VS: BP 124/70 mm Hg, P 80 bpm, RR 16/min, T 37.0°C (98.6°F)

CV: RRR; normal Si, S2; no murmurs, rubs, gallops

Abd: Soft, nontender, nondistended; (+) bowel sounds; bladder not palpable

Neuro: Within normal limits (gross sensory, motor, reflexes)

GU: Valsalva caused urine spurt; friable, bleeding vaginal lining on pelvic exam

Labs: Hemoglobin A1 8.2% (0.082); rest within normal limits

Given this additional information, what is your assessment of the patient's condition? Identify your treatment goals for the patient.

What nonpharmacologic and pharmacologic alternatives are available to the patient?

• Avoidance or minimization of adverse consequences of treatment

• Minimization of treatment costs

• Improvement in patient's quality of life

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