Course  

NR 507 Advanced Pathophysiology

Instructions  

Mrs. Orndorf is a 28-year-old woman married for 3 years who has just returned from an outdoor camping trip with her husband, with symptoms of dysuria with a burning sensation, urgency to urinate, & frequent urination. She said, “I have had similar symptoms three times over the last 2 years. Pubic & low back discomfort awoke me two nights ago & that is why I am here.” On physical examination, her temperature was 98.6° F, blood pressure was 114/64 mm Hg, pulse was 68 beats per minute, & the respiratory rate was 12 breaths per minute. Other than a tender abdominal pelvic area, the examination was unremarkable.

• What is your list of differential diagnoses in this case & explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis & explain why.

SOLUTION 

Acute Cystitis secondary to Urinary Tract Infection (UTI)

Cystitis is the inflammation of the bladder & is usually caused by urinary tract infections. Cystitis is caused by the invasion of the bladder mucosal by enteric coliform bacteria (Escherichia coli) that ascends into the bladder via the urethra (Brusch, 2016). Cystitis causes urgent & frequent urination that can be associated with a stinging & burning pain as seen in Mrs. Orndorf. Other symptoms include blood in the urine (hematuria), cloudy or strong-smelling urine, pelvic discomfort, a feeling of pressure in the lower abdomen, & low-grade fever (Brusch, 2016). The pain can radiate from the abdomen & to the back which is also another symptom Mrs. Orndorf reports to experience. Women with cystitis feel generally unwell & groggy. They may also have difficulties sleeping, & feel tired, irritable & unable to concentrate.

Pyelonephritis

Acute pyelonephritis is a potentially organ- &/or life-threatening infection that often leads to renal scarring (Fulop, 2016). Acute pyelonephritis results from bacterial invasion of the kidneys from the lower urinary tract or bloodstream. Timely diagnosis & management of acute pyelonephritis has a significant impact on patient outcomes. The classic presentations of acute pyelonephritis are back or flank pain, fever, feeling sick (malaise), nausea &/or vomiting, painful urination (dysuria), & increased urination frequency (Fulop, 2016). This disorder could also explain Mrs. Orndorf’s symptoms of dysuria with a burning sensation, her frequent urination, & back pain.……please click the purchase button below to access the entire solution at $10