Information: Primary care practice Chief Complaint: "I've been...

Question Answered step-by-step Information: Primary care practice Chief Complaint: “I’ve been… Information: Primary care practiceChief Complaint: “I’ve been feeling really tired over the last few weeks and I haven’t felt like doing anything or going anywhere. On top of that, yesterday, I started feeling burning when I tried to urinate, but I don’t think I’m fully emptying my bladder. It’s getting really uncomfortable. I just want to enjoy the summer.”History of Present Illness: AA female with PMH significant for hypothyroidism, CAD s/p PCI with 2 stents to LAD (2015), and CKD3 who presented with complaints of fatigue over the last week with new urinary symptoms including burning and retention. She reports she is overdue for her annual physical, but reports her BP has been controlled measuring 110/70s.Today’s visit type: Urinary tract infectionPast Medical History: Hypothyroidism, CAD (2015), HTN, CKD3Allergies: amoxicillin (rash)Medications: Levothyroxine 75 mcg daily, aspirin 81 mg daily, atorvastatin 10 mg daily, losartan 100 mg daily, carvedilol 6.25 mg BIDImmunizations: Influenza (2020), Tdap (2009), Shingrix (2019)Family History:Father: Died of heart attackMother: HTN, MDDBrother: HTN, Social History: Occupation: Retired . PlSubstances: Occasional margaritaSexual: Sexually active with husbandInsurance: Medicare D – Johns Hopkins Med Adv HMOReview of Systems:HEENT: no vision changes, no ear pain/pressure/fullness, no sore throatNeuro: no headachesCV: no chest pain, no palpitations, no edemaResp: no cough, no SOB, no DOEGI: no nausea, no vomiting, no diarrheaGU: burning and retention during urinationPhysical Exam: General: Comfortable, non-toxicVitals: BP 120/65, HR 82, RR 20, Temp 37.1 C, O2 sat 98% on room airHeight: 5’9” Weight: 88 kgNeuro: alert and oriented x 3HEENT: dry mucus membranesCV: regular rate and rhythm, no murmurs, rubs, or gallopsResp: lung sounds are clear in all lobes bilaterally without rales, ronchi, or wheezesGI: soft, nondistended abdomen, normoactive bowel sounds, no discomfort in suprapubic regionGU: normal pelvic examSkin: skin warm, dry and intact without rashes or lesionsPertinent labs: SCr 1.7 (baseline 1.3)eGFR 35K 5.4A1c 5.7%TSH 18T4 0.5Total cholesterol 220HDL 35LDL 90Urine studies:(+) Nitrates(+) Leukocyte esteraseEpi: 0WBC: >10 WBC/hpfToday’s acute diagnosis: Uncomplicated UTIWhat are the first-line treatment options for an adult patient with an uncomplicated UTI? What factors from this patient’s case influence which antibiotic you will prescribe?What signs and symptoms is the patient experiencing that indicates she has a urinary tract infection? What objective data supports a UTI?What preventative medicine screenings and follow-up is needed for this patient? Health Science Science Nursing NURS 210 Share QuestionEmailCopy link Comments (0)