1. Clinical Case Study Presentation Sarah Maxwell

2. Situation 66 yr old male CC: generalized weakness leg pain orbital eye pain Patient brought to ER by wife. Admitting Dx: Anemia Prostate Cancer

3. Background Pt goes to Riverside for cancer treatment No known allergies Hx: Hyperlipidemia, 2010 prostate biopsy negative (although dx with metastatic prostate cancer sometime b/w 2010-2012.) 2012 biopsy of bone lesion showing metastatic adenocarcinoma. Previous surgery: vasectomy, left shoulder surgery, wrist surgery, colonoscopy.

4. Nursing Assessment urinary system. Pt on CBI- 3000 ml every hour. Pt still “clots off.” Urine “watermelon colored” Wife asks for palliative care consult as doesn’t think her husband can take much more. Rest of Physical exam un-noteworthy

5. Diagnostic Assessment Barrett’s Esophagus Esophageal ulcers 6mm-2.5cm in size from 26-35 cm Liver Lesions Sigmoid diverticula Bladder mass 4.9X 3.8 cm

6. Recommendation Speak to the doctor about determining level of metastasis Consulting Palliative Care Calling patient’s urologist to discuss bladder urinary clotting situation. Calling Riverside Hospital (Patient’s urologist) to discuss possible transfer Pain Management!!!!