BPH56 Flashcards
To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH), the nurse will ask the patient about
a. blood in the urine. c. force of urinary stream.
b. lower back or hip pain. d. erectile dysfunction (ED).
ANS: C
The American Urological Association Symptom Index for a patient with BPH asks questions about the force and frequency of urination, nocturia, and so on. Blood in the urine, ED, and back or hip pain are not typical symptoms of BPH.
A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because it might affect his ability to have sexual intercourse. Which action should the nurse take?
a. Discuss alternative methods of sexual expression.
b. Teach about medication for erectile dysfunction (ED).
c. Clarify that TURP does not commonly affect erection.
d. Offer reassurance that fertility is not affected by TURP.
ANS: C
ED is not a concern with TURP, although retrograde ejaculation is likely, and the nurse should discuss this with the patient. Erectile function is not usually affected by a TURP, so the patient will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the patient has not asked about fertility, reassurance about sperm production does not address his concerns.
The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that
a. he should change position from lying to standing slowly to avoid dizziness.
b. his interest in sexual activity may decrease while he is taking the medication.
c. improvement in the obstructive symptoms should occur within about 2 weeks.
d. he will need to monitor his blood pressure frequently to assess for hypertension.
ANS: B
A decrease in libido is a side effect of finasteride because of the androgen suppression that occurs with the drug. Although orthostatic hypotension may occur if the patient is also taking a medication for erectile dysfunction, it should not occur with finasteride alone. Improvement in symptoms of obstruction takes about 6 months. The medication does not cause hypertension.
A 70-yr-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient statement indicates a need for the nurse to provide additional instruction?
a. “I should call the doctor if I have incontinence at home.”
b. “I will avoid driving until I get approval from my doctor.”
c. “I should schedule yearly appointments for prostate examinations.”
d. “I will increase fiber and fluids in my diet to prevent constipation.”
ANS: A
Because incontinence is common for several weeks after a TURP, the patient does not need to call the health care provider if this occurs. The other patient statements indicate that the patient has a good understanding of post-TURP instructions.
A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, “My symptoms are much worse this week.” Which response by the nurse is appropriate?
a. “Have you taken any over-the-counter (OTC) medications recently?”
b. “I will talk to the doctor about a prostate specific antigen (PSA) test.”
c. “Have you talked to the doctor about surgery such as transurethral resection of the prostate (TURP)?”
d. “The prostate gland changes in size from day to day, and this may be making your symptoms worse.”
ANS: A
Because the patient’s increase in symptoms has occurred abruptly, the nurse should ask about OTC medications that might cause contraction of the smooth muscle in the prostate and worsen obstruction. The prostate gland does not vary in size from day to day. A TURP may be needed, but more assessment about possible reasons for the sudden symptom change is a more appropriate first response by the nurse. PSA testing is done to differentiate BPH from prostatic cancer.
A patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine. Which prescribed therapy should the nurse implement first?
a. Infuse normal saline at 50 mL/hr.
b. Insert a urinary retention catheter.
c. Draw blood for a complete blood count.
d. Schedule pelvic magnetic resonance imaging
ANS: B
The patient data indicate that the patient may have acute kidney injury caused by the BPH. The initial therapy will be to insert a catheter. The other actions are also appropriate, but they can be implemented after the acute urinary retention is resolved.
