Nursing 3020 Winter 2014

Pre Clinical Preparation

Student Name: Marissa Brown Date: October 19, 2018

Client Initials: AH Gender: F Age: 65

Medical Diagnosis (Dx): Urosepsis

Explain the Dx in your own words:

Urosepsis is a form of sepsis that occurs as a result of infection in the Genitourinary Tract. Sepsis
is a systemic response to infection in the body where the systemic inflammatory response is
triggered and damages tissues.

Surgery (Sx) or Treatment (Tx) or Diagnostic Test

Cystoscopy with insertion of 2 stents.

Explain the Sx or Tx or Test in your own words:

A cystoscopy is a endoscopy of the urinary bladder via the urethra. The surgeon inserted a camera
through a tube inserted into the urethra to examine the urinary bladder. The surgeon then saw a
blockage of kidneys stones in the ureters. The surgeon then placed a stents in each ureter to allow
for the passage of urine.

Priority Assessments:

1. Urinary (foley) catheter output and color 4. Pain

2. Intake vs. Output amount 5. GI Assessment

3. Bleeding from insertion site (urethra) 6. Electrolytes and Hemoglobin

Identify special care needs or approaches for this client:

The patient is taking Chemo meds for her breast cancer. Because of this her bodily secretion can
be hazardous to me. When emptying her catheter or assisting with washing or oral hygiene, I have
you use protective equipment such as a splash shield and double nitrile gloves.

What will you need assistance or supervision with?

IV, Meds, transfers, boosting a pt. in bed.

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Post Clinical

Identify four laboratory/diagnostic tests that have been completed for your client:

1. Creatinine 3 . CT Scan

2. Hemoglobin (Hgb) 4. ECG

Select two of the test results above and explain the rational for conducting the test; note
the test result; compare the result with the normal range or findings; and interpret the
reason for any abnormal values as it relates to the client’s condition.

1. Creatinine – The kidneys are responsible for the removal of creatinine from the blood
stream and excretes it in the urine. The normal Creatinine level is 50-90 mmol/L. When
the kidneys are not functioning effectively, the creatinine level in the blood will be
increased. In this pt, her creatinine level was high which meant her kidneys were not
functioning the way they are supposed to.
2. Hemoglobin (Hgb) - The hemoglobin level in the blood is normally 120-150g/L. When
the hemoglobin is low, it means that there is most likely active bleeding – this is
especially important for post-op patients because they most often have an open
incision or some other trauma.

Choose two prescribed medications for this client and include:

1. Generic & Trade Name: Thyroid (Synthroid)

Classification: Thyroid Replacement Supplement

Reason for Medication: Pt. most likely has damage to Thyroid from previous medications or
cancer treatment

Nursing Implications: Long term therapy can cause bone loss

2. Generic & Trade Name: Budesonide (Symbicort)

Classification: Bronchodilator – Corticosteroid

Reason for Medication: Patient has lung cancer

Nursing Implications: long term use is associated with decreased bone density

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Discuss one thing from theory that related to your client and how you integrated this
theory into practice or discuss a theoretical framework that assisted you in decision-
making today?

This patient was a new admission, which means her medications she normally takes had to be
inputted into her chart and MARS by the Pharmacist. When going over the medication with the
patient and her husband, she expressed that she takes Naproxen every day for her chronic pain.
Using my knowledge of medications and patient teaching, I had to explain to the patient that she
could not take naproxen because her kidneys were not functioning like they were supposed to
and that it is very dangerous to take NSAIDS when kidneys are not working properly.