Formative Assessment

The case study to be presented here is of the patient who is suffering from Pyelonephritis that is a type of urinary tract infection (UTI). As mentioned by NMC (2015), the confidentiality and privacy of the patients are to be ensured while providing care to them by the nurses so that their rights regarding them are well protected. Thus, anonymity of the patient is maintained in the case study to ensure confidentiality. The patient’s consent was also taken prior using information regarding her to be mentioned in the case study. Moreover, the patient was informed regarding the need and way her personal information would be used. In the case study, the nurse mentor will be known as Nurse B and the patient will be known as Patient J. Patient J is a 77-year-old female who has been admitted to the Elderly Ward in the hospital by her family as she was experiencing problem with Pyelonephritis. For those seeking social work dissertation help, understanding such case studies can be crucial in illustrating the application of confidentiality practices and patient care principles. As mentioned by Johnson & Russo (2018), Pyelonephritis is a nature of urinary tract infection which initiates from the urinary bladder or urethra and extends to one or both of the kidneys.

Patient J is also seen to be suffering from interstitial cystitis for the last two years and has become dependent on using indwelling catheter. Interstitial cystitis is referred as the condition in which the patient feels discomfort or pain when the bladder gets filled. In this type of disease, it is often seen that people feel urgency or frequency of emptying urinary bladder that results them to become dependent on using urinary catheter (Grundy, Caldwell & Brierley, 2018). In case of Patient J, it was reported that she suffered pain in the bladder as a result of interstitial cystitis and often feel urgency to eliminate due to which she is confined to use indwelling catheter. During the hospital admission, the family of Patient J informed that she for the past few days was reported of high fever, frequent urinating, vomiting and facing abdominal pain with burning sensation while urinating that made them hospitalise her. Patient J is seen to live in a separate household in the city outskirts with her husband who is 83 years old who is suffering from arthritis. Patient J belongs from the middle-class society and her son visits them weekly who is presently studying. Pyelonephritis often rises among patients using urinary catheter for a long time because of unhygienic management of the catheter tube. This is because the unhygienic management leads to create an environment for bacterial growth around or inside the tube that enters the urinary tract causing complication due to spread of infection (Zhang et al. 2016).

Activities of Living

The nursing model presented by Roper Logan Tierney informs about the activities to be maintained to offer effective care to the patients (Williams, 2017). One of the major activities of life for Patient J is urinating to eliminate wastes from the body. The elimination of the waste is usually done by the body through urination and faecal discharge through the use of urinary system. The Pyelonephritis which is a urinary tract infection being suffered by the Patient J is usually treated with administration of antibiotics such as sulfamethoxazole, levofloxacin and others in oral manner (Cattrall, Robinson & Kirby, 2018). In case of individuals suffering from Pyelonephritis reports vomiting, they require hospitalisation as they cannot take antibiotics orally as the vomiting renders them dehydrated. Thus, in such condition, the patient is provided antibiotics intravenously by the doctors (da Silva et al. 2016). In case of Patient J, it is reported that she is vomiting continuously which may have resulted her to get dehydrated making her require hospitalisation. The high fever during Pyelonephritis indicates that the infection may have spread to the kidney. In this condition, the patients are asked by the doctors to execute other tests to identify the condition of the kidney (Choi et al. 2017). Since Patient J is also suffering from high fever, thus she may be asked by the doctor to execute other tests to analyse the condition of her kidneys that are parts involved in the elimination process in urinary system.

According to Bio-psycho-social model, the interaction between the biological, psychological and social factors results to cause diseases that deteriorate health conditions (Artioli et al. 2017). The biological factors such as physiological pathology or the genetic vulnerabilities are seen to relate with causing illness (Van de Velde et al. 2016). In case of Patient J, her urgent need of urination as an effect of interstitial cystitis made her use urinary catheter that may have resulted her get affected by urinary tract infection in the form of pyelonephritis. The psychological factors such as coping methods, stress, attribution and others are responsible to rise of deteriorated health condition (Artioli et al. 2017). In case of Patient J, her psychological condition of feeling abdominal pain and burning sensation while eliminating may result to contribute to facing hindrances with urinating. The social factors are referred to the family circumstances, work environment and others related to cause disease (Van de Velde et al. 2016). In case of Patient J, the family circumstance where her husband is the only carer present who is also not physically well may have rendered her to be unable to manage proper hygiene methods may have affected her to develop pyelonephritis.

References

• Artioli, G., Foà, C., Cosentino, C., & Taffurelli, C. (2017). Integrated narrative nursing: a new perspective for an advanced assessment. Acta Bio Medica Atenei Parmensis, 88(1-S), 7-17. Retrieved on 18 February 2019 from: https://www.researchgate.net/profile/Giovanna_Artioli/publication/315383680_Integrated_narrative_nursing_a_new_perspective_for_an_advanced_assessment/links/58cf9e4892851c374e18c16b/Integrated-narrative-nursing-a-new-perspective-for-an-advanced-assessment.pdf
• Cattrall, J. W., Robinson, A. V., & Kirby, A. (2018). A systematic review of randomised clinical trials for oral antibiotic treatment of acute pyelonephritis. European Journal of Clinical Microbiology & Infectious Diseases, 37(12), 2285-2291. Retrieved on 21 February 2019 from: https://link.springer.com/article/10.1007/s10096-018-3371-y
• https://link.springer.com/article/10.1007/s10096-018-3371-y Choi, H. K., Chung, J. W., Oh, W. S., Jun, J. B., Kwak, Y. G., Park, S. Y., & Kim, B. N. (2017). Outpatient treatment in women with acute pyelonephritis after visiting emergency department. The Korean journal of internal medicine, 32(2), 369. Retrieved on 18 February 2019 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339470/
• da Silva, C. N. G., Safadi, A. P. L., de Azevedo Silva, A. B., & Lanzieri, P. G. (2016). Epidural abscess in a diabetic patient with complicated pyelonephritis: Case report and literature review. Medical Case Studies, 7(1), 1-4. Retrieved on 18 February 2019 from: https://academicjournals.org/journal/MCS/article-full-text-pdf/8C15A2759608
• Grundy, L., Caldwell, A., & Brierley, S. (2018). Mechanisms Underlying Overactive Bladder and Interstitial Cystitis/Bladder Pain Syndrome. Frontiers in neuroscience, 12, 931. Retrieved on 22 February 2019 from: https://www.frontiersin.org/articles/10.3389/fnins.2018.00931/full
• Jansåker, F., Frimodt-Møller, N., Benfield, T. L., & Knudsen, J. D. (2018). Mecillinam for the treatment of acute pyelonephritis and bacteremia caused by Enterobacteriaceae: a literature review. Infection and drug resistance, 11, 761. Retrieved on 21 February 2019 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973435/
• Johnson, J. R., & Russo, T. A. (2018). Acute pyelonephritis in adults. New England Journal of Medicine, 378(1), 48-59. Retrieved on 18 February 2019 from: http://clinicainfectologica2hnc.webs.fcm.unc.edu.ar/files/2018/03/Acute-Pyelonephritis-in-Adults.pdf
• Van de Velde, D., Eijkelkamp, A., Peersman, W., & De Vriendt, P. (2016). How competent are healthcare professionals in working according to a bio-psycho-social model in healthcare? The current status and validation of a scale. PloS one, 11(10), e0164018. Retrieved on 18 February 2019 from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164018
• Williams, B. C. (2017). The Roper-logan-tierney model of nursing. Nursing2018 Critical Care, 12(1), 17-20. Retrieved on 18 February 2019 from: https://journals.lww.com/nursingcriticalcare/Fulltext/2017/01000/The_Roper_Logan_Tierney_model_of_nursing.5.aspx