Chemotherapy for bladder cancer.

Sample Solution

     

Based on the provided information, your patient is likely experiencing Septic Shock secondary to a urinary tract infection (UTI) due to her indwelling urinary catheter and chemotherapy-induced immunosuppression.

Supporting evidence for Septic Shock:

• Fever: Temperature of 102.2°F is indicative of fever.
• Tachycardia: Heart rate of 136 beats per minute is above the normal range.
• Tachypnea: Respiratory rate of 28 breaths per minute is above the normal range.
• Hypotension: Blood pressure of 110/50 mmHg is below the normal range.
• Source of infection: Indwelling urinary catheter and dark, foul-smelling urine suggest a UTI.

Full Answer Section

    Additional factors:

• Chemotherapy: Weakened immune system due to chemotherapy makes the patient more susceptible to infections.
• Catheter: Indwelling urinary catheters increase the risk of UTIs.

Anticipated Interventions: The doctor will likely order the following interventions:

• Blood cultures: To identify the specific bacteria causing the infection.
• Urinalysis and urine culture: To confirm UTI and identify the causative organism.
• Intravenous fluids: To restore blood pressure and improve circulation.
• Antibiotics: Broad-spectrum antibiotics like Bactrim are commonly used initially for suspected UTIs, pending culture results for targeted therapy.
• Pain management: Medications to manage fever and discomfort.
• Catheter removal: Depending on the severity of the UTI and the patient's overall condition, the doctor might consider removing the catheter to reduce the risk of further infection.

Infection Prevention Education: Educate the patient about UTI prevention strategies, including:

• Proper catheter care: Maintaining kebersihan of the catheter insertion site and drainage bag.
• Hydration: Drinking plenty of fluids to flush out bacteria from the urinary tract.
• Urination habits: Emptying the bladder regularly and completely.
• Wiping technique: Wiping from front to back after using the toilet to prevent bacteria from entering the urethra.
• Diet: Avoiding bladder irritants like caffeine and alcohol.
• Early recognition of symptoms: Promptly reporting any symptoms of UTI like fever, urinary urgency or frequency, burning during urination, or blood in the urine.

Concerns regarding Bactrim: While Bactrim is a common antibiotic choice for UTIs, there are some concerns in this case:

• Allergy to Sulfa: Bactrim contains sulfamethoxazole, which is a sulfa antibiotic. Although cross-reactions with penicillin are less common, it's crucial to inform the doctor about the patient's sulfa allergy to assess alternative antibiotics with a lower risk of allergic reaction.
• Potential for adverse effects: Bactrim can cause side effects like nausea, vomiting, diarrhea, and skin rash. Monitor the patient for these side effects and report them to the doctor if they occur.

Remember: This information is for educational purposes only and should not be interpreted as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional for any medical concerns.