Running Head: GU CASE STUDY
GU Case Study
GU CASE STUDY
Question 1: In this case study, it is evident that the patient has a recurrent urinary tract
infection, possibly acute pyelonephritis. Therefore the concern is to find more information
regarding the urinary tract infection and be able to rule out other possible conditions. Often
women presenting with urinary tract infections have suprapubic and costovertebral angle
tenderness (key finding); it is necessary to examine these areas as it will help rule out vaginitis,
cervicitis, or possible pelvic tenderness which may suggest pelvic inflammatory disease
(American College of Obstetricians and Gynecologists, 2008).
Similarly, while culture results show the presence of E. coli, it is appropriate to examine
extremities for clamminess or orthostatic as this may show poor vascular tone, which is often
linked to gram-negative bacteremia and will rule out uncomplicated cystitis (Simerville, Maxted
& Pahira, 2005). History about vomiting, nausea, chills, and fever above 38 degrees Celsius is
essential since they may suggest pyelonephritis instead of cystitis. It is vital to know about the
pain, its location, and its severity. Often acute pyelonephritis presents with moderate to severe or
flank pain mostly in the abdominal region while cystitis tends to the around the suprapubic area
and is mild to moderate. The patient is sexually active and seemingly has recurrent urinary tract
infection; thus, it is appropriate to enquire about the sexual partner, whether she has new sexual
partners or one partner. Lastly, it is crucial to check the urine amount, smell, and whether cloudy.
Question 2: The patient has a hyaline cast, which may lead to possible blockage in the
flow of urine, causing the urgency with a reduced amount of urine (Simerville, Maxted & Pahira,
2005). Also, she has a history of urinary tract infection for sometimes, and it seems there is
underlying causing. Thus voiding cystourethrogram is crucial to examine how the bladder and
urethra empties, fills and identify a possible defective bladder emptying...
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