A 60-year-old Hispanic male presents with the chief complaint of decreased urinary flow.Provide a bulleted list of your learning points from the clinical case you analyzed this week and the salient features of what you have envisioned for patient education in your care plan.
Provide a bulleted list of your learning points from the clinical case you analyzed this
week and the salient features of what you have envisioned for patient education in your
care plan. List key points about the patients presenting diagnoses, how you determined
these, what diagnostic tests you ordered to confirm your diagnoses, and, most importantly,
what you learned about patient education for genitourinary system based on your research.
Week 4: Genitourinary Clinical Case
HPI
A 60-year-old Hispanic male presents with the chief complaint of decreased urinary flow.
The patient has been experiencing this over the past two years, but for the past two weeks,
the symptoms have increased significantly. The current symptoms are similar to what he
experienced in the past. However, for the past two weeks, he has had increased nocturia,
with decreased strength of urinary flow and slight terminal dysuria. Patient has had no
treatment in the past. The nocturia has been very troublesome over the past two weeks.
Yesterday he had significant difficulty in starting his urine flow and this is interfering
with daily activities. He needs to pass urine four to five times every night. He has been
urinating frequently and always needs to know if there are bathrooms around.
Patient does not complain of any other radiating pain. He has had no treatment or
diagnostic work up in the past, but now the symptoms have been increasing in severity. He
believes he had a low-grade fever yesterday. The patient is not sure what is going on but
thinks he may have cancer. He had significant obstructive symptoms two days ago. Gradual
worsening of symptoms has compelled him to seek medical help now.
PMH
Patient has not sought any medical care for this problem to date. He is being treated for
hypertension and hypercholesterolemia. There is no known history of heart disease, but he
was hospitalized five years ago as a suspected case of angina. He was diagnosed with chest
wall syndrome for which he was treated and then released. There are no recent
hospitalizations and no surgeries.
ROS
Denies any other positive review of systems. Denies abdominal pain, nausea or vomiting. No
blood in the stool. No gross hematuria.
MEDICATIONS
Cardizem 240mg daily Zocor 20mg daily
Patient is compliant with the prescribed regimen and knows why he is being treated.
ALLERGIES/REACTIONS
No known drug allergies
SOCIAL HISTORY
Patient has a masters degree in engineering and his income is $65,000.00 per year. Though
the patient is educated, he lacks an understanding of resources available to him. Patient
has no problems with finances. He has excellent access to healthcare, but most often does
not utilize the services to the extent that is expected. He has an excellent health
insurance coverage including a prescription plan.
Patient is married and his spouse has excellent general health. He has two grown-up sons
who live with their own families. They are 35 and 37 years old, both alive and well.
Although the patient has a masters in engineering, his knowledge of healthcare is
inadequate. He believes that he is generally healthy.
His perception of self-efficacy is adequate. He has very little stress. His support systems
include his wife and friends from work who provide him with the required emotional support.
There is no family dysfunction. The patient is high strung and an over achiever. He gets
little from social support outside the home or work.
Patient is originally from United States. He lives in a suburban setting. His resources
include his wife and the people he works with. Though there are other resources available
to him, he is not sure what they are.
HABITS
Smoking: Non smoker Alcohol: Does not drink
Substance use: Denies substance abuse
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