Course task: CU10

George is a 75 year-old patient with urosepsis being treated in the Intensive care unit (ICU). The
nurse assesses George and finds that he has blood in his urine and stool, and is oozing blood
from his central line site and his gums.

 What does the nurse suspect maybe occurring with George?

 Urosepsis is a type of sepsis that is caused by an infection in the urinary
tract.
 What medications should the nurse avoid administering to George?
 The nurse should avoid administering any kind of rectal drugs. Avoid the
use of urinary catheters whenever possible.
 The nurse is monitoring George’s vital signs every 15 minutes. What other
monitoring is essential to include along with the vital signs?
 Monitor fluid and electrolyte levels to avoid dehydration.
 What medication does the nurse anticipate infusing?
 The primary treatment for urosepsis is use of broad-spectrum antibiotics to
get rid of the infection. The treatment may also include supportive
measures such as intravenous fluids and oxygen therapy.

Fred, a 43 year-old construction worker, has a history of hypertension. He smokes two packs of
cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping
with stress. His current concern is calf pain during minimal exercise, which decreases with rest.

1. What does the nurse is the hallmark symptom of peripheral arterial occlusion disease?
 The hallmark of peripheral arterial disease is the symptom of claudication which
is an intermittent cramping pain in the leg that is induced by exercise and relieved
by rest.
2. The patient is having ankle-brachial index (ABI) determined. The right posterior tibial
reading is 75 mm Hg, and the brachial systolic pressure is 150mm Hg. What would the
ABI be for this patient?
 The ABI for this patient is 0.5 ratios.
3. The nurse is educating Fred about managing his condition. What methods can the nurse
suggest to increase arterial blood supply?
 Systemic lowering of the extremity below heart level
 Buerger Allen exercise- specific exercises intended to improve circulation to the
feet and legs. The lower extremities are elevated to a 45 to 90 degree angle and
supported in this position until the skin blanches (appears dead white).
 Stress management.
 4. What is the best method for the nurse to assess Fred’s peripheral pulses to obtain
consistent results with other health care practitioners?
 Use light touch
 Avoid using only the index finger for palpation because this finger has the
strongest arterial pulsation of all fingers
 The thumb should not be used for the same reason

Georgia, a 30 year-old woman, is diagnosed as having secondary hypertension when serial blood
pressure recordings 170/100 mm Hg. Her hypertension is the result of renal dysfunction.

1. How will Georgia’s kidney help maintain her hypertensive state?

 Release renin in response to decrease renal perfusion.
2. The nurse informs Georgia that she should see her ophthalmologist. Why is it important
that Georgia adhere to follow up with an ophthalmologist?
 An eye examination with an ophthalmoscope is particularly important because
retinal blood vessel damage indicate some more damage elsewhere in the vascular
system. The patient is questioned about blurred vision, spots in front of eyes, and
diminished visual acuity
3. Georgia is prescribed with Furosemide (Lasix) 20mg once every day. What does the
nurse understand about the action of Lasix?
 It blocks reabsorption of sodium, chloride, and water in the kidneys.
4. What health education can the nurse suggest to Georgia to reduce complications and
improve disease outcomes?
 Adhere to dietary regiments, become involved with a regular exercise program
and take medication as prescribed.