40 years old lady has increased frequency of urine in night. What does it indicate?

NCL (MP) Nursing Officer - 2020

Medical Surgical Nursing

Medium

Appeared in: NCL (MP) Nursing Officer - 2020

Explanation

The patient's symptom of increased urinary frequency at night is clinically termed nocturia.
In diabetes mellitus, high blood glucose levels exceed the kidney's threshold for reabsorption, leading to glucose in the urine (glucosuria).
This glucosuria causes osmotic diuresis, where excess glucose pulls water into the urine, increasing the total urine volume (polyuria).
Polyuria is a hallmark symptom of uncontrolled diabetes and manifests as both daytime frequency and nighttime urination (nocturia).

Option B: Prostatitis is an inflammation of the prostate gland, an organ exclusive to the male anatomy. The patient is female.
Option C: While severe liver disease (like cirrhosis) can cause systemic fluid shifts and affect kidney function, it is not a primary or common cause of isolated nocturia.
Option D: This option is incorrect because a very strong and common cause for the patient's symptom (diabetes mellitus) is provided as a choice.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nocturia as a clinical manifestation of Diabetes Mellitus as background academic context rather than a clinical decision trigger.
A nurse encountering a patient with new-onset nocturia should consider it a significant finding and initiate further assessment. Key nursing actions include screening for diabetes (blood glucose check), inquiring about other symptoms (thirst, hunger, weight loss), and assessing for urinary tract infections (UTIs), which can also cause urinary frequency.
Patient education is crucial. The nurse should explain the importance of follow-up testing and, if diagnosed, provide education on managing diabetes to prevent complications.
What if? If the patient were a 65-year-old male on diuretic medication for hypertension, the primary cause of nocturia might be the medication's effect, although underlying diabetes or benign prostatic hyperplasia (BPH) would still need to be considered.

How to Approach the Question

First, identify the key clinical symptom presented in the question: 'increased frequency of urine in night,' which is nocturia.
Next, analyze the patient's demographic information: '40 years old lady.' The gender is a crucial piece of data.
Evaluate each option based on the patient's presentation. Option B, 'prostatitis,' can be immediately eliminated because the patient is female.
Consider the most common causes of nocturia. Diabetes mellitus (Option A) is a classic cause due to osmotic diuresis.
Evaluate the other options. Liver problems (Option C) are a less direct and less common cause for this specific symptom.
Conclude that diabetes is the most plausible explanation among the choices provided.

Concept Tested & Keywords

Concept Tested: Nocturia as a clinical manifestation of Diabetes Mellitus
Stem keywords: 40 years old lady, increased frequency of urine in night
Lead-in keywords: What does it indicate?
Clinical cues: The patient's gender ('lady') is a critical cue that immediately rules out male-specific conditions like prostatitis.

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E6 Gynecology Williams p. 107-133

E6 Medicine Harrison 22e Part 2 p. 1794-1796