My differential diagnosis and a list of my primary diagnosis
After assessing Leroy’s issue, I realize that he may be suffering several differential diagnoses. Acute Pyelonephritis, Kidney stones, Appendicitis, and Urinary Tract Infection (UTI) are among the diagnoses that top the list of my examination. In the case of Acute Pyelonephritis that leads to renal scarring, individuals display symptoms that include fever, vomiting, costovertebral angle pains, and nausea. The disease is caused by bacteria that may infect the renal parenchyma through the bloodstream or by ascending to the kidneys via the urinary tract.
Consequently, kidney stone disease is a condition that takes place when stones develop in the kidney and block the normal functions of the ureter. The symptoms associated with the stones usually include renal colic, vomiting, and restlessness. These symptoms transpire because of the sensational pain that an individual feels when the ureter tries to release the stones. Drinking lots of water and avoiding food that has excess calcium can prevent the development of stones.
Although the role of the human appendix is not clearly defined its inflammation also known as Appendicitis is a life-threatening condition. When the appendix swells, there is a need for timely medical attention to remove it. Cancer, stool, or foreign bodies are some of the factors linked to the condition. Severe cramps, pain when passing urine, abdominal pain, fever, loss of appetite, and inability to release gas are some of the signs that indicate the presence of the ailment.
After a close examination and attention to Leroy’s case, my primary diagnosis becomes UT infection. The symptoms presented by the old man substantiate my diagnosis. Mody and Juthani-Mehta (2014) explain that fever, confusion, costovertebral angle tenderness, violence, and impaired judgment are primary signs demonstrated by old individuals suffering from UTIs. In effect, when bacteria enter into the bladder and affect the kidney through the urethra, old individuals demonstrate signs that differ from the young people. Instead of feeling a sensational pain when passing urine, old individuals suffer from confusion, loss of memory, withdrawal, and violence.
Additional tests that I would do to confirm my diagnosis
To ascertain my diagnosis, I would undertake some tests. I would start by taking samples of urine through a process known as a urine culture. I will also take samples of blood and test them to check if the patient suffers from diabetes. The importance of assessing whether the man suffers from diabetes takes effect because the disease increases the probability of contracting UT infection (Rowe & Juthani-Mehta, 2013).
On the other hand, urine samples will help in establishing whether there are bacteria in the urine that have led to an eventuality of a UT infection. To get good results, I will insist that the urine samples be taken in the morning. According to Grigoryan, Trautner, and Gupta (2014), Bacteria such as E. Coli, are the most common types of bacteria that initiate UT infections. In this regard, I will check the presence of E. Coli in the urine samples, Leroy. After ascertaining that the patient suffers from UTI, I will prescribe an oral medication of Amoxicillin that should be taken in the amounts of 3g within a range of 10-12 hours for 5 days.
Advise the patient to prevent any further recurrences
Urinary Tract Infection is a disease that becomes more prevalent with old age. Several women become victims of the disease, especially after menopause. To prevent the disease from recurring, I will advise Leroy to maintain good hygiene, empty his bowels regularly, and drink a lot of water. Kaye (2015) asserts that people who have UT infections should drink about eight glasses of water daily. Since Leroy suffers from memory lapses, I will ask his caretaker, Ms. Webb, to ensure that the old man follows the advice. Moreover, I will ask his caretaker to try applying some changes in the setting of the bathroom and make it more appealing to the old man so that the frequency of bathroom visits increase. The implication of increased visits to the bathroom is a reduced risk of suffering from a recurring infection.
References
Grigoryan, L., Trautner, B., & Gupta, K. (2014). Diagnosis and management of urinary tract infections in the outpatient setting: A review. Jama, 312(16), 1677-1684.
Kaye, D. (2015). Complicated urinary tract infection in the geriatric population. Current geriatrics reports, 4(1), 79-86.
Mody, L., & Juthani-Mehta, M. (2014). Urinary tract infections in older women: A clinical review. Jama, 311(8), 844-854.
Rowe, T., & Juthani-Mehta, M. (2013). Urinary tract infection in older adults. Aging health, 9(5), 519-528.