Question

Ken Washington, a 61-year-old male patient, arrived today for a follow-up visit from a recent hospitalization for a stroke. Up until his hospitalization, he had hypertension but no other major health issues. He now has weakness in his left arm and leg and his speech is difficult to understand. His wife tells you that she has noticed some blood in the toilet after he urinates. She also tells you that he has had some pain when he urinates and often only urinates a small amount. While he was in the hospital, Ken had a urinary catheter in place for 6 days.

While you are giving Ken Washington care instructions for urinary catheterization, his wife states that she is not happy that Ken has to have another urinary catheter. She tells you that she thinks that the “man in the hospital” did not insert his urinary catheter properly and that is what has caused Ken’s problem. She asks you if you think it is possible that Ken was “damaged” at the hospital when he had his urinary catheter inserted. What should you tell Ken’s wife?

Answer 1

The patient's symptoms, i.e. pain in the left arm, leg, slurred speech, are the consequences of stroke. The urinary tract symptoms, i.e. pain during urination, frequent urination, blood in the urine are the symptoms of urinary tract infection. Most of the stroke patients are at increased risk of developing UTI due to the urinary retention, bladder abnormality problems, and indwelling catheters. In the given case, the patient had the stroke, so the improper insertion and or maintenance of catheters cannot be considered as the sole possible cause of UTI in this patient. Thus, the nurse has to explain the patient about the possible causes of the patient's symptoms and evaluate the symptoms appropriate to determine the possible cause.