Clark is a 72-year-old patient who complains of worsening symptoms of BPH, his nocturia has increased significantly over the past year. He would like to try a medication to ease these symptoms. List two medications you would consider for him and describe the mechanism of action for the two medications you chose.
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Doxazosin-this drug is an alpha-adrenergic antagonist which selectively inhibits the receptors alpha-1 adrenergic
Tamsulosin-this drug falls under the category of α1receptor antagonists and is known for his selective action in the prostate which subsequently relaxes the smooth muscle tissue. NRNP-6540 Week 7 Knowledge Check
A 79-year-old patient presents with cramping abdominal pain, nausea, and vomiting for 4 days. List at least three (3) differential diagnoses.
Mary is a 67-year-old post-menopausal female who complains of vaginal dryness, vulvar and vaginal itching, urinary frequency, blood-tinged vaginal discharge, and dyspareunia. What would be your primary diagnosis?
Sam is a pleasant 72-year-old male who comes in with his wife. His wife states that he is getting up “at least seven to eight times a night to pee.” What ROS questions would you ask Sam? Please list at least four.
When did your symptom initially begin?
Are there any recent changes you made in your diet?
Are you taking any prescription or OTC medications?
When you go to the bathroom, is there a small or large amount of urine?
Is there a decrease or an increase in the amount of urine you make? NRNP-6540 Week 7 Knowledge Check
Do you have an underlying diagnosis of heart failure, diabetes, or hypertension without or with leg edema?
You suspect that Ben, your 85-year-old patient has mild BPH with a UAU-SI score less than 8. List your treatment recommendations for him. (List three treatment options).
Currently existing guidelines recommend watchful waiting as the management strategy of choice for patients with mild BPH and an AUA-SI score <8. Therefore, the treatment options in this case include;
Reducing the overall intake of fluids
Moderating the intake of alcohol and products that contain caffeine
Maintaining timed schedules of voiding
Limiting the use of spices and salt
NRNP-6540 Week 7 Knowledge Check
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Maggie is a 70-year-old female who presents for a routine checkup. She admits she has not been to a health care provider for 10 years. Describe at least four (4) important ROS questions you will ask this older female about her genitourinary and reproductive system. NRNP-6540 Week 7 Knowledge Check
Do you experience any difficulties with voiding, urinary frequency, burning with urination, odor with urine, or blood in urine?
Do you experience incomplete bladder emptying and nocturia?
Are you sexually active? How many sexual partners do you have?
Do you have any vaginal discharge? NRNP-6540 Week 7 Knowledge Check What is the color, odor, and consistency?
What was the last time you went for a Pap smear and what was the outcome?
Do you have a past history of STIs or UTIs?
Your 75-year-old female patient calls to complain of “a pain in my right side that won’t go away.” She tells you she has had nausea, vomited twice in 2 days, feels terrible, and cannot eat. When you examine her, she has a positive Murphy’s sign. What diagnostic test would you order? NRNP-6540 Week 7 Knowledge Check
Harry is an 81-year-old male who complains of increasing urinary frequency, nocturia, weak or intermittent urine stream, and a sensation of incomplete voiding, what would your differential diagnoses consist of? Name at least three.
Benign Prostatic Hyperplasia(BPH)
Urinary Tract Infection (UTI)
Would you perform a pap smear on June, your 69-year-old patient? (She has had normal pap smears in the past.) NRNP-6540 Week 7 Knowledge Check
The recommended screenings for cervical cancer in the USA require that, for post-menopausal women who have had three negative pap smear tests in the past 10 years or haven’t been diagnosed with precancer or cervical cancer can stop having annual pap smears. Therefore, for this patient, I wouldn’t perform a pap smear.
Mary is a 71-year-old female who has always had normal mammograms. She recently found a lump in her right breast upon self-examination in the shower. She is very concerned it could be breast cancer. You send her for a mammogram, and possible follow up ultrasound if indicated. You explain to Mary that a breast lump is not always cancerous. Please list at least four (4) other differential diagnoses. NRNP-6540 Week 7 Knowledge Check
NRNP-6540 Week 7 Knowledge Check
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