Case Summary
An 84-year-old woman reported abdominal pain, urinary incontinence, new-onset mental confusion, and loose stools. Abdominal discomfort, urinary incontinence, and mental confusion are all abnormal physical findings. The patient also had a temperature of 98.4 degrees Fahrenheit (37.4 degrees Celsius), which could be abnormal. The woman had cloudy urine after having the catheter inserted, which is not normal. Urinalysis showed nitrates and elevated pH, which are abnormal laboratory findings.
Diagnosis
The presence of nitrates may indicate an infection. Because the female had recently been transferred to a nursing home and complained of symptoms shortly after, it is possible that she contracted E. coli, as an institution is a breeding ground for the bacteria (Wallace et al., 2020). Because it is an older adult, it should be noted that her body can tolerate infection in different ways, and the presence of bacteria in the urine of elderly patients may not show disease; therefore, a more detailed urinalysis should be performed, which will be completed in three days (Doodkorte et al., 2022).
Nursing Care
M.Z. should be given diapers because she has diarrhea, and the diapers should be changed to prevent atopic dermatitis, as well as a preventive ointment. It is also necessary to ensure that the catheter is inserted correctly and does not cause significant discomfort. Because the patient will be in a fully supine position, it is critical to provide her with everything she requires and to be available when she requests something.
It is also essential to ensure that M.Z. is not dehydrated due to diarrhea and a mild fever. If a urine test confirms the presence of a specific infection, the female will most likely be prescribed antibiotics. Her mental state should improve following the antibiotics. In the meantime, administer a saline drip. If M.Z. is unable to take the medicine orally, it should be administered intravenously. Before determining the type of infection the patient has, the doctor may prescribe general antibiotics as a preventive measure.
References
Doodkorte, R., Sinervo, T., & Clemens, T. (2022). The implementation and outcomes of self-managing teams in elderly care: A scoping review. Journal of Nursing Management, 30(8), 4549-4559.
Wallace, D. W., Hudson, B., & Delaney, M. (2020). Urinalysis: A simple test with complicated interpretation. The Journal of Urgent Care Medicine.