ASSIGNMENT # 1-Week 5 Discussion
MP is a 55-year-old woman who presents with complaint of inability to hold urine. She describes incidents where laughing or coughing results in a small to moderate release of urine. She has started wearing Peri Pads to avoid embarrassment.
Past Medical History
• Six vaginal deliveries, all to full term
• Osteoarthritis
• Postmenopausal
Medications
• Boniva, 150 mg once a month
• Calcium, 500 mg daily
• Vitamin D3, one daily
Family History
• Mother, alive and well; hypertension, type 2 diabetes
• Father, deceased; cardiovascular disease, myocardial infarction at age 77
Social History
• No alcohol intake
• Previous smoker
• Walks 2 miles/day
Physical Examination
• Vital signs normal
• Palpation of uterus suggests enlargement
Labs
• Liver function: Normal
Discussion Questions
1. What factors in MP’s history would help support a diagnosis of overactive bladder?
2. The clinician prescribes oxybutynin 10 mg (extended-release). What does MP need to know about this drug?
3. If oxybutynin is ineffective, the clinician could use mirabegron, a beta-3 agonist. What does MP need to know about this new drug?
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1 PAGE FOR ASSIGNMENT # 1
ASSIGNMENT # 2 CASE STUDY
Use APA 7th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers. All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 3 pages, excluding cover page and reference page.
Patient With Sudden Onset of Intermittent Mid-Epigastric Pain
PR is a 35-year-old female who presents with a sudden onset of intermittent mid-epigastric pain that started 4 weeks ago. Pain is 6/10 on the pain scale and described as burning that worsens after she eats Mexican food and when she is lying down. She has never experienced this before. PR reports that she has been taking over the counter (OTC) antacids that seemed to help at first, but now they provide no relief. She reports associated regurgitation and feeling of fullness all the time and this morning she had a sore throat.
Past Medical History
• Anaphylactic reaction to penicillin Medications
• OTC antacids
Family History
• Noncontributory
Social History
• Occupation: Elementary school teacher (10 years)
• Nonsmoker
• Denies illicit drug use
• Consumes wine two to three times per month •
Regular exercise
Physical Examination
• Weight: 145 lbs.; blood pressure: 128/72; pulse: 80; respiration rate: 18; temperature: 98.7 °F
• General: Calm, cooperative, in no apparent distress
• Eyes: Pupils equal, round, reactive to light
• Ears: Tympanic membranes clear
• Nares: Without nasal septal deviation; pharyngeal mucosa pink and moist
• Throat: Oropharynx without edema, erythema, tonsillar enlargement, lesions
• Abdomen: Nondistended, soft, round, nontender; normoactive bowel sounds in all quadrants
Discussion Questions
1. What are the top three differential diagnoses for PR?
2. What diagnostic tests, if any, are required for PR?
3. What pharmacological, nonpharmacological, and/or nutraceutical therapies should be prescribed for PR?
4. The results from PR’s H. pylori test returned positive. What treatment should be added to her plan of care?
2 PAGES FOR ASSIGNMENT # 2
NO PLAGIARISM, EACH ANSWER NEED TO BE IN A DIFFERENT WORD DOCUMENT
CHECK PROPER GRAMMAR AND APA 7TH EDITION
DUE DATE 1/27/2023
