Case Study

K.N.  is a 24-year-old woman who presents to the family practice clinic  complaining of sudden urgency to urinate, back pain, frequent urination,  and pain with urination. Symptoms began approximately 48 hours ago. She  awoke from sleep with urgency and suprapubic discomfort 2 nights ago.  Her urine now has a strong odor and a cloudy appearance. She has an  allergy to Bactrim.

1. What are some appropriate questions to ask the patient?
2. What are three differential diagnoses for the patient?
3. What physical examination would you perform?
4. What diagnostics would you include?
5. Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.

Urine  dipstick results: Color, dark yellow, specific gravity 1.035, ph 5.5,  protein (-), Ketones (-), Bilirubin (-), Trace blood, Leukoesterase (+),  Nitrites (+), Urobilinogen (-)

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