Exam (elaborations)
NUR 6111 Adv Nursing Practice 1 Case study 11 week 11
- Institution
- William Paterson University
NUR 6111 Adv Nursing Practice 1
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Case study#11-answerA 21-year-old woman is staying the night at her boyfriend’s apartment. They have had a relaxing evening
and are getting ready for bed. The woman goes to the restroom and empties her bladder. She feels some
mild burning upon urination but decides that it is probably from wearing her swimming suit all day the
previous day. Throughout the night, she develops feelings of frequency and urgency. The next day, she
visits the health clinic at the university and waits to be seen. She voids into a sterile cup, and a dipstick
urinalysis is performed. Based on her initial symptoms, she is diagnosed with cystitis. The remainder of
the urine is sent for microscopic examination and culture. The woman is prescribed a single dose of a
broad-spectrum antibiotic and is encouraged to drink plenty of fluids. Analgesics may help alleviate any
discomfort she may have. Instructed to call the clinic in 3 days for the culture report, she is scheduled for
a follow-up visit and a repeat urinalysis in 1 week.
Acute cystitis is an inflammation of the bladder and is the most common site of UTIs. A UTI is an
inflammation of the urinary epithelium most usually caused by:
1. Fungus from the perineal area
2. Bacteria from gut flora
3. Herpes simplex 2
4. A worm or parasite
Answer: A UTI is an inflammation of the urinary epithelium most usually caused by Bacteria from gut
flora. Bacterial contamination of the normally sterile urine usually occurs by retrograde movement of
uropathic gram-negative bacilli from the gut into the urethra and bladder then to the ureter and kidney.
2. Approximately 1 month later, the young woman notices that her ankles and feet are swollen. She
assumes she has not been drinking enough water. Within a week, she has difficulty buttoning her jeans
and has gained 8 pounds. She immediately begins to restrict her caloric intake drastically and is dismayed
when the number on the scale continues to rise. A few days later, her urine is pink tinged. Her boyfriend
drives her to the emergency department. She reports her history and symptoms she has noted over the
past 6 weeks. She is seen by a nephrologist and begins to undergo multiple tests to reach the diagnosis
of acute postinfectious glomerulonephritis.
Different patterns of urinary sediment may be associated with varying types of glomerulonephritis. The
loss of the negative electrical charge across the glomerular filtration membrane and an increase in
filtration pore size enhances the movement of proteins into the urine. The type of sediment
characterized by the presence of blood and varying degrees of protein in the urine is:
1. Nephritic
2. Urodynamic
3. Polymorphic
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