Ginger Jones is a 46 y/o white Female. Presents to clinic with her 4 children and her
mother. All children are adopted. She reports occasionally smoking (1 pack/week x 12 years) and
drinking about 3-‐4 beers a week. She thinks she may have a UTI and wants a medication for that.
Symptoms include burning on urination, frequency, and dark colored urine with a bad smell. She also
reports being in a recent new sexual relationship. They use condoms for contraception currently, but
she states she doesn’t want to get pregnant and wants to be put on a birth control pill or something
better than what she’s using now. She wonders what she needs to do about getting a mammogram, as
she has never had one. Patient is also asking about other screenings she may need. She describes a
sedentary lifestyle with a diet high in fast-‐foods and processed foods but states she does eat fruit like
oranges, apples, and grapefruit at least once a day. She works as a secretary at a busy law firm, so she
sits most of the day. Her fasting BS today is 304.PMH includes depression, HTN, High Triglycerides,
Type 2 DM, resolved GC (Gonorrhea) 3 years ago. She takes the following medications: Glipizide 5 mg
ER po bid; HTCZ 25 mg qd, Zocor 20 mg qd, Zoloft 100mg qd, St. John’s Wort 600 mg qd. She reports
an allergy to Cipro (itching).
BMI 34.
Impression/concerns
Questions for Ginger: When did the symptoms(UTI) started? Do you have fever or chills? Any
vaginal discharge? Any blood in urine? Describe the “bad smell”. Does it have an ammonia, musty,
foul or sweet smell? Wipe front to back? Handwashing? Frequent changes of hygienic products? Do
you void after having sexual intercourse? Douching, bubble bath? Have you had a UTI before? How
much water, caffeine intake? Back or flank pain? I’m aware that the patient is a diabetic and
recurrent infections such as a Urinary Tract Infection (UTI)are common (Cash 2021). Have you been
taking your Glipizide as prescribed? who else lives in house, safety concerns carbon monoxide
detector, smoke detector, safe neighborhood, children exposed to drug use?
Section I: INTRODUCTION TO THE STUDY Introduction The country is encountering a basic deficiency of medical care suppliers, a lack that is supposed to increment in the following five years, similarly as the biggest populace in our country’s set of experiences arrives at the age when expanded clinical consideration is vital (Pike, 2002). Staffing of emergency clinics, facilities, and nursing homes is more basic than any time in recent memory as the huge quantities of ‘gen X-ers’ start to understand the requirement for more continuous clinical mediation and long haul care. Interest in turning into a medical caretaker has disappeared lately, likely because of the historical backdrop of the extraordinary and requesting instructive cycle, low compensation, firm and extended periods of time, and fast ‘wear out’ of those rehearsing in the calling (Wharrad, 2003).
A complex oversaw care climate in this country is restricting the dollars accessible to be spent on nursing care. Numerous wellbeing callings, particularly nursing, have the standing of ‘eating their young’ as opposed to offering compelling coaching to develop future medical services suppliers. Because of these variables, the quantity of medical attendants has diminished and businesses regard themselves as understaffed and seeking able work force. Before 2001 the decay had been apparent for a considerable length of time (Sadler, 2003). Nursing schools, public pioneers, medical services pioneers and the overall population is impacted by the absence of Registered Nurses (RNs) accessible.
As the populace ages, the assumption is that a rising number of RNs will be required essentially to keep up with the ongoing degree of medical care. Furthermore, the momentum ecological and political worries of expanding pandemic sickness, event of synthetic and catastrophic events, and expanding dangers of war, requires critical expansions in the medical services labor force (Jefferys, 2001). The public nursing lack and factors that increment the interest for expanding the nursing labor force notwithstanding public, state, and nearby debacles make the potential for a general wellbeing emergency. Nursing programs have endeavored to satisfy need for medical attendants by expanding enlistment and campaigning effectively for expansions in program subsidizing by schools and states for understudies.
Tragically, the issue of nursing understudy weakening hampers the best endeavors of nursing programs and irritates the public lack of Registered Nurses in the United States (Ofori, 2002). In 2003, the National League for Nursing revealed a positive vertical pattern in the nursing labor force supply in any case, the American College of Healthcare Executives (2006) detailed that in 2005, 85% of emergency clinic directors decided medical clinics needed more enlisted medical attendants to fulfill patient consideration needs. The United States Bureau of Labor insights showed by 2014, more than 1.2 million new and substitution nursing positions would be expected to meet the public medical services needs (Ramsburg, 2007).
Various broad endeavors to diminish weakening have been made by nursing programs including reinforcing affirmation methods and executing maintenance programs. Unfortunately, the issues of weakening keep on continuing nursing schools the nation over. Admission to a nursing program is serious and numerous potential understudies are denied confirmation every semester. Steady loss from nursing programs influences not just the particular understudy who is acknowledged to a nursing program and ineffective, yet in addition the understudy denied confirmation that might have been effective. Steady loss rates are expensive to understudies, nursing projects, and medical services the same by diminishing the quantity of likely alumni from schools of nursing and adding to the nursing lack. Many examinations feature the a lot higher than wanted whittling down rates for nursing understudies