Question

Denzel Armstrong Case Study

Welcome to Dr. Jones’s busy general practice clinic where he sees patients of varying ages. You are one of three RNs in the clinic and your general duties include assessment, patient education, assistance with minor dressing changes, obtaining routine labs (i.e. urine, blood etc.) to name just a few. You have been a nurse for five years and feel very comfortable in this environment. On this day, you have a student nurse, Mary, assigned to work along with you. Mary is a second-year nursing student in a local university where she is working towards her BSN degree. Let’s help Mary get started with her first patient, Denzel Armstrong!

Denzel Armstrong is an obese 65-year-old African American male who is new to the clinic. His previous physician retired 1 year ago and he is now seeking care for his hypertension. He also has complaints of urinary frequency and nocturia three to four times/night for 2 weeks. He denies dysuria or fever, but admits to urgency and mildly decreased force of stream. Denzel reports 8 – 12 bathroom visits per day. He denied previous problems with urination and states that his only medical problem is high blood pressure, for which he takes hydrochlorthiazide 25 mg/day.

QUESTION-

1. After meeting Mary, you both review the information above on Denzel Armstrong together. Your first plan of the day is to complete a thorough assessment on Denzel as this is his first visit at the clinic. To develop a plan of care, it is important to identify any abnormal data so that it can be clearly addressed. Based on the information presented in the case study, what is the abnormal data that Denzel presents with? What is the possible cause of the abnormality? Please include at least one citation in the cause of each abnormality.

Answer 1

Denzel Armstrong had a previous history of Hypertension and he using medication of tablet: Hydrochlorthiazide: 25mg/day.

Abnormal data i observed in the case study is increase in the frequency of urination and nocturia of three to four times for 2 weeks and dysuria (difficult in urination).

Cause for the abnormality: Hydrochlorthaizide is belongs to diuretic and it is also called as "water pill"that can increase urine frequency and may cause urinary urgency and incontinence by overwhelming the patient bladder capacity and which helps to get rid of extra salts and water from the body.

• Other common cause for Nocturia and dysuria is Urinary tract infection or bladder infection can cause burning sensation and urgent urination throughtout the day and night.
• Hydrochlorthiazide can be taken with or without food and usual dose is 12.5 to 50mg once daily. Avoid taking hydrochlorthiazide with in 4hrs before going to bed it may result to increase urine frequency during night.