Key points
Hurts when I pee
Burning when urinating
Consistent Moderate Pain and discomfort when urinating.
Abdominal cramps
Mild abdominal pain. Pain is always there since it started. Worst when peeing.
Frequency of urination. Goes 2-3 times per hour.
Can’t completely empty bladder.
Symptoms started 3 days ago.
Came from I trip, and sex with BF.
Sexually active with 1 BF
BF always use condoms.
No allergies.
PMH– started periods around 13, LMP 1 week ago.
On birth control to regulate cycles, mild cramping the first 2 days of her cycles, no spotting, light cycles without clots or heavy flow.
No hospitalization/ surgeries
Medication – Eithinyl estridiol/ norgestimate 0.035/0.25 mg 1 tab PO daily.
Allergies – NKDA
Preventive care- last checkup – 1 year. Recently saw dentist, no caries.
Up to date on vaccines.
Family history
Father (42) – smoker
Mother (44) type 2 Diabetes.
Maternal grandmother (age 74) –HTN, hyperlipidemia.
Maternal grandfather (76) –goat, hyperlipidemia
Parental grandmother (deceased at age 62 from MI
Parental grandfather (73) – Hyperlipidemia, sciatica
Social history
Tobacco- denies personal use. Report smoke exposure from father.
Alcohol- occasionally at parties with friends, has 2-12oz wine color per party, CAGE0/4.
Drugs – Denies.
Diet – healthy meals at home with veggies, fruits, lean meat.
Tends to eat fast food on weaken dafter school or practice.
Activity: cheerleading practice most days of the week.
Sleep – 7-8 hours nightly between 10 pm and 6 am, sleeps in on weekends, no change with recent popularity.
Stressors – repots adjusting to new popularity, talks with friends with parents about changes and it helps.
Living situation/Housing: lives in a 2 story with her mom and dad, parents work long hours, only child.
Support system: Parents, friends, local family.
Occupation/education: still doing well in school, keeping pace with staying, loves to read classic books.
Safety: does not drink or text and drink. Wear seat belt.
Sexual history: identify as a woman. Recently become active with BF. Vaginal and oral intercourse.
When did the pee start?
I have had
burning when I pee and. i feel like always need to pee. My pee also smells strong.
Do you have pain/discomfort when you urinate?
yup
when did you have pain/discomfort when you urinate start?
Well, it really got going about 3 days ago. that was about a day after we got back from a group trip with friends for the weekend. My boyfriend and I went, and we were really excited about it. It happened to be our Zone-year anniversary, and it just felt special to get out of town with our friends while we celebrated.
Does anything make your pain/discomfort with urinary better or worse?
Not really
How severe is your pain/discomfort with urination?
Moderate, I guess. Enough I don’t want to have pee so much.
Does your pain/discomfort with urination come and go?
It had been there since it started.
How long does your urination pain/discomfort last?
As long as I pee.
Feels crampy.
When did the difficulty urinating start?
I can go fine. It just hurt.
is the amount of urine more or less that usual?
It is same amount; I just need to pee more often.
When you urinate do you feel that you cannot completely empty your bladder?
Yes, I have noticed that lately.it feels like I even need to go even after I have just finished. It’s pretty frustrating.
When you pee is the stream or flow of urine weak or do you dribble?
Not really.
Does anything make your urination difficulty better or worse?
It’s more like it hurts to pee. I can go just fine.
How severe is your difficulty urinating?
It’s more like it hurts to pee, not like I can’t go.
Does your difficulty urinating come and go?
It hurts to pee, but I wouldn’t say I have a hard time going.
What are the events surroundings the start of your difficulty urinating?
It’s more like it hurts to pee, not like I can’t go.
What treatments have you had for your urinating difficulty?
I haven’t had to anything for that.
When did the pee start?
I have had brining when I pee and. i feel like always need to pee. My pee also smells strong.
Do you have pain/discomfort when you urinate?
yup
when did you have pain/discomfort when you urinate start?
Well, it really got going about 3 days ago. that was about a day after we got back from a group trip with friends for the weekend. My boyfriend and I went, and we were really excited about it. It happened to be our Zone-year anniversary, and it just felt special to get out of town with our friends while we celebrated.
Does anything make your pain/discomfort with urinary better or worse?
Not really
How severe is your pain/discomfort with urination?
Moderate, I guess. Enough I don’t want to have pee so much.
Does your pain/discomfort with urination come and go?
It had been there since it started.
How long does your urination pain/discomfort last?
As long as I pee.
Feels crampy.
When did the difficulty urinating start?
I can go fine. It just hurt.
is the amount of urine more or less that usual?
It is same amount; I just need to pee more often.
When you urinate do you feel that you cannot completely empty your bladder?
Yes, I have noticed that lately.it feels like I even need to go even after I have just finished. Its pretty frustrating.
When you pee is the stream or flow of urine weak or do you dribble?
Not really.
Does anything make your urination difficulty better or worse?
Its more like it hurts to pee. I can go just fine.
How severe is your difficulty urinating?
Its more like it hurts to pee,not like I can’t go.
Does your difficulty urinating come and go?
It hurts to pee,but I wouldn’t say I have a hard time going.
What are the events surroundings start of your difficulty urinating?
It’s more like it hurts to pee, not like I can’t go.
What treatments have you had for your urinating difficulty?
I haven’t had to anything for that.
Allergies – no
