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April 2012, Volume 42 Number 4 , p 72 - 72


  • Michael M. Evans MSN, RN, CNS, CMSRN, CNE


Ms. S, 85, is brought to the ED by her daughter, with whom she lives, after experiencing new episodes of confusion associated with anorexia, urinary frequency, urgency, and dysuria. According to her daughter, Ms. S has no known allergies and takes metformin to treat type 2 diabetes.Ms. S is awake and alert but disoriented to time and place. Her vital signs are: temperature, 98.2[degrees] F (36.8[degrees] C); heart rate, 108; respirations, 22; BP, 120/60; and SpO2 96% on room air. Physical assessment demonstrates no abnormalities with the exception of dry oral mucous membranes. An ECG demonstrates sinus tachycardia without ectopy or other abnormalities.Ms. S's dry mucous membranes and tachycardia suggest dehydration; her urinary symptoms, along with her change in mental status, suggest a lower urinary tract infection (UTI). Ms. S's risk factors for UTI include her older age, diabetes, dehydration, and age-related decrease in immune function. It's important to remember that older adults

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