NR601 week 5 discussion part 1 and 2
Mr. K. is a 70-year-old Native American male who presents with complaints of nocturia. He indicates that he has been waking up to urinate more than 3 times each night. In addition, he reports having urinary frequency during the day, starting and stopping a stream, and doesn’t feel like his bladder is completely empty after urination. He denies any pain on urination, fever or chills. His last PSA 2 years ago was negative.
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PMH: arthritis in both knees; takes over the counter ibuprofen as needed for joint pain.
Social history: non-smoker; drinks 2-3 beers on the weekend
Discussion Questions Part One
- What additional assessments/diagnostic tests might be helpful in the work-up? (patient’s chief complaint)
- Conduct a ROS on this patient.
- List your differential diagnoses.
- Share at least one tool that could be used to assess the severity of urinary symptoms in men.
- What primary diagnosis are you choosing at this point?
Discussion Part Two (graded)
Physical Exam:
Discussion Part Two (graded)
Vital signs: blood pressure 140/80, heart rate 76, respirations 16, temperature 98.0;
weight 210 pounds; height 5’9”
General:no distress; no weakness or fatigue
HEENT: unremarkable
Heart: S1 and S2 RRR; no murmurs, gallops or rubs
Lungs: breath sounds clear throughout lung fields
Abdomen: soft, nontender with positive bowel sounds all 4 quadrants
GU: negative CVA tenderness
Rectal: digital rectal exam reveals enlarged prostate that is smooth and nontender
Discussion Questions Part Two
- For the primary diagnosis, what non-pharmacological and pharmacological strategies would be appropriate?
- Include the following: lab work and imaging studies
- Describe patient education strategies.
- Describe follow-up.
- Describe any referrals that may be necessary.
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