Nicole is a 55-year-old woman who presents with complaint of inability to hold urine. She describes incidents where laughing or coughing results in a small to moderate release of urine. She has started wearing Peri Pads to avoid embarrassment.
Past Medical History
• Six vaginal deliveries, all to full term
• Osteoarthritis
• Postmenopausal
Medications
• Boniva, 150 mg once a month
• Calcium, 500 mg daily
• Vitamin D3, one daily
Family History
• Mother, alive and well; hypertension, type 2 diabetes
• Father, deceased; cardiovascular disease, myocardial infarction at age 77
Social History
• No alcohol intake
• Previous smoker
• Walks 2 miles/day
Physical Examination
• Vital signs normal
• Palpation of uterus suggests enlargement
Labs
• Liver function: Normal
Discussion Questions
1. What factors in Nicole's history would help support a diagnosis of overactive bladder?
2. The clinician prescribes oxybutynin 10 mg (extended-release). What does Nicole need to know about this drug?
3. If oxybutynin is ineffective, the clinician could use mirabegron, a beta-3 agonist. What does Nicole need to know about this new drug?
Instructions:
APA 7th edition format
Use at least 2 evidenced-based, peer-reviewed references no older than 5 years.
Two paragraph, minimum 250 words.