MN566 Kaplan Unit 5 Urgency and Difficulty Urinating Patient Discussion

Mr. E.D. is a 63-year-old retired mail carrier who presents to his primary care provider for a routine follow up for his hypertension. He complains of a 4-day history of dysuria, increased urinary frequency, and nocturia. He states that he has been having fever and chills. Denies any recent sexual activity. On examination, his temperature is 99.5 F., pulse 75 and regular, respiratory rate 16 and unlabored, and blood pressure 135/85. He does not appear acutely ill and is in no apparent distress. Examination of the abdomen was normal. A digital rectal exam revealed a moderately enlarged, firm, non-tender prostate gland. He states that he has severe urgency and difficulty urinating.

  1. What are some appropriate questions to ask the patient?
  2. What are three differential diagnoses for the patient?
  3. What physical examination would you perform?
  4. What diagnostics would you include?
  5. Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.