For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.
Case 1
Chief Complaint (CC)
“It burns when I urinate”
History of Present Illness (HPI)
A 68-year-old Caucasian male who reports to have increase on the frequency of urination with urgency for the last 5 days. He also present dysuria and nocturia.
PMH
Benning prostatic hyperplasia diagnosed 3 years ago, UTI 6 months ago, Lithotripsy left kidney 10 years ago. No issues after treatment
Drug Hx
Rosuvastatin 20 mg Olmesartan 20 mg
Subjective
Fever and chills, no changes in vision or hearing, no difficulty chewing or swallowing. No sexually active, nocturia, dysuria. Yellowish urethral secretion.
VS
B/P 150/96; Pulse 89; RR 16; Temp 99.4; Ht 6,1; wt 180;
General
well-developed male, no acute distress
HEENT
Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
Lungs
CTA AP