Clinical Case Presentation
Subjective
During routine visits to the hospital, patients complain of noticing blood in the urine. Although the patient had no complaints of dysuria or any pain, he complains of irritation. Upon diagnosis and assessment, it was concluded that the patient has hematuria where blood is characterized in the urine. Hematuria is usually is not a cause of major alarm, though it should not be ignored because it can indicate a serious disorder.
Hematuria can range from gross hematuria where blood can be easily noticed in urine to microscopic hematuria. A cross-examination of the urine is normally conducted on patient urine, to determine the reason for the bleeding. Hematuria is characterized by red or cola-colored urine due to the presence of red blood cells (Bataille et al., 2016). In most cases, hematuria occurs without any sign and symptoms with no point unless when the individual passes blood cloths in the urine, which can be painful. The clinical presentation involving urine in the blood has far-reaching causes that are not limited to medical conditions. The causes include bladder infections (acute cystitis), Kidney Cancer, Urinary tract/kidney infections, enlarged prostate, and vigorous exercise. Besides, there are other causes and risk factors that can be associated with the presence of blood in the urine such as diet and kidney injury from accidents or sports.
Objective
The management of hematuria began further blood tests and cystoscopy to determine the causative agents to identify the correct causes and integration of the management plan. Repeating urine testing is essential in ensuring that there is no serious health issue such as a tumor in the kidney and cancer (Bataille et al., 2016). Conversely, taking prescription medication to shrink an enlarged prostate, shock wave therapy to break up kidney stones, and antibiotics to clear a urinary tract infectioncan be used to manage the diseases depending on the cause (Schmitz-Dräger et al., 2016). Epidemiology of hematuria shows that the clinical manifestation can occur in 6% to 39% of the population. The indication from the study shows that the prevalence of microscopic hematuria ranges from 1-20%, depending on the population under study (Benali, 2019). The population at risk of hematuria includes the elderly, individual taking strenuous exercise, infections, family history, and associated medical conditions. Though microscopic hematuria is quite common, their causes are not clear unless detailed extermination is performed on patients.
Assessment
Diagnosis, assessment, and management can be archived through patient, family, and health professional collaboration. Upon suspicion of blood in the urine, patients are encouraged to seek medical attention for diagnosis purposes. Apart from being asked about the medical and family history, the patient can be taken through a urine test that involves urinalysis alongside other testing such as CT scan, cystoscopy, kidney ultrasound, and renal biopsy. During evaluation, health professions or doctor can encourage follow-ups to take further testing and monitoring blood pressure to curb the possibility of development of other associated morbidities that results from risk factors that include bladder cancer. To effectively help in management, health professions, especially nurses can equip patients with knowledge through patient education to help them in self-management and self-monitoring.
Plan
From this particular clinical presentation, it is evident that every case of hematuria requires investigation in order to address them and prevent the complication that may result from it. Indeed, the lesson learned from the use of SOAP in the analysis of clinical problems helps in providing clear information in the nursing profession that can help in establishing and improving clinical competency. In-depth hematuria assessment is significant in shaping the knowledge about its causes and primary intervention, which are essential in addressing similar problems in the future when handling patients with the same problems.
References
Bataille, A., Wetzstein, M., Hertig, A., Vimont, S., Rondeau, E., &Galichon, P. (2016).Evidence of dipstick superiority over urine microscopy analysis for detection of hematuria. BMC Research Notes, 9(1), 435.
Benali, S. (2019).Hematuria.
Bolenz, C., Schröppel, B., Eisenhardt, A., Schmitz-Dräger, B. J., & Grimm, M. O. (2018).The investigation of Hematuria. DeutschesArzteblatt International, 115(48), 801-807. Retrieved from https://doi.org/10.3238/arztebl.2018.0801
Schmitz-Dräger, B. J., Kuckuck, E. C., Zuiverloon, T. C., Zwarthoff, E. C., Saltzman, A., Srivastava, A., … Grossman, H. B. (2016, October). Microhematuria assessment an IBCN consensus—based upon a critical review of current guidelines.Urologic Oncology: Seminars and Original Investigations, 34(10), 437-451.
