This week discussion involves a 68 -year-old Caucasian male who complained of burning when urinating.  He admits to the pain increasing with the more he urinates and it has been going on for the past 5 days.  His past medical history includes prostatic hyperplasia, high cholesterol and hypertension. The medications he is prescribes are Olmesartan 20mg and Crestor 20 mg. He has been diagnosed with nocturia and dysuria. The subjective data I would inquire is his diet. How much water does he consumes daily? Was there an odor present when urinating?  Due to your history of UTI’s, are you taking any probiotics as needed and were you prescribed with antibiotics, if so, how long? With his systolic Blood pressure in the 150’s, when is the last time you took the Olmesartan. Did the fever occur before or after the Burning started, and did you take any acetaminophen or Motrin to break it?             The Labs that I would order is a urine culture with sensitive, CBC, BMP and lipid panel. A kidney, ureter, and bladder (KUB) X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal (GI) system. A KUB X-ray may be the first diagnostic procedure used to assess the urinary system.

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           A few diagnoses that can relate to the symptoms will include Bladder infection. They are the most common type of urinary tract infection caused by bacteria and can lead to problems like pain in your lower belly and having to pee way more often than usual (Rhoads, 2021). Symptoms may include Pain in the bladder, groin, lower abdomen, or pelvis that can occur during urination or during sexual intercourse.  The body may experience fatigue, fever, or malaise. Chronic Kidney Disease is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke (CDC,2019) CKD can cause Anemia, increased infections, abnormal electrolytes, loss of appetite or depression.
         A Kidney infection (pyelonephritis) is a type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels to one or both of your kidney. Symptoms observed in a kidney infection are Fever, Chills, Back, side (flank) or groin pain, Abdominal pain, Frequent urination, Strong, persistent urge to urinate and Burning sensation or pain when urinating.
                    Furthermore, patient teaching would include increasing intake of water and/or cranberry juice. Fluids can help remove bacteria from your body when you urinate. Kidney scarring can lead to chronic kidney disease, high blood pressure and kidney failure. When the infection remains in the blood, septicemia can occur.  Your kidneys filter waste from your blood and return your filtered blood to the rest of your body.  Urinate as soon as you need to. Avoid delaying urination when you feel the urge to urinate. It is important to empty the bladder after intercourse. Urinating as soon as possible after intercourse helps clear bacteria from the urethra, reducing your risk of infection (CDC, 2019).
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System website. Accessed January 7, 2019.
Rhoads, J., & Wiggins Petersen, S. (2021). Advanced Health Assessment and Diagnostic Reasoning. Burlington, MA: Jones and Bartlett Learning. ISBN: 9781284105377