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UTI Nursing Assessment, Diagnosis, Treatment (Reading & Sharing)

According to Haddock & MacDonald (2013), over half of all women will have at least one urinary tract infection (UTI) in their lifetime, which results in fifteen percent of the prescribed antibiotics in primary care. When assessing a history of presenting illness, appropriate questions will be:

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Costochondritis -Reading and Sharing

Pathophysiology

Much of the chest wall consists of ribs and cartilage, which serve as an elastic bridge between the individual rib bones and also the sternum. Costochondritis is a condition of inflammation in the costochondral junctions of the ribs or chondrosternal joints, in the absence of swelling or induration, in the chest wall causing chest wall pain and tenderness (Proulx & Zryd, 2009).

Incidence and prevalence

Costochondritis can affect both children and adults and is a diagnosis that accounts for nearly thirty percent of adults who present to the hospital with chest pain (Proulx & Zryd, 2009). The condition occurs most often in women and adults over the age of forty (Mayo Clinic, 2011).

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Amyotrophic Lateral Sclerosis (ALS) – Reading & Sharing

Definition, Etiology, and Incidence


Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig disease after the famous New York Yankees baseball player, is a devastating neurologic disorder that selectively affects motor function with an unknown origin, results in muscle weakness, disability, respiratory insufficiency, and eventually death. ALS has an annual incidence of 0.5-2 per 100,000 population, is primarily a disorder of middle to late adulthood, affecting people most frequently in their fifties, with men developing the disease nearly twice as often as women. The median survival duration for patient is approximately 3 years, yet approximately 20% of patients survive greater than 5 years, and 10% will survive for greater than 10 years.

As the main area of involvement is the motor neurons of the brain and spinal cord, ASL affects motor neurons in three locations as follows: the anterior horn cells (lower motor neurons – LMNs) of the spinal cord; the motor nuclei of the brain stem, particularly the hypoglossal nuclei; and the upper motor neurons (UMNs) of the cerebral cortex. The death of the LMNs leads to denervation, with subsequent shrinkage of musculature and muscle fiber atrophy. It is this fiber atrophy, called amyotrophy, which appears in the name of the disease. The loss of nerve fibers in lateral columns of the white matter of the spinal cord, along with fibrillary gliosis, imparts a firmness or sclerosis to this CNS tissue. The term lateral sclerosis designates these changes.

A remarkable feature of the disease is that the entire sensory system, the regulatory mechanisms of control and coordination of movement, and the intellect remain intact.

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Migraine Headaches

Definition, Pathophysiology Incidence, and Prevalence

Migraine headaches are a particular type of recurrent headache that can be debilitating for the affected individual. They can occur with or without preceding focal neurologic symptoms or have an atypical presentation (Ferri, 2018). The classification of headaches is as follows: vascular (migraine and cluster), muscle contraction (tension), mixed headaches (vascular and muscle), traction, or inflammatory headaches (Warren, 2017). Migraine headaches are typically severe and throbbing and last from 4 to 72 hours, accompanied by either or both nausea or vomiting and photophobia or phonophobia (Warren, 2017). The pain from migraines may occur all over the head but typically is localized to a hemisphere; migraine pain is throbbing in character, of moderate or severe intensity, and made worse by exercise (Ferri, 2018). Migraine incidence increases from infancy, peaks during the 30’s and typically decreases over time; peak ages are between 18 and 49 years of age (Ferri, 2018). There is a 3:1 female (18% of females) to male (6% of males) ratio of migraine sufferers and more than 50% of migraine sufferers have an affected family member (Ferri, 2018). Migraines are often hereditary and so acquiring a thorough family history is important in order to determine a diagnosis for the headache sufferer. The pathophysiology of migraines is not clear; however, there is evidence supporting that a primary neuronal event can result in trigeminovascular reflex which causes neurogenic inflammation (Migraine, 2017; Ferri, 2018).

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