Assignment task: Patient-Centered Care; Evidence-Based Practice
The patient is a 45-year-old woman who reports leakage of urine when she sneezes, coughs, and laughs. She states that the problem started several years ago and it occurred only a once or twice a month but now it occurs almost daily. She is able to drive and does not have any motor or sensory dysfunctions; however, she is embarrassed and now is afraid to go anywhere in case she "wets her pants". She states that the problem is because she is getting older and asks how other woman her age handle the leakage. She currently works at home and seldom goes to church or out with her spouse because of the urine leakage. Currently, the client reports using toilet paper in her undergarments so no one will find out she has a problem with urine leakage. Client history includes seasonal allergies, vaginal deliveries of three full-term infants and type II diabetes mellitus.
Q1. What assessment information in this client situation is the most important and immediate concern for the nurse? (Hint: Identify the relevant information first to determine what is most important.)
Q2. What client conditions are consistent with the most relevant information? (Hint: Think about priority collaborative problems that support and contradict the information presented in this situation.)
Q3. Which possibilities or explanations are most likely to be present in this client situation? Which possibilities or explanations are the most serious? (Hint: Consider all possibilities and determine their urgency and risk for this client.)
Q4. What actions would most likely achieve the desired outcomes for this client?
Q5. Which actions are the most appropriate and how should they be implemented? In what priority order should they be implemented? (Hint: Consider health teaching, documentation, requested health care provider orders or prescriptions, nursing skills, collaboration with or referral to health team members, etc.)