Hemorrhagic CVA
The focus of the presentation must reflect current treatment recommendations from accepted professional organizations.
Presentations must be no more than twelve slides in a PowerPoint format with a Reference List in APA format.
1.Presents the case including CC, HPI, Hx, ROS and PE findings concisely
2. List possible differential diagnosis with supporting/excluding criteria.
3. What labs or tests are typically ordered concerning this condition? What results should the Does NP expect to see with this diagnosis?
4. What medications are typically prescribed for this condition? List specific drugs, starting doses, dose ranges, precautions to keep in mind when prescribing these drugs.
5. What are the outcomes expected or unexpected for this specific condition? Moreover, What patient outcomes will trigger a referral?
6. Provide patient teaching materials specific to their condition.
Hematuria Maritza Leon Leonardo Trobajo ARNP- BC
Hematuria
This is also known as blood in the urine.
The blood in the urine comes from the kidneys.
They can also come from the following parts:
Ureters
Bladder
Urethra
Symptoms of Hematuria
Pink, tea-colored or red urine
The urine might have visible blood (Bazari, 2014).
Pain when urinating
Belly pain
causes and risk factors Kidney stones
Kidney inflammation
Kidney or bladder cancer (Resnick, 2018).
Prostate cancer
Vigorous exercise
CC
Mr. Kim is a 75-year-old male who has been admitted in the hospital for evaluating of blood in the urine and pain when urinating.
HPI
Mr. Kim comes to the hospital today.
He has blood in the urine.
He denies weight loss.
ROS
He accepts that he experiences 3 level pain (on a scale of 0-10).
He has noticed swollen nodes in the groin.
He has been having these signs for three weeks.
Other signs are negative.
PE
Mr. Kim is healthy appearing.
His eyes are clear.
Neck has good range of motion without lymphadenopathy.
The oropharyngeal membranes are pink in color and are also moist.
The heart has a regular rate as well as rhythm.
The lungs are clear to auscultation.
The abdomen is soft as well as tender
He is alert and oriented X3.
Has no skin discoloration.
Hx
The patient has no family history of hematuria.
None of the family member has ever had the same condition.
Possible differential diagnosis of hematuria
BPH: The patient has painful and frequent urination. Blood in urine
Nephrolithiasis: Blood in urine or frequent urination cause by kidney stone( hard deposit of minerals and acid salts that stick together in concentrated urine)
Cystitis: A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine.
Lab test for hematuria
CBC with Diff ,Urinalysis, Urine Culture,
CT scan which can identify the stones or tumors in the ureters, bladder or kidneys. The presence of tumor in the kidney shows infections.
Kidney ultrasound that can create an image in the kidney to identify any abnormality. Swollen or bleeding kidneys shows kidney infections.
Cystoscopy where a camera is taken through bladder through the urethra and take some tissue samples and check for cancerous cells. Presence of cancerous cells shows that the patient has cancer of bladder.
Medications and Treatments
Macrobid 100 mg 1 Tab PO BID X 7 days
Pyridium 200 mg 1 tab PO TID for 2 days
Tylenol 650 mg 1 tab PO q8hrs as needed for pain
Increase oral fluid intake
Expected outcomes
The patient is expected to produce urine free of urine which proofs that the bleeding parts has healed.
The pain in the abdomen and in the urethra is expected to come to an end and this shows that the infections have healed.
A continuous production of urine with blood will trigger a referral.
Patient’s teaching materials
Will provide education to patient and caregiver about Disease, signs and symptoms and treatment through;
Brochures
Posters or charts
Journals and books
References
Bazari, H. (2014). Hematuria and Proteinuria. The Brigham Intensive Review of Internal Medicine, 615-625. https://doi.org/10.1093/med/9780199358274.003.0061
Benson, G. S. (2018). Hematuria: Algorithms for diagnosis. JAMA, 246(9), 993. https://doi.org/10.1001/jama.1981.03320090053034
Brewczyńska, A. (2016). Cardiac causes of hematuria. https://doi.org/10.26226/morressier.57d034d1d462b802923834f2
Resnick, M. J. (2018). Re: Association between use of Antithrombotic medication and hematuria-related complications. Journal of Urology, 199(5), 1103-1103. https://doi.org/10.1016/j.juro.2018.02.053
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