Clinical Manifestations
The following conditions are present for Mr. M. He has average body temperature, normal blood pressure, healthy heart and respiratory rates, and normal pulse oximetry. His white blood cell count appears beyond the average range, and is overweight (27.92) Mr. M.’s lymphocyte count appears beyond the average count (6,700), which signifies a potential infection. Although Mr. M.’s protein level seems roughly average, the results of his urine exam indicate a possible urinary tract infection; the urine contains leucocytes and is cloudy. Mr. M. does not, however, indicate signs of internal injury or bleeding given that the CT scan shows no significant changes from the previous one. He is, however, aggressive, fearful, and with signs of dementia – he quickly forgets what he reads and family member names. Mr. M. has shown drastic deterioration regarding daily life activities; he is unable to walk steadily and requires assistance bathing, dressing, and other vital activities. He has a history of high blood pressure and high cholesterol.
Primary and Secondary Diagnoses
Mr. M.’s condition necessitates a kidney examination – the diagnosis for potential urinary tract infection as the primary diagnosis. The extraordinary white blood cell and lymphocyte levels indicate the potential for infection. Furthermore, the presence of leucocytes (6,700) in the urine signifies the presence of a urinary tract infection. The health history for Mr. M. reveals the presence of high cholesterol, which he acquired after appendectomy. It might be possible that the removal of the appendices opened an opportunity for bacteria or other pathogens into Mr. M.’s urinary tract. The proximity of these systems increases the probability of Mr. M. to have acquired an infection after appendectomy. Furthermore, research indicates that the risk of chronic kidney disease increases with appendectomy (Chang et al., 2018). The health history of Mr. M. also reveals that he has been using Lisinopril, which may have caused a kidney problem. The presence of leucocytes in the urine strengthens the possibility of kidney destruction resulting from the use of Lisinopril. It is, therefore, crucial for Mr. M. to receive a kidney examination.
One of the drugs included in Mr. M.’s drug list is Lipitor, which has a known side effect of confusion and mild memory loss. The medicine may be responsible for memory loss. Since the CT scan ruled out the possibility of internal bleeding, injury, and cancer, it is prudent for the physician to consider substituting Lipitor with another drug with less severe side effects. The other drug under Mr. M.’s drug therapy is Ambien, which has known side effects such as memory loss, anxiety, and aggression. It is possible that this medicine is responsible for the observed memory loss, anxiety, and aggression. As such, the physician may consider substituting this medicine with an alternative one with less severe side effects.
Mr. M. may require a liver examination as a secondary diagnosis. Some of the medicines included in Mr. M.’s drug therapy may produce side effects on the liver. Lisinopril and Lipitor, which may have affected the kidney, might also have affected the functioning of the liver. Although Mr. M. shows no apparent symptoms of liver infection, he must receive a liver examination as a precaution against potential liver infection. Given the role of the liver in detoxification and other processes, it would be necessary to track any damage to the liver before it becomes an emergency problem.
Expected Abnormalities
Some abnormalities expected in the case of a urinary tract infection include the presence of blood in urine, which accompanies the coloring of the urine. The patient may report symptoms such as pain during urination, pelvic pains, and burning sensation when urinating. A secondary diagnosis of the liver may produce results such as jaundice and a record of change in the amounts of urine if indeed the patient has a liver problem.
Effects on Physical, Psychological, and Emotional Aspects
Physical impacts likely to be associated with a urinary tract infection include pain and constipation. Psychological effects include the loss of personal morale related to depression. Such changes may generally reduce the patient’s quality of life (Renard et al., 2015). The patient may become confused and agitated and may lose appetite. Sudden behavioral changes may also be part of the observed differences. Mr. M. manifested some of these changes, and that supports the claim that he might have had a urinary tract infection.
Interventions
If Mr. M.’s examination reveals the presence of a urinary tract infection, the right response for him will include drug and physical therapies. Drugs will consist of antibiotics and penicillin. Besides the drugs, Mr. M. should undergo lifestyle changes to help him resolve his hypertension and obesity problems. One of the crucial lifestyle changes that Mr. M. requires is a regular physical exercise to help him reduce his cholesterol level. The evolution of diet is a vital component of Mr. M.’s intervention; he should increase his intake of fruits and reduce the consumption of foods with high amounts of fat. Another lifestyle change is an increase in water intake to help clean bacteria off the urinary tract before infection. Hygiene is also crucial to keep bacteria off the urinary tract.
References
Chang, C. H., Kor, C. T., Wu, C. L., Chiu, P. F., Li, J. R., Tsai, C. C., … & Chang, C. C. (2018). Increased chronic kidney disease development and progression in diabetic patients after appendectomy: a population-based cohort study. PeerJ, 6, e5019.
Renard, J., Ballarini, S., Mascarenhas, T., Zahran, M., Quimper, E., Choucair, J., & Iselin, C. E. (2015). Recurrent lower urinary tract infections have a detrimental effect on patient quality of life: a prospective, observational study. Infectious diseases and therapy, 4(1), 125-135.