Case Study - Reproductive System Disorders S. M. is a 68-year old man who is being seen at your clinic for routine healt

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Case Study - Reproductive System Disorders
S. M. is a 68-year old man who is being seen at your
clinic for routine health maintenance and health promotion. He
reports that he has been feeling very well and has no specific
complaints except for some trouble “emptying his bladder.” He had a
CBC and chemistry survey completed 1 week before his visit, and the
results are as follow: Na 140 mEq/L, K4.2 mEq/L, Cl
100 mEq/L, HCO3 26 mEq/L, BUN 22 mg/dL, creatinine 0.8
mg/dL, glucose 94 mg/dL, RBC 5.2 mm3, WBC 7.4 mm3, Hgb 15.2
g/dL, Hct 46%, platelets 348 mm3. His VS at this
visit are 148/88, 82, 16.
1. What can you tell S. M. about his lab work?
While obtaining your nursing history, you discover that there is
no family history of cancer or other genitourinary problems. During
further questioning you discover that S. M. has had progressive
symptoms over the past 6 months, which include the urge to urinate
frequently, decreased ability in starting the stream of urine, and
decrease in the force of the urinary stream. The health care
provider examines S. M. and reports that his prostate is enlarged
and gives a tentative diagnosis of benign prostatic hypertrophy
(BPH). The health care provider also orders a clean-catch urine and
PSA test.
2. S. M. is curious why this condition would affect his
urination. What would you teach him?
3. Why were the additional tests of the UA and PSA
ordered?
4. What concepts would you include in teaching S. M. to obtain a
clean-catch urine specimen for UA?
S. M.’s UA returns with results that are within normal limits
(wnl). His PSA is 2.0 ng/mL. The health care provider informs
S. M. his blood work was normal. S. M. tells you he still has
several questions. What information would you include in answering
the following questions?
5. S. M. asks you, “Do I have cancer?”
6. “Will this condition affect my relationship with my
wife?” what do you tell him?
7. Before being discharged, the health care provider gives S. M.
a prescription for doxazosin (Cardura) with instructions to take 1
mg/dL x 7 days, then 2 mg/dL x 7 days, and then 4 mg/dL thereafter.
What type of drug is Cardura, and what are the indications for the
use of this drug?
8. What are the most common side effects for this drug
class?
9. From a safety standpoint, what information does S. M. need to
know about his treatment with Cardura?