Urinary and Fluid/Electrolytes/Acid/Base Balance
Case Studies Instructions
This week, you have two separate focus areas: Urinary and Fluid/Electrolytes/Acid/Base
Balance.
Some cases have multiple parts. Please read instructions carefully.
Use at least one in-text citations/references and include scholarly references (within the
past 5 years). This can include your textbook.
Use literature supporting United States Clinical Practice Guidelines when available (go to
PubMed, search “clinical guidelines” and “diagnosis you are researching”.
These case studies will help build your clinical intelligence. Thus, it is imperative use your own
words. Do not use other student’s work or plagiarize from any source, including Artificial
Intelligence. Paraphrase instead of including direct quotes.
Any use of Artificial Intelligence must be disclosed and cited using APA format. The purpose of
this assignment is to help you learn for clinical practice, not to copy and paste. Please use this
time for active learning.
Download this document, type your answers, include references (including at least one
reference/in-text citations). Then turn into the appropriate assignment folder in your
Moodle assignment folder (scroll to the bottom of the course).
Do not share your work with others (current or future students). Do not share these studies in any
format for public or private use.
Turn-it-in is not required, as this is a template and repeats.
Urinary Function
Note: All case studies are provided as a learning tool for students who wish to have them.
Part 1– Please complete only one case (of your choosing) from Part 1. Only
one case is required.
Review the cases. Determine the most likely cause (i.e., pathogen and mode of transmission).
Discuss data that supports your decision.
Case 1: A 54-year-old female complains of a “burning” when urinating x 2 days. She shared, “I
feel like I have to pee every 60 minutes or so.” She denies suprapubic/back pain and fever.
Past medical history: high cholesterol, high blood pressure.
, Medications: atorvastatin for cholesterol.
Allergies: Penicillin (skin rash).
Physical examination: temperature 98.8°F; pulse 80 bpm; respirations 14 per minute; blood
pressure 114/68 mmHg.
Examination unremarkable; no suprapubic or costovertebral angle tenderness.
Urine dipstick reveals moderate leukocytes and positive nitrites, with all other values within
normal limits.
1. What is the most likely diagnosis?
- The most likely diagnosis is cystitis. The patient denies flank pain, which makes
pyelonephritis unlikely.
2. Which pathogen is likely causing this disorder?
- The most common cause of acute UTI is E coli. It accounts for the majority of
community-acquired UTIs.
3. What is the likely mode of transmission? Discuss data that support your decision.
- E coli is a normal component of the intestinal flora. It can migrate from the peri-anal into
the urethra. Women are also at higher risk of developing UTIs due to having a shorter
urethra.
- E coli is also transmitted via contact. Contact precautions and handwashing are warranted
to prevent transmission.
4. What diagnostic test, if any, should be done?
- A urine dipstick was already done. A urine culture can also be done to confirm the
organism in case of a complicated UTI that will need antibiotic treatment.
5. What are diagnostic test findings would support your diagnosis?
- The urine dipstick is positive for leukocytes, indicating white blood cells in the urine,
which means an infection. Positive nitrites suggest E coli, as Enterobacteriaceae convert
urine nitrate to nitrite.
6. Develop a treatment plan for this client.
- Hydration is encouraged to flush the urinary tract. Antibiotics are also used for UTIs.
Nitrofurantoin microcrystal is generally safe and effective for acute uncomplicated
cystitis in adult women (Mahdizade Ari et al., 2023). It is also an appropriate class of
antibiotics since the patient is allergic to penicillin.
Add your Reference:
Dlugasch, L., & Story, L. (2024). Applied Pathophysiology for the advanced practice nurse.
Jones & Bartlett Learning.
Mahdizade Ari, M., Dashtbin, S., Ghasemi, F., Shahroodian, S., kiani, P., Bafandeh, E.,
Darbandi, T., Ghanavati, R., & Darbandi, A. (2023). Nitrofurantoin: Properties and
potential in treatment of urinary tract infection: A narrative review. Frontiers in Cellular
and Infection Microbiology, 13. https://doi.org/10.3389/fcimb.2023.1148603
Case Studies Instructions
This week, you have two separate focus areas: Urinary and Fluid/Electrolytes/Acid/Base
Balance.
Some cases have multiple parts. Please read instructions carefully.
Use at least one in-text citations/references and include scholarly references (within the
past 5 years). This can include your textbook.
Use literature supporting United States Clinical Practice Guidelines when available (go to
PubMed, search “clinical guidelines” and “diagnosis you are researching”.
These case studies will help build your clinical intelligence. Thus, it is imperative use your own
words. Do not use other student’s work or plagiarize from any source, including Artificial
Intelligence. Paraphrase instead of including direct quotes.
Any use of Artificial Intelligence must be disclosed and cited using APA format. The purpose of
this assignment is to help you learn for clinical practice, not to copy and paste. Please use this
time for active learning.
Download this document, type your answers, include references (including at least one
reference/in-text citations). Then turn into the appropriate assignment folder in your
Moodle assignment folder (scroll to the bottom of the course).
Do not share your work with others (current or future students). Do not share these studies in any
format for public or private use.
Turn-it-in is not required, as this is a template and repeats.
Urinary Function
Note: All case studies are provided as a learning tool for students who wish to have them.
Part 1– Please complete only one case (of your choosing) from Part 1. Only
one case is required.
Review the cases. Determine the most likely cause (i.e., pathogen and mode of transmission).
Discuss data that supports your decision.
Case 1: A 54-year-old female complains of a “burning” when urinating x 2 days. She shared, “I
feel like I have to pee every 60 minutes or so.” She denies suprapubic/back pain and fever.
Past medical history: high cholesterol, high blood pressure.
, Medications: atorvastatin for cholesterol.
Allergies: Penicillin (skin rash).
Physical examination: temperature 98.8°F; pulse 80 bpm; respirations 14 per minute; blood
pressure 114/68 mmHg.
Examination unremarkable; no suprapubic or costovertebral angle tenderness.
Urine dipstick reveals moderate leukocytes and positive nitrites, with all other values within
normal limits.
1. What is the most likely diagnosis?
- The most likely diagnosis is cystitis. The patient denies flank pain, which makes
pyelonephritis unlikely.
2. Which pathogen is likely causing this disorder?
- The most common cause of acute UTI is E coli. It accounts for the majority of
community-acquired UTIs.
3. What is the likely mode of transmission? Discuss data that support your decision.
- E coli is a normal component of the intestinal flora. It can migrate from the peri-anal into
the urethra. Women are also at higher risk of developing UTIs due to having a shorter
urethra.
- E coli is also transmitted via contact. Contact precautions and handwashing are warranted
to prevent transmission.
4. What diagnostic test, if any, should be done?
- A urine dipstick was already done. A urine culture can also be done to confirm the
organism in case of a complicated UTI that will need antibiotic treatment.
5. What are diagnostic test findings would support your diagnosis?
- The urine dipstick is positive for leukocytes, indicating white blood cells in the urine,
which means an infection. Positive nitrites suggest E coli, as Enterobacteriaceae convert
urine nitrate to nitrite.
6. Develop a treatment plan for this client.
- Hydration is encouraged to flush the urinary tract. Antibiotics are also used for UTIs.
Nitrofurantoin microcrystal is generally safe and effective for acute uncomplicated
cystitis in adult women (Mahdizade Ari et al., 2023). It is also an appropriate class of
antibiotics since the patient is allergic to penicillin.
Add your Reference:
Dlugasch, L., & Story, L. (2024). Applied Pathophysiology for the advanced practice nurse.
Jones & Bartlett Learning.
Mahdizade Ari, M., Dashtbin, S., Ghasemi, F., Shahroodian, S., kiani, P., Bafandeh, E.,
Darbandi, T., Ghanavati, R., & Darbandi, A. (2023). Nitrofurantoin: Properties and
potential in treatment of urinary tract infection: A narrative review. Frontiers in Cellular
and Infection Microbiology, 13. https://doi.org/10.3389/fcimb.2023.1148603
