Assessment

Q. Which of the following would you complete as part of John’s initial assessment?

Feedback if Yes is selected:

Establish if any previous bladder problems – as continence problem may not be new. John has not had any previous problems.

Establish previous bowel function – this gives the baseline of patients normal bowel habit. John has daily bowel movements and no problems with constipation.

Establish any previous investigation / treatments – this may give established diagnosis. John has previously had prostate exam and Prostate Specific Antigen (PSA) blood test. Both were negative.

Daily fluid intake – this identifies whether the patients is taking in too much or too little fluid. John’s intake has been between 1800 and 2500mls.

Type of fluid consumed – this may identify fluids which are stimulants/diuretic effect. John only drinks water & tea. Likes a bedtime drink of hot chocolate.

Current medications – as certain drugs may affect bladder/bowel function and may exacerbate previous  bladder/bowels problems. John’s medication is clopidogrel 75mgs, atorvastatin 40mgs, ramipril 2.5mgs.

Relevant contributing factors e.g. operations, past medical history – may give established diagnosis. John has no specific past medical history.

Feedback if No is selected:

Establish if any previous bladder problems – this is the wrong answer it is important to establish any previous history and whether bladder problems are new. John has not had any previous problems. These have been identified as new problems.

Establish previous bowel function – this is the wrong answer it is important to maintain previous bowel habit. John has daily bowel movements and no problems with constipation.

Establish any previous investigation / treatments – this is the wrong answer you may repeat tests unnecessarily or miss any previous diagnosis. John has previously had prostate exam Prostate Specific Antigen (PSA) blood test. Both were negative.

Daily fluid intake – this is he wrong answer you need to know if patient has adequate intake. John’s intake has been between 1800 and 2500mls.

Type of fluid consumed – this is the wrong answer because type of fluid can affect bladder function. John only drinks water & tea. Likes a bedtime drink of hot chocolate.

Current medications – this is the wrong answer as medication can affect bladder function. John’s medication is clopidogrel 75mgs, atorvastatin 80mgs, ramipril 2.5mgs.

Relevant contributing factors e.g. operations, past medical history – this is the wrong answer because you need to ascertain relevant history as may have impact on continence. John has no specific past medical history.