Based on your clinical experience seeing a patient with one of the symptoms listed in Chapter 5 of your Kennedy-Malone textbook covered in this

Question Answered step-by-step Based on your clinical experience seeing a patient with one of thesymptoms listed in Chapter 5 of your Kennedy-Malone textbook covered in this lesson, describe one of the symptoms or syndromes. Provide etiology, possible causes, signs/symptoms, the treatment suggested, and how you educated the patient. Would you change the treatment based on this week’s readings? Why? If yes, how?I had a 79 year-old woman who presented with complaints of blood in their urine. She also complained of right flank pain which she described as moderate, sharp, and intermittent. She had no other complaints. She denied dysuria, urgency, frequency, incontinence, changes in the color of their urine, stomach pain, nausea, vomiting, fever, and chills.Etiology:Blood could enter the urine anywhere along the urinary tract (kidneys, ureters, bladder, prostate, or urethra) (Duffy, 2019). The pathophysiology is dependent upon the site from which the blood loss occurred (Duffy, 2019). Hematuria can be gross or microscopic. Gross hematuria is suspected when blood can be seen in the urine with the naked eye, whereas microscopic hematuria is only identified by laboratory analysis (Duffy, 2019). The causes of hematuria range from benign to life-threatening. According to Duffy (2019), 5% of patients with microscopic hematuria are found to have a malignancy, and 30% to 40% of patients with gross hematuria are found to have a malignancy (p. 63). With that being said, all patients with hematuria, gross or microscopic, require an evaluation (Duffy, 2019).Possible Causes:The most common causes of hematuria are inflammation or infection of the bladder, stones, a kidney or urinary tract malignancy, or benign prostatic hyperplasia (Perazella & O’Leary, 2021). Other causes include sub-therapeutic anticoagulation, glomerular disease, trauma, vigorous exercise, menstruation, viral illness, medication (analgesics, antibiotics, non steroidal anti-inflammatory drugs [NSAIDS]), and anatomical deficits (Duffy, 2019). Signs and Symptoms:Gross hematuria would present as red or brownish color of the urine, but there may not be signs or symptoms associated with microscopic hematuria (Duffy, 2019). It would be important to get a thorough history. Associated flank pain, fever, chills, nausea or vomiting, abdominal pain, or renal colic could be suggestive of a kidney stone (Duffy, 2019). Urinary frequency, lower abdominal pain, or dysuria could be suggestive of a urinary tract infection (Duffy, 2019). For males, a prostate and testicular examination may be warranted; and for females, a vaginal examination (Duffy, 2019).Suggested Treatment:Treatment is directed at the cause. With this specific patient, a urinalysis (UA) with microscopy was initially performed, as well as a complete blood count (CBC) and a comprehensive metabolic profile (CMP). The UA resulted with 3+ blood in the urine. The CBC and CMP were normal. Since the clinic had the ability to perform ultrasound, a pelvic ultrasound was scheduled and performed, which confirmed that the patient had few, small stones. She was started on tamsulosin (Flomax) 0.4 mg once daily by mouth. She was instructed to take over-the-counter NSAIDs for pain. She was given a calculi urine strainer to recover the stones and instructed to bring them to the office to be analyzed. She was also referred to a Urologist to be seen as soon as possible. She would follow-up after her visit with Urology, or more frequently as needed.  Patient Education:For this specific patient, education included the above treatment plan, as well as referral to a Urologist. She was instructed to increase her fluid intake, as drinking more fluids can help lower the risk of future kidney stones (Preminger & Curhan, 2021). She was also instructed to avoid sugar-sweetened beverages as they also increase the risk of kidney stones (Preminger & Curhan, 2021). Her diet would need to change as well, but this would be dependent upon the analysis of the composition of the stones she passed (Preminger & Curhan, 2021). She was informed that she should always report any signs or symptoms of hematuria.Reply to the initial post of at least one classmate, using the RISE Model for Meaningful Feedback (PDF)This is an example of how to answer the discussion in the Rise Model. R – I like how you broke down your discussion into sections. This allows the reader to follow your thoughts and refer to the discussion easily. The diagnostic tests were appropriate for this patient, especially the urinalysis and ultrasound.I – Would you change your initial treatment for this patient after reading this week’s readings? Why or why not?S – I would suggest adding the suggested recommended treatment from this week’s readings. The recommendation for hematuria and kidney stone is treatment with pain management and oral hydration (Duffy, 2019). You mentioned both in your discussion as your treatment for your patient, but not as the recommended treatment for hematuria and kidney stones. Giving more treatment options for pain would further support your treatment plan. E – I agree with you that your treatment plan was appropriate for this patient, and not sure I would have changed anything based on the readings and what I learned this week. Great job on treatment of your patient and presenting your discussion. Health Science Science Nursing NUR 648 Share QuestionEmailCopy link Comments (0)