Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN: 9781451194524
Author: Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher: JONES+BARTLETT PUBLISHERS, INC.
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Question
What was the route of approach for the prostate ultrasound?
## Patient Case Summary for Educational Purposes ### Case Overview: The patient tolerated the procedure well. On postoperative day #2, the patient developed nausea and vomiting, which was likely due to a postoperative paralytic ileus. The patient was treated conservatively with a nasogastric tube to address low concomitant suction. During the hospitalization, the patient also underwent a transrectal ultrasound of the prostate with biopsy. Operative report revealed that the seminal vesicles were not dilated and the prostatic capsule was intact. Biopsy results were positive for adenocarcinoma of the prostate. ### Planned and Follow-Up Care: The patient is to be scheduled for Transurethral Resection of the Prostate (TURP) on a subsequent admission. The patient was treated with intravenous Levaquin for a urinary tract infection (UTI). The patient’s ileus resolved and he was discharged on postoperative day #5 with plans for outpatient follow-up. The prognosis for the patient is favorable. ### Discharge Diagnoses: - Cholelithiasis/Cholecystitis - Paralytic Ileus - Adenocarcinoma of the Prostate/Gleason’s Grade 3 - Chronic Kidney Disease - Osteoarthritis - Gastroesophageal Reflux Disease (GERD) - Peptic Ulcer Disease (PUD) - Contact Dermatitis - Status Post Total Knee Replacement (TKR) - Urinary Tract Infection (UTI) ### Discharge Medications: - Zofran - Zantac - Levaquin - Tylenol #3 - Dulcolax - Flomax
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Transcribed Image Text:## Patient Case Summary for Educational Purposes ### Case Overview: The patient tolerated the procedure well. On postoperative day #2, the patient developed nausea and vomiting, which was likely due to a postoperative paralytic ileus. The patient was treated conservatively with a nasogastric tube to address low concomitant suction. During the hospitalization, the patient also underwent a transrectal ultrasound of the prostate with biopsy. Operative report revealed that the seminal vesicles were not dilated and the prostatic capsule was intact. Biopsy results were positive for adenocarcinoma of the prostate. ### Planned and Follow-Up Care: The patient is to be scheduled for Transurethral Resection of the Prostate (TURP) on a subsequent admission. The patient was treated with intravenous Levaquin for a urinary tract infection (UTI). The patient’s ileus resolved and he was discharged on postoperative day #5 with plans for outpatient follow-up. The prognosis for the patient is favorable. ### Discharge Diagnoses: - Cholelithiasis/Cholecystitis - Paralytic Ileus - Adenocarcinoma of the Prostate/Gleason’s Grade 3 - Chronic Kidney Disease - Osteoarthritis - Gastroesophageal Reflux Disease (GERD) - Peptic Ulcer Disease (PUD) - Contact Dermatitis - Status Post Total Knee Replacement (TKR) - Urinary Tract Infection (UTI) ### Discharge Medications: - Zofran - Zantac - Levaquin - Tylenol #3 - Dulcolax - Flomax
**Case Study: Medical Admission and Treatment** **Admitted:** 11/1/19 **Discharged:** 11/12/19 --- ### Chief Complaint: This 66-year-old male was admitted for nausea, vomiting, and anorexia of three days' duration. The patient also complained of recent right upper quadrant (RUQ) pain and pyrosis after heavy meals. This is the second hospital admission for this patient, who has a known history of chronic kidney disease, hypertension, osteoarthritis, asthma, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD) with prior hemorrhage, and bilateral total knee replacement. Prior to admission, the patient had been drinking heavily as he had in the past, and he had tremors. He sleeps on two pillows and has dyspnea after climbing one flight of stairs. He denied recent colds, upper respiratory infections, hematemesis, or diarrhea. The patient complained of some urinary frequency and urgency. There was a rash noted on the forearms, which the patient had been treating with Benadryl cream. ### Physical Examination: The patient was in some distress on examination. Examination of the head revealed pupils and eye movements to be within normal limits. The chest was clear, and the heart rate was normal. The blood pressure was elevated at 200/120. Temperature was slightly elevated at 100.6°F. Pulse was 72 and respirations were 16. Examination of the abdomen revealed some distention with pain in the RUQ. The rectal examination revealed an enlarged prostate of two to three times the normal size. Occult blood was negative. The rest of the exam was within normal limits. ### Laboratory Studies: Admission blood tests revealed an elevated white blood cell count as well as elevated serum bilirubin. Urinalysis showed albuminuria, the presence of bacteria, too numerous to count (TNTC) white cells and pus. Sonography and HIDA scan revealed cholelithiasis. Prostate-specific antigen (PSA) was 19.8 ng/mL. ### Impression: - Cholelithiasis/cholecystitis. - Enlarged prostate with elevated PSA, possible benign prostatic hyperplasia (BPH), rule out tumor. - Consider esophagogastroduodenoscopy (EGD) due to history of GERD and PUD. ### Hospital Course: The patient was diagnosed with cholelithiasis/chole
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Transcribed Image Text:**Case Study: Medical Admission and Treatment** **Admitted:** 11/1/19 **Discharged:** 11/12/19 --- ### Chief Complaint: This 66-year-old male was admitted for nausea, vomiting, and anorexia of three days' duration. The patient also complained of recent right upper quadrant (RUQ) pain and pyrosis after heavy meals. This is the second hospital admission for this patient, who has a known history of chronic kidney disease, hypertension, osteoarthritis, asthma, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD) with prior hemorrhage, and bilateral total knee replacement. Prior to admission, the patient had been drinking heavily as he had in the past, and he had tremors. He sleeps on two pillows and has dyspnea after climbing one flight of stairs. He denied recent colds, upper respiratory infections, hematemesis, or diarrhea. The patient complained of some urinary frequency and urgency. There was a rash noted on the forearms, which the patient had been treating with Benadryl cream. ### Physical Examination: The patient was in some distress on examination. Examination of the head revealed pupils and eye movements to be within normal limits. The chest was clear, and the heart rate was normal. The blood pressure was elevated at 200/120. Temperature was slightly elevated at 100.6°F. Pulse was 72 and respirations were 16. Examination of the abdomen revealed some distention with pain in the RUQ. The rectal examination revealed an enlarged prostate of two to three times the normal size. Occult blood was negative. The rest of the exam was within normal limits. ### Laboratory Studies: Admission blood tests revealed an elevated white blood cell count as well as elevated serum bilirubin. Urinalysis showed albuminuria, the presence of bacteria, too numerous to count (TNTC) white cells and pus. Sonography and HIDA scan revealed cholelithiasis. Prostate-specific antigen (PSA) was 19.8 ng/mL. ### Impression: - Cholelithiasis/cholecystitis. - Enlarged prostate with elevated PSA, possible benign prostatic hyperplasia (BPH), rule out tumor. - Consider esophagogastroduodenoscopy (EGD) due to history of GERD and PUD. ### Hospital Course: The patient was diagnosed with cholelithiasis/chole
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