Nursing Care Plan: Addressing UTI, Hypertension, and Lymphoedema

This nursing care plan presents a detailed case study of a patient exhibiting symptoms of urinary tract infection (UTI), high blood pressure, and lymphoedema, likely stemming from a history of breast cancer treatment. The plan includes a thorough analysis of the patient's condition, outlining the rationale behind each symptom and the underlying health issues, such as Type 2 Diabetes and the impact of chemotherapy. It provides specific interventions and nursing goals for managing the patient's UTI, aiming to restore normal bladder function, and for addressing high blood pressure, with the goal of reducing hypertension. The interventions include laboratory analysis, encouraging fluid intake, maintaining an acidic bladder environment, monitoring blood pressure, and assessing peripheral pulses. This plan offers a comprehensive approach to patient care, emphasizing the importance of timely interventions and ongoing monitoring to improve patient outcomes. The report is well-referenced and provides valuable insights for healthcare professionals and students alike.

Running head: NURSING CARE PLAN
Nursing Care Plan
Name of the Student
Name of the University
Author Note

1
NURSING CARE PLAN
Table of Contents
Case Study 1...............................................................................................................2
Answer 1..................................................................................................................2
Answer 2..................................................................................................................2
Answer 3..................................................................................................................2
Answer 4..................................................................................................................3
Answer 5..................................................................................................................3
References..................................................................................................................5

2
NURSING CARE PLAN
Case Study 1
Answer 1
Intervention: Laboratory analysis of the urine sample for the evaluation of the
presence of bacterial culture, red blood cells and white blood cells.
Rationale: The gold standard for the detection of the urinary tract infection
(UTI) is via urine culture via using midstream urine. It helps in the estimation of
bacteriuria or the concentration of the bacterial population in the urine. 10^5 colony
forming unit (CFU) is considered as the threshold, the CFU higher than the threshold
signifies UTI (Foxman, 2014). However, the threshold might change depending on
the bacterial strain residing in the urine culture.
Answer 2
Betty White is suspected to be suffering from UTI because her urine has
offensive odour. Normal urine is clear with a mild straw-yellow colour. The odour of
the urine may vary from person to person but does not have a strong smell. The
presence of bacteria in the urine (as in case of UTI) can alter the urine odour making
it pungent or offensive (Foxman, 2014).
Other symptoms which indicated UTI are
a) Type 2 Diabetes: Type 2 Diabetes increases the chance of UTI. Diabetes
hampers normal circulation of blood as a result the WBC, the principal immune cells
fail to travel to all portion of the body, leading to bacterial colonization in the urine
(UTI). Moreover, during diabetes, the emptying of the bladder urine gets hampered
as a result urine stays in the bladder for long promoting bacterial proliferation
(Foxman, 2014).
b) Breast Cancer: Chemotherapy for breast cancer treatment causes drying
out of the vaginal tissue and reduces body’s ability to combat against infection
generating susceptibility for UT. Moreover, UTI is common in older women (Mody &
Juthani-Mehta, 2014)

3
NURSING CARE PLAN
Answer 3
Lymphoedema occurs due to swelling of the lymph nodes that blocks the
normal functioning of the lymphatic system. Out of the five women who have been
suffering from breast cancer develops lymphoedema (DiSipio, Rye, Newman &
Hayes, 2013). Bratty White has a clinical history of breast cancer and hence she has
developed lymphoedema in her right arm. Here the obstruction of the lymphatic
system might have occurred due to the consequence of tumor, radiation therapy,
chemotherapy or surgery of the breast cancer (Brahmi & Ziani, 2016).
Answer 4
Intervention Rationale
Periodic encourage Betty to void urinary
bladder after every 2 to 3 hours while
accessing patient’s pattern of urination
This will prevent accumulation of urine in
the bladder and thus reducing the
number of bacterial colonization (Oman
et al., 2012)
Encourage Betty to consume 3-4 litres of
water per day (if tolerated)
It will help to increase the fluid balance in
the body, help in proper renal flow via
diluting the concentration of urine (Oman
et al., 2012)
Maintain acidic environment inside the
bladder via administration of medicines
like vitamin C or ascorbic acid
Acidic environment will prevent the
growth f bacteria (Oman et al., 2012)
Answer 5
Nursing Care Plan: 1
Nursing diagnosis Urinary Tract Infection
Nursing goal Restoration of the normal bladder function and resolution of
the urinary infection
Interventions Rational
Proper access of the urine colour,
concentration, odour and urine clarity
Helps in the identification of the chronicity
of the disease
Performance of the appropriate Helps in the identification of the bacterial

4
NURSING CARE PLAN
laboratory test strain colonizing inside the urinary tract
(Oman et al., 2012)
Nursing Care Plan: 2
Nursing diagnosis High blood pressure (BP) (145/90)
Nursing goal To reduce the high blood pressure of Betty White and
provide her relief from hypertension
Interventions Rational
Proper monitoring and recording of the
BP in both the arm and things after an
interval of 5 mins while the patient is at
rest
Comparison of the BP level helps to get a
clear view of the nature of vascular
impairment or the scope of the underlying
problem
Taking notes of the peripheral pulses Helps in the detection of the level of
vaso-constriction followed by proper
diagnosis of the disease condition and
care (Benetos et al., 2015)

5
NURSING CARE PLAN
References
Benetos, A., Labat, C., Rossignol, P., Fay, R., Rolland, Y., Valbusa, F., ... & Gautier,
S. (2015). Treatment with multiple blood pressure medications, achieved
blood pressure, and mortality in older nursing home residents: the PARTAGE
study. JAMA internal medicine, 175(6), 989-995.
Brahmi, S. A., & Ziani, F. Z. (2016). Lymphedema after breast cancer. Pan African
Medical Journal, 23(1).
DiSipio, T., Rye, S., Newman, B., & Hayes, S. (2013). Incidence of unilateral arm
lymphoedema after breast cancer: a systematic review and meta-
analysis. The lancet oncology, 14(6), 500-515.
Foxman, B. (2014). Urinary tract infection syndromes: occurrence, recurrence,
bacteriology, risk factors, and disease burden. Infectious disease clinics of
North America, 28(1), 1-13.
Mody, L., & Juthani-Mehta, M. (2014). Urinary tract infections in older women: a
clinical review. Jama, 311(8), 844-854.
Oman, K. S., Makic, M. B. F., Fink, R., Schraeder, N., Hulett, T., Keech, T., & Wald,
H. (2012). Nurse-directed interventions to reduce catheter-associated urinary
tract infections. American journal of infection control, 40(6), 548-553.