HEALTH VARIATION.

Running head: HEALTH VARIATION
HEALTH VARIATION
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HEALTH VARIATION1
In this case study the patient, Mr Kirkman, 75 years old man, was admitted in the
emergency department (ED) accompanied by the issue of burning sensation in urine while
urinating associated with lower abdominal ache spreading to his right side. Kirkman was
diagnosed and was suffering from urinary tract infection (UTI). The pathophysiology of UTI
takes place through three different routes namely lymphatic, ascending and haematogenous
route. The infection starts once bacterial pathogen enters the patient body and forms colony
in the periuretheral area and upsurges to the urinary bladder from the urethra. Fimbria allows
the pathogenic bacteria to reach the part of epithelial cells, where the bacteria replicates and
produces biofilms (Flores et al. 2015). The continuous replication of bacteria leads to urinary
tract irritation and later develops into urinary tract infection. Hence, this condition develops
the symptom of frequent urination or the urge to urinate frequently and suffer from burning
sensation while urinating. As the patient is urinating more they often sense the urge to drink
more water as they get dehydrated from continuous urination. Because of bacterial replication
development of severe inflammation happens in the urinary bladder of the patient, which
result in suffering and pain by narrowing of bladder during urinating that result in dysuria.
The capability of bladder is highly reduced as the inflammatory edema leads to compliance
and pain due to bladder distension (Detweiler, Mayers and Fletcher 2015). Hence, the
formation of inflammatory edema leads to abdominal pain that involves active bacterial
colonization in ureter that will affect the kidney. The movement of pathogenic bacteria to the
kidney is assisted by fimbria, which will affect the parenchyma and result in an inflammatory
reaction termed as pyelonephritis. The developed pyelonephritis result in tubular damage and
impediment, which leads to interstitial edema. The symptom of pain and burning sensation is
due to the edema formation of bacterial pathogen that develops in urinary tract infection
(Schaeffer and Nicolle 2016).

HEALTH VARIATION2
Mr Kirkman exhibited clinical symptoms that clearly showed that his health condition
was worsening and his heart rate (HR) was abnormal as compared to the standard range.
Kirkman exhibited heart rate of 135bpm that was very high from the standard range, which
lies between 60 to 100 bpm. Once the pathogen invade the parenchyma it results in an
inflammatory reaction that result in the formation of pyelonephritis. If the condition is not
diagnosed early it leads to the condition of urosepsis (Dreger et al. 2015). In urosepsis, the
urinary tract infection (UTI) radiate from the urinary tract and enter the blood that result in
systematic infection. This systematic infection circulates throughout the body by bloodstream
developing the disorder of sepsis that further results in reduced blood pressure, urine output,
augmented heart rate and trouble in breathing. Hence, the patient Kirkman had abnormal
heart rate due to urinary tract infection connected with severe sepsis. The clinical symptom of
Kirkman also showed that he had hypotension, which results due to low blood pressure. The
standard blood pressure (BP) is 120/80 mm HG but Kirkman had extremely low blood
pressure of 80/42 mm HG. During tubular impediment and damage caused by pyelonephritis,
it further results in damage by leads to the development of interstitial nephritis
(Schneeberger, Holleman and Geerlings 2016). This lingering situation will upsurge the
danger of bacterial pathogen to transport to blood stream from the kidney developing a life
threatening situation and hence leads to urosepsis. Urosepsis leads to septic shock that
involves initiation of different systemic reaction and therefore activates the cytokine
discharge from the immune system that will fight from the infection. This released cytokines
will lead to blood vessel dilation hence permitting extra quantity of blood to flow through the
septic area that ultimately results in low blood pressure thereby affecting the function of
human body (Yamamichi et al. 2017).
The patient who is suffering from sepsis and urinary tract infection (UTI) often
exhibit high respiratory and heart rate because of the situation of tachypnea that is considered