Informed consent: The provision of information to patient is a cornerstone of good practice in health care.

I took verbal and written consent from the patient after detailing the process and procedure. I assured that the confidentiality will be maintained in all steps.Raxxxx understood that she can withdraw from the study at any time being her participation is voluntary. The process of agreeing to take part in a study based on access to all relevant and easily digest able information about what participation means in particular in terms of harms and benefits(Parahoo, 2006)

Chief complaint: I feel burning sensation upon urination with frequent urgency History of present illness (HPI Xxxx reports lower abdominal pain for last 24 hours. She describes the pain as intermittent with urination and as a "burning" sensation. Her complaints slight foul odor to her urine. Even without drinking water she has tendency to urinate more frequently the amount of urine produced tends to be very little. She feels more pain when initiating the urine stream and immediately upon urinating. She told me that abdominal pain was rated 6/10 irregular, and positioned in the left lower quadrant with no radiation. She has fever fatigue &weakness,. The patient denies urinary leaks nausea, vomiting, diarrhea, or constipation.
Xxxxx has been taking pain relief and without any effect. She feels restless resulting lack of sound sleep. she feels her symptoms getting worsens in the evening with increased tendency of urination.

Medical , Surgical and psychiatric history. Medical Previous MI CHF secondary to NSTEMI and COPD RLL pneumonia End stage COPD Renal impairment 2012

SOB Ex smoker Surgical Female sterilization 1983 Psychiatric No history of psychiatric disorders Major Child hood illness Measles at early childhood (unsure of age) Chorionic illness. None Immunisation Child hood immunizations up to date taken flu vaccine every year Obstetric history G2P2 Current Medications Frusemide 40mg1 tab in the morning Flixotide 125mcg Inhaler 2 puff twice daily Spiriva 18 Mcg Inhaler 1 Puff in the morning Chlorvescent 2 tab BD Ferro tab 200 Mg 1tab OD Aspirin 100Mg 1 tab Morning Cholecalciferol 1.25 Mg 1 tab monthly Allergies No known allergies so far Family History Xxxxx mother died due to heart failure at the age of 82.Her father had a normal death. All her aunties uncles and grandparents have passed away. She has 8 siblings out of 3 passed away and had natural death.others are living their healthy life.No family history of diabetes and pulmonary dieses.

Personal / Social History. XXXX worked as maternity nurse for more than 5 years. She also worked as telephone operator, clerk and in a famous sawmill. She helped her brother by working in his Diary .Her husband was retired armyman.she has two sons both living with their family in capital city. Currently she lives in a aged care facility in gisborne. Her has a caring and a lovely husband who visits her daily. She is getting good support from her family and her sons and grand children are frequent visitors. She was a very active person and interested in sport and other volunteering activities. She is interested in travelling and visited almost all of the European countries. She likes fishing and knitting.She has a strong Christian belief but rarely attend church service. She is a friendly to other residents and staff and has strong orientation in social activities inside the faculty.She is very health coicnous and takes medications as charted and attends regular GP visits. Current health habits I am the most normal person in the universe, but nowadays I am very health conscious She was chain smoker for quite long years but she quit five years ago. She drinks occasionally with her friends in parties or in very special occasions.

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Im a vegetarian because I love animals. I grew up on a farm and they were all my pets! So the thought of me or someone else eating my pets kind of freaked me out at a young age. I love working out. I love taking care of myself. We only have one body apiece and its going to expire sometime, and Im going to make sure its a long, long time from now. AlternATIVE HEALTH PRACTICES None

Review of systems (Ros) General: Weight change, fever and malaise Skin: Rashes , bruises present on skin. Dry skin no previous history of skin disease. Hair: Grey in colour, slight dandruff Nails: No abnormalities Lymphatic: Swelling on both the legs

Head No unusually and severe headaches, no head injury, dizziness, syncope or vertigo. Neck No pain, limitation of motion, lumps or swollen glands Eyes: No difficulty with vision or double vision, no eye pain, inflammation, discharge , lesions no history of cataracts. Ears: No hearing loss of difficulty no ear aches, infection. No discharge, tinnitus or vertigo.

Nose: No nasal discharge. Three or four colds infections per year. No sinus pain, nasal obstruction, epistaxis or allergy. Throat & Mouth: no mouth pain, bleeding gums, tooth ache sours or lesions in mouth, dysphagia or sour throat Chest: Shortness of breath, wheezing. Colds sometimes go to my chest Lungs: Past history of lung disease

Breasts: No pain lump, nipple discharge, rash, swelling or trauma. No history breast disease in self or family. Cardiovascular: SOB , swelling of extremities present. History of heart disease and anemia.does has hypertension. Haematology: Bruises easily, past history of anemia, no blood cell disorder or transfusions. Gastrointestinal: Endocrine Menustral history/ Sexual health: Genitounrinary Musculoskeletal Neurologica Mental status