NUR 504 506

Neurological & Male Genitourinary Disorders 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 2


Case 1 Case 2 Case 3 Chief Compl aint (CC)

“It burns when I urinate”

“I had a severe headache yesterday with difficulty to speak”

“I have been having frequents headaches lately”

Histor y of Prese nt 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.

PMH

Benning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatment

Atrial Fibrillation, Hypertension. Is allergic to Non- steroidal Anti- inflammatory drugs Aspirin

Frequent headaches since I was 15, with menses.

Drug Hx

Rosuvastatin 20 mg Olmesartan 20 mg

Losartan 50 mg Xarelto 15 mg BID

Ibuprofen for Headaches

Subje ctive

Fever 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 episode

Light 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

VS B/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;

Gener al

well-developed male, no acute distress

well-developed female, no acute distress

25-year-old female appears well developed and well- nourished, healthy appearing, wearing dark glasses in a dim room

HEEN T

Atraumatic, 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

Lungs CTA AP&L CTA AP&L CTA AP&L

Card S1S2 without rub or gallop S4 present

Irregular heart beat with normal rate

S1S2 without rub or gallop


 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?

Submission Instructions:

• Your instructor will assign you your case number and you will post on the case number you have been assigned.

• You will reply to the other two case studies (One of each). • 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

Abd No tenderness normoactive bowel sounds x 4;

No tenderness normoactive bowel sounds x 4;

benign, normoactive bowel sounds x 4;

Rectal exam

Warm, swollen and painful prostate gland Non contributory Non contributory

Integu ment

good skin turgor noted, moist mucous membranes

intact without lesions masses or rashes.

intact without lesions masses or rashes.

Neuro No obvious deformities, CN grossly intact II-XII

No obvious deficits and CN grossly intact II-XII

Cranial nerves II to XII intact; sensation intact, DTRs 2+ throughout. Functional neurological exam is WNL

Neurological & Male Genitourinary Disorders 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 2


Case 1 Case 2 Case 3 Chief Compl aint (CC)

“It burns when I urinate”

“I had a severe headache yesterday with difficulty to speak”

“I have been having frequents headaches lately”

Histor y of Prese nt 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.

PMH

Benning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatment

Atrial Fibrillation, Hypertension. Is allergic to Non- steroidal Anti- inflammatory drugs Aspirin

Frequent headaches since I was 15, with menses.

Drug Hx

Rosuvastatin 20 mg Olmesartan 20 mg

Losartan 50 mg Xarelto 15 mg BID

Ibuprofen for Headaches

Subje ctive

Fever 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 episode

Light 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

VS B/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;

Gener al

well-developed male, no acute distress

well-developed female, no acute distress

25-year-old female appears well developed and well- nourished, healthy appearing, wearing dark glasses in a dim room

HEEN T

Atraumatic, 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

Lungs CTA AP&L CTA AP&L CTA AP&L

Card S1S2 without rub or gallop S4 present

Irregular heart beat with normal rate

S1S2 without rub or gallop


 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?

Submission Instructions:

• Your instructor will assign you your case number and you will post on the case number you have been assigned.

• You will reply to the other two case studies (One of each). • 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

Abd No tenderness normoactive bowel sounds x 4;

No tenderness normoactive bowel sounds x 4;

benign, normoactive bowel sounds x 4;

Rectal exam

Warm, swollen and painful prostate gland Non contributory Non contributory

Integu ment

good skin turgor noted, moist mucous membranes

intact without lesions masses or rashes.

intact without lesions masses or rashes.

Neuro No obvious deformities, CN grossly intact II-XII

No obvious deficits and CN grossly intact II-XII

Cranial nerves II to XII intact; sensation intact, DTRs 2+ throughout. Functional neurological exam is WNL