UNIVERSITY OF SOUTH FLORIDA

COLLEGE OF NURSING

Student: Kimone Wright

Assignment Date: March 8, 2016
MSI & MSII PATIENT ASSESSMENT TOOL .
Agency:
1 PATIENT INFORMATION Florida Hospital of Tampa
Patient Initials: K.K. Age: 71 years Admission Date: February 22, 2016
Gender: Male Marital Status: Widow Primary Medical Diagnosis:
Urinary Tract Infection
Primary Language: English
Level of Education: 12th grade Other Medical Diagnoses: N/A
(new on this admission)
Occupation (if retired, what from?): Retired Coordinator
Number/ages children/siblings:
Daughter- 44, Son-46, Brother-65

Served/Veteran: No Code Status: Full Code

If yes: Ever deployed? Yes or No
Living Arrangements: Advanced Directives:
Lives with son No Power of Attorney/ Living Will
Surgery Date: N/A Procedure: N/A
Culture/ Ethnicity /Nationality: White
Religion: Methodist Type of Insurance: Medicare Mana

1 CHIEF COMPLAINT:
Urinary Tract Infection

3 HISTORY OF PRESENT ILLNESS: (Be sure to OLDCART the symptoms in addition to the hospital
course of stay)
The patient is a 71-year-old gentleman who was presented to the Emergency Room (ER) on February 22, 2016
with complaints of generalized weakness, decreased oral intake, lethargy, and dysuria. He reported that he had
been having these symptoms for the last few days prior to his visit. After thorough examination and tests, the
patient was diagnosed with a urinary tract infection. He was also severely dehydrated and had an elevated blood
sugar level. He denied fever, chills, diarrhea, constipation, headache, joint pain, skin rash, and lower back pain.
He was admitted to the hospital for further observation and medical treatment.

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 2 PAST MEDICAL HISTORY/PAST SURGICAL HISTORY
Include hospitalizations for any medical illness or operation; include treatment/management of disease
Date Operation or Illness
2015 Pancreatic Cancer
1993 Hypertension
1988 Type 2 Diabetes Mellitus
N/A Erosive Esophagitis
N/A Duodenal Stricture
N/A Hiatal hernia

N/A Endoscopy
N/A Colonoscopy
N/A Duodenal Stent
N/A MediPort Placement
Age (in years)

Trouble
Environmental

Health

Stomach Ulcers
Bleeds Easily

Hypertension
MI,
Alcoholism

Cause

Glaucoma
FAMILY

Kidney
Diabetes
Arthritis

Seizures
Anemia

Asthma

Problems
Problems
Cancer
Allergies

of

Tumor
Stroke
etc.)
Gout
MEDICAL

(angina,
Death

Heart

Mental
HISTORY (if

DVT
applicab
le)
Father
Mother
Brother
Sister
relationship
relationship
relationship
Comments: Include age of onset

1 IMMUNIZATION HISTORY
(May state U for unknown, except for Tetanus, Flu, and Pna) YES NO
Routine childhood vaccinations
Routine adult vaccinations for military or federal service
Adult Diphtheria (Date): Unknown
Adult Tetanus (Date) Is within 10 years? 1 year ago
Influenza (flu) (Date) Is within 1 years? 1 year ago
Pneumococcal (pneumonia) (Date) Is within 5 years? 1 year ago
Have you had any other vaccines given for international travel or
occupational purposes? Please List
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 If yes: give date, can state U for the patient not knowing date received

1 ALLERGIES
NAME of
OR ADVERSE Type of Reaction (describe explicitly)
Causative Agent
REACTIONS
None N/A

Medications

None N/A
Other (food, tape,
latex, dye, etc.)

5 PATHOPHYSIOLOGY: (include APA reference and in text citations) (Mechanics of disease, risk factors,
how to diagnose, how to treat, prognosis, and include any genetic factors impacting the diagnosis, prognosis or
treatment)
A urinary tract infection (UTI) is an inflammation of the urinary epithelium, and is commonly caused by
Escherichia coli, and Enterobacter, Pseudomonas, and Serratia species (Huether, S. E. & McCance, K. L.,
2012). A UTI can occur anywhere along the urinary tract, including the urethra, prostate, bladder, ureter, or
kidney. However, most infections occur within the lower urinary tract (the bladder and the urethra) (Huether, S.
E. & McCance, K. L., 2012). Urinary tract infections typically occur when bacteria enter the urinary tract
through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out
such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow
into a full-blown infection in the urinary tract.
Some causes of a UTI are allergens or irritants (such as soaps, sprays, bubble bath, perfumed sanitary
napkins, etc.), bladder distention, calculus, hormonal changes influencing alterations in vaginal flora, indwelling
urinary catheters, invasive urinary tract procedures, loss of bacterial properties of prostatic secretions in the
male, microorganisms, poor-fitting vaginal diaphragms, sexual intercourse, synthetic underwear and pantyhose,
urinary stasis, use of spermicides, and bathing suits. At risk for a UTI are premature newborns, pre-pubertal
children, sexually active and pregnant women, women treated with antibiotics that disturb normal flora,
spermicide users, estrogen-deficient postmenopausal women, women with indwelling catheters, and persons
with diabetes mellitus, neurogenic bladder, or urinary tract obstruction (Osborn, K. S., Wraa, C. E., Watson, A.
B., & Holleran, R., 2014). UTI is more common in women because women have a shorter urethra than men and
their urethra is located closer to the rectum. This increases the possibility of bacterial contamination.
Some common signs and symptoms of a UTI are frequency and urgency, burning on urination, dysuria,
voiding in small amounts, inability to void, incomplete emptying of the bladder, suprapubic and low back pain,
cloudy, dark, foul-smelling urine, hematuria, bladder spasms, malaise, chills, fever, nausea and vomiting, WBC
counts greater than 100,000 cells/mm3 on urinalysis, and an elevated specific gravity (Osborn et al., 2014). The
pH may be noted on urinalysis. Also, altered mentation is a sign of urinary tract infection in older adults.
Generally, UTIs are mild, without complications, and occur in individuals with a normal urinary tract. These
infections are termed uncomplicated UTIs (Huether, S. E. & McCance, K. L., 2012). On the other hand, a
complicated UTI develops when there is an abnormality in the urinary system or a health problem that
compromises host defenses or response to treatment (Huether, S. E. & McCance, K. L., 2012). A UTI may
occur alone, or in association with pyelonephritis, prostatitis or kidney stones. Tests and procedures used to
diagnose urinary tract infections include urine culture of specific microorganisms with counts of 10,000/ml or
University of South Florida College of Nursing Revision September 2014 3
more from freshly voided urine. Lab analysis of the urine is sometimes followed by a urine culture. This test
provides information on the bacteria causing the infection and gives the doctor an idea of which medications
will be most effective (Huether, S. E. & McCance, K. L., 2012). Urine dipstick testing that is positive for
leukocyte esterase or nitrite reductase is also used for diagnoses of uncomplicated UTI. Evidence of bacteria
from urine culture and antibiotic sensitivity warrants treatment with a microorganism-specific antibiotic. A 3-
day course may be effective for uncomplicated UTI. However, 3-7 days of treatment is most common (Osborn et
al., 2014). If a recurrent UTI is present, a cystoscopy, using a long, thin tube with a lens (cystoscope) to see
inside your urethra and bladder, may be performed. The cystoscope is inserted into the urethra and passed
through the bladder. Some patients may have frequent infections caused by complicated UTI. They may have an
ultrasound, a computerized tomography (CT) scan or magnetic resonance imaging (MRI) done for their
diagnoses. A contrast dye may be used to highlight structures in their urinary tract (Osborn et al., 2014).
Complicated UTI requires 7-14 days of treatment. Follow-up urine cultures should be obtained one week after
initiation of treatment and at monthly intervals for 3 months for both complicated and uncomplicated UTIs
(Osborn et al., 2014). Clinical symptoms are frequently relieved, but bacteria may still be present.
Antibiotics, such as Trimethoprim/sulfamethoxazole, Ciprofloxacin, Ceftriaxone, Azithromycin, and
Doxycycline, are used to treat UTIs since they either kill or inhibit the growth of bacteria (Osborn et al., 2014).
However, it is very important for patients to finish the prescribed cycle of medicine completely, even after
starting to feel better. They should also drink a lot of water to help flush the bacteria from your system. Some
physicians may prescribe a medication to soothe the pain, and a heating pad may also be helpful.

5 MEDICATIONS: [Include both prescription and OTC; hospital (include IVF) , home (reconciliation),
routine, and PRN medication . Give trade and generic name.]
Name: acetaminophen-oxyCODONE Concentration: N/A Dosage Amount: 1 tablet
(Percocet 5/325)
Route: Oral Frequency: Q6H
Pharmaceutical class: Analgesic Home Hospital or Both
Indication: Mild to moderate pain, moderate to severe pain with opioid analgesics, fever
Adverse/ Side effects:
Acute generalized exanthematous pustulosis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, rash,
urticarial, Hepatotoxicity, agitation, anxiety, headache, fatigue, insomnia, atelectasis, dyspnea,
constipation, increased liver enzymes, nausea, vomiting, hypokalemia, renal failure (high doses), muscle
spasms, trismus
Nursing considerations/ Patient Teaching:
1) Advice patients to take medications exactly as directed and not to take more than the recommended
amount, to avoid alcohol if taking more than an occasional 1-2 doses, to discontinue and notify
healthcare provider if rash occurs, consult health care professional if discomfort or fever is not
relieved by routine doses of this drug or if fever is greater than 39.5 C (103 F) or last longer than 3
days.
2) Inform patients with diabetes that acetaminophen may alter results of blood glucose monitoring.
Advice patient to notify health care professional if changes are noted.
3) Caution patients to check labels on all OTC products. Advice patients to avoid taking more than
one product containing acetaminophen at a time to prevent toxicity.

Name: bisacodyl (Dulcolax Laxative) Concentration: N/A Dosage Amount: 10 mg

Route: SUPP Frequency: PRN
Pharmaceutical class: Stimulant laxative Home Hospital or Both

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Indication:
Treatment of constipation
Evacuation of the bowel before radiologic studies or surgery
Part of bowel regimen in spinal cord injury patients
Adverse/ Side effects:
Abdominal cramps, nausea, diarrhea, rectal burning, hypokalemia, muscle weakness, protein- losing
enteropathy, tetany
Nursing considerations/ Patient Teaching:
1) Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel
function.
2) Advice patients that laxatives should be only for short-term therapy. Prolonged therapy may cause
electrolyte imbalance and dependence.
3) Advise patient to increase fluid intake to at least 1500-2000 mL/day during therapy to prevent
dehydration.
4) Instruct patients with cardiac disease to avoid straining during bowel movements.
5) Advice patients that bisacodyl should not be used when constipation is accompanied by abdominal
pain, fever, nausea, or vomiting.

Name: Sodium Chloride (Saline Flush) Concentration: N/A Dosage Amount: 10 mL

Route: Syringe, IV Push Frequency: Q8H
Pharmaceutical class: Mineral and electrolyte replacement Home Hospital or Both
Indication (IV):
Hydration and provision of NaCl in deficiency states
Maintenance of fluid and electrolyte status in situations in which losses may be excessive
0.45% solution is most commonly used for hydration and treatment of hyperosmolar diabetes
Adverse/ Side effects:
Heart failure, pulmonary edema, edema, hypernatremia, hypervolemia, hypokalemia, extravasation,
irritation at IV site
Nursing considerations/ Patient Teaching:
1) Explain to patient the purpose of the infusion
2) Advise patients at risk for dehydration due to exposure to extreme temperatures when and how to
take NaCl tablets. Inform patients that undigested tablets may be passed in the stool; oral
electrolyte solutions are preferable.

Name: lisinopril Concentration: N/A Dosage Amount: 10 mg

Route: Oral Frequency: Daily
Pharmaceutical class: ACE-Inhibitor Home Hospital or Both
Indication:
Alone or with other agents in the management of hypertension
Management of heart failure
Reduction of risk of death or development of heart failure after myocardial infarction

Adverse/ Side effects:

Angioedema, dizziness, fatigue, headache, weakness, cough, hypotension, chest pain, abdominal pain,
diarrhea, nausea, vomiting, erectile dysfunction, impaired renal function, rashes, hyperkalemia.

Nursing considerations/ Patient Teaching:

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 1) Inform patient to notify health care professional if rash, mouth sores, sore throat, fever, swelling of
hands or feet, irregular heartbeat, chest pain, dry cough, hoarseness, swelling of face, eyes, lips, or
tongue, or if difficulty swallowing or breathing occurs.
2) Emphasize the importance of continuing to take the medication as directed at the same time each
day, even if feeling well. Take missed doses as soon as remembered but not if almost time for next
dose. Do not double doses. Warn patient not to discontinue ACE Inhibitor therapy unless directed
by healthcare professional.
3) Caution patient to avoid salt substitute containing potassium or foods containing high levels of
potassium or sodium unless directed by health care professional.
4) Caution patients to change position slowly to avoid orthostatic hypotension. Use of alcohol, standing
on feet for long periods, exercising, and hot weather may increase hypostatic hypotension.
5) May cause dizziness, especially during first few days of therapy. Caution patient to avoid driving
and other activities that require alertness until response to medication is known.
6) Instruct patient and family on correct technique for monitoring blood pressure. Advise them to take
blood pressure at least weekly and report significant changes to health care professional.

Name: omeprazole Concentration: N/A Dosage Amount: 40 mg

Route: Oral Frequency: Daily
Pharmaceutical class: Proton pump inhibitor Home Hospital or Both
Indication:
PO and IV: GERD/erosive esophagitis
IV: Reduction in risk of rebleeding following therapeutic endoscopy for acute bleeding gastric or duodenal
ulcers.
PO: Hypersecretory conditions, including Zollinger-Ellison syndrome.
With amoxicillin and clarithromycin to eradicate Helicobacter pylori in duodenal ulcer disease.
Decrease the risk of gastric ulcer during continuous NSAID therapy.
OTC: Heartburn occurring more than or equal to twice per week.
Adverse/ Side effects:
Life threatening: Clostridium Difficile-Associated diarrhea (CDAD)
Others: Abdominal pain, constipation, diarrhea, dry mouth, flatulence, nausea, hypomagnesemia, acute
interstitial nephritis, vitamin B12 deficiency, bone fracture
Nursing considerations/ Patient Teaching:
1) Monitor bowel function.
2) May alter hemoglobin, WBC, platelets, serum sodium, potassium, and thyroxine levels.
3) Patients should take medication as directed at the same time each day even if feeling well. Take
missed dose as soon as remembered but not if almost time for next dose.
4) Patients should avoid alcohol. Products containing aspirin or NSAIDS, and foods that may cause an
increase in GI irritation.
5) Patients should report onset of black, tarry stools, diarrhea, abdominal pain or persistent headache
to healthcare professional promptly.
6) Patients should notify healthcare professional if fever and diarrhea occur, especially if stool contains
blood, pus, or mucus.
7) Patients should notify healthcare professional if hypomagnesemia (seizures, dizziness, abnormal or
fast heartbeat, jitteriness, jerking movements or shaking, muscle weakness, spasms of the hands
and feet, cramps or muscle aches, spasm of the voice box) occur.

Name: fluconazole Concentration: N/A Dosage Amount: 100 mL/hr

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Route: IVPB, IV Frequency: Q24H
Pharmaceutical class: Antifungal Home Hospital or Both
Indication:
Fungal infections caused by susceptible organisms, including urinary tract infections and peritonitis
Prevention of candidiasis in patients who have undergone bone marrow transplant
Prevention of recurrent vaginal yeast infection
Adverse/ Side effects:
Hepatotoxicity, Stevens-Johnson syndrome, headache, dizziness, seizures, abdominal discomfort, diarrhea,
nausea, vomiting, hypokalemia, hypertriglyceridemia, allergic reactions including analphylaxis
Nursing considerations/ Patient Teaching:
1) Monitor liver function tests before and periodically during therapy
2) Instruct patient to notify health care professional if skin rash, abdominal pain, fever of diarrhea
becomes pronounced
3) Patients should take medication as directed at the same time each day even if feeling well. Take
missed dose as soon as remembered but not if almost time for next dose.

Name: cefTRIAXone Concentration: N/A Dosage Amount: 100 mL/hr

Route: IV Frequency: Q24H
Pharmaceutical class:
Home Hospital or Both
Third generation cephalosporin- anti-infective
Indication:
Treatment of infections
Preoperative prophylaxis
Adverse/ Side effects:
Seizures, Clostridium difficile-associated diarrhea, anaphylaxis, super infection, gallbladder sludging,
pancreatitis, bleeding, hemolytic anemia, thrombocytosis, pain at IM site, phlebitis at IV site
Nursing considerations/ Patient Teaching:
1) Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, wheezing, laryngeal
edema), and notify provider if these symptoms occur
2) Monitor bowel movement. Diarrhea, abdominal cramping, fever, and bloody stools should be
reported to healthcare professional promptly as a sign of Clostridium difficile- associated colitis
3) Assess for infection at beginning of and throughout therapy
4) Obtain specimens for culture and sensitivity before initiating therapy

Name: metoprolol (Metoprolol Tartrate) Concentration: N/A Dosage Amount: 25 mg

Route: Oral Frequency: Daily
Pharmaceutical class: Beta-blocker Home Hospital or Both
Indication:
Hypertension, angina pectoris, prevention of MI and decreased mortality in patients with recent MI,
management of stable, symptomatic (class II or III) heart failure due to ischemic, hypertensive or
cardiomyopathc origin
Adverse/ Side effects:
Bradycardia, HF, pulmonary edema, fatigue, weakness, anxiety, depression, dizziness, drowsiness,
insomnia, memory loss, mental status changes, nervousness, nightmares, blurred vision, stuffy nose,
bronchospasm, wheezing, hypotension, peripheral vasoconstriction, constipation, diarrhea, drug-induced
hepatitis, dry mouth, flatulence, gastric pain, heartburn increase liver enzymes, nausea, vomiting, erectile
dysfunction, decrease libido, urinary frequency, rash, hyperglycemia, hypoglycemia, back and joint pain,

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drug-induced lupus syndrome
Nursing considerations/ Patient Teaching:
1) Abrupt withdrawal may precipitate life-threatening arrhythmias, hypertension, or myocardial
ischemia
2) Advice patient to notify healthcare professional if slow pulse, difficulty breathing, wheezing, cold
hands and feet, dizziness, light-headedness, confusion, depression, rash, fever, sore throat, unusual
bleeding, or bruising occurs
3) Advice patient to carry identification describing disease process and medication regimen at all times
4) Reinforce the need to continue additional therapies for hypertension (weight loss, sodium
restriction, stress reduction, regular exercise, moderation of alcohol consumption, and smoking
cessation). Medication controls but does not cure hypertension.
5) Advise patient to change position slowly to minimize orthostatic hypotension.
6) Teach patient and family how to check pulse daily and blood pressure biweekly and to report
significant changes to health care professional.
7) Monitor BP, ECG and pulse frequently during dose adjustment and periodically during therapy.
8) Monitor intake and output ratios and daily weights. Assess routinely for symptoms of HF (dyspnea,
rales/crackles, weight gain, peripheral edema, jugular vein distention).
9) Monitor vital signs and ECG every 5-15 min during and for several hours after parental
administration.

Name: insulin isophane (HumuLIN H) Concentration: N/A Dosage Amount: 15 Units

Route: INJ, Subcut Frequency: QHS and QAM
Pharmaceutical class: Pancreatics Home Hospital or Both
Indication: Control of hyperglycemia in patients with diabetes mellitus
Adverse/ Side effects:
Hypoglycemia, hypokalemia, lipodystrophy, pruritus, erythema, swelling, allergic reactions such as
anaphylaxis
Nursing considerations/ Patient Teaching:
1) Assess patient periodically for symptoms of hypoglycemia
2) Instruct patient on proper technique for administration.
3) Demonstrate technique for mixing insulins by drawing up regular insulin or insulin lispro first and
rolling intermediate-acting insulin vial between palms to mix, rather than shaking
4) Caution patient not to share pen device with another person, even if clean needles are used
5) Instruct patient on signs and symptoms of hypoglycemia and what to do if they occur
6) Patient with diabetes mellitus should carry a source of sugar and identification describing their
disease and treatment regimen at all times
7) Emphasize the importance of compliance with nutritional guidelines and regular exercise as
directed by healthcare professional
8) Advice patient to notify healthcare professional if nausea, vomiting, or fever develops, if unable to
eat regular diet, or if blood glucose levels are not controlled.

Name: insulin lispro Concentration: N/A Dosage Amount: High dose

Route: INJ, Subcut Frequency: WMHS
Pharmaceutical class: Pancreatics Home Hospital or Both
Indication: Control of hyperglycemia in patients with type 1 and type 2 diabetes mellitus
Adverse/ Side effects:
Hypoglycemia, hypokalemia, lipodystrophy, pruritus, erythema, swelling, allergic reactions such as
anaphylaxis

University of South Florida College of Nursing Revision September 2014 8

Nursing considerations/ Patient Teaching:
1) Assess patient periodically for symptoms of hypoglycemia
2) Due to short duration of action, insulin lispro must be used with a longer acting insulin, insulin
infusion pump, or a combination of oral sulfonylurea agents
3) Use only insulin syringes to draw up doses
4) Administer insulin lispro within 15 minutes before a meal. Rotate injection sites.
5) Instruct patient on proper technique for administration.
6) Demonstrate technique for mixing insulins by drawing up regular insulin or insulin lispro first
and rolling intermediate-acting insulin vial between palms to mix, rather than shaking
7) Caution patient not to share pen device with another person, even if clean needles are used
8) Instruct patient on signs and symptoms of hypoglycemia and what to do if they occur
9) Patients with diabetes mellitus should carry a source of sugar and identification describing their
disease and treatment regimen at all times
10) Emphasize the importance of compliance with nutritional guidelines and regular exercise as
directed by healthcare professional
11) Advice patient to notify healthcare professional if nausea, vomiting, or fever develops, if unable
to eat regular diet, or if blood glucose levels are not controlled.

University of South Florida College of Nursing Revision September 2014 9

 5 NUTRITION: Include type of diet, 24 HR average home diet, and your nutritional analysis with
recommendations.
Diet ordered in hospital? Analysis of home diet (Compare to My Plate and
Ensure, banana
Diet patient follows at home? Consider co-morbidities and cultural considerations):
24 HR average home diet
Breakfast: Eggs, muffin,
grits, oatmeal

Lunch: Mashed potatoes,

gravy, ground beef

Dinner: Rice, beans, chicken

Snacks: N/A

Liquids (include alcohol):

Coffee, apple juice

Use this link for the nutritional analysis by comparing the patients 24 HR
average home diet to the recommended portions, and use My Plate as a
reference.

A balanced diet consists of an appropriate amount of grains, vegetables,

fruits, dairy, protein, and water. According to ChooseMyPlate.gov, the
recommended amounts of grains, vegetables, fruits, dairy, and protein that
should be consumed on a daily basis are 6 oz., 2.5 cups, 2 cups, 3 cups, and 5.5
oz. respectively (United States Department of Agriculture, 2015). However, the
patients average daily consumption is 6.5 oz. of grains (accepted), 1.5 cups of
vegetables (under), 2 cup of fruits (accepted), 0 cups of dairy products (not
accepted)), and 10.5 oz. of protein (over). On an average, the patient consumes
1,601 calories on a daily basis. The total amount of calories recommended daily
is 2,000 calories. Also, the patient consumes 16 grams (under) of saturated fat
when the limit is 22 grams. He also consumes an average of 2,696 mg (over) of
sodium on a daily basis, when the recommended amount is 2300 mg.
These results clearly show that the patient does not have a balanced diet
and some modifications need to be made to his diet. For example, the patient
does not include vegetables in his average 24-hour home diet but he eats an
excessive amount of protein. He should definitely include more vegetables in
his diet on a daily basis. He also does not consume milk and dairy products on a
regular. He needs milk and dairy products because they are a good source of
energy and protein, and contain a wide range of vitamins and minerals,
including calcium, which people need to build healthy bones and teeth. He also
needs to reduce his sodium intake. High sodium intake may negatively affect
his hypertension. Also, it is very important that this patient drinks at least 2500
mL of water per day. Overall, I would recommend that the patient eats
vegetables, fruits, dairy, grains, protein, and drinks water in the correct
proportion. I would also recommend that the patient do some physical exercise
University of South Florida College of Nursing Revision September 2014 10
 along with his dietary changes.

1 COPING ASSESSMENT/SUPPORT SYSTEM: (these are prompts designed to help guide your
discussion)
Who helps you when you are ill?
The patients daughter and son helps him when he is sick.

How do you generally cope with stress? or What do you do when you are upset?
The patient usually thinks about things that make him happier when he is stressed or upset.

Recent difficulties (Feelings of depression, anxiety, being overwhelmed, relationships, friends, social life)
Patient stated that he has no recent difficulties

+2 DOMESTIC VIOLENCE ASSESSMENT

Consider beginning with: Unfortunately many, children, as well as adult women and men have been or
currently are unsafe in their relationships in their homes. I am going to ask some questions that help me to
make sure that you are safe.

Have you ever felt unsafe in a close relationship?

Patient has never felt unsafe in a close relationship.

Have you ever been talked down to?

Patient said that he had been talked down to.

Have you ever been hit, punched or slapped?

When asked if he had ever been hit, punched, or slapped, the patient responded by saying, of course, when I
was a kid.

Have you been emotionally or physically harmed in other ways by a person in a close relationship with you?
Patient stated that he has never been emotionally or physically harmed in other ways by a person in a close
relationship with him.
If yes, have you sought help for this? N/A

Are you currently in a safe relationship?

Patient said that he is currently in a safe relationship.

4 DEVELOPMENTAL CONSIDERATIONS:
Eriksons stage of psychosocial development: Trust vs. Mistrust Autonomy vs. Doubt & Shame
Initiative vs. Guilt Industry vs. Inferiority Identity vs. Role Confusion/Diffusion Intimacy
vs. Isolation Generativity vs. Self absorption/Stagnation Ego Integrity vs. Despair
Check one box and give the textbook definition (with citation and reference) of both parts of Ericksons
developmental stage for your patients age group:

Describe the stage your patient is in and give the characteristics that the patient exhibits that led you to your
University of South Florida College of Nursing Revision September 2014 11
determination:
Erikson believes that ego integrity reflects a satisfaction with life and an understanding of ones place in the
life cycle, while, a sense of loss, discomfort with life and aging, and a fair of death are seen in despair (Treas
and Wilkinson, 2014). The task at this stage is the acceptance of ones life, worth, and eventual death. I believe
that this patient is satisfied with his life and accepts his place in the life cycle. He appears to have a fair
relationship with his children since they are the ones that takes care of him when he is ill. He also lives with his
son. The patient mentioned that he rarely gets upset, and has never been emotionally or physically harmed by a
person in close relationship with him. Also, throughout the interview, the patients behavior was appropriate and
he seemed comfortable.

Describe what impact of disease/condition or hospitalization has had on your patients developmental stage of
life:
I believe that the UTI has an impact on the patients developmental stage. When asked what his illness meant to
him, he mentioned that it made him feel incapacitated. Hence, I believe his sense of satisfaction with life has
decreased.

+3 CULTURAL ASSESSMENT:
What do you think is the cause of your illness?
When asked what he thinks is the cause of his illness, the patient responded by saying, it got too far before
they finally decided to do anything. They took forever to treat the UTI.

What does your illness mean to you?

When asked what his illness meant to him, the patient responded by saying, incapacitated.

+3 SEXUALITY ASSESSMENT: (the following prompts may help to guide your discussion)
Consider beginning with: I am asking about your sexual history in order to obtain information that will
screen for possible sexual health problems, these are usually related to either infection, changes with aging
and/or quality of life. All of these questions are confidential and protected in your medical record

Have you ever been sexually active?

Patient was sexually active.

Do you prefer women, men or both genders?

Patient prefers women.

Are you aware of ever having a sexually transmitted infection?

Patient said that he is not aware of having a sexually transmitted infection in the past.

Have you or a partner ever had an abnormal pap smear?

Patient said that his partner has never had an abnormal pap smear.

Have you or your partner received the Gardasil (HPV) vaccination?

Patient said that neither he nor his partner has received the Gardasil (HPV) vaccination.

Are you currently sexually active?

Patient is not currently sexually active.
If yes, are you in a monogamous relationship? N/A
University of South Florida College of Nursing Revision September 2014 12
When sexually active, what measures do you take to prevent acquiring a sexually transmitted disease or an
unintended pregnancy?
The patient is not currently sexually active, hence this question is not relevant to him. However, when he was
sexually active he did not take any measures to prevent acquiring a sexually transmitted disease or an
unintended pregnancy. He believed that this was unnecessary since he was in a monogamous relationship.

How long have you been with your current partner?

The patient is currently a widow. His wife died July, 2014. However, he was with his wife for 46 years before
she died.

Have any medical or surgical conditions changed your ability to have sexual activity?
Patient said that there is no medical or surgical condition that changed his ability to have sexual activity.

Do you have any concerns about sexual health or how to prevent sexually transmitted disease or unintended
pregnancy?
Patient has no concerns about sexual health or how to prevent sexually transmitted disease or unintended
pregnancy.

University of South Florida College of Nursing Revision September 2014 13

1 SPIRITUALITY ASSESSMENT: (including but not limited to the following questions)
What importance does religion or spirituality have in your life?
When asked what importance religion or spirituality has in the patients life, the patient replied by saying,
pretty important. It reinforces my belief in a higher power.

Do your religious beliefs influence your current condition?

The patients religious beliefs do not have an influence on his current condition. However, he believes that his
beliefs give him strength to cope with his illness.
__________________________________________________________________________________________

+3 SMOKING, CHEMICAL USE, OCCUPATIONAL/ENVIRONMENTAL EXPOSURES:

1. Does the patient currently, or has he/she ever smoked or used chewing tobacco? Yes No
How much?(specify daily
If so, what? N/A amount) For how many years? N/A
N/A
If applicable, when did the
Pack Years: N/A patient quit? N/A

Does anyone in the patients household smoke tobacco? Yes Has the patient ever tried to quit? N/A
If so, what, and how much? Patient in unable to answer. If yes, what did they use to try to quit? N/A

2. Does the patient drink alcohol or has he/she ever drank alcohol? Yes No
What? N/A How much? N/A For how many years? N/A
Volume: N/A
Frequency: N/A
If applicable, when did the patient quit? N/A

3. Has the patient ever used street drugs such as marijuana, cocaine, heroin, or other? Yes No
If so, what? N/A
How much? N/A For how many years? N/A
If not, when did
Is the patient currently using these drugs? N/A
he/she quit? N/A
Yes No
4. Have you ever, or are you currently exposed to any occupational or environmental Hazards/Risks?
The patient has never been exposed to any occupational or environmental Hazards/Risks.

5. For Veterans: Have you had any kind of service related exposure? N/A

University of South Florida College of Nursing Revision September 2014 14

 10 REVIEW OF SYSTEMS NARRATIVE

Gastrointestinal Immunologic
Nausea, vomiting, or diarrhea Chills with severe shaking
Constipation Irritable
Integumentary Night sweats
Bowel
Changes in appearance of skin GERD Cholecystitis Fever
Indigestion Gastritis /
Problems with nails HIV or AIDS
Ulcers
Hemorrhoids Blood in the
Dandruff Lupus
stool
Psoriasis Yellow jaundice Hepatitis Rheumatoid Arthritis
Hives or rashes Pancreatitis Sarcoidosis
Skin infections Colitis Tumor
Life threatening allergic
Use of sunscreen SPF: N/A Diverticulitis
reaction
Bathing routine: Varies Appendicitis Enlarged lymph nodes
Other: N/A Abdominal Abscess Other: N/A
Last colonoscopy? Last year
HEENT Other:N/A Hematologic/Oncologic
Difficulty seeing Genitourinary Anemia
Cataracts or Glaucoma nocturia Bleeds easily
Difficulty hearing dysuria Bruises easily
Ear infections hematuria Cancer
Sinus pain or infections polyuria Blood Transfusions
Blood type if known: Not
Nose bleeds kidney stones
known
Normal frequency of urination:
Post-nasal drip Other: N/A
4-5x/day w/o catheter
Oral/pharyngeal infection Bladder or kidney infections
Dental problems Metabolic/Endocrine
Routine brushing of teeth
Diabetes Type: 2
2x/day; morning and night
Routine dentist visits
Hypothyroid /Hyperthyroid
2x/year
Vision screening Intolerance to hot or cold
Other: N/A Osteoporosis
Other: N/A
Pulmonary
Difficulty Breathing Central Nervous System
Cough - dry or productive WOMEN ONLY CVA
Asthma Infection of the female genitalia Dizziness
Bronchitis Monthly self breast exam Severe Headaches
Emphysema Frequency of pap/pelvic exam Migraines
Pneumonia Date of last gyn exam? Seizures
menstrual cycle regular
Tuberculosis Ticks or Tremors
irregular
Environmental allergies menarche age? Encephalitis
University of South Florida College of Nursing Revision September 2014 15
 last CXR? N/A menopause age? Meningitis
Other: N/A Date of last Mammogram &Result: Other: N/A
Date of DEXA Bone Density &
Result:
Cardiovascular MEN ONLY Mental Illness
Infection of male
Hypertension Depression
genitalia/prostate?
Hyperlipidemia Frequency of prostate exam? N/A Schizophrenia
Chest pain / Angina Date of last prostate exam? N/A Anxiety
Myocardial Infarction BPH Bipolar
CAD/PVD Urinary Retention Other: N/A
CHF Musculoskeletal
Murmur Injuries or Fractures Childhood Diseases
Thrombus Weakness Measles
Rheumatic Fever Pain Mumps
Myocarditis Gout Polio
Arrhythmias Osteomyelitis Scarlet Fever
Last EKG screening, when? N/A Arthritis Chicken Pox
Other: N/A Other: N/A Other: N/A

General Constitution
Recent weight loss or gain
How many lbs.? 12.3 lbs. gained
Time frame? 15 days
Intentional? No
How do you view your overall health? Patient believes that his health has declined within the past year.

Is there any problem that is not mentioned that your patient sought medical attention for with anyone?
There is no problem that is not mentioned that the patient sought medical attention for with anyone.

Any other questions or comments that your patient would like you to know?
The patient did not have any more questions or comments.

University of South Florida College of Nursing Revision September 2014 16

10 PHYSICAL EXAMINATION:

General Survey: Height: 188 cm Weight: 99.7 kg BMI: 28.21 Pain: (include
No obvious Pulse: 108 bpm Blood Pressure: (include location) rating and
abnormalities Respirations: 17 br/min 129 mmHg SBP/65mmHg DBP location)
Temperature: 97.7 F S:pO2 : 95% Is the patient on Room Air or O2: 0/10
(Oral) Via room air
Overall Appearance: [Dress/grooming/physical handicaps/eye contact]
clean, hair combed, dress appropriate for setting and temperature, maintains eye contact, no obvious handicaps

Overall Behavior: [e.g.: appropriate/restless/odd mannerisms/agitated/lethargic/other]

awake, calm, relaxed, interacts well with others, judgment intact

Speech: [e.g.: clear/mumbles /rapid /slurred/silent/other]

clear, crisp diction

Mood and Affect: pleasant cooperative cheerful talkative quiet boisterous

flat
apathetic bizarre agitated anxious tearful withdrawn aggressive hostile
loud
Other: N/A
Integumentary
Skin is warm, dry, and intact Skin turgor elastic No rashes, lesions, or deformities
Nails without clubbing Capillary refill < 3 seconds Hair evenly distributed, clean, without vermin
Skin tear to the left arm and a stage III pressure ulcer to the coccyx. Dressings are dry, clean, and intact.
Although not intact, skin is warm and dry.
Skin turgor is fair.

Central access device Type: N/A Location: N/A Date inserted: N/A
Fluids infusing? no yes - what? Ceftriaxone, sodium chloride

HEENT: Facial features symmetric No pain in sinus region No pain, clicking of TMJ Trachea
midline
Thyroid not enlarged No palpable lymph nodes sclera white and conjunctiva clear; without
discharge
Eyebrows, eyelids, orbital area, eyelashes, and lacrimal glands symmetric without edema or tenderness
PERRLA pupil size / mm Peripheral vision intact EOM intact through 6 cardinal fields without
nystagmus
Ears symmetric without lesions or discharge Whisper test heard: right ear- inches & left ear-
inches
Nose without lesions or discharge Lips, buccal mucosa, floor of mouth, & tongue pink & moist without
lesions
Dentition: N/A
Comments: N/A

Pulmonary/Thorax: Respirations regular and unlabored Transverse to AP ratio 2:1 Chest

expansion symmetric
University of South Florida College of Nursing Revision September 2014 17
 Percussion resonant throughout all lung fields, dull towards posterior bases
Sputum production: thick thin Amount: scant small moderate large
Color: white pale yellow yellow dark yellow green gray light tan brown red
Lung sounds:
RUL: clear and diminished LUL: clear and diminished
RML: clear and diminished LLL: clear and diminished
RLL: clear and diminished

CL Clear; WH Wheezes; CR Crackles; RH Rhonchi; D Diminished; S Stridor; Ab - Absent

Cardiovascular: No lifts, heaves, or thrills
Heart sounds: S1 S2 audible Regular Irregular No murmurs, clicks, or adventitious heart sounds
No JVD
Rhythm (for patients with ECG tracing tape 6 second strip below and analyze)

Calf pain bilaterally negative Pulses bilaterally equal [rating scale: 0-absent, 1-barely palpable, 2-weak,
3-normal, 4-bounding]
Apical pulse: 111 bpm Carotid: Brachial: Radial: Femoral: Popliteal:
DP: PT:
No temporal or carotid bruits Edema: anasarca [rating scale: 0-none, +1 (1-2mm), +2 (3-
4mm), +3 (5-6mm), +4(7-8mm) ]
Location of edema: Torso pitting non-pitting
Extremities warm with capillary refill less than 3 seconds

GI Bowel sounds active x 4 quadrants; no bruits auscultated No organomegaly

Percussion dull over liver and spleen and tympanic over stomach and intestine Abdomen non-tender to
palpation
Last BM: (date 03/07/2016) Formed Semi-formed Unformed Soft Hard Liquid
Watery
Color: Light brown Medium Brown Dark Brown Yellow Green White Coffee
Ground Maroon Bright Red
Nausea emesis Describe if present:
Genitalia: Clean, moist, without discharge, lesions or odor Not assessed, patient alert, oriented, denies
problems
Other Describe: Patient is incontinent

GU Urine output: Clear Cloudy Color: Yellow Previous 24 hour output: 1001.67 mLs
Foley Catheter Urinal or Bedpan Bathroom Privileges without assistance or with assistance
CVA punch without rebound tenderness

Musculoskeletal: Full ROM intact in all extremities without crepitus

Strength bilaterally equal at 4 RUE, 4 LUE, 4 RLE & 4 in LLE
[rating scale: 0-absent, 1-trace, 2-not against gravity, 3-against gravity but not against resistance, 4-against some

University of South Florida College of Nursing Revision September 2014 18

 resistance, 5-against full resistance]
vertebral column without kyphosis or scoliosis
Neurovascular status intact: peripheral pulses palpable, no pain, pallor, paralysis or paresthesia

Neurological: Patient awake, alert, oriented to person, place, time, and date Confused; if confused attach
mini mental exam
CN 2-12 grossly intact Sensation intact to touch, pain, and vibration Rombergs Negative
Stereognosis, graphesthesia, and proprioception intact Gait smooth, regular with symmetric length of the
stride
DTR: [rating scale: 0-absent, +1 sluggish/diminished, +2 active/expected, +3 slightly hyperactive, +4
Hyperactive, with intermittent or transient clonus]
Triceps: +1 Biceps: +1 Brachioradial: +1 Patellar: +1 Achilles: +1
Ankle clonus: positive negative Babinski: positive negative

10 PERTINENT LAB VALUES AND DIAGNOSTIC TEST RESULTS (include pertinent normals as well as
abnormals, include rationale and analysis. List dates with all labs and diagnostic tests):

Lab Dates Trend Analysis

XR Abdomen AP March 03, 2016 Right upper quadrant stent,
no pathologic calcification,
moderate colonic stool, no
evidence of bowel
obstruction.
This test was done because
the patient was complaining
of abdominal pain. This pain
cold have been as a result of
the UTI.

Urinalysis/Reflex Cult
University of South Florida College of Nursing Revision September 2014
February 22, 2016 UA Spec Type:Clean catch; Urinalysis is used to diagnose
UA Color: yellow; urinary system infection and
UA Appear: Clear; kidney disease.
UA Spec Grav: 1.03 These results shows
UA pH: 5 abnormalities that could be as
UA Protein: Negative a result of a urinary tract
UA Glucose: 3+ infection. For example, a
UA Ketones: 1+ trace of bacteria was noted,
UA Bili: Negative and the RBC and WBC
UA Blood: Negative results were above the normal
UA Urobilinogen: Negative range. This increased WBC
UA Nitrite: Negative could be as a result of the
UA Leuk Est: Trace urinary tract infection.
UA RBC: 13
19
 UA WBC: 12
UA Squam Epithelial: 2
UA Bacteria: Trace
UA Gran Cast: 4
UA Renal Epi: 1

Glucose Level POC March 01, 2016- 132, 88, 94, 125, 149, 128, High glucose levels increases
March 08, 2016 179, 155 respectively the risk of infection. Also, this
shows that the patients
glucose level is not being
controlled adequately.
BUN March 02, 2016 8 These results are used to
monitor renal dysfunction.
Creatinine 0.6 The BUN and creatinine are
within normal limits.
Hgb March 02, 2016 11.9 (L) A low hemoglobin and
hematocrit count may indicate
Hemocrit 35.8 (L) that the patient is anemic.
This is possible since the
patient had a poor appetite.
This test is also important to
diagnose a kidney
dysfunction.
Sodium March 02, 2016 136 Sodium and potassium are
important electrolytes. Too
Potassium 3.7 much or too little can be fatal,
hence it is important to
monitor them.

+2 CURRENT HEALTHCARE TREATMENTS AND PROCEDURES:

1. Dietician requested that Ensure Plus be added to the patients meal twice daily since the patient has
inadequate oral intake.
2. Patient is encouraged to take antibiotic as directed by his healthcare professional to treat his UTI.
3. Glucose Level POC is monitored daily in order to treat Type 2 diabetes effectively.
4. Nurse will maintain sterile technique during urinary catheterization and irrigations to prevent introduction
of pathogens into urinary tract.
5. Nurse will request urinalysis if signs and symptoms of urinary tract infection are not alleviated.
6. Patient is encouraged to increase fluid intake to promote urine formation and subsequent voiding, which
flushes pathogens from the urethra and bladder.

8 NURSING DIAGNOSES (actual and potential - listed in order of priority)

1. Urinary tract infection related to introduction of pathogens into the urinary tract as evidence by patients
lab value results (for example, increased WBC in urinalysis).

2. Acute pain related to inflammation and infection of the urethra, bladder and other urinary tract structures
as evidence by patient stating that he was feeling lower abdominal pain (7/10) before the nurse
administered his pain medication (acetaminophen).

University of South Florida College of Nursing Revision September 2014 20

3. Ineffective self-health management related to deficient knowledge regarding methods to treat and prevent
UTIs as evidence by patient not drinking enough water daily and maintaining a high blood glucose level.

4. Risk for impaired urinary elimination related to urinary tract infection.

5. Risk for ineffective renal perfusion related to infection.

University of South Florida College of Nursing Revision September 2014 21

 15 CARE PLAN

Nursing Diagnosis #1:

Urinary tract infection related to introduction of pathogens into the urinary tract as evidence by patients lab value results (for example, increased
WBC in urinalysis).
Patient Goals/Outcomes Nursing Interventions to Achieve Rationale for Interventions Evaluation of Goal on Day Care
Goal Provide References is Provided
Patient will:
Remain free of urinary tract *Nurse will anchor tubing securely This in-and-out movement can Patient was not free of urinary tract
infection. to reduce the amount of in-and-out result in introduction of pathogens infection. However, nurse was able
movement of the urinary catheter. into the urinary tract, which can to anchor tubing securely, maintain
result in colonization of sterile technique, and maintain
microorganisms (Ackley and catheter care as needed to prevent
Ladwig, 2014). introduction of pathogen into the
urinary tract.
Nurse will maintain sterile This will prevent introduction of
technique during urinary pathogens into urinary tract.
catheterization and irrigations.

*Nurse will perform catheter care This will prevent the accumulation
as often as needed. of mucus around the meatus which
may attract pathogens (Ackley and
Ladwig, 2014).

*Nurse will keep urine collection This will prevent reflux or stasis of Nurse was able to keep urine
container below bladder level at all urine (Ackley and Ladwig, 2014). collection container below bladder
times. level at all times.

Nurse will change catheter This will decrease the risk of

according to hospital policy. urinary tract infection.

Nurse will assist client with This will decrease the risk of Nurse was able to assist the client
perineal care routinely and after pathogens entering the urinary tract with perineal care routinely and
each bowel movement. to cause a urinary tract infection. after each bowel movement.

University of South Florida College of Nursing Revision September 2014 22

Drink at least 2500 mL of water
daily.
Patient will experience less signs
and symptoms of a urinary tract
infection.
University of South Florida College of Nursing Revision September 2014
*Nurse will encourage a fluid
intake of at least 2500 ml/day
unless contraindicated.
Nurse will monitor the patients
intake and output.
*Monitor signs and symptoms
(S/S) of urinary tract infection (for
example: cloudy urine, reports of
frequency, urgency, or burning on
urination, chills, elevated
temperature, urinalysis showing a
WBC count greater than 10 or the
presence of nitrites or bacteria, and
a positive urine culture) and report
S/S that are abnormal, elevated,
and/or not improving.
*Administer antibiotic treatment
and pain medications as ordered by
the physician.
This promotes urine formation and Patient drank only 1001.67 mLs of
subsequent voiding, which flushes water within the last 24 hours.
pathogens from the urethra and
bladder (Ackley and Ladwig,
2014).
This will give the nurse an idea as
to how much water the patient
drinks daily and the amount of
urine expelled daily.
This will give the nurse an idea of There was no worsening of the
whether or not the regimen is patients signs and symptoms of the
working (Ackley and Ladwig, UTI.
2014).
Eradication of UTI using Antibiotic treatment and pain
antibiotics will alleviate or reverse medications were administered as
symptoms (site). Pain medications ordered by the physician.
will also alleviate symptoms such
as suprapubic discomfort.
23
 Nursing Diagnosis #2:
Acute pain related to inflammation and infection of the urethra, bladder and other urinary tract structures as evidence by patient stating that he was
feeling lower abdominal pain (7/10) before the nurse administered his pain medication (acetaminophen)

Patient Goals/Outcomes
Patient will:
Use a self-report pain tool to
identify current pain intensity level
and establish a pain level of 2/10 or
less
Nursing Interventions to Achieve
Goal
Assess for pain presence, location,
quality, onset/duration, intensity,
aggravating and relieving factors,
and effects of pain on function and
quality of life.
Rationale for Interventions
Provide References
Pain assessment is critical in
determining the effectiveness of
treatment for the UTI (Ackley and
Ladwig, 2014). This will also help
the nurse manage the pain better.
Evaluation of Goal on Day Care
is Provided
Nurse assessed for pain and patient
used a self-report pain tool to
identify his pain intensity level and
established a pain level of 0/10.

Monitor pain level and administer Pain medication reduces the Pain medication was administered
pain medication as needed. intensity of pain and increases as needed.
patient comfort.

Describe non-pharmaceutical
methods that can be used to help
achieve a pain level of 2/10 or less
Support the clients use of non-
pharmaceutical methods to control
pain. For example, the nurse will
support the client when he watches
the television.
Non-pharmaceutical methods will Nurse supported the client when he
keep the patient busy and distract was watching the television.
him from the pain.

The nurse could encourage the Applying a heating pad can help Patient did not need the heating
client to use a heating pad to soothe the area of pain. pad.
reduce the pain.

Notify member of the health care Nurse will do hourly checks on This will give the nurse the Patients pain was monitored
team promptly for pain intensity patient. opportunity to get information effectively. Patient did not
level that is consistently greater from the patient about pain complain of pain that was
than 2/10, or the occurrence of side intensity and side effects of consistently greater then 2/10.
effects medications.
University of South Florida College of Nursing Revision September 2014 24
 Nurse will observe patients non- This will also help the nurse Nurse paid attention to the patients
verbal communication and/or their understand the severity of the non-verbal communication as well
verbal communication with regard patients pain. as his verbal communication.
to pain.

2 DISCHARGE PLANNING: (put a * in front of any pt education in above care plan that you would include for discharge teaching)
Consider the following needs:
SS Consult
Dietary Consult: Patient needs dietician to plan his meals so that he can better manage his illness (For example, UTI and hypertension)
PT/ OT
Pastoral Care
Durable Medical Needs
F/U appointments: Follow-up urine cultures should be obtained one week after initiation of treatment and at monthly intervals for 3 months for both
complicated and uncomplicated UTIs (Osborn et al., 2014).
Med Instruction/Prescription: Patient needs DC education on his insulin lispro and isophane, his blood pressure medications (lisinopril and
metoprolol), and his antibiotic/antifungal medication (fluconazole).
are any of the patients medications available at a discount pharmacy? N/A Yes No
Rehab/ HH
Palliative Care

University of South Florida College of Nursing Revision September 2014 25

 References

Ackley, B.J. & Ladwig, G.B. (2014). Nursing Diagnosis Handbook. St. Louis, MO: Mosby Elsevier.

Huether, S. E. & McCance, K. L. (2012). Understanding Pathophysiology. Missouri: Elsevier.

Osborn, K. S., Wraa, C. E., Watson, A. B., & Holleran, R. (2014). Medical-surgical nursing: Preparation for

practice (2nd ed.). Upper Saddle River, NJ: Pearson Education Inc.

Treas, L.S. & Wilkinson, J.M. (2014). Basic Nursing Concepts, Skills & Reasoning. Philadelphia: F.A. Davis

Company.

United States Department of Agriculture. (2016). SuperTracker: Food Tracker. Retrieved from

https://www.supertracker.usda.gov/foodtracker.aspx

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University of South Florida College of Nursing Revision September 2014 27