Genitourinary Case Study and Plan of Care
Infections like acute prostatitis in the male genitourinary system are rare while disorders like benign prostatic hyperplasia are more common with aging (Yoon et al., 2012). Mr. H.S. is a 60-year-old male with history of urinary issues for two years. Reports today symptoms have increased in severity. He reports today nocturia consisting of 4-5 episodes a night and interference of daily activities related to frequent urination with a decreased urinary stream and fever.
Subjective Date:
Client Complaint “I am going to the bathroom a lot at night and also having difficulty when I urinate. It has been worse the past two weeks. I am worried I might have cancer.”
History of Present Illness Mr. S. presents …show more content…
S. has a bacterial infection noted to the prostate. This may be secondary to risk factors like, unprotected sexual intercourse, urinary tract infections or other structural issues like benign prostate hyperplasia which often leads to urinary stasis and retention and is represented by fever, rectal and back pain and tenderness of the prostate (Yoon et al., 2012). Mrs. S.’s symptoms of fever, dysuria, and a tender and boggy prostate are representative of acute prostatitis (Dickson, 2013). The first step in management of the acute infection requires a urinalysis with a urine culture. Next, a sexual history will be obtained to determine if sexually transmitted diseases could be a factor. If a positive history is indicated these test may be added as needed. According to Dickson (2013), bacterial agents such as chlamydia and gonorrhea can be a causative agent. If these cultures are positive indications require Mr. S. to be treated with ceftriaxone and azithromycin accordingly (Dickson, 2013). These cultures will identify the causing bacterial agent and sensitivity to guide the course of treatment with appropriate antibiotics. While Mr. S. has an elevated PSA it is not indicative of cancer secondary to his clinical presentation but of an infection and can be elevated with prostatitis (Dickson, 2013). The client will be prescribed antibiotic therapy to include Ciprofloxin 500mg orally BID for up to 6 weeks as it is indicated for treatment for the most common bacteria cause E. coli and he will need to be revaluated following 48-72 hours after cultures have identified the causing agent to ensure appropriate antibiotic choice (American Family Physician, 2010). Along with the antibiotics therapy Mr. S. will verbalize an understanding of his medication regimen and the need to complete the therapy along with recommendations of taking over the counter NSAIDs for pain and fever relief. Other educational points will include informing him of abdominal
Infections like acute prostatitis in the male genitourinary system are rare while disorders like benign prostatic hyperplasia are more common with aging (Yoon et al., 2012). Mr. H.S. is a 60-year-old male with history of urinary issues for two years. Reports today symptoms have increased in severity. He reports today nocturia consisting of 4-5 episodes a night and interference of daily activities related to frequent urination with a decreased urinary stream and fever.
Subjective Date:
Client Complaint “I am going to the bathroom a lot at night and also having difficulty when I urinate. It has been worse the past two weeks. I am worried I might have cancer.”
History of Present Illness Mr. S. presents …show more content…
S. has a bacterial infection noted to the prostate. This may be secondary to risk factors like, unprotected sexual intercourse, urinary tract infections or other structural issues like benign prostate hyperplasia which often leads to urinary stasis and retention and is represented by fever, rectal and back pain and tenderness of the prostate (Yoon et al., 2012). Mrs. S.’s symptoms of fever, dysuria, and a tender and boggy prostate are representative of acute prostatitis (Dickson, 2013). The first step in management of the acute infection requires a urinalysis with a urine culture. Next, a sexual history will be obtained to determine if sexually transmitted diseases could be a factor. If a positive history is indicated these test may be added as needed. According to Dickson (2013), bacterial agents such as chlamydia and gonorrhea can be a causative agent. If these cultures are positive indications require Mr. S. to be treated with ceftriaxone and azithromycin accordingly (Dickson, 2013). These cultures will identify the causing bacterial agent and sensitivity to guide the course of treatment with appropriate antibiotics. While Mr. S. has an elevated PSA it is not indicative of cancer secondary to his clinical presentation but of an infection and can be elevated with prostatitis (Dickson, 2013). The client will be prescribed antibiotic therapy to include Ciprofloxin 500mg orally BID for up to 6 weeks as it is indicated for treatment for the most common bacteria cause E. coli and he will need to be revaluated following 48-72 hours after cultures have identified the causing agent to ensure appropriate antibiotic choice (American Family Physician, 2010). Along with the antibiotics therapy Mr. S. will verbalize an understanding of his medication regimen and the need to complete the therapy along with recommendations of taking over the counter NSAIDs for pain and fever relief. Other educational points will include informing him of abdominal