ch 44 Medsurg BPH and Urinary for males

A nurse is instructing a client who is scheduled for a transurethral resection of the prostate (TURP) about his postoperative care. Which of the following information should the nurse include in the teaching? A. "You may have a continuous sensation of needing to void even though you have a catheter." B. "You will be on bed rest for the first 2 days after the procedure." C. "You will be instructed to limit your fluid intake after the procedure." D. "Your urine should be clear yellow the evening after the surgery."

A. "You may have a continuous sensation of needing to void even though you have a catheter." ATI MS

BPH complications

urinary retention→UTI

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the health care provider (HCP)? 1. Red bloody urine 2. Pain rated 2 on a 0-10 scale 3. Urinary output of 200 mL higher than intake 4. Blood pressure, 100/50 mm Hg; pulse, 130 beats/minute

4. Blood pressure, 100/50 mm Hg; pulse, 130 beats/minute (some bleeding may occur the day after surgery) NCLEX

pt teaching: preventing dribbling

kegel exercises

The nurse is monitoring a client who has just returned from surgery after a transurethral resection of the prostate (TURP). The client has a 3-way Foley catheter in place for ongoing bladder irrigation. The nurse is observing the color of the client's urine and should expect which urine color during the immediate postoperative period? 1. Pale pink urine 2. Dark pink urine 3. Tea-colored urine 4. Bright red blood with small clots in the urine

1. Pale pink urine (If the bladder irrigation is infusing at a sufficient rate, the urinary drainage through the Foley tubing should be pale pink. Dark pink urine indicates that the rate of the irrigation solution should be increased.) NCLEX

The nurse is conducting an interview of an older client and is concerned about the possibility of benign prostatic hyperplasia (BPH). Which are characteristics of this disorder? Select all that apply. 1. nocturia 2. incontinence 3. enlarged prostate 4. nocturnal emissions 5. decreased desire for sexual intercourse

1. nocturia 2. incontinence 3. enlarged prostate NCLEX

The client diagnosed with benign prostatic hyperplasia (BPH) is scheduled for a transrectal ultrasound examination and a test to measure the level of prostate-specific antigen (PSA). The client says to the nurse, "I can't remember...can you tell me again why I need these tests to be done?" The nurse responds knowing that these tests are done for which purpose? 1. Specifically predict the course of BPH 2. Help to rule out the possibility of cancer 3. Pinpoint the likelihood of developing urinary obstruction 4. Give an indication of whether intermittent self-catheterization is needed

2. Help to rule out the possibility of cancer NCLEX

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia? 1. Nocturia 2. Scrotal edema 3. Occasional constipation 4. Decreased force in the stream of urine

4. Decreased force in the stream of urine (Decreased force in the stream of urine is an early symptom of BPH. The stream later becomes weak and dribbling. The pt then may develop hematuria, frequency, urgency, urge incontinence, and nocturia.) NCLEX

A nurse in a provider's office is obtaining a history from a client who is undergoing an evaluation for benign prostatic hyperplasia (BPH). The nurse should identify that which of the following findings are indicative of this condition? (Select all that apply.) A. Backache B. Frequent urinary tract infections C. Weight loss D. Hematuria E. Urinary incontinence

B. Frequent urinary tract infections D. Hematuria E. Urinary incontinence ATI MS

A nurse is providing discharge instructions to a client who is postoperative from a TURP. Which of the following instructions should the nurse include? (Select all that apply.) A. Avoid sexual intercourse for 3 months after the surgery. B. If urine appears bloody, stop activity and rest. C. Avoid drinking caffeinated beverages. D. Take a stool softener once a day. E. Treat pain with ibuprofen (Motrin).

B. If urine appears bloody, stop activity and rest. C. Avoid drinking caffeinated beverages. D. Take a stool softener once a day. (avoid intercourse 2-6 weeks after surgery, NSAIDs can cause bleeding) ATI MS

What is the effect of finasteride (Proscar) in the treatment of BPH? a. A reduction in the size of the prostate gland b. Relaxation of the smooth muscle of the urethra c. Increased bladder tone that promotes bladder emptying d. Relaxation of the bladder detrusor muscle promoting urine flow

a. A reduction in the size of the prostate gland MS workbook

A patient with continuous bladder irrigation following a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first? a. Slow the rate of the irrigation. b. Assess the patency of the catheter. c. Encourage the patient to try to urinate around the catheter. d. Administer a belladonna and opium (B&O) suppository as prescribed.

b. Assess the patency of the catheter. MS workbook

Which treatment for BPH uses a low-wave radiofrequency to precisely destroy prostate tissue? a. Laser prostatectomy b. Transurethral needle ablation (TUNA) c. Transurethral microwave thermotherapy (TUMT) d. Transurethral electrovaporization of prostate (TUVP)

b. Transurethral needle ablation (TUNA) MS workbook

The male pt is admitted with a diagnosis of BPH. What urination characteristics should the nurse expect to assess in this pt? a. oliguria b. hesitancy c. hematuria d. pneumaturia

b. hesitancy -hesitancy: difficulty starting urine stream -oliguria: decreased urine output -hematuria: blood in the urine -pneumaturia: urine containing gas MS workbook ch 44

Following a TURP, a patient has continuous bladder irrigation. Four hours after surgery, the catheter is draining thick, bright red clots and tissue. What should the nurse do? a. Release the traction on the catheter. b. Manually irrigate the catheter until the drainage is clear. c. Increase the rate of the irrigation and take the patient's vital signs. d. Clamp the drainage tube and notify the patient's health care provider.

c. Increase the rate of the irrigation and take the patient's vital signs. (Bleeding and blood clots from the bladder are expected after a TURP, and continuous irrigation is used to keep clots from obstructing the urinary tract. The rate of irrigation may be titrated to keep the clots from forming, but the nurse should also check the vital signs because hemorrhage is the most common complication of prostatectomy.) MS workbook

The extent of urinary obstruction caused by BPH can be determined by which diagnostic study? a. A cystometrogram b. Transrectal ultrasound c. Uroflowmetry d. Postvoiding catheterization

c. Uroflowmetry MS workbook

When taking a history from a patient with BPH, the nurse would expect the patient to report a. nocturia, dysuria, and bladder spasms b. urinary frequency, hematuria, and perineal pain c. urinary hesitancy, postvoid dribbling, and weak urinary stream d. urinary urgency with a forceful urinary stream and cloudy urine

c. urinary hesitancy, postvoid dribbling, and weak urinary stream (bladder spasms, perineal pain, and cloudy urine do not occur with BPH) MS workbook

What is the most common screening intervention for detecting BPH in men over age 50? a. PSA level b. Urinalysis c. Cystoscopy d. Digital rectal examination

d. Digital rectal examination MS workbook

A client with benign prostatic hyperplasia undergoes a transurethral resection of the prostate. Postoperatively the client is receiving continuous bladder irrigations. The nurse assesses the client for manifestations of transurethral resection syndrome. Which assessment data would indicate the onset of this syndrome? 1. Tachycardia and diarrhea 2. Bradycardia and confusion 3. Increased urinary output and anemia 4. Decreased urinary output and bladder spasms

2. Bradycardia and confusion NCLEX

The nursing student is caring for a client with a diagnosis of benign prostatic hyperplasia (BPH). The nursing instructor asks the student to identify the clinical manifestations associated with this condition. The student needs to research the condition further if the student states that which finding is an EARLY symptom of BPH? 1. Nocturia 2. Hematuria 3. Decreased force of urine stream 4. Difficulty initiating urine stream

2. Hematuria (not an EARLY finding) NCLEX

The nurse caring for a client immediately after transurethral resection of the prostate (TURP) notices that the client has suddenly become confused and disoriented. Which is the priority nursing action for this client? 1. Reorient the client. 2. Notify the health care provider (HCP). 3. Ensure that a clock and calendar are in the room. 4. Increase the flow rate of the intravenous infusion.

2. Notify the health care provider (HCP). (The pt who suddenly becomes disoriented and confused after TURP could be experiencing early signs of hyponatremia.) NCLEX

A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). The nurse should anticipate a prescription for which of the following medications? A. Oxybutynin B. Diphenhydramine C. Ipratropium D. Tamsulosin

D. Tamsulosin ATI MS

The nurse provides discharge teaching to a patient following a TURP and determines that the patient understands the instructions when he makes which statement? a. "I should use daily enemas to avoid straining until healing is complete." b. "I should avoid heavy lifting, climbing, and driving until my follow-up visit." c. "At least I don't have to worry about developing cancer of the prostate now." d. "Every day I should drink 10 to 12 glasses of liquids such as coffee, tea, or soft drinks."

b. "I should avoid heavy lifting, climbing, and driving until my follow-up visit." MS workbook

Before undergoing a TURP, what should the patient be taught? a. Some degree of urinary incontinence is likely to occur. b. This surgery results in some degree of retrograde ejaculation. c. Erectile dysfunction is a common complication of this prostate surgery. d. An indwelling catheter will be used to maintain urinary output until healing is complete.

b. This surgery results in some degree of retrograde ejaculation. MS workbook

On admission to the ambulatory surgical center, a patient with BPH informs the nurse that he is going to have a laser treatment of his enlarged prostate. The nurse plans patient teaching with the knowledge that the patient will need to know what? a. The effects of general anesthesia b. The possibility of short-term incontinence c. Home management of an indwelling catheter d. Monitoring for postoperative urinary retention

c. Home management of an indwelling catheter MS workbook

Symptoms of BPH are primarily caused by: a. obstruction of the urethra b. untreated chronic prostatitis c. decreased bladder compliance d. excessive secretion of testosterone

a. obstruction of the urethra MS

Which characteristics describe transurethral resection of the prostate (TURP)? (Select all that apply) a. Best used for a very large prostate gland b. Inappropriate for men with rectal problems c. Involves an external incision prostatectomy d. Uses transurethral incision into the prostate e. Most common surgical procedure to treat BPH f. Resectoscopic excision and cauterization of prostate tissue

e. Most common surgical procedure to treat BPH f. Resectoscopic excision and cauterization of prostate tissue MS workbook