Homework Help is Here – Start Your Trial Now!
Science
Nursing
What is the significance of an elevated PSA?

What is the significance of an elevated PSA?

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
See similar textbooks
icon
Related questions
Question
What is the significance of an elevated PSA?
**Case Study: Admission and Discharge Summary** **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 66-year-old male patient with 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 had tremors prior to admission. 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 200/102. Temperature was slightly elevated at 100.6. 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 an 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. PSA (Prostate-Specific Antigen) was 19.8. **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:**
Transcribed Image Text:**Case Study: Admission and Discharge Summary** **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 66-year-old male patient with 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 had tremors prior to admission. 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 200/102. Temperature was slightly elevated at 100.6. 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 an 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. PSA (Prostate-Specific Antigen) was 19.8. **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:**
### Medical Case Study: Postoperative Management and Discharge Summary #### Patient Overview: The patient underwent a procedure and tolerated it well initially. However, on postoperative (post-op) day 2, the patient developed nausea and vomiting, which were likely due to a postoperative paralytic ileus. The treatment protocol included conservative management with a nasogastric tube to address the low concomitant suction. #### Diagnostic Interventions: During the hospital stay, the patient underwent transrectal ultrasound of the prostate with a biopsy. The operative report revealed that the seminal vesicles were not dilated and the prostatic capsule remained intact. Following the biopsy, results indicated the presence of adenocarcinoma of the prostate. #### Follow-up Procedures: The patient is scheduled for Transurethral Resection of the Prostate (TURP) on a subsequent admission and has been treated with intravenous (IV) Levaquin for a diagnosed Urinary Tract Infection (UTI). The patient’s ileus resolved, and they were discharged on postoperative day 5 with a favorable prognosis. #### 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 (Ondansetron) - Zantac (Ranitidine) - Levaquin (Levofloxacin) - Tylenol #3 (Acetaminophen and Codeine) - Dulcolax (Bisacodyl) - Flomax (Tamsulosin) This case study highlights the importance of postoperative care and timely intervention in resolving complications such as paralytic ileus and managing infections to ensure favorable outcomes for patients with complex medical histories.
Transcribed Image Text:### Medical Case Study: Postoperative Management and Discharge Summary #### Patient Overview: The patient underwent a procedure and tolerated it well initially. However, on postoperative (post-op) day 2, the patient developed nausea and vomiting, which were likely due to a postoperative paralytic ileus. The treatment protocol included conservative management with a nasogastric tube to address the low concomitant suction. #### Diagnostic Interventions: During the hospital stay, the patient underwent transrectal ultrasound of the prostate with a biopsy. The operative report revealed that the seminal vesicles were not dilated and the prostatic capsule remained intact. Following the biopsy, results indicated the presence of adenocarcinoma of the prostate. #### Follow-up Procedures: The patient is scheduled for Transurethral Resection of the Prostate (TURP) on a subsequent admission and has been treated with intravenous (IV) Levaquin for a diagnosed Urinary Tract Infection (UTI). The patient’s ileus resolved, and they were discharged on postoperative day 5 with a favorable prognosis. #### 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 (Ondansetron) - Zantac (Ranitidine) - Levaquin (Levofloxacin) - Tylenol #3 (Acetaminophen and Codeine) - Dulcolax (Bisacodyl) - Flomax (Tamsulosin) This case study highlights the importance of postoperative care and timely intervention in resolving complications such as paralytic ileus and managing infections to ensure favorable outcomes for patients with complex medical histories.
Expert Solution
trending now

Trending now

This is a popular solution!

steps

Step by step

Solved in 2 steps

SEE SOLUTIONCheck out a sample Q&A here
Blurred answer
Knowledge Booster
Acids and Bases
Learn more about
Need a deep-dive on the concept behind this application? Look no further. Learn more about this topic, nursing and related others by exploring similar questions and additional content below.
Recommended textbooks for you
Phlebotomy Essentials
Phlebotomy Essentials
Nursing
ISBN:
9781451194524
Author:
Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:
JONES+BARTLETT PUBLISHERS, INC.
Gould's Pathophysiology for the Health Profession…
Gould's Pathophysiology for the Health Profession…
Nursing
ISBN:
9780323414425
Author:
Robert J Hubert BS
Publisher:
Saunders
Fundamentals Of Nursing
Fundamentals Of Nursing
Nursing
ISBN:
9781496362179
Author:
Taylor, Carol (carol R.), LYNN, Pamela (pamela Barbara), Bartlett, Jennifer L.
Publisher:
Wolters Kluwer,
Fundamentals of Nursing, 9e
Fundamentals of Nursing, 9e
Nursing
ISBN:
9780323327404
Author:
Patricia A. Potter RN MSN PhD FAAN, Anne Griffin Perry RN EdD FAAN, Patricia Stockert RN BSN MS PhD, Amy Hall RN BSN MS PhD CNE
Publisher:
Elsevier Science
Study Guide for Gould's Pathophysiology for the H…
Study Guide for Gould's Pathophysiology for the H…
Nursing
ISBN:
9780323414142
Author:
Hubert BS, Robert J; VanMeter PhD, Karin C.
Publisher:
Saunders
Issues and Ethics in the Helping Professions (Min…
Issues and Ethics in the Helping Professions (Min…
Nursing
ISBN:
9781337406291
Author:
Gerald Corey, Marianne Schneider Corey, Cindy Corey
Publisher:
Cengage Learning
SEE MORE TEXTBOOKS