MCA I : Benign Prostatic Hyperplasia

When explaining transurethral needle ablation (TUNA) as a treatment option to a patient, which common disadvantages of the procedure would the nurse include? Select all that apply. a. Hematuria b. Urinary retention c. Retrograde ejaculation d. Irritative voiding symptoms e. Risk of erectile dysfunction

A, B, D Rationale Hematuria, urinary retention, and irritative voiding symptoms are the common disadvantages of the TUNA procedure. Erectile dysfunction is rare with TUNA treatment. Retrograde ejaculation is also rare in TUNA and is more common in laser prostatectomy, transurethral electrovaporization of prostate (TUVP), and transurethral resection of prostate (TURP). p. 1258

Which conditions place a patient at risk for developing benign prostatic hyperplasia (BPH)? Select all that apply. a. Aging b. Vegetarian diet c. Physical inactivity d. Less fluid intake e. Alcohol consumption

A, C, E Rationale Risk factors for BPH include aging, obesity (in particular, increased waist circumference), lack of physical activity, alcohol consumption, erectile dysfunction, smoking, and diabetes. A vegetarian diet and less fluid intake are not relevant. p. 1255

A patient with benign prostatic hyperplasia (BPH) may experience complications of urinary obstructions due to the presence of which manifestations? Select all that apply. a. Bladder calculi b. Cardiac disorders c. Digestive problems d. Urinary tract infection e. Acute urinary retention

A, D, E Rationale Bladder calculi and urinary tract infection can occur due to incomplete bladder emptying (associated with partial obstruction), which results in residual urine and provides a favorable environment for bacterial growth. Acute urinary retention is a complication manifested by the sudden and painful inability to urinate. Cardiac disorders and digestive problems are not directly related to BPH. p. 1255

A patient is suspected of having benign prostatic hyperplasia (BPH). Which signs and symptoms reported by the patient correlates with BPH? Select all that apply. a. Anuria b. Dysuria c. Nocturia d. Incontinence e. Intermittency

B, C, D, E Rationale Because of the enlarged prostate, the patient experiences disruption of the urinary tract as the prostate compresses the urethra. These symptoms include dysuria; nocturia, which is often the first complaint the patient will have; incontinence; and intermittency, which is starting and stopping several times while trying to void. Anuria is not a typical symptom for patients with BPH; however, if a complication arises from BPH, the patient will develop acute urinary retention. p. 1255

A nurse is caring for a patient who has benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Which drug would the nurse expect to incorporate into the plan of care? a. Prazosin b. Tadalafil c. Silodosin d. Finasteride

B. Tadalafil Rationale Tadalafil is an erectogenic drug that is used to treat ED for the patient diagnosed with BPH. Prazosin and silodosin are α-adrenergic receptor blockers used to treat BPH; however, these drugs do not treat ED. Finasteride is a 5α-reductase inhibitor used to treat BPH; however, this drug does not treat ED. p. 1274

A patient with benign prostatic hyperplasia (BPH) presents with obstructive symptoms. Which instructions would the nurse give this patient to relieve the symptoms? Select all that apply. a. Reduce fluid intake. b. Rapidly increase fluid intake. c. Maintain adequate fluid intake. d. Urinate every two to three hours. e. Urinate when experiencing the first urge to void.

C, D, E Rationale A patient with obstructive symptoms should be advised to urinate every two to three hours, and fluid intake should be maintained at a normal level to avoid dehydration or fluid overload. When the patient experiences the first urge to void, to minimize urinary stasis and acute urinary retention the patient should urinate immediately. If fluid intake is reduced, then it can increase the chances of an infection; and if the patient increases his intake too rapidly, then bladder distention can develop because of the prostatic obstruction. p. 1261

An older adult patient reports urinary urgency. Which diagnostic findings would the nurse correlate with benign prostatic hyperplasia (BPH)? Select all that apply. a. Negative urinalysis and culture b. Elevated serum creatinine levels c. Residual urine with postvoiding catheterization d. Enlarged prostate as observed on ultrasonography e. Vesicle neck obstruction as observed on cystoscopy

C, D, E Rationale An enlarged prostate as observed on ultrasonography, vesicle neck obstruction as observed on cystoscopy, and residual urine with postvoiding catheterization are possible diagnostic findings of BPH. Having a negative urinalysis and culture and elevated serum creatinine levels do not necessarily indicate BPH. p. 1259

Which information would the nurse identify as increasing the patient's risk for benign prostatic hyperplasia (BPH)? a. A history of hyperthyroidism b. A father with a history of BPH c. A body mass index (BMI) of 28 d. Physical activity for 30 minutes at least five days a week

b. A father with a history of BPH Rationale A first-degree relative, such as the patient's father, with a history of BPH is a risk factor for developing this condition. A history of diabetes, not hyperthyroidism, is a risk factor. Obesity, not being overweight as indicated by the current BMI, is a risk factor for BPH. A lack of physical activity is a risk for BPH. p. 1255

A nurse is caring for a patient who has undergone radical prostatectomy. Which complication would the nurse monitor the patient for during the early postoperative period? a. Septicemia b. Hemorrhage c. Renal failure d. Respiratory distress

b. Hemorrhage Rationale Hemorrhage is the most common complication after prostate surgery. The main reason for this is that the prostate lies deep within the pelvis and is surrounded by highly vascular tissue that requires resection before the prostate is reached. Septicemia, renal failure, and respiratory distress are all potential postoperative complications related to any abdominal or genitourinary surgical procedure. However, after radical prostatectomy, hemorrhage is considered a higher risk. p. 1261

A patient will undergo laser prostatectomy for the treatment of benign prostatic hyperplasia (BPH). Which technique would the nurse discuss when educating the patient? a. Open prostatectomy b. Transurethral incision of the prostate (TUIP) c. Photoselective vaporization of the prostate (PVP) d. Transurethral electrovaporization of the prostate (TUVP)

c. Photoselective vaporization of the prostate (PVP) Rationale The PVP procedure is one technique that is an example of a laser prostatectomy; therefore the nurse should include this procedure in the teaching session. An open prostatectomy, TUIP, and TUVP are not examples of laser prostatectomies. p. 1257

The nurse is planning care for a patient diagnosed with benign prostatic hyperplasia (BPH). Which diagnostic assessment would the nurse expect to be included in the plan of care as a method of active surveillance for this disease process? a. Serum creatinine b. Urinalysis with culture c. Transrectal ultrasound (TRUS) d. Annual prostate-specific antigen (PSA)

d. Annual prostate-specific antigen (PSA) Rationale An annual PSA test is a diagnostic assessment that is conducted when active surveillance of BPH is required. While serum creatinine, urinalysis with culture, and TRUS are all diagnostic assessments as well, they are not appropriate for active surveillance of BPH. p. 1256