Nocturia Case Studies

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

Past Medical history includes : Essential Hypertension, Cardiac pacemaker, Coronary Artery Disease, Dyspnea, Sensiosenural hearing loss, Restless legs, headache, acute hypothyroidism due to radiation, Mandible Cancer, Pseudophakia of both eyes, Posterior vitreous detachment, malnutrition, Generalized weakness, Smoker of 2 packs of cigarettes per day for 30 years.

Renal History: The patient learned that he had kidney disease a few years ago. He had a biopsy in October 2012 that showed IgA nephropathy per TGH records. He started dialysis in 2013. Initially, he started peritoneal dialysis for seven months. He had a lot of side effects

Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow-up visit after his discharge from the hospital on 08/08/2017. He was admitted on 08/04/2017 due to normocytic anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis. The esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in the antrum, and small hiatal hernia. He had a colonoscopy which revealed internal hemorrhoids. Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus, hypertension, stable chronic kidney disease stage III, and bilateral impacted cerumen. It was noted that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes at a time for 1

The patient is a 75-year-old female who did see a new pulmonologist (Daniel Kim, DO) as Elvira Aguila, MD left this area. She did have a CT scan done of her lungs. She was told to hold her metformin and had blood work done because of IV contrast. Her creatinine did go up to a high of 1.5, but then on repeat came back to 1.37 with a BUN of 14. I did have her decrease her dose of metformin from 1000 mg b.i.d. to 500 mg b.i.d. She did have a BUN and creatinine done in December of 2014, which showed creatinine of 1.46, BUN of 35. Repeat in March of 2015 showed creatinine of 1.1 with a BUN of 49. The patient has also been found to have proteinuria with a urine microalbuminuria/creatinine

This 60 year old Hispanic male presents at the clinic today with a chief complaint of urinary frequency, decreased urine flow, increased nocturia, slight terminal dysuria and low grade fever. The patient was experiencing these symptoms for the past two years, but they had increased a whole lot more during the last two weeks. Upon assessment, it is noted that the patient has a

Past Medical History: The patient has a history of end-stage renal disease secondary to IgA nephropathy, hypertension, alcohol abuse, biopsy proven liver cirrhosis, history of right leg cellulitis,

Sign and symptoms of BPH are frequent urination or inability to urinate, incontinence/dribbling, pain when urinating, and unable to completely empty bladder. A short-term goal will be that the patient will not or experience less pain when urinating. The patient will not be dehydrated will be the long-term goal. These goals will be accomplished if patient follow medication regimen and the patient will report pain level to the nurse for pain management. By reducing the discomfort level of urinating, the patient will not be afraid of drinking more fluids. Teaching the patient, the importance of staying hydrated will also reduce the risk of getting an UTI. T.M. is Flomax for BPH. One of the teaching for Flomax is it “May cause sudden drop in BP, especially after first dose or when changing dose” Wolters Kluwer

He was in his usual state of health until 4 weeks ago when he had bilateral hernia repair on 7/20. He was discharged from day surgery on the same day. Within 24 hours after discharged, he developed a urinary retention and went to ER, where Foley catheter was placed and again discharged home with an appointment to be seen by Urology . On 7/29, he was seen in Urology clinic and a Cystoscopy was done which showed BPH and planning for TURP procedure at a later date.

Mr. Newman is a 49 year old male who has hematuria, fever and severe flank pain. He also has bilateral lumbar tenderness, bilateral renal enlargement, liver enlargement, ankle and facial edema, skin pallor, and lung sounds suggest pulmonary edema.

is not significant except with diagnosis of renal stones 3 years ago. Patient lives alone and

Vital sign: Patient weigh 169 pounds, temperature 99, pulse is 56, respiration rate 16, pulse ox 98%, blood pressure 96/60. Pain level

The patient is a licensed carpenter and is the sole provider for his household. He lives with his wife in a small apartment in an inner city. He admits that he does not get involved in physical activities due to unsafe neighborhood with high crime rate. He has no hobbies and prefer to read at home. He eats one large meal a day after work, misses breakfast majority of the times. He admits eating unhealthy meals for lunch, few serving of fruits and vegetables, and high- calorie food mostly pasta and meat at home. He does not engage in any street drugs or alcohol intake, however he admits smoking cigarette one pack per day for the past thirty years.

The patient is an 87-year-old female who is brought in by her daughter because of ongoing dizziness over the past several days which is worsening. The patient keeps getting out of bed and moving around. She is also complaining of retrosternal chest pain which is worse with walking and exertion. She is unable to ambulate at home. It is to be noted she had a recent cardiac workup as an outpatient which was negative. She also had recent EGD that demonstrated a small hiatal hernia, as well as a large to what duodenal diverticulum. Her medical history is significant for diabetes mellitus with the known neuropathic arthropathy, hyperlipidemia, hypertension, chronic kidney disease stage III, as well as systemic lupus erythematosus. The patient

My patient was a 90-year-old Caucasian female who presented to the E.R. from Scotia Village for urology consult, with complaints of abdominal pain and hematuria. She was admitted on November 07, 2016 for monitoring and further management and treatment of Hematuria. CT of abdomen on November 07, 2016 is positive for diagnosis of Renal Calculi. Past medical history of cerebral palsy, glaucoma, hematuria, hypercholesterolemia, hypertension and hypothyroidism. Past surgical history consists of cataracts in 2016 and appendicitis. She has never been married, has never had children and has been a resident of Scotia Village since December of 1988.