Gerontology Case

Full Answer Section

 

• Social history: I would want to know about the patient's living situation. Does he live alone? Does he have help with his activities of daily living? Does he have a history of falls?
• Relevant family history: I would want to know if there is a family history of urinary tract infections or other urological problems.

2. What additional objective data will you be assessing for? In addition to the vital signs that are already documented, I would want to assess the following:

• Mental status: I would want to assess the patient's level of consciousness and orientation. I would also want to perform a mini-mental status examination (MMSE) to get a more accurate assessment of his cognitive function.
• Urinary system: I would want to assess the patient's urine for color, clarity, and odor. I would also want to assess the patient for any signs of urinary tract infection, such as fever, flank pain, or cloudy urine.
• Skin: I would want to assess the patient's skin for any signs of infection, such as redness, swelling, or warmth.

3. What are the differential diagnoses that you are considering? The differential diagnoses that I am considering include:

• Urinary tract infection: This is the most likely diagnosis, given the patient's history of urinary tract infections and the presence of foul-smelling urine.
• Dehydration: The patient has been incontinent since his return from the hospital, which could lead to dehydration.
• Medication side effect: The patient is taking donepezil and memantine, which can both cause urinary incontinence.
• Infection of the skin: The patient has a history of falls, which could have led to an infection of the skin.

4. What laboratory tests will help you rule out some of the differential diagnoses? The following laboratory tests will help me rule out some of the differential diagnoses:

• Urinalysis: This test will help to determine if the patient has a urinary tract infection.
• Complete blood count (CBC): This test will help to rule out dehydration and infection of the skin.
• Blood cultures: This test will help to rule out a systemic infection.

Sample Solution

 

• Past medical history: I would want to know more about the patient's history of urinary tract infections. What were the symptoms? How were they treated? Were there any complications?
• Social history: I would want to know about the patient's living situation. Does he live alone? Does he have help with his activities of daily living? Does he have a history of falls?