Urinary Obstruction

Urinary Obstruction

Case Studies

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft.

Studies

Results

Routine laboratory studies

Within normal limits (WNL)

Intravenous pyelogram (IVP)

Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate

Uroflowmetry with total voided flow of 225 mL

8 mL/sec (normal: >12 mL/sec)

Cystometry

Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)

Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)

Electromyography of the pelvic sphincter muscle

Normal resting bladder with a positive tonus limb

Cystoscopy

Benign prostatic hypertrophy (BPH)

Prostatic acid phosphatase (PAP)

0.5 units/L (normal: 0.11-0.60 units/L)

Prostate specific antigen (PSA)

1.0 ng/mL (normal: <4 ng/mL)

Prostate ultrasound

Diffusely enlarged prostate; no localized tumor

Diagnostic Analysis

Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.

Critical Thinking Questions

1. Does BPH predispose this patient to cancer?

2. Why are patients with BPH at increased risk for urinary tract infections?

3. What would you expect the patient’s PSA level to be after surgery?

4. What is the recommended screening guidelines and treatment for BPH?

5. What are some alternative treatments / natural homeopathic options for treatment?

 
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Urinary Tract Infections 19104193

  

Urinary Tract Infections

Urinary tract infections (UTIs) are caused by bacteria—most often Escherichia coli. However, certain viruses, fungi, and parasites can also lead to infection. The infection can affect the lower and upper urinary tract, including the urethra, prostate (in males), bladder, ureter, and kidney. Due to the progression of the disease and human anatomy, symptoms present differently among the sexes as well as among age groups. It is important to understand how these factors, as well as others, impact the pathophysiology of UTIs. Advanced practice nurses must have this foundation in order to properly diagnose patients.

To Prepare

· Review Chapter 30 in the Huether and McCance text. Identify the pathophysiology of lower and upper urinary tract infections. Consider the similarities and differences between the two types of infections.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

Write

· a description of the pathophysiology of lower and upper urinary tract infections, including their similarities and differences. (I am looking for an explanation at the cellular or molecular level (whenever possible).

· Then explain how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

 
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Urinary Tract Infections

  

Post a description of the pathophysiology of lower and upper urinary tract infections, including their similarities and differences. Select two of the following factors: age, genetics, behavior, gender, and ethnicity. Then explain how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

– This work should have Introduction and conclusion

– This work should have at 4 to 5 current references (Year 2013 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

LEARNING RESOURCES

**Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

  • Chapter      29, “Structure and Function of the Renal and Urologic Systems”

This chapter introduces the structure and function of the renal and urologic systems. It covers renal blood flow, kidney function, and tests for renal and bladder function.

  • Chapter      30, “Alterations of Renal and Urinary Tract Function”

This chapter examines alterations of the renal and urinary tract function, including urinary tract obstruction, urinary tract infection, acute kidney injury, and chronic kidney disease. It focuses on the pathophysiology, clinical manifestation, and evaluation and treatment of those renal and urinary tract alterations.

  • Chapter      31, “Alterations of Renal and Urinary Tract Function in Children”

This chapter presents alterations of renal and urinary tract function that are common in children. These alterations include structural abnormalities, bladder disorders, nephroblastoma, and urinary incontinence.

**Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

  • Chapter      16, “Renal Disease”

This chapter explores the structure and function of the kidney for preparation of examining renal diseases. It then examines renal diseases such as acute kidney injury and chronic renal failure.

**National Kidney Foundation. (2012). Retrieved from http://www.kidney.org/index.cfm 

 
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Urs 6051 Week 2 Assignment Due Sundaymarch 3rd

   

Make sure to iinclude detailed speaker notes and follow the grading rubric closely, as I will be grading according to the grading rubric.

Tip:  ALWAYS include detailed speaker notes when developing a PowerPoint.  This is VERY important.

To Prepare:

  • Review the concepts of informatics as presented in the Resources.
  • Reflect on the role of a nurse leader as a knowledge worker.
  • Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

  • Explain the concept of a knowledge worker.
  • Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
  • Develop a simple infographic to help explain these concepts.

    NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” as presented in the Resources.

  • Present the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ replies.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6051_Module01_Week02_Assignment_Rubric

  • Grid View
  • List View

ExcellentGoodFairPoorDevelop a 5- to 6-slide PowerPoint presentation that addresses the following:

·   Explain the concept of a knowledge worker.
·   Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.32 (32%) – 35 (35%)The presentation clearly and accurately explains the concept of a knowledge worker.

The presentation clearly and accurately defines and explains nursing informatics with a detailed explanation of the role of the nurse leader as a knowledge worker.28 (28%) – 31 (31%)The presentation explains the concept of a knowledge worker.

The presentation defines and explains nursing informatics with an explanation of the role of the nurse leader as a knowledge worker.25 (25%) – 27 (27%)The presentation inaccurately or vaguely explains the concept of a knowledge worker.

The presentation inaccurately or vaguely defines and explains nursing informatics with an inaccurate or vague explanation of the role of the nurse leader as a knowledge worker.0 (0%) – 24 (24%)The presentation inaccurately and vaguely explains the concept of a knowledge worker, or is missing.

The presentation inaccurately and vaguely defines and explains nursing informatics with an inaccurate and vague explanation of the role of the nurse leader as a knowledge worker, or is missing.·   Develop a simple infographic to help explain these concepts.14 (14%) – 15 (15%)The presentation provides an accurate and detailed infographic that helps explain the concepts related to the presentation.12 (12%) – 13 (13%)The presentation provides an infographic that helps explain the concepts related to the presentation.11 (11%) – 11 (11%)The presentation provides an infographic related to the concepts of the presentation that is inaccurate or vague.0 (0%) – 10 (10%)The infographic provided in the presentation related to the concepts of the presentation is inaccurate and vague, or is missing.·   Present the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data you could use, how the data might be accessed/collected, and what knowledge might be derived from the data. Be sure to incorporate feedback received from your colleagues’ replies.32 (32%) – 35 (35%)The presentation clearly and thoroughly includes the hypothetical scenario originally shared in the Discussion Forum, including a detailed and accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data.28 (28%) – 31 (31%)The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data.25 (25%) – 27 (27%)The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data that is vague or inaccurate.0 (0%) – 24 (24%)The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data that is vague and inaccurate, or is missing.Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.0 (0%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors.4 (4%) – 4 (4%)Contains a few (1-2) grammar, spelling, and punctuation errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) grammar, spelling, and punctuation errors.0 (0%) – 3 (3%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.5 (5%) – 5 (5%)Uses correct APA format with no errors.4 (4%) – 4 (4%)Contains a few (1-2) APA format errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) APA format errors.0 (0%) – 3 (3%)Contains many (≥ 5) APA format errors.Total Points: 100

Name: NURS_6051_Module01_Week02_Assignment_Rubric

 
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Us Health Care System Summary Writing Assignment

Health care 

 
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Us Health Care System Summary

Writing Assignment 

 
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Us Heathcare System

The U.S healthcare system 

 
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Use A Provided Template To Develop A 2 4 Page Submission In Which You Research And Define A Patient Family Or Population Health Problem Relevant To Personal Practice

Important: Complete this assessment first and complete all other assessments in the order they are presented.

In this assessment, you will lay the foundation for the work that will carry through your capstone experience and guide the practice hours to complete the work in this course. The purpose of this assessment is to allow you to define a patient, family, or population health problem that is relevant to your personal practice and to begin building a body of evidence that will inform your approach to your practice hours, the intervention you design, and the professional product you will deliver.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Lead people and processes to improve patient, systems, and population outcomes. 
    • Define a patient, family, or population health problem that is relevant to personal practice.
  • Competency 2: Make clinical and operational decisions based upon the best available evidence. 
    • Analyze evidence from the literature and professional sources to support decisions related to defining and guiding nursing actions related to a health problem.
  • Competency 7: Implement patient-centered care to improve quality of care and the patient experience. 
    • Propose strategies to improve patient or population outcomes related to a health problem.
  • Competency 8: Integrate professional standards and values into practice. 
    • Reflect on state board nursing practice standards relevant to a selected health problem.
    • Communicate professionally with clear, logically organized writing, using correct grammar, spelling, and APA style.

Important: Complete this assessment first and complete all other assessments in the order they are presented.

Professional Context

Nurses are leaders in problem identification and solution, planning and implementing patient care strategies to address problems in the home, hospital, and community. This assessment will help you develop a problem statement for a patient, family, or population health concern.

Instructions

Throughout this capstone course, you will be investigating a patient, family, or population health problem relevant to your practice. For this assessment, you will identify the problem that you will address throughout your clinical practicum in this course, as well as begin to establish your evidence and research base to plan, implement, and share findings related to your project. The Problem Identification Template [DOC] will guide you through development of a problem statement, evidence collection and analysis, and best practices to help you create your implementation plan for the second assessment in this course.

Your submission for this assessment will be the completed template. When working through the template, you may use the resources provided in this course; however, most of your research and search for evidence will be conducted by you. Use the Capella University Library, professional organization and government resources, and relevant organizational best practices as sources of evidence. This is the capstone course for your BSN degree; your goal is to demonstrate your achievement of the program outcomes through your work on this project.

The following are some health issues that would be appropriate for your project:

  • Diabetes self-management.
  • Hypertension management and prevention.
  • Medication reconciliation within a family or group.
  • Parkinson’s disease support group.
  • Patient family education communication improvements.
  • Postoperative home care.

This list is by no means exhaustive. You should choose a patient, family, or population health issue that is relevant to your practice and organization; you must be able to study the problem in your clinical practicum effectively.

Your submission will be assessed based on the following criteria:

  • Define a patient, family, or population health problem and realistic goals relevant to personal practice.
  • Analyze evidence from the literature and professional sources to define and guide nursing actions related to a health problem.
  • Propose strategies to improve patient or population outcomes related to a health problem.
  • Reflect on state board nursing practice standards relevant to an identified health problem.
  • Communicate professionally, with writing that is clear, logically organized, and uses correct grammar, spelling, and APA style.

CORE ELMS

Completion of this course requires a face-to-face clinical practicum. You are required to log your time in the CORE ELMS system just as you have for past courses with direct interaction. The CORE ELMS link is located in the left-hand navigation pane.

Additional Requirements

  • Length of submission: Use the provided template. Most submissions will be 2 to 4 pages. You do not need to include a title page. Be sure to complete the reference page at the end of the template.
  • Number of references: Cite a minimum of 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old.
  • APA formatting: Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the assessment to your ePortfolio. After you complete your program you may want to consider leveraging your Portfolio as part of a job search or other demonstration of your academic competencies.

 
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Use A Provided Template To Develop A 3 5 Page Proposal For An Intervention And Implementation Plan Related To The Health Problem You Defined In The First Assessment

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care. 
    • Propose a plan, referencing relevant existing and newly created processes, to implement an intervention to improve quality and safety, and reduce costs within the context of a chosen health problem.
  • Competency 4: Apply health information and patient care technology to improve patient and systems outcomes. 
    • Analyze technology within a chosen health care practice context to support a proposed plan.
  • Competency 5: Analyze the impact of health policy on quality and cost of care. 
    • Explain the ways in which governmental or organizational policies could impact the proposed plan.
  • Competency 6: Collaborate interprofessionally to improve patient and population outcomes. 
    • Explain strategies for communicating and collaborating with patients and interprofessional teams to improve health outcomes.
  • Competency 8: Integrate professional standards and values into practice. 
    • Communicate professionally in clear, logically organized writing, using correct grammar, spelling, and APA style.

Important: You must complete all of the assessments in order for this course.

Professional Context

As a professional nurse, you perform a critical role in solving a host of health care problems. In this assessment, you will use the literature to plan best-practice strategies to foster positive health outcomes for your chosen patient or population.

Preparation

Your intervention and implementation plan should be carried out in an interprofessional context, aligned to your topic, and based on the work you did in the first assessment. You should find collaborators as soon as possible so you can solicit their feedback about intervention and implementation plans to inform your approach.

Instructions

Having identified a health problem relevant to your current or future nursing practice and reviewed the literature to support nursing standards, decision making, and improvement strategies, you should now plan an intervention to address the chosen health problem based on the research you conducted.

Construct a plausible plan that leverages the best practices and research collected to date as well as additional research into similar projects that you find in the literature. Be sure to frame your plan within the context of the health care setting in which you are completing your practicum hours. Incorporate relevant site-specific processes and policies into your implementation plan.

Use the Plan Proposal Template [DOC] to complete this assessment.

As you develop your plan, be sure to address the following:

  • Collaboration and communication with patients and colleagues to improve health outcomes.
  • Governmental or organizational policies that could affect the plan.
  • Quality and safety improvement strategies.
  • Technology at the site that could be leveraged.

Scoring Guide Criteria

  • Propose a plan, referencing relevant existing and newly created processes, to implement an intervention to improve quality and safety, and reduce costs within the context of a chosen health problem.
  • Analyze technology within a chosen health care practice context to support a proposed plan.
  • Explain the ways in which existing governmental or organizational policies could impact the proposed plan.
  • Explain strategies for communicating and collaborating with patients and interprofessional teams to improve health outcomes.
  • Communicate professionally in writing that is clear, logically organized, and uses correct grammar, spelling, and APA style.

Additional Requirements

  • Length of submission: Use the provided template. Most submissions will be 3 to 5 pages. You do not need to include a title page. Be sure to complete the reference page at the end of the template.
  • Number of references: Cite a minimum of 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old.
  • APA formatting: Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the assessment to your ePortfolio. After you complete your program you may want to consider leveraging your Portfolio as part of a job search or other demonstration of your academic competencies.

 
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Use An Evidence Based Clinical Model

Use an evidence based clinical model. Discuss a clinical problem that you would like to address in your work setting. Explain how you would use the Iowa Model of EBP from your reading this week as a framework to implement a clinical change addressing this problem.

 
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