University of Nevada, Las Vegas
NURS 320
Pathophysiology and Pharmacology for Nursing II
Paper: Unfolding Case Study
Urinary Tract Infection (UTI)
Directions:
1. Download this document and save in Word adding your first name initial and last name to the end of the document
title: for example, save as Unfolding Case Study-PD-MJones.
2. Answer all the questions. Use APA for references and through the paper when appropriate and necessary.
3. References: It is acceptable to use your course text, but you also must use additional reference sources in addition to
your course textbook, and at least one of them MUST be current journal articles (no older than 5 years).
3. Following completion, upload to the appropriate place in the Assignments section by the due date and time.
4. This is NOT a group assignment, and you must complete this assignment on your own. This paper is part of unfolding
case study assignments and whole unfolding case study is worth 25% of your course grade.
Current Situation:
Ruby Sispes is an 86-year-old widow who lives independently. Her daughter Mary has been concerned as Ruby
has appeared more fatigued the last few days. She has had a low-grade fever and back pain over the last twentyfour hours and winces, as if in pain, when she urinates. Mary became alarmed when she called Ruby today and
Ruby didn’t know the day or Mary’s name. Mary went to Ruby’s home and found her lying in the bathtub
napping. Mary took Ruby to her primary health care providers (PHCP) office. Nursing assessment on arrival
reveals that she was more alert but could not remember when she took her medications last or what day it was.
The PHCP prescribes a urinalysis which reveals cloudy dark colored urine and increased white blood cells and
the presence of red blood cells.
Ruby has a history of diabetes type II, hyperlipidemia, hypertension, and gout. She is overweight and the gout
affects her mobility. Her medications include allopurinol, pioglitazone, simvastatin, metoprolol, lisinopril, and
furosemide.
Personal/Social History:
Ruby lives independently in a senior apartment retirement community. She was married for 60 years to her
husband John and has never gotten over or accepted his death last year. She has two children, Mary who is 63
years old lives nearby and Matthew who is 65 lives in the next state. Ruby has consistently rejected the
children’s recommendation to move to assisted living. She stated, “I would rather die and be with your father.”
Ruby has a small pension for her work in a textile mill and collects social security. Her health insurance is
Medicare. She loves going to bingo and watching soap operas.
1. What is Urinary Tract Infection? Include a brief description, manifestations (list 6), pathophysiology, and general
treatment (list 3). Provide in-text citations as needed.
Brief Description
(This should be
written in a language
you would use to
explain to your
patient)
Manifestations
1.
(List 6 of them)
2.
3.
4.
5.
6.
Pathophysiology
(Please make sure to
explain physiology
that is pathological in
UTI, do not just
describe the
condition)
General Treatment
(List 3)
(It can be both
pharmacological and
nonpharmacological:
Please do not list
three medical drugs,
drug therapy is only
one treatment)
1.
2.
3.
3. What are the contraindications of furosemide? (List 4)
Contraindications:
4. What is a concern when taking allopurinol?
Concern:
5. What is the drug classification of metoprolol?
6. Why is Ruby receiving lisinopril?
Case Study adapted with permission from: Keith Rischer, RN