NUM2409 Adult Health 2 – Assessment 2 Case study presentation Sem XXXXXXXXXXCase Study 1 – Benign...

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NUM2409 Adult Health 2 – Assessment 2 Case study presentation Sem XXXXXXXXXXCase Study 1 – Benign prostatic hyperplasia (BPH) and Parkinson’s disease (PD) Presenting complaint. Peter Stacy aged 76 yrs, is admitted to your emergency department complaining of lower abdominal pain and a persistent urge to void. A provisional diagnosis of urinary retention and possible urinary tract infection (UTI) secondary to Benign Prostatic Hyperplasia (BPH) is made by the admitting doctor. You are asked to prepare the equipment for insertion of an indwelling catheter (IDC). Past medical history and subjective data. Peter’s wife tells you that his condition is deteriorating, and he is finding it increasingly difficult to meet his ADL’s. You notice that when he walked into the ward his gait was shuffling with marked bradykinesia and he had a stooped posture. On examination he has a blank inexpressive face, speaking in a monotone voice. Objective data BP 106/54 mmhg HR 92 BPM T 37o c RR 19 breaths per minute Parkinson’s disease (PD) - diagnosed 4 1/2 years ago BPH – diagnosed 3 months ago by digital rectal examination and PSA 10 ng/mL Medications Prazosin 1mg twice daily Selegiline 5mg twice daily Sinemet CR (25mg Carbidopa/ 100mg Levodopa) TDS The following is to be addressed in your presentation. Pathophysiology Discuss the pathophysiology and diagnosis of BPH. Include in your answer the pathophysiological changes that have contributed to Peter’s urinary retention and risk of UTI. Discuss what other probable causes of urinary retention are specific to Peter? Support with rationale and evidence-based research. Pharmacology Discuss how the medications Peter is currently prescribed help manage both his BPH and PD. Include in your answer mechanisms of action, normal dosage, ADR’s and any specific nursing and poly pharmacy considerations. (DO NOT USE TABLES) Specific Nursing Care Discuss and provide rationale for what nursing assessment would be required to confirm Peter’s urinary retention and UTI. Identify, discuss and provide rationale for at least 2 specific problems (to Peters Parkinson’s disease and medications) you will need to address when planning Peter’s post-operative nursing care post Trans urethral prostatectomy (TURP). NUM2409 Adult Health 2 – Assessment 2 Case study presentation Sem XXXXXXXXXXSpecific Assignment instructions The aim of this case study presentation is to provide an opportunity for you to apply your new knowledge of specific disease pathophysiology, diagnosis and treatment (pharmacological, non-pharmacological, nursing and allied health professional interventions ) to a “real life” clinical scenario. There is a word limit of 2000 words Submission is via Turnitin link in BB – Assessment 2 folder When you submit your file, please ensure your “Submission Title” on the Submit Turnitin Assignment page contains the Case study number and description, e.g. “Case Study 1 PD and BPH”. Nothing else is required for the title. Please also ensure you get a receipt; no receipt means it is not submitted. Students should refer to the SNM A - Z Guide & SNM Presentation and Assessment guide 2020 and ECU referencing guide A detailed SNM rubric is attached to the end of this document outlining criterions and mark allocation. Introduction: should include • An introduction to your topic • Highlight the main issues (do not copy the case study, summarise only) • Include a statement that outlines the structure and purpose of the paper. • Include research parameters Content: In this area it is necessary to present the topics relevant to the paper. • Address the pathophysiology questions • Address the pharmacology questions • Address the care questions Discussion Is supported by your learning, your research and knowledge of your professional responsibilities. Critical Thinking: Exploration and application of the case study information and relevant evidence-based information to support your discussion • Research: Journal articles, texts, theoretical knowledge. • Presentation of resources. (evidence based) • Appraise, analyse, compare and discuss the case study applying your theoretical and research knowledge. • Application to practice e.g. client centre care (based on analysis of case study) • Professional responsibilities. NUM2409 Adult Health 2 – Assessment 2 Case study presentation Sem XXXXXXXXXXStructure and presentation: • As per the assignment requirements and the SNM guidelines. • Clear introduction to the topic. • Well defined sentence structure and paragraph formation leading to a cohesive development and comprehensive discussion of ideas. Conclusion: • Wind up of your paper by restating your introductory statement. • Restate your main ideas • DO NOT introduce new ideas. References: Work must be both In and End text referenced using APA 7th edition format. The essay requires a minimum of ten (10) quality citations (peer reviewed) journals, (not more than 7 years old), academic texts and quality web sites i.e. Government (NOT Wikipedia). In addition, these can be supplemented with general websites i.e. Cancer Council, Parkinson’s Australia English Language Proficiency: • As per ECU requirements (see SNM marking rubric)

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Case study1: BPH and PD									6
Case study1: BPH and PD
Table of contents 
Introduction	3
Pathophysiology and Diagnosis of BPH	3
Pharmacology and medication	5
Specific nursing care	6
Critical thinking and discussion	7
Conclusion	8
Reference	9
Introduction
The given case study is revealing a specific situation of a patient Peter Stacy of age 76years who has been admitted to the emergency department with abdominal pain and a persistent urge to void. It has been stated that the patient had a provisional diagnosis of urinary retention along with a possible urinary tract infection. The past medical history of the patient is explaining that the patient had been diagnosed with Parkinson's disease 4.5years ago. It has also been noticed that the patient is facing problems while walking around the ward. From the observational data, it can be seen that the blood pressure of the patient is 106/54 mmHg and the heart rate is 92 BPM. The body temperature has been observed 37°C and the respiratory rate is 19beats per minute. Medical reports of the patient tell that the patient has been diagnosed with a digital rectal examination of BPH three months ago. 
This particular assessment deals with the real-life scenario to enhance the knowledge of any specific disease pathophysiology and the diagnosis process. This study also helps in judging the decision making ability of a nurse along with the enlargement of the overall idea of the pharmacological and non-pharmacological intervention into the health care study.
Pathophysiology and Diagnosis of BPH
Benign prostatic hyperplasia (BPH) can be defined as a proliferation of the cellular molecule of the prostate that results in the enlargement of the prostate and blockage of the bladder outlet (McAuley, et al., 2017). The human prostate is divided into three major histological or biological distinct parts such as central, transitional, and peripheral (Alves, et al., 2018). A patient can face obstruction in the bladder outlet or any other lower urinary tract symptoms (LUTS) due to prostatic hyperplasia. It has been estimated that more than 50% of the male population above age 60 faces the problems of BPH worldwide (Lee, & Kuo, 2017).  Hypersensitivity of the bladder along with the prostatic obstruction, urethral sphincter dysfunction, etc. can be the major symptoms of it (Sakakibara, et al., 2018). Nowadays a variety of medical treatments are widely available to treat BPH. Mostly all targets diminish the bladder outlet obstruction in case of reducing the prostate volume (Fusco, et al., 2018). By reducing the tension of the smooth muscle of the prostate, the urinary blockage can also be treated (Yu, et al., 2019). 
According to the given scenario, it can be seen that the patient has an emergency situation of the lower abdominal pain along with a urinary tract infection and benign prostatic hyperplasia. The observational data of the patient tells the critical condition of the health. The blood pressure (BP) of the patient is 106/54 mmHg that indicates a very lower level of BP. The resting heart rate and the body temperature and respiratory rate of the patient have been detected in a normal range. In the general observational phase, the patient has been marked with bradykinesia and a stooped posture while waking into the ward. As the patient has a medical history of Parkinson's disease, this current physical appearance of the patient is being considered as quite a sensitive issue. PSA level has been observed 10ng/ml. This indicates that there is a 25% chance that the patient is having prostate cancer (Vukovic, et al., 2017). Here in this case the diagnosis process is needed to be adopted after judging the overall physical situation of the patient. As the patient already had an issue of BPH and having a three months history of the digital rectal examination, hence it can be predicted that the urinary retention and risk of UTI may be caused by it. The enlargement of the prostate volume has been considered as age-related stuff nowadays (Trayssac, Hannun, & Obeid, 2018). The urinary retention can be considered as a life-threatening outcome of the BPH and this urinary retention is directly related to the prostate volume (De Nunzio, et al., 2020). Here the reduction of the prostate volume by using necessary inhibitors or any other way is the only way to reduce the risk of this urinary retention (Mendez, et al., 2020). 
Pharmacology and medication
The patient has been prescribed numerous numbers of medical instructions. The patient has been prescribed with the drug prazosin 1mg twice daily. This drug generally uses for regulating blood pressure apart from that this drug also belongs to the medication process of alpha-blockers (Assad Kahn, et al., 2016). It helps in relaxing the blood vessels as well as the prostate and neck muscles. Another drug that has been prescribed to the patient is selegiline 5mg twice daily. This drug generally increases the amount of dopamine in the brain and helps in controlling the symptoms of Parkinson’s disease (PD) (Chiriță, et al., 2019). Sinemet CR (25mg carbidopa / 100mg Levodopa) TDS is also being included in the medication chart of the patient. This drug also reduces the symptoms of Parkinson’s disease (Motz, et al., 2020). As the patient has already a history of Parkinson’s disease and currently a few symptoms are also being arisen in the patient’s physical activity hence those drugs are the best precautionary mechanism in this case (Edwards, et al., 2016).

NUM2409 Adult Health 2 – Assessment 2 Case study presentation Sem XXXXXXXXXXCase Study 1 – Benign prostatic hyperplasia (BPH) and Parkinson’s disease (PD) Presenting complaint. Peter Stacy aged 76...

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