What are some appropriate questions to ask the patient? OLDCART is the mnemonic for gathering information at the chairside or bedside (Senger & Smith, 2020). The symptoms started 48 hours ago and were sudden, with pain in the suprapubic region. The onset, location, duration, characteristics, does anything make it better? Has this ever happened to you before? Do you have any chills or fever with these symptoms? What are three differential diagnoses for the patient? Benign prostatic hypertrophy (BPH)- men can experience symptoms of urinary flow obstruction. Prostatitis-men can experience urinary frequency along with painful urination and rectal pain. Complicated UTI- suprapubic pain, frequency, dysuria, costovertebral angle pain (Epocrates Web, n.d.). What physical examination would you perform? Check a complete set of vital signs that includes a temperature. Examine appearance for guarding or grimacing. Auscultate heart and lungs in all fields. Percussion over the bladder and CVA area for pain. Palpate the abdomen, kidneys, and asses for any masses or tenderness. Palpate the back and notate any CVA pain. Palpate the inguinal lymph nodes checking for engorgement or pain. Assess the rectal area and palpate the prostate for any bogginess (Cash et al., 2020). What diagnostics would you include? According to Epocrates, . appropriate diagnostics include UA, urine cx, gram stain, and urine microscopy, which could consist of a renal CT and or ultrasound. Create an evidence-based plan of care. Include pharmacological and non-pharmacological treatments. Non-pharmacological-Drink at least one glass of liquid every hour. Avoid foods that create bladder irritation, such as caffeine, spicy foods, citrus, and alcohol. Pharmacological treatment-Pyridium 100mg tid for two days given with antibiotic, Levaquin 500mg once daily for seven days. Men treated for UTIs are classified as complicated UTI, and fluoroquinolones therapy is appropriate (Epocrates, .). Positive nitrite and leuks warrant for treatment of a UTI. Please add 1 referenceShow more
