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hello dear writer please help to make my case study. it is based on management of clients with renal and urologic disorders. the case scenario is based on Mr. Mr.. M. a 79-year-old man who was admitted today to your unit for a urinary tract infection and urosepsis. Based on what you have learned this week about management of clients with renal and urologic disorders answer the following questions:
What else would you do in this situation with Mr. M?
What other options or alternatives would you explore and why for Mr. M?
What referrals might you make for Mr. M at this time?
Who else on the interprofessional team would you involve in Mr. M’s care? everything related to this case study i will post here please you add information according it and at the end i will post a sample similar to this case study for your guidance. The required (necessary) readings for this week are:
Lewis , S., Heitkemper, M., Dirksen, S., Barry, M., Goldsworthy, S., & Goodridge, D. (2014) Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems, (3rd Edition). Reed Elsevier Canada, Ltd. Toronto, Canada. Chapters: 47-49 THIS IS THE BOOK RECOMMNDED BY MY TEACHER TO GET ONFO REGARDING UROLOGICAL AND RENAL SYSYTEM. NOW I AM SHARING ONFO REGARDING MR,M
..Name: Mr. M
Age: 79
Diagnosis: Urinary Tract Infection and Urosepsis
VS q4h
Ambulate with assistance prn
I&O q8h
IV Lactated Ringers 100 ml/hr
Bathroom privileges with assistance
Diet: soft as tolerated
Routine meds: Acetamenophen 500 mg tabs i po q4h for temperature greater than 38 degrees celcius; Ceftriaxone 1 g IVPB qAM as orderedIt is now 0730. As you enter his room you notice he is restless and seems disoriented. You are planning your initial care activities for Mr. M. Using the list below, think about how you would prioritize the five nursing interventions as you would do them to initially take care of Mr. M.
INSERT A NUMBER BOX FOR THIS ACTIVITY
Assess for call bell and bed safety features
Take vital signs
Gather urinary output data
Assess mental status
Perform a body systmes physical assessment
NEED FEEDBACK/ANSWERS WITH RATIONALES – TO DOWNLOAD FROM PUBLISHER WEBSITE
As you provide morning care to Mr. M you note the following signs and symptoms:
VS: T 38.5 C, P 98, R 22, BP 120/76, pulse oximetry 94%
Fine crackles audible on auscultation in the bilateral lower lung fields
Crackles audible throughout the bilateral lung fields
He is sleepy, lethargic
He is incontinent of a scant (small) amount of urine
Based on your nursing assessment and critical thinking select the nursing diagnosis that is a high priority at this time. You should have a rationale for your selection.
Answers – Week 8
Week 8 – Mr M
Nursing Assessment
It is now 0730. As you enter his room you notice he is restless and seems disoriented. You are planning your initial care activities for Ms. M. Using the list below, think about how you would prioritize the five nursing interventions as you would do them to initially take care of Mr. M.
5 – Assess for call bell and bed safety features
Minimize fall or injury to patient
1 – Take vital signs
Reassess, especially temperature
4 – Gather urinary output data
Assess amount, color and voiding pattern
3 – Assess mental status
Assess delirium and manage confusion
2 – Perform a body systems physical assessment
Establish baseline; assess bladder; patient may have a full bladder; which may contribute to his restlessness
Follow-up Action Plan
As you take his 12:00 noon vital signs you note the following signs and symptoms: lethargic, skin very warm and flushed, VS T 39.1 C, P 130, R 28, BP 90/5484, pulse oximetry 88%. Based on this new information what are your next steps? What do you think is going on with Mr. M? What would you identify as the PRIORITY PROBLEM? Now prioritize the following nursing interventions for this situation and identify your follow up action plan for Mr. M.
1. Check pulse oximetry: attach probe to ear, nose or forehead preferably
4. Take vital signs q5min
6. Notify physician
2. Prepare to start oxygen
5. Document findings
3. Prepare to insert indwelling urinary catheter
Priority Problem: Signs and symptoms of septic shock
New action plan: Monitor vital signs and oxygenation; prepare to transfer to intensive care unitFeedback – Week 8
Points to consider for Mr M:
At 0600 Temp was 38
There is no documentation that Tylenol was given
Restlessness
Agitated and restless all night – why?
What are your thoughts about why this is happening?
Sepsis
Urinary retention
Fever
Dehydration
What should you be considering?
Geriatric patient
What should you be assessing?
Initiate neuro checks
At 0730
Temp was 38.5
Did you give Tylenol?
P has gone from 78 to 98
BP has dropped from 146/88 to 120/76
Fine crackles audible
Sleepy and lethargic
All night was agitated and restless
Scant amount of urine
Complete a physical assessment as baseline has been deviated from
What should you be considering as this is an elderly patient?
You should be concerned for this patient
Notify physician of change in status
At 1200 Temp was 39.1
P – 130
R – 28
BP – 90/54
Lethargic, skin warm and flushed
Oximetry 88%
What is happening?
If Tylenol had been given would this situation have developed?
Prepare for transfer to ICU
ALL ABOVE DATA PLEASE USE TO MAKE MY CASE STUDY.
NOW I AM SHARE ONE OF MY CASE STUDY WHICH WAS RELATED TO ANOTHER SYSYTEM U CAN USE IT AS SAMPLE
Case Study on Mr. L.
Peripheral vascular disorder (PVD) is an infection and complication affecting organs in the body, including the brain, kidney, limbs, and the digestive system (Fanari & Weintraub, 2015). PVD results from blockage of veins and arteries. Cholesterol in the body causes the blood vessels to narrow, leading to the inadequate blood supply to the other organs. As noted by Zoccali and London (2017), nursing practitioners’ management of peripheral vascular and lymphatic disorders involves coming up with ways to help patients alleviate the condition. Also, management consists of referring the patient to other healthcare practitioners for necessary assistance. If a nurse cannot manage to deal with the patient’s condition on their own, it would be logical for them to involve other medical practitioners within the institution to develop strategies to help the patient.
In addition to identifying that Mr. L is suffering from the peripheral vascular disorder, I would come up with patient care strategies focusing on the needs of the client, their beliefs, and personal decisions. As indicated by Zoccali and London (2017), just like all other patients, Mr. L has his own specific needs and preferences. As a result, all the PVD management approaches may not be essential for his situation. In coming up with the management plan for Mr. L, I would also consider the environment he is living in to ensure that the strategies are beneficial in his case. Since Mr. L stays alone, my PVD management strategies will find this to ensure that the treatment procedures give the best outcomes. Also, in planning for his medication, I would ensure that I prescribe medicines that can work for a patient who is a smoker to avoid adverse side effects.
Under Fanari and Weintraub (2017), I would also consider lifestyle and home care remedies for his condition besides treatment alternatives for MR. L. Life changes and home remedies are essential in mitigating the symptoms of PVD. Some of the lifestyle changes that I would recommend for Mr. L includes advising that he quits smoking. Smoking tobacco increases the chances of constriction of arteries, which makes PVD worse. Also, smoke may affect the efficacy of the medication, meant to help manage the diseases. Since Mr. L is suffering from tobacco addiction, I suggest that he receives cessation medication to help him quit the habit. Also, I would recommend that he takes regular exercise, which increases blood supply to body organs, which aids in the treatment of PVD.
Since Mr. L’s condition is far worse, and some of the management strategies might not work, I would refer Mr. L to a physiotherapist, a foot care nurse, and a cardiologist. The physiotherapist will help Mr. L exercise to ensure that there is enough blood flow to his limbs. The foot care nurse will ensure that the dressing on the wounds on his feet is appropriate to avoid cases of infections. Al illustrated by Fanari and Weintraub (2017), the cardiologist will check for any arterial and venous blockages on his left femoral-popliteal that contribute to the legs’ inadequate blood flow leading to the darkening of toes. On the interprofessional team, I would like to involve community health volunteers to help in ensuring that MR. L focuses on his recovery outside the hospital.
Conclusively, patient management is essential in ensuring that PVD patients get the necessary assistance o to enhance their recovery. Also, control ensures that nurses have a plan in place that supports the needs of their patients. Also, nursing practitioners have to make sure that their patients will stick to the treatment protocols outside the institution. In this case, the community health volunteer will be essential in the daily dressing of the wounds, and ensuring patients who stay alone take their medication on time.

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