Question

In: Nursing

P.J is an 82-year-old man who presents to the outpatient office for a 6-month check-up. Subjective...

P.J is an 82-year-old man who presents to the outpatient office for a 6-month check-up.

Subjective Data

Lives in assisted living apartments
Widower
One meal a day in dining room, has light meals for breakfast and lunch
Nonsmoker, never smoked
Retired police officer
Has three grown children who live nearby
Walks with cane
Complains of urinary incontinence

Objective Data

Vital signs: T 37.7 BP 108/62 HR 62 Resp 14
Height and weight = Within normal limits
Immunizations = Up-to-date
Medications: Digoxin (Lanoxin) 0.5 mcg per day, hydrochlorothiazide (HCTZ) 5 mg per day, aspirin 81 mg per day
Allergy to sulfa medications = Hives

Questions

What special considerations should the nurse keep in mind regarding the physical exam for individuals in this patient’s age group?

What similarities does assessment of older adults have to the assessment of younger adults?

What are the expected findings in the older adult for the following systems: skin, hair and nails, eyes and vision, ears and hearing, mouth, and musculoskeletal system?

What are some abnormal findings in the older adult for the following systems: skin, eyes and vision, ears and hearing, mouth, and musculoskeletal system?

Based on the readings and the objective and subjective findings, what is the most likely cause of this patient’s urinary incontinence?

What interventions should be implemented for this patient’s urinary incontinence

Solutions

Expert Solution

Special Consideration regarding physical examination of aged people:

a) Head to foot examination with special care to pain, movement,etc.

b) Rage of movement of all joints

c) Skin intergrity which includes dryness,cracks, which are signs of dehydration.

b) Urinary and bowel habits to rule out early symptoms of incontinence and constipation.

Similarities in the assessment of younger and older people

The similarities include

a) Physical examination

b) Range of motion

c) Eating habits

d) Bowel and bladder habits

e) Psycho-Social development to rule out depression etc.

Expected findings in old age

Skin: Dryness,cracks - indicate dehydration

Hair - Usually spares, brittle in case of deficiency

Nail: Calcium deficiency indicate discoloration of nails.

Purple or Cynosed nails indicate hypoxia

Eyes: Vision - clearity of vision, cataract, glucoma

Hearing: ability to hear , degree of hearing loss

Mouth: Presence of dentures, intactability of tooth.

Musculoskeletal system: Parkinson's disease, movement restrictions, joints intergrity and range of motion

The main reason for urinary incontinence may be due to age factor or may be due to Benign Prostrate Hypertrophy which is most commonly seen at this age group.

Intervention:

- Use of adult diapers

- use of condom catheter

- Prostratectomy

- as he is living alone even an indwelling catheter may also be useful

Nightingale answered 1 year ago

Next > < Previous

Related Solutions

Mike is a 69-year-old man who presents to the outpatient office with a cough. Subjective Data...

Mike is a 69-year-old man who presents to the outpatient office with a cough. Subjective Data PMH: HTN, DM Cough is productive, bringing up green phlegm Runny nose, sore throat Denies fever Sore throat pain when swallowing No history of smoking or seasonal allergies Objective Data Vital signs: T 37, P 72, R 14, BP 134/64 Lungs: + Rhonchi bilateral upper lobes O2 sat: 98% Ears: TM bulging Nose: + erythema, yellow discharge Throat: + erythema, pustules Medications: metoprolol 12.5...

M.C. is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough....

M.C. is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough. Past Medical History: HTN (hypertension), DM (diabetes mellitus) Subjective Data Cough is productive, bringing up green sputum. Runny nose, sore throat Denies fever Sore throat pain when swallowing No history of smoking or seasonal allergies Complains of fatigue Objective Data Vital signs: T 37 P 72 R 14 BP 134/64 Lungs: + Rhonchi bilateral upper lobes, wheeze O2 Sat = 98% room air Ears...

M.C. is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough....

M.C. is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough. Subjective Data PMH: HTN, DM Cough is productive, bringing up green phlegm Runny nose, sore throat Denies fever Sore throat pain when swallowing No history of smoking or seasonal allergies Complains of fatigue Objective Data Vital signs: T 37 P 72 R 14 BP 134/64 Lungs: + Rhonchi bilateral upper lobes, wheeze O2 Sat = 98% Ears = TM bulging Nose = + erythema,...

Part 1 M.C. is a 69-year-old man who presents to the outpatient office with a hacking,...

Part 1 M.C. is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough. Subjective Data PMH: HTN, DM Cough is productive, bringing up green phlegm Runny nose, sore throat Denies fever Sore throat pain when swallowing No history of smoking or seasonal allergies Complains of fatigue Objective Data Vital signs: T 37 P 72 R 14 BP 134/64 Lungs: + Rhonchi bilateral upper lobes, wheeze O2 Sat = 98% Ears = TM bulging Nose =...

Part 1 M.C. is a 69-year-old man who presents to the outpatient office with a hacking,...

Part 1 M.A. is a 69-year-old man who presents to the outpatient office with a hacking,...

Part 1 M.A. is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough. Subjective Data PMH: HTN, DM Cough is productive, bringing up green phlegm Runny nose, sore throat Denies fever Sore throat pain when swallowing No history of smoking or seasonal allergies Complains of fatigue Objective Data Vital signs: T 37 P 72 R 14 BP 134/64 Lungs: + Rhonchi bilateral upper lobes, wheeze O2 Sat = 98% Ears = TM bulging Nose =...

M.C is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough....

M.C is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough. Subjective Data PMH: HTN, DM Cough is productive, bringing up green phlegm Runny nose, sore throat Denies fever Sore throat pain when swallowing No history of smoking or seasonal allergies Complains of fatigue Objective Data Vital signs: T 37 P 72 R 14 BP 134/64 Lungs: + Rhonchi bilateral upper lobes, wheeze O2 Sat = 98% Ears = TM bulging Nose = + erythema,...

B. E. is a 68-year-old man who presents to the outpatient office with continuing visual pain...

B. E. is a 68-year-old man who presents to the outpatient office with continuing visual pain and joint pain in his left knee. As you begin taking his history, you notice he is wearing a hearing aid. You decide to do a functional assessment. He states that he can bathe himself as long as he sits down to bathe but cannot climb into the bathtub. His wife has placed a chair in the bathroom for him to use during bathing....

M.P. is a 45-year-old woman who presents to the family practice for a yearly check-up. Subjective...

M.P. is a 45-year-old woman who presents to the family practice for a yearly check-up. Subjective Data Married Exercises daily Nonsmoker, never smoked A registered nurse in hospital setting Has two children who live at home No complaints at this time Objective Data Vital signs: T 98.7 BP 108/62 HR 62 Resp 14 Height: 5 feet, 7 inches Weight: 160 pounds Immunizations: All immunizations are up to date Medications: No medications, multivitamin daily Allergy to PCN = Hives Questions: How...

J.P. is a 50-year-old man who presents to the gastroenterologist with cramping and diarrhea. Subjective Data...

J.P. is a 50-year-old man who presents to the gastroenterologist with cramping and diarrhea. Subjective Data Pain level is a 6/10 location = right and left lower abdomen Works as a union construction worker, has missed 1 day of work States he has been going to the bathroom about 8 to 10 times a day for past 2 days Appetite is decreased PMH: Crohn’s disease, depression, anxiety Objective Data Vital signs: T 37 P 80 R 14 BP 120/68 Bowel...

Subjects