Health And Wellbeing

Client Profile

A case study regarding a patient suffering from urinary tract infection (URI) is developed as a part of the essay. The confidentiality of the patient is ensured by referring all the information about the individual in an unidentified manner as per the suggested code of conduct by the Nursing and Midwifery Council (NMC). The consent is taken from the patient regarding whom the case study is framed prior to mentioning the facts by informing the individual regarding the way the shared information is to be used. In the case study, the patient will be named as P and the nurse mentor will be indicated as NM. P is an 80-year-old woman who is admitted to the Elderly Ward in the hospital as she was facing problem of urinary tract infection which includes cystitis, urinary incontinence, urethritis and cystocele. The cystitis is referred to the infection of the bladder and urethritis is infection of urethra which is common form of UTIs. They commonly affect the women urinary system due to its anatomical structure which allows the bacteria and microorganisms to thrive easily to infect the tract (Lapides et al. 2017). The Cystocele is referred to the condition in which the supportive tissues holding the bladder as well as the vaginal wall weakness resulting the bladder to bulge in the vagina (Jameel & Mahmud, 2016). The treatment of cystocele is repair surgery where the surgeon fixes the tissues but the surgery often leads to urine leakage, injury to bladder, narrowing of vagina and others (Vitale et al. 2016).

P has a long history of burning sensation, pain and irritation in the urinary tract; infrequent urine passage; uncontrolled bladder condition and stomach pain which is the key cause of her many admission to the hospital. Moreover, P has history of diabetes mellitus along with various allergies with food and gastroesophageal reflux disease. The patient named P is seen to currently live in a slum within an attached household where she is to share a single washroom with five of her family members as well as six of the neighbours. The washroom conditions are informed to be unhygienic in nature as reported by P during communication with the nurse in the hospital. The UTIs often arise among women who use washroom that is in unhygienic condition as bacteria and fungi responsible for causing the UTIs are found abundantly in such condition. Moreover, suppressed immune system as a result of diabetes results to raise risk of causing UTIs (Nitzan et al. 2015). The UTIs are often treated by using antibiotics to avoid the infection to be spread into the blood and other parts of the body. This is because such condition may lead to kidney damage and blood in the urine (Bryce et al. 2016).

Activities of Living

The Roper-Logan-Tierney model is a nursing model that focuses on the activity of living for the patient (Williams, 2015). One of the key activities of living to be considered for the patient P is her elimination of wastes outside the body. The elimination is done by the individuals through breathing, urinating and faecal release through the urinary system. The elimination is required by the body so that the harmful waste produced in the body does not affect the internal parts (Lamb et al. 2016). The UTIs are often controlled and treated through medication and surgery and the surgical process are nowadays invasive in nature (Schaeffer & Nicolle, 2016). However, the patients require discussing the side-effects of the surgery and medication so that they are able to take proper precautions and measures to lead a healthy life through effective planning.

The Bio-psycho-social model informs the biological, psychological and social factors and their interactions that responsible in causing the disease or illness for gaining understanding regarding the cause and prevention of the health issue. The biological factors are the genetic vulnerabilities and physiological pathology related to the disease whereas the psychological factors are psychological stress, coping methods, attribution and others of the patient regarding the illness. The social factors are the work environment, family circumstances and relationships (Van de Velde et al. 2016). The women are more prone to urinary tract infection because of their anatomy which shows that they have a shorter urethra in comparison to the men that shortness the travelling distance of the bacteria to infect the bladder (Aydin et al. 2015). Therefore, women are more prone to get infected easily through microorganisms during elimination under unhygienic condition. The psychological stress such as anxiety, confusion, depression and others acts in a potential way in causing urinary incontinence and bladder problems. This mainly occurs because during psychological stress serotonin and norepinephrine are activated which indicates the body to respond in different unusual ways out of which bladder leakage may be one (de Jesus et al. 2016).

The study of Ahmed et al. (2018), informed that out of the total number of patients they surveyed in the UK during 2004 to 2014 it is found that 21% of adults who are above the age of 65 are at least once diagnosed with UTI during the period. The study also informed that women are more prone to get UTI in comparison to men and the complication of UTI also increases with age. This is because with ageing different functions of the body is hindered leading to development of UTI (Ahmed et al. 2018). The lower social status leads individuals towards getting infected with UTI as they are unable to manage effective living conditions (Wagenlehner et al. 2018).

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References

• Ahmed, H., Farewell, D., Jones, H. M., Francis, N. A., Paranjothy, S., & Butler, C. C. (2018). Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004-2014. PloS one, 13(1), e0190521.
• Aydin, A., Ahmed, K., Zaman, I., Khan, M. S., & Dasgupta, P. (2015). Recurrent urinary tract infections in women. International urogynecology journal, 26(6), 795-804.
• Bryce, A., Hay, A. D., Lane, I. F., Thornton, H. V., Wootton, M., & Costelloe, C. (2016). Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis. bmj, 352, i939.
• de Jesus, L. E., Tomé, A., Cobe, D., & Camelier, P. (2016). Psychosocial and respiratory disease related to severe bladder dysfunction and non-monosymptomatic enuresis. Journal of pediatric urology, 12(2), 126-e1.
• Jameel, S., & Mahmud, S. N. (2016). Frequency of different risk factors associated with Recurrent Urinary Tract Infection among Postmenopausal Women. Journal of Ayub Medical College Abbottabad, 28(2), 353-356.
• Lamb, M. J., Baillie, L., Pajak, D., Flynn, J., Bansal, V., Simor, A., ... & Leis, J. A. (2016). Elimination of screening urine cultures prior to elective joint arthroplasty. Clinical Infectious Diseases, 64(6), 806-809.
• Lapides, J., Diokno, A. C., Silber, S. J., & Lowe, B. S. (2017). Clean, intermittent self-catheterization in the treatment of urinary tract disease. The Journal of urology, 197(2s), S122-S124.
• Nitzan, O., Elias, M., Chazan, B., & Saliba, W. (2015). Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes, metabolic syndrome and obesity: targets and therapy, 8, 129.
• Schaeffer, A. J., & Nicolle, L. E. (2016). Urinary tract infections in older men. New England Journal of Medicine, 374(6), 562-571.
• 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.
• Vitale, S. G., Laganà, A. S., Gulino, F. A., Tropea, A., & Tarda, S. (2016). Prosthetic surgery versus native tissue repair of cystocele: literature review. Updates in surgery, 68(4), 325-329.
• Wagenlehner, F., Wullt, B., Ballarini, S., Zingg, D., & Naber, K. G. (2018). Social and economic burden of recurrent urinary tract infections and quality of life: a patient web-based study (GESPRIT). Expert review of pharmacoeconomics & outcomes research, 18(1), 107-117.
• Williams, B. C. (2015). The Roper-Logan-Tierney model of nursing: A framework to complement the nursing process. Nursing2018, 45(3), 24-26.