1-maceda
What other assessment data would be helpful for the nurse practitioner to have?
The diagnosis of UTI by clinical criteria alone has an error rate of approximately 33%; therefore, the NP should be vigilant and pay attention to additional assessment data (Allen, Manilal & Gezmu, 2019). For example, patient population is typically premenopausal women of any age with risk factors of diabetes, diaphragm use, especially those with spermicide, history of UTI or UTI during childhood, mother or female relatives with history of UTIs, and sexual intercourse.
What are the organisms most likely to cause an UTI?
Urinary tract infections are primarily caused by gram-negative bacteria, but gram-positive pathogens may also be involved. More than 95% of uncomplicated UTIs are monobacterial. The most common pathogen for uncomplicated UTIs is E.coli (75%–95%), followed by Klebsiella pneumoniae, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococci, and Proteus mirabilis (Bollestad, Vik, Grude& Lindbæk, 2018).
What is the pharmacological treatment for Shelly? Keep in mind safe dosing.
The first step in treating Shelly is to classify the type of infection, such as acute uncomplicated cystitis or pyelonephritis, acute complicated cystitis or pyelonephritis, CA-UTI, asymptomatic bacteriuria (ASB), or prostatitis (Allen, Manilal & Gezmu, 2019). The Infectious Diseases Society of America (IDSA) recommends that empiric regimens for uncomplicated UTIs be guided by the local susceptibility, particularly to E. coli. They recommend considering trimethoprim/sulfamethoxazole if the local resistance rate is less than 20% and fluoroquinolones if the resistance rate is less than 10% (Bollestad, Vik, Grude& Lindbæk, 2018). The empiric regimen for complicated UTIs should also be guided by local susceptibility trends of uropathogens, and definitive regimens should be tailored according to susceptibility results, when available.
What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?
The teaching priority for Shelly is hydration. During UTI management, hydration dilutes the uropathogen and removes infected urine by frequent bladder emptying. However, the bacterial count returns to the prehydration level after hydration is discontinued. Potential problems with forcing fluids include urinary retention in a patient with a partially obstructed bladder and decreased urinary antibiotic concentration.
References
Allen, M., Manilal, A., Gezmu, T., (2019). Prevalence and associated factors of urinary tract infections among women. Journal of Urology, 45(1), 56–62. https://doi.org/10.5152/tud.2018.32855
Bollestad, M., Vik, I., Grude, N., & Lindbæk, M. (2018). Predictors of Symptom Duration and Bacteriuria in Urinary Tract Infection. Scandinavian Journal of Primary Health Care, 36(4), 446–454. https://doi.org/10.1080/02813432.2018.1499602
2-alberto
What other assessment data would be helpful for the nurse practitioner to have?
Nurse practitioners are well positioned to have important roles in the assessment and management of UTIs. The bacterial count is an assessment data helpful to the NP. Urine dip sticks are one of the most frequently used instruments for diagnostic testing if there is clinical evidence that a patient is suffering from UTI. Multistix are most often used, which may be able to detect nitrite (a metabolic product of typical pathogens of the urinary tract), leukocyte esterase, protein and blood (as a marker of inflammation).
What are the organisms most likely to cause an UTI?
Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.
What is the pharmacological treatment for Shelly? Keep in mind safe dosing.
Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine.
Drugs commonly recommended for simple UTIs include:
Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
Fosfomycin (Monurol)
Nitrofurantoin (Macrodantin, Macrobid)
Cephalexin (Keflex)
Ceftriaxone
What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?
In many states, NPs already have the authority to manage UTIs, to varying degrees. Teaching priority includes drinking plenty of water. Water helps to dilute the urine and flush out bacteria. Avoiding drinks that may irritate the bladder. Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until your infection has cleared. They can irritate the bladder and tend to aggravate the frequent or urgent need to urinate. Use a heating pad. Apply a warm, but not hot, heating pad to the abdomen to minimize bladder pressure or discomfort.
Some alternative remedies may include drinking cranberry juice to prevent UTIs. There’s some indication that cranberry products, in either juice or tablet form, may have infection-fighting properties. Researchers continue to study the ability of cranberry juice to prevent UTIs, but results are not conclusive.
References
Collins, L. (2019). Diagnosis and management of a urinary tract infection. British Journal of Nursing, 28(2), 84–88. https://doi.org/10.12968/bjon.2019.28.2.84
Duncan, D. (2019). Alternative to antibiotics for managing asymptomatic and non-symptomatic bacteriuria. British Journal of Community Nursing, 24(3), 116–119. https://doi.org/10.12968/bjcn.2019.24.3.116
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Pediatric Week One Discussion One
/in Uncategorized /by developerDiscuss the concept of accountability as it relates to the delivery of nursing care to pediatric patients.
17 words
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Peer 4 1
/in Uncategorized /by developerAssignment 4.1: Peer Influence
Step 1: Research the social and emotional development of an Adolescent.
Step 2: In a one page pager, explain how peer influences change during adolescence
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Peer Editing Review
/in Uncategorized /by developerPeer Review Give comments on the section about the paper attached. This is a peer review edit where you grade and give comments to the paper attached
Instructions for peer review and original instructions
Attached Files:
Instructions for results section
Instructions for peer reviewing classmates work
Classmates results section
This isnt a long assignment and only involves a 100 words on comments to give
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Peer Editing Task 19162025
/in Uncategorized /by developerwill post draft to peer edit once tutor is chosen
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Peer Editing Task
/in Uncategorized /by developerThis is a peer review assignment. Your task will be to edit and grade the peer’s assignment.
You will need to use the track changes to record the editing suggested changes
Attached are the
1) peer Introduction paper you are to review
2) peer review rubric
3)Introduction
4) Introduction Rubric
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Peer Post 19240541
/in Uncategorized /by developerI need a peer post 1 for each Discussion
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Peer Replies Db4 19360189
/in Uncategorized /by developerPeer replies
1-Alberto :
Polypharmacy is an area of concern for many patients, especially the elderly. Elderly patients are at a greater risk for adverse drug reactions (ADRs) because of the reduced drug clearance associated with aging and because of metabolic changes (Boris, Cafiero & Smith, 2014). Some risk factors associated with polypharmacy are potential of drug-drug interactions because it is further increased by use of multiple drugs. Another risk factor is hip fractures, associated with adverse drug reactions and losing balance or fainting (Boris, Cafiero & Smith, 2014). Polypharmacy may sometimes lead to “prescribing cascades.”4 Prescribing cascade is said when signs and symptoms (multiple and nonspecific) of an ADR is misinterpreted as a disease and a new treatment/drug therapy is further added to the earlier prescribed treatment to treat the condition (Piere & Farrell, 2012).
In my practice working with the elderly population, to reduce the incidence of polypharmacy medication, patients are evaluated on a monthly basis. Additionally, a single drug is be prescribed instead of multiple drugs for the treatment of a single condition, if possible. Another strategy we use is staring medication with the lower drug dosage and slowly increasing as indicated.
A strategy that seems to be effective, according to research, is prescribe drugs that can be given once or twice a day instead of prescribing drugs that require to be taken three times a day (Thomas, Liao, & McCliar, 2016). The reasoning behind this is to lower the risk of forgetting to take the medication or taking the medication together with other drugs. Another strategy that can be employed is that if the drug taken has no therapeutic beneficial effect or clinical indication it should be eliminated. Unessential drugs should be identified and eliminated prescribed by different health care providers for the same condition/disease (Thomas, Liao, & McCliar, 2016).
2-maceda
Polypharmacy refers to the effects of taking multiple medications concurrently to manage coexisting health problems, such as diabetes and hypertension (Piere & Farrell, 2014). Too often, polypharmacy becomes problematic, such as when patients are prescribed too many medications by multiple healthcare providers working independently of each other. Also, drug interactions can occur if no single healthcare provider knows the patient’s complete medication picture. Nurses have a unique opportunity to help identify patients at risk for inappropriate polypharmacy and to educate patients and families about risk reduction. Nurses can use strategies such as patient teaching and consistency in care plan (Piere & Farrell, 2014).
Some of the risk factors of polypharmacy are age and chronic conditions. The elderly are more sensitive to the effects of certain drugs, particularly those that affect the central nervous system. As a consequence, drug classes such as benzodiazepines should be used with caution, and if absolutely necessary, then at a reduced dose to minimize the risk of falls and other adverse events (Thomas, Liao & McCliar, 2016). In addition, age is associated with decreased regulatory functions, therefore anti-hypertensives can more easily result in postural hypotension and opiates in respiratory depression. Communication barriers often go undetected in health care settings and can have serious effects on the health and safety of patients. Limited literacy skills are one of the strongest predictors of poor health outcomes for patients (Thomas, Liao, & McCliar, 2016). If the patient is deaf, can’t see or is illiterate there are various strategies the nurse can use for example, advise the patient to bring someone with them to the visit. Nurses who are responsible for checking patients in should be friendly and helpful. The length and number of forms patients are asked to fill out should be limited.
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Peer Replies Db4
/in Uncategorized /by developerPeer replies
1-Alberto :
Polypharmacy is an area of concern for many patients, especially the elderly. Elderly patients are at a greater risk for adverse drug reactions (ADRs) because of the reduced drug clearance associated with aging and because of metabolic changes (Boris, Cafiero & Smith, 2014). Some risk factors associated with polypharmacy are potential of drug-drug interactions because it is further increased by use of multiple drugs. Another risk factor is hip fractures, associated with adverse drug reactions and losing balance or fainting (Boris, Cafiero & Smith, 2014). Polypharmacy may sometimes lead to “prescribing cascades.”4 Prescribing cascade is said when signs and symptoms (multiple and nonspecific) of an ADR is misinterpreted as a disease and a new treatment/drug therapy is further added to the earlier prescribed treatment to treat the condition (Piere & Farrell, 2012).
In my practice working with the elderly population, to reduce the incidence of polypharmacy medication, patients are evaluated on a monthly basis. Additionally, a single drug is be prescribed instead of multiple drugs for the treatment of a single condition, if possible. Another strategy we use is staring medication with the lower drug dosage and slowly increasing as indicated.
A strategy that seems to be effective, according to research, is prescribe drugs that can be given once or twice a day instead of prescribing drugs that require to be taken three times a day (Thomas, Liao, & McCliar, 2016). The reasoning behind this is to lower the risk of forgetting to take the medication or taking the medication together with other drugs. Another strategy that can be employed is that if the drug taken has no therapeutic beneficial effect or clinical indication it should be eliminated. Unessential drugs should be identified and eliminated prescribed by different health care providers for the same condition/disease (Thomas, Liao, & McCliar, 2016).
2-maceda
Polypharmacy refers to the effects of taking multiple medications concurrently to manage coexisting health problems, such as diabetes and hypertension (Piere & Farrell, 2014). Too often, polypharmacy becomes problematic, such as when patients are prescribed too many medications by multiple healthcare providers working independently of each other. Also, drug interactions can occur if no single healthcare provider knows the patient’s complete medication picture. Nurses have a unique opportunity to help identify patients at risk for inappropriate polypharmacy and to educate patients and families about risk reduction. Nurses can use strategies such as patient teaching and consistency in care plan (Piere & Farrell, 2014).
Some of the risk factors of polypharmacy are age and chronic conditions. The elderly are more sensitive to the effects of certain drugs, particularly those that affect the central nervous system. As a consequence, drug classes such as benzodiazepines should be used with caution, and if absolutely necessary, then at a reduced dose to minimize the risk of falls and other adverse events (Thomas, Liao & McCliar, 2016). In addition, age is associated with decreased regulatory functions, therefore anti-hypertensives can more easily result in postural hypotension and opiates in respiratory depression. Communication barriers often go undetected in health care settings and can have serious effects on the health and safety of patients. Limited literacy skills are one of the strongest predictors of poor health outcomes for patients (Thomas, Liao, & McCliar, 2016). If the patient is deaf, can’t see or is illiterate there are various strategies the nurse can use for example, advise the patient to bring someone with them to the visit. Nurses who are responsible for checking patients in should be friendly and helpful. The length and number of forms patients are asked to fill out should be limited.
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Peer Replies Theory
/in Uncategorized /by developerAttached file
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Peer Reply 19435189
/in Uncategorized /by developer1-maceda
What other assessment data would be helpful for the nurse practitioner to have?
The diagnosis of UTI by clinical criteria alone has an error rate of approximately 33%; therefore, the NP should be vigilant and pay attention to additional assessment data (Allen, Manilal & Gezmu, 2019). For example, patient population is typically premenopausal women of any age with risk factors of diabetes, diaphragm use, especially those with spermicide, history of UTI or UTI during childhood, mother or female relatives with history of UTIs, and sexual intercourse.
What are the organisms most likely to cause an UTI?
Urinary tract infections are primarily caused by gram-negative bacteria, but gram-positive pathogens may also be involved. More than 95% of uncomplicated UTIs are monobacterial. The most common pathogen for uncomplicated UTIs is E.coli (75%–95%), followed by Klebsiella pneumoniae, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococci, and Proteus mirabilis (Bollestad, Vik, Grude& Lindbæk, 2018).
What is the pharmacological treatment for Shelly? Keep in mind safe dosing.
The first step in treating Shelly is to classify the type of infection, such as acute uncomplicated cystitis or pyelonephritis, acute complicated cystitis or pyelonephritis, CA-UTI, asymptomatic bacteriuria (ASB), or prostatitis (Allen, Manilal & Gezmu, 2019). The Infectious Diseases Society of America (IDSA) recommends that empiric regimens for uncomplicated UTIs be guided by the local susceptibility, particularly to E. coli. They recommend considering trimethoprim/sulfamethoxazole if the local resistance rate is less than 20% and fluoroquinolones if the resistance rate is less than 10% (Bollestad, Vik, Grude& Lindbæk, 2018). The empiric regimen for complicated UTIs should also be guided by local susceptibility trends of uropathogens, and definitive regimens should be tailored according to susceptibility results, when available.
What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?
The teaching priority for Shelly is hydration. During UTI management, hydration dilutes the uropathogen and removes infected urine by frequent bladder emptying. However, the bacterial count returns to the prehydration level after hydration is discontinued. Potential problems with forcing fluids include urinary retention in a patient with a partially obstructed bladder and decreased urinary antibiotic concentration.
References
Allen, M., Manilal, A., Gezmu, T., (2019). Prevalence and associated factors of urinary tract infections among women. Journal of Urology, 45(1), 56–62. https://doi.org/10.5152/tud.2018.32855
Bollestad, M., Vik, I., Grude, N., & Lindbæk, M. (2018). Predictors of Symptom Duration and Bacteriuria in Urinary Tract Infection. Scandinavian Journal of Primary Health Care, 36(4), 446–454. https://doi.org/10.1080/02813432.2018.1499602
2-alberto
What other assessment data would be helpful for the nurse practitioner to have?
Nurse practitioners are well positioned to have important roles in the assessment and management of UTIs. The bacterial count is an assessment data helpful to the NP. Urine dip sticks are one of the most frequently used instruments for diagnostic testing if there is clinical evidence that a patient is suffering from UTI. Multistix are most often used, which may be able to detect nitrite (a metabolic product of typical pathogens of the urinary tract), leukocyte esterase, protein and blood (as a marker of inflammation).
What are the organisms most likely to cause an UTI?
Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.
What is the pharmacological treatment for Shelly? Keep in mind safe dosing.
Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine.
Drugs commonly recommended for simple UTIs include:
Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
Fosfomycin (Monurol)
Nitrofurantoin (Macrodantin, Macrobid)
Cephalexin (Keflex)
Ceftriaxone
What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?
In many states, NPs already have the authority to manage UTIs, to varying degrees. Teaching priority includes drinking plenty of water. Water helps to dilute the urine and flush out bacteria. Avoiding drinks that may irritate the bladder. Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until your infection has cleared. They can irritate the bladder and tend to aggravate the frequent or urgent need to urinate. Use a heating pad. Apply a warm, but not hot, heating pad to the abdomen to minimize bladder pressure or discomfort.
Some alternative remedies may include drinking cranberry juice to prevent UTIs. There’s some indication that cranberry products, in either juice or tablet form, may have infection-fighting properties. Researchers continue to study the ability of cranberry juice to prevent UTIs, but results are not conclusive.
References
Collins, L. (2019). Diagnosis and management of a urinary tract infection. British Journal of Nursing, 28(2), 84–88. https://doi.org/10.12968/bjon.2019.28.2.84
Duncan, D. (2019). Alternative to antibiotics for managing asymptomatic and non-symptomatic bacteriuria. British Journal of Community Nursing, 24(3), 116–119. https://doi.org/10.12968/bjcn.2019.24.3.116
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