...Pyelonephritis in pregnancy ------------------------------------------------- Urinary tract infection (UTI) incorporates a range of conditions including acute pyelonephritis or kidney infection. It is almost invariably caused by bacteria (Brown et al 2005, Le 2004). The incidence of this disease in pregnancy has decreased in recent years (Dawkins et al 2012), possibly due to improved antenatal care. However, it remains one of the most common complications in pregnancy (Hill et al 2005) affecting 1-2% of pregnant women (Dawkins et al 2012, Hill et al 2005, McCormick 2008). Acute Pylonephritis is the most serious urinary tract infection in pregnancy (Le 2004, McCormick et al 2008) and successful treatment usually requires hospital admission (Jolly and Wing 2010). It is most often seen in nullparous and younger women and there appears to be a link with lower socioeconomic status, diabetes and sickle cell disease, although not with ethnicity (Hill et al 2005, Jolley et al 2012). It is more common in the 2nd and 3rd trimester (Archabald et al 2009, Hazhir 2007, Hill et al 2005) as the presence of urinary pathogens seems to increase as pregnancy advances (Hill et al 2005). There does appear to be an association between repeated urinary tract infections and sexual activity (Bernard et al 2011, Pfau and Sacks 1992). If not effectively treated, acute pyelonephritis may have serious consequences for both the mother and fetus. Urinary tract infections in pregnancy may lead to septic...
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...Case Study: Ectopic Pregnancy A 28 year old female patient whom is about 8 weeks pregnant was rushed to the ER (Emergency Room) after noticing some vaginal spotting. She also had two abortions in the past 3 years. The patient has been diagnosed and treated for gonorrhea and chlamydia once. She’s been having chills throughout the night but no fever. Some nausea and vomiting was reported. Her weight is at 110 lbs and her BP (Blood Pressure) is 97/54 mmHg. She complained about cloudy urine and pain after urination. She was treated for recurrent UTI (Urinary Tract Infection) and bacterial vaginosis. The RN (Register Nurse) had her to take a urine test, draw blood and orders a CBC (Complete Blood Work) and following up with a pelvic exam. The examination revealed normal external genitalia. The patient was diagnosis for different test to rule out any UTI, GTI (Genital Tract Infection), Ectopic pregnancy, and normal pregnancy. The doctor ordered an ultrasound exam. Her hCG (Human Chorionic Gonadotropin) was at 15,900 mUI/mL. The radiologist reported the patient’s ultrasound shows a thickened endometrium and slightly enlarged uterus. The result shows increased vascularity adjacent in the right ovary while the left ovary was normal. The doctor rushed in the room and told the patient that ectopic pregnancy was suspected. After being rushed in the surgery room, they prepare the patient for surgery. During the diagnostic laparoscopy, a corneal pregnancy was noted on the left side. They removed...
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...Introduction Urosepsis is a severe illness that occurs when an infection starts in the urinary tract and spreads into the bloodstream. Neonatal urosepsis is urosepsis that develops in a baby younger than 90 days. The bacteria may come from another part of the body or from outside the body. Bacteria that come from another part of the body are carried to the urinary tract by the blood. Bacteria then grow and multiply in the kidneys or bladder and go back into the bloodstream. Bacteria that get into the urinary tract from outside the body come in through the urinating tube (urethra) and infect the bladder. The infection then spreads to the kidneys and into the bloodstream. What are the causes? This condition is caused by bacteria in your child’s...
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...Urinary Tract Infection (UTI) –Bacterial Infection Causes: * Bacteria traveling from the digestive tract to the urethra (women) * Having a large prostate gland or not being circumcised (men) * Weak immune system * Kidney stones * Sexual intercourse Symptoms: * Pain or burning when you urinate * Urine is cloudy or smells bad * Stomach feels tender or heavy * Nausea and vomiting * Having pain on one side of your back, under your ribs (Kidney area) Diagnosis: Doctors can confirm if you have a Urinary Tract Infection (UTI) by testing a sample of your urine, having a blood test done or a X-ray to screen for structural abnormalities or incomplete emptying of the bladder. Mode of transmission: * UTI is not a contagious disease, it occurs from cross contamination. Example- wiping from back to front after a bowel movement. Treatment: * Antibiotics (Penicillin, Cephalosporin, and Minocycline etc.) * Drinking cranberry and blueberry juice (contains hippuric acid which acidify the urine making it less hospitable to bacteria) * Drinking more liquids and not holding urine Relevant Comments: * UTI’s are most common in females * UTI’s during pregnancy can cause premature birth Scabies- Skin infection Causes: * Sarcoptes Scabiei Symptoms: * Itching * Rashes * Thin, pencil like mark lines Diagnosis: A simple examination of the skin shows signs of scabies. You may have to do an examination...
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...Case Study 7 Case 1 D.K. is being seen in the clinic for complaints of urinary frequency, urgency, and burning. She reports that her urine appears cloudy and smells abnormal. A urine culture is obtained, and D.K. is given a prescription for antibiotics. 1) What is the most likely cause of D.K.’s signs and symptoms? The most likely cause of the signs and symptoms is a urinary tract infection. 2) Was antibiotic therapy the appropriate treatment? What organism should the antibiotic be effective against since it is the most common cause of this disorder? Yes, antibiotics are indicated for symptomatic urinary tract infection. E. Coli causes about 80% of UTIs. 3) What factors predispose to development of this urinary tract disorder? Factors that predispose the development of a UTI are: sexually active women, failure to void after intercourse, incorrect hygiene (i.e. wiping from front to back), female anatomy, low estrogen in postmenopausal women, catheters, tubes or foreign objects placed in the urinary tract, pregnancy and diabetes mellitus. 4) What strategies could be suggested to help D.K. avoid recurrence of this problem? Strategies that will help to avoid the recurrence of an UTI: If sexually active void after intercourse, wipe perineal area from front to back, wear cotton crotch underwear, drink six to eight glasses of water a day, avoid bubble baths and highly perfumed soaps, avoid douches and feminine hygiene deodorants. Case 2 P.W. was...
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...Ryan Chavez Patho 2 Case study 7 Case1 1. Due to D.K.’s signs and symptoms she probably has a urinary tract infection or urinary cystitis. 2. Since E. coli is the most common cause of urinary treat infections, antibiotics are an appropriate treatment for D.K. because she is symptomatic with frequency, urgency and burning upon urination. 3. The factors that predispose the development of a UTI are sexually active women,the us of a diaphragm, failure to void after intercourse, improper hygiene, female anatomy, low estrogen levels in postmenopausal women, catheters or a foreign object placed in the urinary tract for a long period time, pregnancy, and diabetes mellitus. 4. The strategies that D.K can take to avoid the recurrence of a UTI would be clean perineal hygiene, stay well hydrated, wear cotton crotched underwear, void after intercourse, avoid feminine hygiene deodorants, avoid harsh toilet paper, and avoid tight fitting pant. Case 2 1. Due to the loss of blood P.W is at risk for pre-renal acute renal failure and it may lead to poor renal perfusion. 2. The best type of treatment to prevent renal failure would be adequate fluid volume replacement with blood or any isotonic solution maintain proper blood volume circulation and to maintain adequate blood pressure and perfusion to the kidneys. 3. P.W. is in the stage of pre-renal oliguria. This means that the kidneys are functioning as the should if blood volume and pressure are low. The kidneys will conserve...
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...Subjective Data: Mrs. Jones is a 34 year old client who present to the office for routine prenatal care at 17 weeks and is also complaining of burning on urination. This pregnancy is from a new relationship and Mrs. Smith admitted that she did not welcome the news at the beginning, but she has accepted it. She reports this pregnancy to be different form her last pregnancies. She says she has not felt pregnant and is feeling odd. History of present illness. The patient complains of burning with urination as well as urinary frequency for the past week. She says she has not been drinking much water and has not tried anything to help with the urinary issues. She also stated “this pregnancy is from a new relationship and Mrs. Smith admitted...
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...Esteban Salazar Professor Lucker HSCS-3302 April 11, 2016 Kidney stones Kidney stones have plagued men throughout recorded history; the problem has even been “diagnosed” in Egyptian mummies that date back some 7,000 years1. At present, kidney stones have sent most three million Americans to the doctor each year, including 500,000 trips to emergency rooms1. Men are more likely to form stones than women at the ages of 20-50, with a peak of 30, but the ones that are in higher risk are those who already suffered from a stone and have a 50 % chance of forming more stones later in life1. Caucasian males are affected more commonly than African-American males, although African-American males have a higher incidence of associated infection with kidney stones whereas females of all races have been noted to have a higher incidence of hydronephrosis2. There are causes, signs and symptoms, diagnostic procedures and treatments, and preventions strategies for kidney stones. Causes of Kidney stones Kidney stones, also known as renal calculi, are commonly composed of calcium (75%), struvite (15%), uric acid (6%) and cysteine (2%)2. Kidney stones are prevalent in hot climates, and it effects about 10% of people over their lifetime3. Kidney stones arise in the kidney when urine becomes supersaturated with a salt that is capable of forming solid crystals2. Although the urine may look like a simple fluid, it’s actually a complex liquid that contains hundreds of chemicals and minerals1...
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...Diabetes and Urinary Incontinence The most common symptom of diabetics (type 1 & type 2) is frequent urination. Excess glucose builds up in the blood stream due to which the fluid gets pulled back from the tissues, resulting in increased thirst. The constant thirst makes you drink more water and you may have to urinate often. The excess glucose that the body produces is excreted out by urinating more than normal. Diabetics and nerve damage Diabetics may cause nerve damage and this includes bowel and bladder nerves too. The autonomic, cranial and peripheral nerves of the nervous system may be damaged if you are diabetic. The autonomic nerves pass from spinal cord to lungs, heart, stomach and bladder. When these nerves get damaged they can...
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...work closely with midwifes to a certain extent. Doctors are normally the first point of contact as they will confirm the pregnancy and will refer their patient to their local hospital where they will meet their midwife. As doctors are medical professional, if a midwife had a patient with a high risk pregnancy, the midwife would need to contact their doctor to have regular check-ups. A paediatrician are also another type of doctor, they are specialised in caring for babies and children. A midwife may ask for paediatrician assistance if they are concerned about any health issues related to the baby’s growth, development or any diseases that the baby may have. Midwifes may ask a social worker to help support pregnant women who have issues that are a cause of concern, for example: women suffering from domestic violence, drug abuse, live in poor conditions and young teenage mothers who may need help with housing and benefits. Social workers help give advice and guidance in areas where a midwife is not specialised in. A midwife may need an obstetrician assistance if her patient is needed to have an emergency caesarean section, has suffered with pre eclampsia and has placenta previa. Obstetrician are also another type of doctor that is speacilised in surgery.They work alongside Gynecologist. If a midwife feels or finds any potential problems with a woman’s pregnancy and delivery, an obstetrician will be on standby if any emergencies arise. A midwife may call or arrange with an Anaesthetist...
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...Case 1 D.K. is being seen in the clinic for complaints of urinary frequency, urgency, and burning. She reports that her urine appears cloudy and smells abnormal. A urine culture is obtained, and D.K. is given a prescription for antibiotics. What is the most likely cause of D.K.’s signs and symptoms? urinary tract infection or cystitis Was antibiotic therapy the appropriate treatment? What organism should the antibiotic be effective against since it is the most common cause of this disorder? yes antibiotic therapy is appropriate for TUI’s. it should be effective against E.coli. What factors predispose to development of this urinary tract disorder? sexually active women, spermicides, improper hygiene, the female anatomy in general, low estrogen levels, pregnancy, diabetes mellitus, catheters, change in vaginal pH, urine stasis. What strategies could be suggested to help D.K. avoid recurrence of this problem? wiping from front to back, drinking recommended amount of water, voiding after sexual activity, avoid tight fitting pants/underwear, wear cotton underwear, avoid bubble baths. Case 2 P.W. was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of the left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency department. P.W.’s vital signs and hematocrit suggest that he has had a major blood loss of about 2000 ml. A catheter is inserted to monitor urine...
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...Urinary Frequency, Adult Urinary frequency means urinating more often than usual. People with urinary frequency urinate at least 8 times in 24 hours, even if they drink a normal amount of fluid. Although they urinate more often than normal, the total amount of urine produced in a day may be normal. Urinary frequency is also called pollakiuria. CAUSES This condition may be caused by: • A urinary tract infection. • Obesity. • Bladder problems, such as bladder stones. • Caffeine or alcohol. • Eating food or drinking fluids that irritate the bladder. These include coffee, tea, soda, artificial sweeteners, citrus, tomato-based foods, and chocolate. • Certain medicines, such as medicines that help the body get rid of extra fluid (diuretics). •...
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...in colour (Lochia rubra). She had used about 2 maxi pad fully soaked. She still had pain over the suture site but no bleeding and no other discharge. She could ambulate well and able to pass urine but no bowel opening yet. She had no problem to breastfeed her daughter with all the experience she had from her first and second child. She was fully rested and was not lethargic. She denied of anaemic symptoms such as shortness of breath, palpitation, syncope, dizziness and blurred of vision. She did not look pale. Baby : She breastfed her baby more than 7 times in 24 hours. Her daughter weighed about 3.1kg and had passed her urine and bowel opening within 24 hours of life. ANTE-NATAL CONDITION 1st trimester (1-12 weeks) Her pre pregnancy weight was 52 kg and height of 155 cm. Her BMI was...
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...Introduction: STI’s by definition are infections of the reproductive tract that is caused by microorganisms. These microorganisms are transmitted through vaginal, anal, or oral sexual intercourse. STI’s pose a serious threat to the health of women and also to the health of a fetus and newborn. Chlamydia is the most common bacterial STI, followed by Gonorrhea. These two sexually transmitted infections are characterized by cervicitis. Cervicitis is inflammation or infection of the cervix. It can be either symptomless or cause bleeding on contact and purulent discharge of the vagina [ (Ricci, 2013) ]. Chlamydia: Chlamydia is caused by the bacterium known as Chlamydia trachomatis. This bacterium is hard to detect because many women are asymptomatic and do not seek testing. If left untreated it can cause serious and permanent damage to a woman’s reproductive system; such as it can make it very difficult or impossible for a woman to become pregnant and can also cause fatal ectopic pregnancies and pre-term labor [ (Chlamydia-CDC Fact Sheet (Detailed), 2014) ]. It can also spread to a woman’s uterus and fallopian tubes, causing pelvic inflammatory disease, and pelvic pain. If a baby is born to an infected mother, it may contract eye and respiratory infections during childbirth [ (Toro, 2008) ]. Chlamydia is most common among young, sexually active persons aged 14-24. This is nearly three times the prevalence of persons aged 25-39. Chlamydia is 6.2 times more prevalent amongst...
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...The Caesarian Section is an operation which is done to deliver a baby also known as a C- section. It is done through a surgical process where a cut is made through the mother’s abdomen and the pelvic area to deliver the baby or babies. The C- section is usually done whenever a vaginal delivery fails and the life of the mother or even the baby is at risk. Some people also request for the C-section to be done without any medical reasons but social or personal reasons. It is however recommended that the caesarian section is done under medical grounds by surgical experts. The main benefit of the caesarian section is that the life of the mother or the baby or even both can be saved through the operation. Another advantage is that the woman does...
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