Question

Mr. T, age 68, presents to the clinic with vague complaints of “just not feeling well.” As the nurse questions him, he alludes to the fact that he is having some problems “down there.” (Learning Objectives: 3–5)

1. How will the nurse approach this situation to obtain the information needed? Mr. T reports that he has been having difficulty urinating and that he never feels like he can completely empty his bladder.

2. What are some possible causes of his symptoms?

3. What questions would be helpful in identifying the possible cause?

4. The only pertinent findings are his medical history of diabetes type 2 and hypertension. Why are these significant? Since Mr. T is not taking a calcium channel blocker, it is determined that the cause is most likely associated with his diabetes. 5. What are some possible complications associated with bladder atony?

Answer 1

1.The nurse can approach in the following ways

• Reassure the patient to gain confidence
• Provide privacy and ensure to maintain confidentiality
• Could the patient tell about his urinary system problems
• Does he have any leaking or urinary incontinence
• Any complaints of lower abdominal pain

2.The possible cause of the symptoms are

• Uncontrolled diabetes
• Diabetic neuropathy
• Prostatitis
• Any tumor
• Obstruction
• Aging

3.The question which can help on identifying the the possible cause are ranges of blood sugar levels, antihypertensive medication

4.The patient with type 2 diabetes if has uncontrolled sugar levels for a prolonged period of time with hypertension can affect the nerves of the bladder and cause flaccid bladder pr atomic bladder or by causing diabetic neuropathy

5.Ths possible complications of bladder agony

• Retention of urine can lead to bladder and renal infection
• vesicourethral reflux
• calculi
• Neurogenic bladder
• Renal failure