Frequency and urgency of urination

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.

Case 1Case 2Case 3
Chief Complaint
(CC)		“It burns when I urinate”“I had a severe headache yesterday with difficulty to speak”“I have been having frequents headaches lately”
History of Present Illness (HPI)A 68-year-old Caucasian male who reports to have increase on the frequency of urination with urgency for the last 5 days. He also present dysuria and nocturia.A 64-year-old African American female who reports having a severe pulsatile diffuse headache yesterday with sudden difficulty to talk with last for about two hours. She did not seek medical attention. This morning she woke up with no problems but is here today due her husband advise.A 25-year-old Hispanic female presents to your clinic with a headache located on right temporal area, pulsatile.
PMHBenning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatmentAtrial Fibrillation, Hypertension. Is allergic to Non-steroidal Anti-inflammatory drugs AspirinFrequent headaches since I was 15, with menses.
Drug HxRosuvastatin 20 mg
Olmesartan 20 mg		Losartan 50 mg
Xarelto 15 mg BID		Ibuprofen for Headaches
SubjectiveFever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, dysuria.
Yellowish urethral secretion.		Feels Palpitations, joint pain with yesterday’s episodeLight makes headache worst Nausea associated with headaches. No vomiting, Headaches improve usually with rest, ibuprofen, and sleep, but it is annoying to have to sleep all-day
Objective Data
VSB/P 150/96; Pulse 89; RR 16; Temp 99.4; Ht 6,1; wt 180;B/P 131/80; temperature 98.2°F; (RR) 18; (HR) 84, irregular; oxygen saturation (PO2) 96%;B/P 108/64; Pulse 86; RR 16; Temp 98.6;
Generalwell-developed male, no acute distresswell-developed female, no acute distress25-year-old female appears well developed and well-nourished, healthy appearing, wearing dark glasses in a dim room
HEENTAtraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition.no injection, anicteric, PERRLA, EOMs intact, without pain to movement; normal vision
LungsCTA AP&LCTA AP&LCTA AP&L
CardS1S2 without rub or gallop S4 presentIrregular heart beat with normal rateS1S2 without rub or gallop
AbdNo tenderness normoactive bowel sounds x 4;No tenderness normoactive bowel sounds x 4;benign, normoactive bowel sounds x 4;
Rectal examWarm, swollen and painful prostate glandNon contributoryNon contributory
Integumentgood skin turgor noted, moist mucous membranesintact without lesions masses or rashes.intact without lesions masses or rashes.
NeuroNo obvious deformities, CN grossly intact II-XIINo obvious deficits and CN grossly intact II-XIICranial nerves II to XII intact; sensation intact, DTRs 2+ throughout.
Functional neurological exam is WNL

 

CASE study number 1 is the one you will be assigned to

Once you received your case number, answer the following questions:

  1. What other subjective data would you obtain?
  2. What other objective findings would you look for?
  3. What diagnostic exams do you want to order?
  4. Name 3 differential diagnoses based on this patient presenting symptoms?
  5. Give rationales for your each differential diagnosis.
  6. What teachings will you provide?
  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

    Please utilize journal articles to support your answer.APA style imperative

    Answer preview

    One of the differential diagnoses based on the patient’s symptoms includes urinary tract infection (UTI). This condition is common in men older than 50 years who experience an enlarged prostate or urethral structure. Symptoms entail frequent urination and abdominal discomfort. Studies indicate dysuria associated with high urine frequency is 75% predictive of a UTI (Bardsley, 2018). Secondly, kidney stones are another differential diagnosis. The main symptom of this condition is pain with urination. The patient had undergone Lithotripsy 10 years ago; hence if the stone reached the ureter or bladder, it might result in a burning feeling when urinating. Lastly, prostate cancer is a differential diagnosis since it may cause trouble passing urine, including burning.

    [678 Words]

    Frequency and urgency of urination
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