UTI in Older Adult - Interactive Case
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Patient Background
Mary Smith, 78, with mild dementia. Frequent UTIs, incontinence. Found this morning more confused than usual, attempting to climb out of bed, high fall risk.
Vital signs: T 37.5°C (99.5°F), HR 94, BP 138/88, RR 20, O₂ sat 97% RA. Urine is cloudy, strong-smelling, suprapubic tenderness. Suspected UTI. Provider orders UA, culture, IV ceftriaxone, fluids.
Key Assessment Highlights
- Older adult with atypical UTI presentation: acute confusion/delirium
- Incontinence → higher risk for UTIs
- Fall risk due to confusion and attempts to ambulate alone
- Mild fever: 37.5°C, no severe systemic signs yet
Priority Interventions
- Ensure safety (fall precautions, supervise toileting)
- Obtain urine culture before antibiotics
- Start IV ceftriaxone 1g in 100 mL over 30 min
- Encourage fluid intake, monitor I&O
- Monitor mental status, temperature, vital signs
Interactive Quiz
Q1: Mary is acutely confused, trying to climb out of bed. What is the priority action?
Q2: You must perform which action *before* starting the IV antibiotic?
Q3: IV ceftriaxone 1 g in 100 mL over 30 min. Drop factor = 15 gtt/mL. Calculate gtt/min if using gravity drip.
Q4: Teaching to prevent future UTIs. Which statement indicates correct understanding?