NU 627-unit 9 discussion Sexuality and the Geriatric Client
NU 627 Geriatric Healthcare
Unit 9 Discussion
Sexuality and the Geriatric Client
Natasha Schlumbrecht
Pertinenet Positives
CC: “I am having burning with urination.”
• HPI: T.B. 82 y.o. M reports that he noticed burning with urination started more than a
week ago.
• reports urgency with urination. Drinking lots of fluids without relief.
• Oxycodone is not helping with pain
• PMH: spondylosis of the lumbosacral region
• He is se xually active with 1 partner for the last year . Does not use condoms. He drinks 2
3 cups of caffeine per day.
ROS
• GU: Patient report s burning with urination and urgency started more than one week ago.
Pertinenet Negatives
• his stream is not affected
• denies abdominal or flank pain. Denies fever, chills, lesions, hematuria or penile
discharge. He has never had a urinary tract infection.
• PMH: Chronic pain syndrome and hypertension. Last colonoscopy was approximately 10
years ago per patient.
• Medications: Oxycodone HCl 20 mg tablet; PO every 6 hours for pain, Atenolol 50 mg
PO daily, Colace 100 mg capsule BID PO.
• Social History : He resides in an apartment for 50+. He is a non smoker and denies
recreational drug use. He walks 30 minutes per day for exercise.
• Family History: Mother: deceased, HTN, smoker, CAD. Father: unknown history.
• Health Maintenance/Promo tion : Influenza, TDaP, Hep A, shingrix vaccine up to date.
ROS:
General: Patient denies fever, chills, malaise, weight loss.
Skin: Patient denies any recent rash, abnormal skin lesions, or open wounds.
Neck: Patient denies neck stiffness or pain.
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HEEN T: He denies any visual changes, ear pain or drainage, denies hearing loss, denies sore
throat or nasal drainage. He reports last eye examination last Summer with minor changes to
his vision.
CV: Patient denies chest pain, chest tightness, heart palpitations or irregular heartbeats. He
denies any swelling in lower extremities. He denies dizziness, syncope, or lightheadedness.
Lungs: Patient denies any shortness of breath at rest or with exertion. He denies a cough. He
denies wheezing or difficult y catching breath with exercise.
GI: He denies abdominal pain, change in bowel habits, or noticing bloody or black colored
stools. He denies constipation with long term opioid use. He reports that he has a bowel
movement every morning.
GU: denies penile discharge or blood in urine. He denies flank pain. He denies incontinence,
straining or dribbling urine. He denies splitting or spraying during urination. He denies inter
mittent urinary stream and feels like he is emptying his bladder. MSK: Patient denies muscle
pain or aches.
Neuro: Patient reports chronic pain is managed well with oxycodone that is prescribed by
pain management. He denies any numbness or tingling, loss of coordination or balance. He
denies any recent falls. He denies blurred or double vision.
Psych: He denies little interest of pleasure in doing things and denies feeling down,
depressed, or hopeless.
Objective
VS: Temp: 98.8 F, BP: 122/81 mm Hg, HR: 5 6 BPM, RR: 18, Oxygen saturation: 98% on
Room Air, Ht: 69 in, Wt.: 200 lbs., BMI: 29.53 Index.
General: Patient appears in no acute distress, well developed, well nourished.
Skin: Skin is without redness, rash, or lesions.
Head: Normocephalic.
Neck: Neck supple; thyroid gland without enlargement.
ENT: Both eyes, fundus normal. Ears: auditory canal intact and clear; tympanic membrane
appears pearly grey. Oral mucosa pink and moist; throat without redness or exudate.
CV: Regular rate and rhythm, normal S1 S2 without murmurs or clicks. No evidence of
swelling in lower extremities. Radial and pedal pulses 2+.
Lungs: Breath sounds clear on auscultation bilaterally. Chest expansion symmetrical without
any evidence of respiratory distress. No wheezes, rhonchi, or rales heard on auscultation.
Abd: Bowel sounds present in all quadrants. Abdomen soft, non tender, and non distended.
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