A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect which of the following findings?
Painful urination
Urge incontinence
Critically elevated prostate-specific antigen (PSA) level
Difficulty starting the flow of urine
The Correct Answer is D
Choice A: Painful urination
Painful urination, or dysuria, is not a typical symptom of benign prostatic hyperplasia (BPH). BPH primarily affects the flow of urine due to the enlargement of the prostate gland, which can obstruct the urethra. While BPH can cause discomfort, it does not usually result in painful urination. Painful urination is more commonly associated with urinary tract infections (UTIs) or other conditions affecting the urinary tract.
Choice B: Urge incontinence
Urge incontinence, characterized by a sudden and intense urge to urinate followed by involuntary loss of urine, can occur in some cases of BPH but is not the most common symptom. BPH typically causes symptoms related to urinary obstruction, such as difficulty starting urination, weak urine stream, and incomplete bladder emptying. Urge incontinence may develop if the bladder becomes overactive due to the obstruction, but it is not a primary symptom.
Choice C: Critically elevated prostate-specific antigen (PSA) level
While an elevated prostate-specific antigen (PSA) level can be associated with BPH, it is not a definitive finding. PSA levels can be elevated due to various conditions, including prostate cancer, prostatitis, and BPH. However, a critically elevated PSA level is more concerning for prostate cancer rather than BPH. Therefore, while PSA testing is useful in the evaluation of prostate conditions, it is not specific to BPH.
Choice D: Difficulty starting the flow of urine
Difficulty starting the flow of urine, also known as hesitancy, is a hallmark symptom of BPH. The enlarged prostate gland can compress the urethra, making it difficult for urine to pass through. This can lead to a weak urine stream, straining to urinate, and a feeling of incomplete bladder emptying. These symptoms are collectively known as lower urinary tract symptoms (LUTS) and are commonly associated with BPH.
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Correct Answer is B
Explanation
Choice A: Take naproxen for generalized discomfort
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can help with generalized discomfort. However, NSAIDs can cause fluid retention and worsen heart failure symptoms. They can also increase the risk of kidney damage and gastrointestinal bleeding, especially in individuals with heart failure. Therefore, it is generally advised to avoid NSAIDs and use alternative pain relief methods, such as acetaminophen, under the guidance of a healthcare provider.
Choice B: Notify the provider of a weight gain of 0.5 kg (1 lb) in a week
Monitoring weight is crucial for individuals with heart failure, as sudden weight gain can indicate fluid retention and worsening heart failure. A weight gain of 0.5 kg (1 lb) in a week is significant and should be reported to the healthcare provider immediately. This allows for timely intervention to adjust medications or other treatments to prevent further complications. Regular weight monitoring helps in early detection of fluid buildup and effective management of heart failure.
Choice C: Take diuretics early in the morning and before bedtime
Diuretics are commonly prescribed to help reduce fluid buildup in individuals with heart failure. However, taking diuretics before bedtime can lead to frequent nighttime urination, disrupting sleep. It is generally recommended to take diuretics early in the morning to minimize this issue. If a second dose is needed, it should be taken in the early afternoon to avoid nighttime disturbances.
Choice D: Exercise at least three times per week
Regular exercise is beneficial for individuals with heart failure as it helps improve cardiovascular health, increase stamina, and reduce symptoms. However, the exercise regimen should be tailored to the individual’s condition and capabilities. It is important to consult with a healthcare provider to develop a safe and effective exercise plan. Cardiac rehabilitation programs can also provide structured exercise guidance and support.
Correct Answer is D
Explanation
Choice A: Perform a Blind Finger Sweep
Performing a blind finger sweep is not recommended because it can push the foreign object further into the airway, making the obstruction worse. This method is only advised if the object is clearly visible and can be safely removed without causing further harm.
Choice B: Turn the Client to the Side
Turning the client to the side can be helpful in certain situations, such as when the client is unconscious or at risk of vomiting. However, in the case of a conscious client with a foreign body airway obstruction, this action does not directly address the obstruction and is not the first priority.
Choice C: Insert an Oral Airway
Inserting an oral airway is typically used to maintain an open airway in an unconscious patient who cannot maintain their own airway. For a conscious client with a foreign body obstruction, this action is not appropriate and could cause further complications.
Choice D: Administer the Abdominal Thrust Maneuver
Administering the abdominal thrust maneuver (also known as the Heimlich maneuver) is the recommended first action for a conscious client with a foreign body airway obstruction. This technique involves standing behind the client, placing a fist just above their navel, and delivering quick, upward thrusts to expel the foreign object. This method is effective in creating an artificial cough that can dislodge the obstruction.
