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Based on the patient profile form, I have all the information needed. Here is a structured patient counselling document for Savithramma, a 48-year-old female discharged with UTI and recurrent hemorrhagic cystitis.
Patient Counselling - Savithramma (IP No. 367904)
Diagnosis: UTI with Recurrent Hemorrhagic Cystitis | Discharged: 12-01-2026
1. Understanding Your Condition
Savithramma, you were admitted with blood in urine (hematuria), abdominal pain, and vomiting. Tests showed you had a urinary tract infection (UTI) caused by bacteria (E. coli earlier, and Pseudomonas on repeat urine culture). The infection had affected your bladder lining and caused bleeding - this is called hemorrhagic cystitis. You also have a small cyst on your right kidney (2 x 1.3 cm cortical cyst) which is benign and needs periodic monitoring.
2. Discharge Medications - How to Take Them
| Medicine | What It Is | How to Take | Duration | Key Instructions |
|---|---|---|---|---|
| T. Niftas 100 mg (Nitrofurantoin) | Antibiotic to clear the UTI | 1 tablet in morning, skip afternoon, 1 tablet at night | 1 week | Take with food or milk to reduce stomach upset. Do NOT skip doses - complete the full course even if you feel better. |
| T. Somprax D (Esomeprazole + Domperidone) | Stomach protector + anti-nausea | 1 tablet in morning, skip afternoon, skip night | 1 week | Take 30 minutes before breakfast on an empty stomach. |
| C. Floristore (Probiotic) | Restores good gut bacteria | 1 capsule in morning | 1 week | Take 2 hours apart from the antibiotic (Niftas) to ensure effectiveness. |
| T. Zincovit (Zinc + Vitamins) | Nutritional supplement | 1 tablet in morning | 1 week | Can be taken with food. |
3. Lifestyle and Dietary Advice
Fluid Intake (most important):
- Drink 2.5 to 3 litres of water every day. This flushes bacteria from the urinary tract.
- Do not hold urine - urinate as soon as you feel the urge.
- Urinate after sexual intercourse.
Diet:
- Eat light, easily digestible food. Include curd, buttermilk, and fruits.
- Avoid spicy, oily, and acidic foods as they irritate the bladder.
- Avoid tea, coffee, alcohol, and carbonated drinks - these worsen bladder symptoms.
- Cranberry juice may help prevent recurrent UTIs.
Hygiene:
- Always wipe from front to back after using the toilet.
- Maintain good personal hygiene to prevent re-infection.
- Avoid tight-fitting synthetic undergarments; prefer cotton.
4. Blood Pressure Monitoring
Your BP was recorded as 140/90 on Day 1 and 140/90 again at discharge. This is Stage 1 hypertension. You should:
- Monitor your BP regularly at a nearby health centre or pharmacy.
- Reduce salt intake in your diet.
- Inform your doctor at the follow-up visit about your BP readings.
- Do not ignore high BP - it puts strain on your kidneys, especially with a kidney cyst.
5. Warning Signs - Return to Hospital Immediately If:
- Blood in urine returns or worsens
- Fever above 101°F (38.3°C)
- Severe pain in the lower abdomen, back, or sides
- Nausea and vomiting that prevents you from taking medicines
- Burning while urinating does not improve within 2-3 days of starting Niftas
- Swelling in legs or face
6. Follow-Up Instructions
- Do not miss your follow-up appointment - likely within 1-2 weeks after discharge.
- Bring a urine sample (midstream, clean catch, first morning urine) for repeat culture and sensitivity test to confirm the infection has cleared.
- The right renal cortical cyst (2 x 1.3 cm) found on CT-KUB needs a repeat ultrasound in 6 months to ensure it has not grown.
- Degenerative spinal changes were noted on imaging - inform an orthopaedic doctor at your next visit if you have back pain.
7. Why It Is Important to Complete the Full Antibiotic Course
Your earlier UTI on 24/12/25 was partially treated, which likely caused this recurrent and more severe infection with hemorrhagic cystitis. Stopping antibiotics early allows surviving bacteria to develop resistance. This time, complete all 7 days of Nitrofurantoin (Niftas) without missing a single dose.
8. About Nitrofurantoin - Side Effects to Watch For
Nitrofurantoin (Niftas) is generally safe but may cause:
- Nausea, vomiting, stomach upset - take with food
- Urine may turn dark yellow or brown - this is harmless and expected
- If you develop shortness of breath, skin rash, or yellowing of eyes - stop the medicine and consult a doctor immediately (rare but serious reactions)
Summary Checklist for Patient
- Take all 4 medicines as prescribed for 1 full week
- Drink at least 2.5 litres of water daily
- Do not skip or stop antibiotics early
- Monitor blood pressure regularly
- Attend follow-up with urine sample
- Get kidney cyst re-checked in 6 months
- Return to hospital immediately if bleeding or fever returns
Counselling provided by: Gaurav C. (Pharmacy Student, Farooqia College of Pharmacy, Department of Clinical Pharmacy)*
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Provide patient counselling of above case for this form
Here is the fully filled Patient Counselling Documentation Form for Savithramma's case:
FAROOQIA COLLEGE OF PHARMACY
DEPARTMENT OF CLINICAL PHARMACY
PATIENT COUNSELING DOCUMENTATION FORM
| Field | Details |
|---|---|
| Sl. No. | 01 |
| Patient Name | Savithramma |
| Date | 12-01-2026 |
| Time | At discharge |
| Unit | MSW |
| Age (yrs) | 48 yrs |
| Wt (Kg) | Not recorded |
| [✓] IP | ☐ OP |
| Sex | F |
| IP No. | 367904 |
Provisional Diagnosis
UTI with Recurrent Hemorrhagic Cystitis; Right Renal Cortical Cyst (2 x 1.3 cm)
Counselling Stage (Counselling given to)
[✓] Patient
(Patient is a 48-year-old adult female, oriented and cooperative - no representative required)
Drug Regimen (Name, Dose, Route & Frequency) - Discharge Medications
| No. | Drug Name | Dose | Route | Frequency | Duration |
|---|---|---|---|---|---|
| 1 | Tab. Niftas (Nitrofurantoin) | 100 mg | Oral | 1-0-1 (Morning & Night) | 1 week |
| 2 | Tab. Somprax D (Esomeprazole + Domperidone) | Standard | Oral | 1-0-0 (Morning only) | 1 week |
| 3 | Cap. Floristore (Probiotic) | Standard | Oral | 1-0-0 (Morning only) | 1 week |
| 4 | Tab. Zincovit (Zinc + Multivitamins) | Standard | Oral | 1-0-0 (Morning only) | 1 week |
| 5 | - | - | - | - | - |
| 6 | - | - | - | - | - |
Counseling Aid Used
[✓] Yes ☐ No
Aid selected: [✓] PIL (Patient Information Leaflet) | [✓] Pictograms
(Pictograms used to illustrate timing of medicines and fluid intake instructions for better patient comprehension)
Points Covered During Counseling Session
[✓] Description of the medication
- Niftas = antibiotic to kill remaining UTI bacteria; Somprax D = stomach protector + anti-nausea; Floristore = probiotic to restore gut flora after antibiotic use; Zincovit = vitamin and zinc supplement for recovery.
[✓] Indication / Purpose of the medication
- Niftas: to completely eradicate Pseudomonas UTI and prevent recurrence. Somprax D: to prevent gastric irritation from antibiotics. Floristore: to replenish beneficial gut bacteria. Zincovit: to support immunity and wound healing.
[✓] Dosage
- Niftas 100 mg twice daily (morning + night); Somprax D once daily (morning); Floristore once daily (morning); Zincovit once daily (morning).
[✓] Route of Administration
- All medicines are oral (by mouth with water).
[✓] Medication Administration Techniques
- Niftas: take with food or milk to reduce nausea. Somprax D: take 30 minutes before breakfast on empty stomach. Floristore: take at least 2 hours apart from Niftas to prevent probiotic inactivation by the antibiotic. Zincovit: take after food.
[✓] Duration of Therapy
- All medicines for 1 full week (7 days). Do not stop early even if symptoms resolve.
[✓] Advice on Missed Dose
- If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose. Do not double the dose. For Niftas especially - never skip as incomplete treatment caused the current recurrent infection.
[✓] Side Effects and Related Details
| Medicine | Common Side Effects | Action |
|---|---|---|
| Niftas (Nitrofurantoin) | Nausea, dark yellow/brown urine (harmless), stomach upset | Take with food; inform doctor if severe |
| Somprax D | Headache, dry mouth, constipation | Usually mild; inform doctor if persistent |
| Floristore | Mild bloating initially | Resolves on its own |
| Zincovit | Nausea if taken on empty stomach | Take after food |
| STOP and seek help if: | Skin rash, difficulty breathing, yellowing of eyes | Rare but serious - go to hospital immediately |
[✓] Special Directions
- Complete the full antibiotic course (Niftas). Previous partial treatment on 24/12/25 led to this recurrent, more severe hemorrhagic infection.
- Drink 2.5 to 3 litres of water daily to flush the urinary tract.
- Urinate frequently; do not hold urine. Urinate after intercourse.
- Maintain personal hygiene: wipe front to back. Wear loose cotton undergarments.
- Monitor BP regularly - BP was 140/90 at discharge.
- Return to hospital immediately if: blood in urine returns, fever >101°F, severe flank/abdominal pain, or vomiting prevents taking medicines.
[✓] Storage Conditions
- Store all medicines at room temperature, away from direct sunlight, heat, and moisture.
- Keep out of reach of children.
- Do not use beyond the printed expiry date.
[✓] Prescription Refill Information
- Medicines are prescribed for 1 week only. Return to the outpatient department after 1 week with a fresh urine sample (midstream, first morning urine) for repeat urine culture to confirm infection clearance.
- Do not self-medicate or purchase antibiotics without prescription in future.
[✓] Diet
- Drink plenty of water and fluids (coconut water, diluted buttermilk, fresh juices).
- Include curd/yoghurt daily (helps urinary tract health and offsets antibiotic effects on gut).
- Avoid spicy, oily, fried food, pickles, and acidic foods (irritate the bladder).
- Avoid tea, coffee, alcohol, and carbonated drinks during the treatment period.
- Reduce salt intake to help control blood pressure.
- Cranberry juice (unsweetened) may help prevent future UTIs.
[✓] Lifestyle Modification
- Complete all prescribed medicines without interruption.
- Maintain adequate hydration every day (not just during illness).
- Follow good perineal hygiene at all times.
- Regular BP monitoring at a local pharmacy or health centre.
- Follow up ultrasound of kidneys in 6 months for the right renal cortical cyst (2 x 1.3 cm) to check for any change in size.
- Inform an orthopaedic doctor about degenerative spinal changes noted on CT-KUB if back pain develops.
- Avoid self-medication with antibiotics in future - always complete a full prescribed course.
Language Used
[✓] Kannada (patient is from Mysore region; Kannada used as primary language of counselling)
Compliance Aids Used
[✓] Yes ☐ No
[✓] Medication Calendar/Diary - a daily pill chart was given to patient to mark off each dose taken, ensuring adherence to the full 7-day course.
Barriers to Counseling
None identified. Patient was cooperative, alert, and expressed willingness to follow instructions. (No language barrier, no hearing impairment, no lack of interest noted.)
Time Taken to Counsel (Approx)
[✓] 10-30 minutes
(Counselling covered 4 discharge medications, disease understanding, diet, hygiene, BP monitoring, follow-up instructions, and warning signs.)
Pharmacist Note
Patient Savithramma (48F, IP No. 367904) was counselled at the time of discharge on 12-01-2026 regarding her diagnosis of UTI with recurrent hemorrhagic cystitis. She was admitted on 08-01-2026 with hematuria for 2 weeks, abdominal pain, and vomiting. Urine C/S grew Pseudomonas (32,000 cfu/ml) sensitive to Piperacillin-Tazobactam (used inpatient) and Nitrofurantoin (prescribed on discharge). Previous partial antibiotic treatment on 24/12/25 was identified as the cause of recurrence - patient was strongly counselled on completing the full antibiotic course. A right renal cortical cyst (2 x 1.3 cm) and degenerative spinal changes were incidentally noted on CT-KUB; patient advised regarding follow-up for the same. BP was 140/90 at discharge; patient educated on salt restriction and regular BP monitoring. PIL and pictogram aids used. Patient verbalized understanding of all counselling points.
Name and Signature of Attending Pharmacist
Name: Gaurav C.
Designation: Pharm D Student, Dept. of Clinical Pharmacy
Preceptor: ___________________
Date: 12-01-2026
Key message reinforced at end of counselling: "Savithramma, please take all your medicines for the full 7 days without missing a single dose - especially the antibiotic (Niftas). Drink plenty of water every day. Come back after 1 week with a urine sample. If you see blood in urine again or develop fever, come to hospital immediately."
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