1) First, the urine sample container should be labeled accordingly. Urine samples and transport containers should be free of any particles or anything that may interfere with the sample. The sample should be in a secure container with a leak resistant lid; this will also prevent exposure to the person handling the sample while also protecting the sample from being contaminated. It is important to not reuse any specimen container to insure that the sample is in a sterile environment and is not at risk from being contaminated.
Nurses can encourage the patient to wash their hands before and after they provide the sample. The patient can also be advised to replace the lid on the specimen as soon as the sample has been collected to keep contaminates from getting in the sample. Nurses should explain that these steps will ensure the most accurate results. Nurses should also follow protocol to avoid contamination. Nurses should wear gloves at all times and wash their hands regularly. Urine should be stored properly as to avoid any additional growth of bacteria. (Becton, 2004)
2) This protocol is for samples analyzed in a doctor’s office or for a routine laboratory culture that were midstream samples for urine culture or for urinary tract infections. Negative macroscopic screened urines do not routinely require microscopic examination of urine sediment. Microscopic examination of urine sediment may be warranted when macroscopic examination is positive for blood (Hb), protein (greater than a trace), nitrite, leukocyte esterase, turbidity, or glucose concentration greater than 55mmol/l. Choices for urinalysis are urine culture only, Macroscopic microscopic if dipstick positive, Macroscopic urine culture if pyuric or nitrite present, Macroscopic dipstick, Microscopic, or special case. (Association, 2011)
3) The most common symptoms of a urinary tract infection are pain or burning feeling during urination, feeling of urgency to urinate, altered appearance of the urine, pain or pressure in the rectum for men or in the area of the pubic bone for women, and only passing a tiny amount of urine even when the urge to urinate is strong. (Net, 2011) Edith is more susceptible to a urinary tract infection because she is a female. Women have shorter urethras therefore it is easier for bacteria to enter the urinary tract. Men are much less likely than women to get UTIs and when they do it is often related to another underlying medical condition, such as kidney stone or an enlarged prostate. (WebMD, 2005-2012)
4) Cipro is short for ciprofloxacin. Ciprofloxacin is an antibiotic that is used to treat bacterial infections. Ciprofloxacin belongs to the fluoroquinolone class of antibiotics. Cipro stops the multiplication of bacteria by inhibiting the reproduction and repair of their genetic material. (Net, ciprofloaxin (Cipro, Cipro XR) – drug class, medical uses, medication side effects, and drug interactions by MedicineNet.com , 2012)
5) Clindamycin inhibits protein synthesis by reversibly binding to the 50s subunit of the ribosomal thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting to stunted cell growth. (LLC)
6) Most antibiotics are taken in a pill form and they can kill many of different strains of good bacteria in the digestive tract. A common complaint of taking antibiotics is stomach upset and diarrhea. Eating yogurt while taking antibiotics may help prevent some of the discomfort of antibiotic use because yogurt is made from milk and fermented with live cultures of the same types of bacteria that are normally present in a healthy digestive tract. Continuing to eat yogurt several days after discontinuing the antibiotics may help to replace good bacteria in the intestines. (Strong)
7) The warnings in using Clindamycin include but are not limited to diarrhea, colitis, and pseudo membranous colitis. These symptoms can persist for several weeks after discontinuing the use of the antibiotic. (A.D.A.M.)
8) The bad bacteria, that can cause diarrhea in people taking antibiotics, are called C difficile and its numbers are normally kept at low levels by the healthy flora in the gut. When a person is treated with antibiotics and the amount of healthy bacteria is decreased, C difficile may begin to multiply and produce a substance that is toxic and can cause diarrhea. This is known as pseudo membranous colitis. (About.com) The Clostridium difficile bacteria are normally present in the intestine; however, it may overgrow when antibiotics are taken. The bacteria release a powerful toxin that causes the symptoms. The lining of the colon becomes inflamed and bleeds, and takes on a characteristic appearance called pseudo membranes. (A.D.A.M)
15) C. difficile often relapses because it passes through a life cycle in which the actively dividing form transforms itself into the spore stage. Spores are inert and metabolically inactive, so they do not cause disease. At the same time though spores are very tough and are hard to kill even with the most powerful antibiotics. (Publications, 2000-2012)
16) A nonsocomial infection can be spread by cross-infection (from one patient to another), endogenous infection (a patient’s own flora), or environmental transfer (an object being used on a patient that is already contaminated). A patient’s risk may be increased due to age, decreased immune resistance, underlying disease, and therapeutic or diagnostic interventions. (Broaddus, 1997)
17) Clostridium difficile was first described in 1935 as a component of the intestinal flora in healthy newborn infants. The active role of C. difficile in human disease was not recognized until the 1970s when it was identified as the causative agent of pseudo membranous colitis. Additional studies demonstrated that C. difficile-associated disease encompasses a range of disease severity from colitis to toxic megacolon.
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