New cloudy, foul-smelling urine with suprapubic tenderness and new confusion, temp 100.8°F, in an indwelling-catheter resident — concerning for a UTI with possible urosepsis. Provider and responsible party notified, urinalysis/culture and evaluation ordered, catheter necessity re-reviewed, antibiotic stewardship engaged, and Section I/N and the care plan updated; mental status and vital signs to be reassessed. Skilled recognition required, as the presentation was a mental-status change.
Model abnormal 2
Acute urinary retention: no output for 8 hours with suprapubic distension and discomfort in a resident without a catheter — bladder scan showed 650 mL, provider notified, an order for straight/indwelling catheterization received and performed with sterile technique (750 mL returned), cause reviewed (medications, constipation); will reassess for recurrence and support the Section H update. Skilled assessment and procedure required.
