HESI Case Studies- Benign Prostatic Hyperplasia – Flashcards

Which additional manifestations would the nurse expect in client's with BPH?

Which assessment finding would indicate that Mr. Hamilton is experiencing urinary retention?

Mr. Hamilton tells the nurse that he has cut back on drinking fluids to reduce his symptoms. How should the nurse respond?

Mr. Hamilton is scheduled for a digital rectal exam, serum prostate-specific antigen (PSA) level, urinalysis, serum creatinine, and blood urea nitrogen (BUN). He states he has had the rectal exam and PSA levels done before the prostate screening. He asks why the other lab test (creatinine and BUN levels) are necessary. What explanation should the nurse provide?

Mr. Hamilton's PSA level is 6mg/ml, a slightly elevated level (normal is <4 ng/ml). Bob appears distressed and asks, "Do I have prostate cancer? Is that why I'm having these symptoms?" How should the nurse respond?

Tests, along with urodynamic flow studies, indicate that Mr. Hamilton's prostate gland is enlarged significantly and treatment is recommended. Mr. Hamilton elects to try medical management of his symptoms. He receives prescriptions of oral finasteride (Proscar) and tamsulosin (Flomax). The nurse provides instructions about these medications. What information should be included when teaching Bob about Flomax?

What does Mr. Hamilton need to know about taking finasteride Proscar?

Mr. Hamilton continues to take his medication for 9 months, but his symptoms do not improve significantly. He is scheduled for residual cathererization at the clinic. What catheter should the nurse select to perform the procedure?

What instruction should the nurse provide Mr. Hamilton before starting the procedure?

Based on his continued lack of symptomatic improvement and high volumes noted during residual catheterization, Mr. Hamilton elects to have surgery. A transurethral resection of the prostate is performed (TURP). While Mr. Hamilton is in surgery, his wife brings his belongings to his assigned room on the surgical nursing unit. The nurse assigned to Mr. Hamilton's care greets her. The nurse recognizes that Mrs. Hamilton is of Asia descent and asks Mrs. Hamilton about her cultural background. Mrs. hamilton states that she is Korean and that she met and married Mr. Hamilton during the Korean War. The nurse asks Mrs. Hamilton if she has any questions or concerns . Mrs. Hamilton responds calmly that she will be happy when Mr. Hamilton returns from surgery, and Mrs. Hamilton turns her head and looks away. What is the best response by the nurse?

The nurse recognizes nonverbal behavior such as eye contact varies in different cultures. How can the nurse best interpret Mrs. Hamilton's minimal eye contact, in light of Mrs. Hamilton's cultural background?

After surgery, Mr. Hamilton is admitted to the surgical nursing unit for overnight observation and postoperative care. Which postoperative intervention should the nurse perform first?

What action should the nurse take?

Mr. Hamilton tells the nurse that he is uncomfortable, because he constantly feels like he has to urinate. The nurse explains that this is the result of the oversize balloon putting pressure on the sphincter of the bladder. What instructions should the nurse relate to Mr. Hamilton?

During the night, Mr. Hamilton reports increased bladder discomfort. The nurse's observation of the urinary drainage catheter indicates minimal output for the last 2 hours. What action should the nurse take?

Early the next morning, the nurse notes that the catheter is draining a large volume of urine with bright red blood that seems thick. What actions should the nurse take? (select all that apply)

During administration of the aminocaproic acid (Amicar) infusion, the nurse monitors Mr. Hamilton for adverse effects of the medication. What assessment data would indicate the onset of thrombotic complication?

The aminocaproic acid (Amicar) infusion successfully stops the bleeding without complications. Mr. Hamilton's hemoglobin and hematocrit drop as the result of the bleeding, and the HCP prescribes the administration of 1 unit of packed red blood cells. Which action should the nurse implement to reduce the risk for a hemolytic transfusion reaction?

When the transfusion is half infused, the unlicensed assistive personnel (UAP) tells the nurse that Mr. Hamilton is very nervous and has a headache. Which action should the nurse implement first?

The nurse assesses that Mr. Hamilton's skin is warm and flushed. Mr. Hamilton reports having generalized body aches and he starts experiencing chills. His BP is 114/68, his pulse is 92, his respirations are 18, and his temperature is 102.2. The nurse suspects that Mr. Hamilton is experiencing a febrile transfusion reaction. What action should the nurse take next after stopping the transfusion?

It is determined that Mr. Hamilton experienced a febrile transfusion reaction. This type of reaction is caused by the body's sensitivity to components in the donor blood such as WBCs, platelets, or plasma proteins. In addition to stopping the transfusion, the nurse sends the blood bag, tubing, and a urinalysis to the lab, and administers and antipyretic medication until Mr. Hamilton is once again afebrile. The nurse is upset that Mr. Hamilton experienced a transfusion reaction and the nurse talks with the change nurse about the situation. The nurse states "I never thought I would get sued for malpractice. Do you think i will be sued because of this?" What is the best initial response by the charge nurse?

The nurses discuss the components needed to prove professional negligence or malpractice. They discuss "Breach of Duty." What statement best describes this term?

The nurse assesses Mr. Hamilton and determines that he is dyspneic, lethargic, pale and cool. He is experiencing a large amount of bright red bleeding in his catheter. In what position should the nurse place Mr. Hamilton?

The nurse administers oxygen per face mask, ensures that the IV is patent, and notifies the HCP that Mr. Hamilton is experiencing overt bleeding and manifestations of hypovolemic shock. Specimens for stat blood work and arterial blood gases are drawn. Which lab value would the nurse question?

Which nursing diagnosis has the highest priority when implementing care?

Mr. Hamilton is scheduled to have emergency surgery as quickly as possible. His wife is with him, and she is very anxious and upset. While Mr. Hamilton is awaiting transport to the Operating Room (OR), which nursing staff should be assigned to his care?

While the nurse is monitoring Mr. Hamilton closely, which additional responsibility is best to assign to the LPN?

What analogy can the nurse use to describe how to contract the pelvic floor muscles?

Mr. Hamilton asks if he will need to have any more yearly rectal exams. How should the nurse respond?