A 78-year-old man has a past medical history of diet-controlled…
Question Answered step-by-step A 78-year-old man has a past medical history of diet-controlled… A 78-year-old man has a past medical history of diet-controlled diabetes and hypertension, and ischemic stroke 2 years ago. He has no residual neurological deficits from his stroke and had no history of post-stroke bowel or bladder incontinence. He comes to the clinic today complaining of a 4-month history of “leaky urine.” He says it happens any time during the day or night and usually involves only a small amount of urine. He reports no issues with getting to the bathroom or mobility and is always fully aware when he has to urinate. When asked to describe his symptoms and frequency, he reports a strong urgency, with difficult initiation and weak stream. He reports urinating up to 8 times per day and at least twice in the evening. “I feel like my bladder is never empty, like there is a constant pressure feeling.” “Sometimes I have to strain to get it out and have cramps in my lower stomach.” He reports that he was treated by his previous doctor with antibiotics a month ago, but treatment didn’t change any of the symptoms or pain. Patient denies any foul-smelling or discolored urine, hematuria, fevers, previous back or pelvic surgeries, and neurological diseases. He is married and denies any extramarital affairs and denies prior history of STDs or genital lesions. He does not take any medication; however, last week he took pseudoephedrine for some nasal congestion and did not leak all day. He denies inciting factors such as laughter, coughing, or sneezing.1. What is the most likely cause of urinary incontinence?2. What type of urinary incontinence does he most likely have?3. Identify the appropriate urinary incontinence work-up.Basic blood work was done. CBC, electrolytes, and liver function tests were all normal. Urinalysis was negative for blood, glucose, or bacteria. BUN 18 and Cr 1.2 revealed mild kidney compromise. PSA is 4.6.4. What would you expect urodynamic studies to show?5. What is the treatment for this type of urinary incontinence? Health Science Science Nursing NURE 131 Share QuestionEmailCopy link Comments (0)
