Question

Part 1

T.A. is a 64-year-old man who presents to the family practice complaining of increased urination at night. The patient has a past medical history of hypertension, hyperlipidemia, and coronary artery disease (CAD). Vital signs are T 97.5, P 85, R 16, and BP 120/60.

Questions:

1. What subjective information should the nurse obtain?
2. The nurse is performing the physical examination of the patient’s genitals. What are the major structures of the male genitalia?
3. The nurse needs to assess the patient for a hernia. What is the proper procedure for this assessment?
4. What is the most likely cause of this patient’s urinary frequency at night?

Answer 1

Q1

Answer: The subjective data nurse should get from the patient includes

- drinking to much water in the evening

- consumption of alcohol, caffeine before bedtime

- frequency of urination at night

- any discomfort like pain during urination or hematuria to find out any infection-related frequent urination

- history of diabetes Mellitus

Q2

Answer: The major structure of the male genitalia includes the testes, epididymis, prostate gland, vas deferens, and seminal vesicles, etc. The nurse should inspect the genital area for any mass or nodules formation, check for any inflammation, hydrocele, hernia, discharges, etc. during the physical examination.

Q3

Answer:

For the identification of the inguinal hernia

- provide privacy

- expose the area to be checked

- ask the patient to be in a standing position

- palpate from the side in the inguinal area for any mass

- asked the patient to cough and check whether hernia swelling expand with cough or not

-if any mass found, then to check the reducibility, asked the patient to be in a supine position

-check whether the hernia reduces spontaneously

- if the hernia still present, reduce by manually using the fingers, then asked stand or cough to check whether the hernia expanded.

Q4

Answer: The most likely cause for frequent urination at night may be diabetes Mellitus. As the patient is having hypertension, hyperlipidemia, and CAD, he has a high chance of developing diabetes Mellitus. frequent urination is one of the signs of diabetes mellitus.