Patient PAS

83 years old, MALE

Diagnosis: Urinary Bladder Malignancy; Benign Prostatic Hyperplasia; Hypertensive Cardiovascular Disease; Diabetes Mellitus Type 2, Hypertension stage 2 – Uncontrolled. Schedule for
Cystoscopy; Transurethral Resection of the Bladder Tumor and Transurethral Incision of the prostate.

Predisposing factors:
- Age: 83 years old Precipitating Factors:
- Gender: male - Lifestyle (smoker for 67 years, diet,
sedentary lifestyle)
- Race: Asian
- Non-compliant to medications
- Diabetes Miletus type II
- Hypertensive Cardiovascular Disease
- Hypertension Type II - Uncontrolled

DIABETES MELLITUS (Type 2)

Increase viscosity of blood

Insulin resistance

• Lifestyle change Capillary basement

Exhaustion of beta cells
• Take medications as
prescribed
• Restricting sodium &
Decreased insulin production fat intake
• Increase fluid intake
• Exercise appropriate
Absorption of glucose by cell for pt’s age.
Thickening of blood vessel
membrane thickening
Occlusion of plaque
Abnormal retinal
vascular permeability
BP: 150/100 mmHg Increased blood pressure

scarring
Cell starvation HYPERTENSION TYPE Hypertension ---- STROKE
2 - UNCONTROLLED
Retinopathy
Stimulation of hunger via hypothalamus Cholesterol: Changes on left ventricle,
5.72mmol/L left atrium, coronary arteries
Cataract surgery in 2009
POLYPHAGIA • Ate chocolates almost
every meal. Increased cardiac workload
• Non-compliance to
mediations
Hypertrophy of the left ventricle ---- HEART FAILURE

Color flow
HYPERGLYCEMIA Glycosylated Hgb: 7.9% doppler study HYPERTENSIVE CARDIOVASCULAR DISEASE
 -------------------------------

----
Nerve demyelination Capillary basement Kidney filtration mechanism
membrane impaired
---- Pain & swelling in lower thickening

----
extremities
Neuropathy
GLYCOSURIA
Diffuse glomerular

----
Uric acid: 583 umol/L RENAL FAILURE Neuropathy sclerosis

Acidity of urine

POLYURIA
BENIGN
Ultrasound of the prostate Bladder outlet obstruction PROSTATIC
HYPERPLASIA

Detrusor response Lower urinary tract Urinary frequency (nocturia)

symptoms

Hgb: 8.30g/dL Primary bladder disease Incomplete emptying of

bladder

Sedentary lifestyle
URINARY BLADDER
Smoker for 67 years Urine accumulation
MALIGNANCY
Non-compliant to meds

• Cystoscopy
Distended bladder • Transurethral resection
RR: 28 bpm of the bladder tumor
O2sat: 96% HEMATURIA
(+) wheezing (chief complaint)
(+) dyspnea upon exertion Increased bladder pressure

Chest x-ray RBC: 2. 92L

Hct: 33.40% Urine goes back up to Transurethral incision of the
ureters, then kidneys prostate
LEGEND

Predisposing Factors

Precipitating Factors

Comorbidity

Actual disease process

Main disease

Risk factors

Laboratory results

Surgical interventions

Nursing interventions

Non-surgical interventions

Signs & symptoms

Assessment

--------------- Possible disease process