Module 7 Assignment: Case Study
Instructions
This assignment addresses the course outcome:
- Describe the diagnostics for and laboratory values monitored in the management of urinary disorders.
Scenario
Read the brief nursing scenario and answer the questions:
Setting: Medical-surgical unit, late afternoon shift.
Patient: Mr. Thompson, a 68-year-old male admitted earlier in the day with complaints of lower abdominal discomfort and difficulty urinating. His history includes benign prostatic hyperplasia (BPH), hypertension, and occasional non-compliance with medications.
Nurse-Patient Interaction:
- Nurse: “Mr. Thompson, I understand you haven’t been able to fully empty your bladder today. I’d like to perform a bladder scan to check how much urine is being retained.”
- Mr. Thompson (irritated): “I don’t need another scan. I just need to go home and relax. You people are making a big deal out of nothing. I’m fine.”
- Nurse: “I understand that this hospital stay is frustrating, but I’m concerned that your bladder may be overfilled, which can lead to more serious complications, like infection or kidney damage. The scan is painless and will only take a few minutes.”
- Mr. Thompson (crossing arms): “All this poking and prodding isn’t helping. I’m not letting anyone stick anything in me either.”
- Nurse: “That’s completely understandable—no one will do anything without your consent. Right now, we’re only talking about the scan. If we find a lot of urine is still in your bladder, we can then talk about the safest way to help relieve that pressure. Can we try the scan first and take it from there?”
- Mr. Thompson (reluctantly): “Fine. But no catheter unless I say so.”
- Nurse: “Absolutely. Let’s just start with the scan and keep you comfortable.”
Questions
- What strategies did the nurse use to build trust and reduce the patient’s resistance? What else could have been done to promote cooperation?
- If the bladder scan shows a post-void residual volume of 475 mL, what would be your next steps? How would you explain the clinical risk to Mr. Thompson in a way that promotes informed consent?
- If Mr. Thompson declines next steps, what are the risks of delaying or refusing intervention for urinary retention? How would you communicate these?
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