Makayla Henderson UTI with Antibiotic Sensitivity shadow health Education & Empathy

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient

1 Urinary Pain and UTI Symptoms

Followed Up

	Description: Ms. Henderson reports discomfort with her associated urinary symptoms such as pain, cramping, burning, and feelings of increased urgency to urinate.
	What brings you in today?	Question 09:47 PM CDT
	I’ve had to pee a lot lately. It burns when I pee, and it looks weird. I thought it would go away on its own, but it hasn’t. So I was like, fine, I need to see someone. [AUDIO COMING SOON]
	I’m sorry that you’re experiencing pain and burning during urination. I’ll try to find a medication that will help alleviate these symptoms.	Empathize 09:49 PM CDT
	Thanks.
	How long have you had these symptoms?	Question 09:50 PM CDT
	Three days ago, I started feeling pretty bad. I kept having to pee, and each time I did, it burned. It was gross, too. The pee looked different. [AUDIO COMING SOON]
	any other symptoms?	Question 09:51 PM CDT
	Other than the pain and burning, I have a little bit of cramping in my lower abdomen. [AUDIO COMING SOON]
	where is the pain?	Question 09:52 PM CDT
	It hurts the most when I pee, right where it comes out. It’s this burning, stinging feeling.
	do the urine have an odor?	Question 09:52 PM CDT
	It smells really strong. It’s basically rank. It’s also, like, dark . . . cloudy.
	how bad does it hurt (Clarified to: How painful is urinating?)	Question 09:53 PM CDT
	It burns every time I pee and I am really not OK with how much pain I’m in. I’d call it a 7 out of 10. (Clarified to: how painful urinating is)
	any factors that make it worse? (Clarified to: What aggravates the pain?)	Question 09:54 PM CDT
	Well, it burns every time I pee, so peeing makes the pain worse, I guess. (Clarified to: what makes my pain worse)
	what do you do to relieve the pain?	Question 09:54 PM CDT
	Since it only burns and stings when I pee, I thought maybe it would hurt less if I didn’t pee so much. I tried drinking less water, but I’m not sure how much good it’s doing.
	I know that you tried to alleviate your symptoms by not drinking fluids; you should try to stay hydrated by drinking more water and avoiding drinks that irritate the bladder such as soda coffee or alcohol	Educate 09:59 PM CDT
	Yeah, OK.
	Model Statement: “I’m sorry that you’re experiencing pain and burning during urination and an increased sense of urgency. I’ll try to find a medication that will help alleviate these symptoms.”

2 Breast Cancer

Followed Up

	Description: Ms. Henderson discloses that her mother is a breast cancer survivor.
	any family history of illness	Question 10:20 PM CDT
	My dad’s really healthy. My mom’s a breast cancer survivor. She’s fine now, though. Totally cancer free. My Nana — that’s my Mom’s mom — died of it, though.
	I’m sorry that your mother had breast cancer. That must have been a difficult thing for your family to go through. I’m glad that she is OK and that you and your sister are are not at risk	Empathize 10:23 PM CDT
	OK.
	Model Statement: “I’m sorry that your mother had breast cancer. That must have been a difficult thing for your family to go through. I’m glad that she is OK and that you and your sister are not at risk.”

3 Hydration

Not Followed Up

	Description: Ms. Henderson reports that she avoided drinking fluids in order to alleviate her pain, burning, and increased urinary urgency.
	do you drink	Question 10:15 PM CDT
	I usually drink one or two nights a week, depending on if there’s good parties or not. But I never have more than a drink or two. Gotta keep my brain right so I can take over the world.
	do you practice safe sex	Question 10:16 PM CDT
	Model Statement: “I know that you tried to alleviate your symptoms by not drinking fluids; you should try to stay hydrated by drinking more water and avoiding drinks that irritate the bladder such as soda, coffee, or alcoholic beverages.”

4 Urinating After Intercourse

Followed Up

	Description: Ms. Henderson reports that she does not have any post-intercourse habits, such as urinating after intercourse.
	do you urinate after sex?	Question 10:03 PM CDT
	Oh . . . I guess I didn’t know you were supposed to.
	Urinating after sex helps lower the risk of UTIs by clearing the urinary tract of any bacteria. Making this a regular habit might decrease your chances of getting a UTI again in the future	Educate 10:05 PM CDT
	Hm. Alright.
	Model Statement: “Urinating after intercourse helps lower the risk of UTIs by clearing the urinary tract of any bacteria. Making this a regular habit might decrease your chances of getting a UTI again in the future.”

5 Safe Sex

Followed Up

	Description: Ms. Henderson reports that she is sexually active.
	do you practice safe sex	Question 10:16 PM CDT
	Uh, I always use protection. I take birth control and I use those spermicidal condoms.
	good, practice sex safe with partners of all genders in order to minimize the risk of STIs	Educate 10:17 PM CDT
	Thanks for the info.
	Model Statement: “Practice safe sex with partners of all genders in order to minimize the risk of STIs.”

6 Cranberry Pills

Followed Up

	Description: Ms. Henderson reports she took cranberry pills to treat her UTI.
	do you take any other medications	Question 10:10 PM CDT
	I don’t know if it qualifies as medication, but I took some cranberry supplements cause apparently they help with UTIs, which I figured I had when my pee started burning.
	do you cranberry pills help (Clarified to: Are the cranberry pills effective?)	Question 10:10 PM CDT
	I don’t know . . . I’ve heard you’re supposed to take them for UTIs, but it’s been three days and nothing’s gotten better. And I even took two at a time. I don’t know the dosage, but regardless, you’d think they’d be doing something. (Clarified to: if the cranberry pills are effective)
	Cranberry pills aren’t an effective treatment against UTIs. In the future when you notice these symptoms contact a healthcare provider sooner so that you can receive medication that will be more effective treatment	Educate 10:13 PM CDT
	Thank you. That makes sense.
	Model Statement: “Cranberry pills aren’t an effective treatment against UTIs. In the future when you notice these symptoms contact a healthcare provider sooner so that you can receive medication that will be more effective treatment.”

Education & Empathy: 5 of 6 (83.3%)