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.

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.