Urinary frequency

Pertinent data
-28 y/o
-Female
-Married
-Does not smoke nor drink alcohol history
-Frequency of urination
-Nonhypertensive
-Not in cardiorespiratory
distress
-Afebrile
-Nonasthmatic
-Nondiabetic

*no other significant physical

examination findings
 Pregnancy (1 st trimester)
Female
28 y/o
Married
Frequency of urination
No abdominal
tenderness
 Any woman of reproductive age who presents with
symptoms, even if not directly related to the
abdomen, should be evaluated for pregnancy.

This is extremely important, because the diagnosis or

treatment of a woman's medical or surgical problem
may be deleterious to the developing fetus if she is
pregnant.

Many of the symptoms of pregnancy are nonspecific

and can be interpreted erroneously if the pregnancy
is not recognized.

*Swartzs Textbook of Physical Diagnosis, 4th ed

The most common symptoms of pregnancy are
the following:
Amenorrhea
Nausea
Breast changes
Heartburn
Backache
Abdominal enlargement
Quickening
Skin changes
Disturbances in urination
Vaginal discharge
Fatigue
 Time in
Explanation
pregnancy

-As a result of less space for the

bladder from pressure from the
growing uterus (1st trimester) or from
the descent of the fetal head (3rd
Urinary trimester), the woman needs to
frequency 1st/3rd trimesters empty her bladder more frequently.

-There is increased blood volume and

increased filtration rate in the
kidneys with increased urine
production.

Bates Guide to Physical Examination

Diagnosis
 Urine Pregnancy Test; Human
Chorionic Gonadotropin (hCG) Test
From the earliest stage of development, the placenta produces
hormones, either on its own or in conjunction with the fetus. The very
young placental trophoblast produces appreciable amounts of the
hormone human chorionic gonadotropin (hCG), which is excreted in
the urine. This hormone is not found in the urine of men or of normal,
young, nonpregnant women.
Increased urinary hCG levels form the basis of the tests for pregnancy;
hCG is present in blood and urine whenever there is living
chorionic/placental tissue. hCG is made up of a- and -subunits. The -
subunit is the most sensitive and specific test for early pregnancy. hCG
can be detected in the urine of pregnant women 26 to 36 days after the
first day of the last menstrual period (ie, 5 to 7 days after conception).
Pregnancy tests should return to negative 3 to 4 days after delivery.
 Ultrasound
Diagnosis and confirmation of early pregnancy.
The gestational sac can be visualized as early as
four and a half weeks of gestation and the yolk sac
at about five weeks. The embryo can be observed
and measured by about five and a half weeks.
Ultrasound can also very importantly confirm the
site of the pregnancy is within the cavity of the
uterus.
If pregnant evaluate for gestational DI
gestational DI A primary deficiency of
plasma AVP can also result from increased
metabolism by an N-terminal
aminopeptidase produced by the placenta.
The signs and symptoms manifest during
pregnancy and usually remit several weeks
after delivery.
 Gestational GI
Urine analysis for DI
Polyuria with normal BUN and creatinine
Decreased osmolality
Almost colorless in color