, respirations appeared unlabored and even with mild tachypnea with expiratory wheezing. Continuous productive cough with greenish-yellow sputum. Resonance percussed over upper chest; area of dullness percussed over left lower lobe. Increased tactile fremitus palpated in right lower lobe. BS are clear to auscultation bilaterally in upper lobes.
3) Xray: Lobar consolidation in the left lower lobe and bilateral infiltrates
4) Past Medical History: Hypertension, Hyperlipidemia, Vitamin D deficiency
5) Social History: No alcohol use, 1 PPD smoker X 30 years
6) VS: BP: 112/77, HR: 98, RR: 24, T: 102.1, SpO2: 94%, Ht: 5'3", Wt: 160 lbs
7) Allergies: Penicillin
Medication List:
Tylenol Cold and Flu 500mg Q12 hours prn
Lisinopril 5mg PO Q day
Vitamin D 50,000 international units Once weekly
A. Analyze the common pathogens that can cause uncomplicated community-acquired pneumonia.
B. Discuss the first-line antimicrobial drugs for community-acquired pneumonia that would be best for this patient specifically (be mindful that this patient has a penicillin allergy).
C. What are the indications for the use of antimicrobial therapy for community acquired pneumonia and discuss any necessary monitoring?
D. Discuss the patient education that you would provide to this patient regarding antibiotic use.