Secondary diagnosis:

Apart from the primary diagnosis that was the excessive weight gain and extreme fatigue, she also mentioned that she feels that her bladder has fallen because of frequent urination. She wakeups twice at night and urinates more frequently at day time and this too has beenhappening for more than 3 months.

Prolapse bladder:

Pathophysiology statement:

Bladder is a hollow organ that stores urine in the pelvis.When the bladder is filled with urine, it creates pressure that creates the desire to urinate. In case of women, bladder is supported by the front wall of vagina that becomes weak and damaged with age, childbirth and if further weakened it can prolapse and will be no longer supportive and will fall into the vagina and will lead to various difficulties.(prolapsed bladder, 2017).

(, 2018 ICD-10-CM Diagnosis Code N81.2, 2018)

Signs and symptoms:

The symptoms that lead to prolapsed bladder are:

  • Unrationing frequently
  • Feeling the presence of tissue in vagina.
  • Pain and feeling uncomfortable in the pelvis

Rational statement:

There are many factors associated with the fallen bladder but the most common factor linked with it is the menopause. Women bodies tend to create the hormone known as estrogen prior to menopause. When menopause occurs their bodies stop creating the required amount of estrogen to prevent the bladder to prolapse and as a result, the muscles weaken, causing the bladder to fall.


Pathophysiology statement:

Polycystic ovary syndrome is a hormonal issue, ordinary among the middle age women. Women having PCOS, will affect their menstrual cycle. It is caused due to the collection of small follicles around ovaries making it difficult to release eggs due to hoist androgens in females.(PCOS, 2017)

(, 2018 ICD-10-CM Diagnosis Code E28.2, 2018)

Signs and symptoms:

  • Irregular periods
  • Menopause
  • Polycystic ovaries

Rational statement:

The cause of PCOS is due to numerous factors. Excessive insulin is one of the primary causes.Resistance in the production of insulin can increase the blood sugar level of the body, making you feel low and tired. It can cause level 2 diabetes, depression and eating disorder.(staff, 2018)

Differential diagnosis:

·         Urinating often.

·         Feeling very thirsty.

·         Feeling very hungry

·         Extreme fatigue.

·         Blurry vision.

·         Cuts/bruises slow to heal.

Promote hypothyroidism, which can cause weight gain.

Weight gain


Breath issues

Increase in blood sugar levels

Change in appetite

Vision changes




Lab Test:

Before going to declare a specific disease, there is a dire need to take a closer look over the lab test of the Hispanic lady, which would assist in drawing a conclusion;

  1. The blood of the women contains 6000/mm3, which ranges between the normal numbers of white blood cells in the blood.
  2. As Mrs. R is middle aged women, her hemoglobin level is 12.5 gm/dl which ranges between 11.7 to 13.8 gm/Dl.
  3. The HCT of the older adult i.e. Mrs. R is 41% which is considered normal hematocrit based on her age.
  4. Her red blood cell count is also normal as it ranges between 4.7 and 6.1 million cells…………….

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