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2023 Urinary Obstruction Case Studies The 57 year old patient noted urinary hesitancy and a decrease in the force of his urinary
by adminNursing 2023 Urinary Obstruction
Urinary Obstruction Case Studies The 57 year old patient noted urinary hesitancy and a decrease in the force of his urinary 2023 Assignment
Urinary Obstruction
Case Studies
The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary
stream for several months. Both had progressively become worse. His physical examination
was essentially negative except for an enlarged prostate, which was bulky and soft.
Studies Results
Routine laboratory studies Within normal limits (WNL)
Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder,
indicating an enlarged prostate
Uroflowmetry with total voided
flow of 225 mL
8 mL/sec (normal: >12 mL/sec)
Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)
Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)
Electromyography of the pelvic
sphincter muscle
Normal resting bladder with a positive tonus limb
Cystoscopy Benign prostatic hypertrophy (BPH)
Prostatic acid phosphatase
(PAP)
0.5 units/L (normal: 0.11-0.60 units/L)
Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL)
Prostate ultrasound Diffusely enlarged prostate; no localized tumor
Diagnostic Analysis
Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical
examination indicated an enlarged prostate. IVP studies corroborated that finding. The
reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the
patient was found to have a normal total voided volume, one could not say that the reduced
flow rate was the result of an inadequately distended bladder. Rather, the bladder was
appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction.
The cystogram indicated that the bladder was capable of mounting an effective pressure and
was not an atonic bladder compatible with neurologic disease. The tonus limb again
indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was
normal, again indicating appropriate muscular function of the bladder. Based on these
studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA
indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis.
Cystoscopy documented that finding, and the patient was appropriately treated by
transurethral resection of the prostate (TURP). This patient did well postoperatively and had
no major problems.
Critical Thinking Questions
1. Does BPH predispose this patient to cancer?
2. Why are patients with BPH at increased risk for urinary tract infections?
3. What would you expect the patient’s PSA level to be after surgery?
4. What is the recommended screening guidelines and treatment for BPH?
5. What are some alternative treatments / natural homeopathic options for treatment?
NOTE:reference at least two updated, and APA format, with plagiarism rate 0%, if possible attach%
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2023 Response for classmate 1 and 2 200 words for each Working in the healthcare settings we come
by adminNursing 2023 Responding
Response for classmate 1 and 2 200 words for each Working in the healthcare settings we come 2023 Assignment
Response for classmate 1 and 2. 200 words for each
Working in the healthcare settings, we come across many different people from different backgrounds, races, and living situation. The philosophy of any public space is the equality and standard way of thinking and feeling about others, but in reality, these differences could often cause tension and/or stress during the interaction of two people. When I come across a patient around my age group, I find that I speak to them as if they were a friend, often using slang and other gestures as I would with friends outside of the workplace. In contrast, with older adults I tend to speak a bit slower and professional due to the age difference. Being a 27-year-old Intensive Care RN, often times older patients initially feel as if my age will affect their care in a negative way because they relate young with inexperienced, therefore the tone and word choice are changed in order to instill confidence thru proper communication. The difference in gender can also have its changes of personality during a patient interaction. Being a male, I tend to talk to the guys a bit more straight forward and not so much emphasis on emotion, while with females, I tend to be more compassionate and understanding of their situation. As for the other factors that make a difference in people, race, sextual preference, living situation, that does not play a factor during patient communication as those are not important to me, instead I may feel the urge to ask more questions to get to know them and their culture or preferences if their difference interest me.
While growing up, the Latin culture has great respect for older adults. A young family member is always expected to take care of their older family members, especially the older females. Grandma’s, Aunt’s, and Mom are always the first to have priority in any situation, starting with the eldest one. The older males in the Latin culture are not left out behind, but typically are carefree to many situations, just wanting everyone to be happy regardless of where they stand. When I was about 5 years old in 1997, the respect for adults was already instilled in me. Always making sure that adults are respected and listened to what they asked of me. In 2007 I was 16, and things started changing, I would be able to challenge adults’ questions and figure out why things are the way that they are; this was a rebellious stage, but I was just trying to figure out why. Fast forward from the rebellious stage, 2011 I was 20 years old, and now had the knowledge as to why adults did what they did, and I understood the meaning behind it. The older adults in the family would now see me as an adult, and although the respect continued as such, I was now an adult as well with my own opinion and choice, regardless of their input.
The way we act and treat others is highly influenced by the upbringing that we have experienced as children, in my opinion, and therefore it is especially important for me to continue what I have been taught as a child, in the workplace, and continue the line of respect with those that surround me. In 2017, my niece was born, and now I find myself also educating her in what is acceptable and not acceptable in our eyes, to continue the same respect and behavior towards other, with her. For us, it doesn’t matter what color you are, which gender you like, where you live, which car you drive, which gender you are, what matters to us is the quality of person you are in the world and how you treat those that surround you.
2.
find myself to be most comfortable working with older adults between the ages of 70-85. As a nurse I have really only worked with the geriatric population. I work at a hospital in Arizona that is close to many different retirement communities. Our hospital’s average patient age is 74. This makes working with younger patients little more uncomfortable for me. I wonder if it is because younger patients are generally not as used to being in the hospital and I worry about not being able to calm their fears.
Cultures that are very different than mine also make me a little uncomfortable to communicate with them. I worry that I will offend the patient with something like eye contact. I work with a lot of Navajo patients. At first, I was nervous to work with Navajo patients because I did not know a whole lot about their culture, but as I have learned and worked with the Navajo, I have felt more comfortable being able to effectively communicate with them.
I had a patient from India and was nervous to be working with them for the same reason. This patient was one of the most kind hearted people I have ever met. By the time she was ready to be discharged I had learned a lot about her culture and enjoyed getting to know her.
I do not feel uncomfortable communicating with other races, I feel more uncomfortable communicating with cultures that are different than mine. I think it is more that I am worried about possibly offending someone because of my own culture’s customs, and I can be unaware of other culture’s customs.
Communicating with someone of a different living situation is generally pretty easy for me as well. I have lived in communities that have a lot of diversity and that has helped me to understand the different living situations that people have.
One thing I have recognized is that as a nurse, we work with so many different people. Everyone at some point in their life is going to need medical attention, and a nurse will be there to take care of them. As nurses we have to learn how to communicate with people who are very different from us and learn to adapt to the many different cultures and personalities we work with.
When I was growing up, many of my experiences with how older adults are treated is mostly with respect. However, I also felt like older adults were seen as to be a burden on the family. I grew up learning that it may be best for older adults to be in an assisted living place. It has been found that many adult children are around the age of 60 or 70 when they are taking care of their 90-year-old parent (Graham, 2018, p. 1). According to Graham (2018) Caregiving at the age of 60 or 70 can be very hard on the body and adds extra mental and physical stress (p. 1). I am not sure if having older adults in an assisted living is the best place for older adults, but I am interested in learning more about this topic this week.
Reference:
Graham, J. (2018, August 23). A late-life surprise: Taking care of frail, aging parents. Retrieved
from https://khn.org/news/a-late-life-surprise-taking-care-of-frail-aging-parents/.
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2023 Please make revision in the prospectus checklist assignment based on my professor feedback For now she wants to only
by adminNursing 2023 Prospectus Draft Revision.
Please make revision in the prospectus checklist assignment based on my professor feedback For now she wants to only 2023 Assignment
Please make revision in the prospectus checklist assignment based on my professor feedback. For now, she wants to only focus on (1) the problem statement, (2) the practice focus question, (3) the social change.
I’m also attaching a copy of the previous prospectus draft which the professor returned to me with her feedback. Also, I included an outline of the project in the file section (see attached file).
Include as many scholarly references (at least 10) as needed and cite often.
APA format required.
Due on Sunday 10/06/19 by 12pm America/New York time.
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We give our students 100% satisfaction with their assignments, which is one of the most important reasons students prefer us to other helpers. Our professional group and planners have more than ten years of rich experience. The only reason is that we have successfully helped more than 100000 students with their assignments on our inception days. Our expert group has more than 2200 professionals in different topics, and that is not all; we get more than 300 jobs every day more than 90% of the assignment get the conversion for payment.
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2023 Select a nurse that historically contributed to the advancement of the profession Write a 2 3 page paper that responds to
by adminNursing 2023 Legacy of Nursing History
Select a nurse that historically contributed to the advancement of the profession Write a 2 3 page paper that responds to 2023 Assignment
Select a nurse that historically contributed to the advancement of the profession. Write a 2-3 page paper that responds to the following questions. Identify the nurse and his/her background and complete the following:
You may use your textbook, readings and the following for background information.
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We give our students 100% satisfaction with their assignments, which is one of the most important reasons students prefer us to other helpers. Our professional group and planners have more than ten years of rich experience. The only reason is that we have successfully helped more than 100000 students with their assignments on our inception days. Our expert group has more than 2200 professionals in different topics, and that is not all; we get more than 300 jobs every day more than 90% of the assignment get the conversion for payment.
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