Urological and Gynecological Disorders

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Martin-Plank, L. (2019). Urological and gynecological disorders. In Advanced practice nursing in the care of older adults (pp.280-304). essay, F.A. Davis Company.
Mrs. C., a 66-year-old woman, presents to your practice with a complaint of recent onset of leaking urine. She has no prior history of this. On further questioning you discover that she is newly married, after being widowed for 15 years, during which time she had no sexual partners. She and her new husband have just returned from a cruise, and she reports that he is a “passionate” lover and she is having difficulty meeting his needs for daily intercourse. Other symptoms that Mrs. C. reports are vaginal burning and general discomfort “down there.”

Medications: Takes fish oil at bedtime, vitamin D3 1,000 IU daily. No known drug allergies.

Vital signs: Blood pressure (BP) 128/76 mm Hg, pulse 82 (regular), respiratory rate 16 breaths/min, temperature 98.2°F (oral), BMI 23.4.

A staff member has obtained a urine specimen for dipstick. Findings are as follows:

Nitrite—negative

Leukocyte esterase—negative

Blood—trace

Protein—trace

Glucose—negative

Ketones—negative

Specific gravity—1.015

1. What additional subjective data are you seeking?

2. What additional objective data will you be assessing for?

3. What national guidelines are appropriate to consider?

6. What are the differential diagnoses that you are considering?

8. Are there any Healthy People 2020 objectives that you should consider?

9. What additional patient teaching may be needed?