St Thomas University Health Assessment Discussion

Neurological & Male Genitourinary DisordersLorraine SimmondsNUR 504November 26, 2020

Subjective Data Besides the subjective data highlighted in the case study, the additional data I would obtain from the patient include the following.

• Nausea/vomiting
• Urethral discharge
• Lower back pain
• Lower abdominal pain (Suprapubic pain)

Objective Findings The additional objective data that may be associated with the patient’s condition include

• Hematuria (microscopic): the presence of blood in the urine.
• Foul-smelling urine
• Oliguria represents a total of either 17 or 21 Ml/hour.

Diagnostic exams The following are some of the diagnostic exams that I would order;Urine analysis; Here, the exam is performed on urine to establish whether bacteria or blood is in the urine. If this is the case, the second step is to order urine bacterial culture.Cystoscopy: This test requires placing a cystoscope into the bladder via the urethra. Biardeau and Corcos (2016) described a cystoscope as “a thin tube with a light camera attached.” The cystoscope can also be used to cut a sample of tissue to be used for lab analysis. However, this test will only be necessary if the patient has presented the same symptoms before.Imaging: while this test might not be necessary, it can be of good use if evidence of infection is not found. For instance, ultrasound can help identify other causes of the burning sensation when urinating.
Differential Diagnoses and RationalesCystitisCystitis is a term used in the medical profession to mean inflammation of the bladder caused by a bacterial infection (Petrino, Tua, & Salvi, 2018). The infection can sometimes be painful because it affects the bladder, and if left untreated, the infection tends to spread to the kidneys.Cystitis qualifies as a differential diagnosis because some of its symptoms, including a strong urge to urinate, are the same as those identified in the case study. Other symptoms associated with Cystitis include fever, Hematuria, and pressure in the lower abdomen.Urethritis Urethritis affects the urethra, a passage that transports urine from the blood outside the body. The main symptom associated with this condition is feeling pain when urinating (Petrino, Tua, & Salvi, 2018). A bacterial infection causes the condition. The condition was included as the differential diagnosis because some of its symptoms are similar to those highlighted in the case study. For instance, Urethritis makes one feel the urge to urinate frequently. Similarly, one may experience some difficulties starting to urinate.PyelonephritisThis is a type of infection that affects the kidney; it starts from the urethra before traveling all the way to the kidney(s) (urinating (Petrino, Tua, & Salvi, 2018). Pyelonephritis requires immediate medical attention because, if left untreated, it can damage the kidney. While this condition may be dismissed or overlooked, it still qualifies as a differential diagnosis since most of its symptoms are similar to those indicated in the case study. Some of the similar symptoms in the two conditions include; chills, fever, frequent urination, strong, persistent urge to urinate, and smelly urine.Teachings I will provide my patient with both the basics and beyond the basics kind of teaching. Regarding the basics, I will focus more on ensuring the patient understands some of the common symptoms associated with Neurological & Male Genitourinary Disorders. Similarly, the teaching will revolve around the diagnostic tests. On the other hand, the main teaching that I would offer my patient, beyond the basics, will revolve around the available treatment options for the condition.

References Biardeau, X., & Corcos, J. (2016). Intermittent catheterization in neurologic patients: update on genitourinary tract infection and urethral trauma. Annals of physical and rehabilitation medicine, 59(2), 125-129.Petrino, R., Tua, A., & Salvi, F. (2018). Urinary Tract Infections in Older Patients. In Geriatric Emergency Medicine (pp. 235-246). Springer, Cham.