NR 576 Week 6 iHuman Virtual Patient Encounter Attempt 3229741 - Tamika Brayton

History Notecard by Suzy Hanah on case Tamika Brayton Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = Sx = Sx = Sx = Sx = Sx = Onset Location Duration Characteristics Aggravating Relieving Timing / Treatments Severity Attempt: 3229741 Report generated on 8/9/2024, 9:52:05 AM America/Los_Angeles Management Plan by Suzy Hanah on case Tamika Brayton PLAN: Diagnostic tests: HCG, UA, urine culture Rationale: When compared to specificity, sensitivity is high (72%-95%), while specificity is low (48%-82%). It is possible to grow urine specimens that have been collected in a clean catch setting in order to identify the causal agent and determine the sensitivity of microorganisms. Both specificity and sensitivity are at a high level. Medications: Cefixime 400mg PO daily x14 days Alternate between: Tylenol 325mg - 1000mg Q6hr PRN pain and fever; max 4g/day Ibuprofen 400mg PO Q6hr PRN pain and fever; max 1200mg/day Rationale: Antibiotics should be selected in accordance with the sensitivity profiles of local microbes, pending the results. For the empiric treatment of uncomplicated pyelonephritis, oral fluoroquinolones and cephalosporins are recommended. In patients without pyelonephritis, the risks of neglecting an infection are significantly greater than the risks of antibiotic therapy. The majority of cases that are uncomplicated are resolved without any complications. Treatment regimen: Generally, oral antibiotics are sufficient for 10 to 14 days of outpatient treatment in moderate cases. Education: Increase fluid intake to 8 glasses every day for bladder hygiene. Respond to initial voiding urges to improve habits. Void after sex to remove bacteria from the urethra and if there is a history of unusual anatomy or recurrent UTIs. Patients should finish the program to avoid re-infection. Fever or flank pain should be reported to the doctor. Urinary infections can reach the kidneys and be serious during pregnancy. If this happens, routine prenatal testing and therapy are crucial. Rationale: Maintain bladder sanitation by increasing fluid intake to a minimum of eight glasses per day. Enhance voiding habits by consistently responding to the initial impulse to void. If there is a history of atypical anatomy or recurrent urinary tract infections, and to rid the urethra of pathogens acquired during sex, the individual should void after intercourse. In order to prevent recurrent infection, patients should adhere to and finish the regimen. Patients should be cognizant of and notify their physician of any symptoms that are alarming, including fever or flank pain. Urinary infections may progress to the kidney and be severe when pregnant. If this