A nurse is caring for a patient with a blood pressure reading of 148/92 mmHg. What classification of blood pressure is this reading?

Choice A reason: Painful urination, or dysuria, involves discomfort during voiding, often due to urinary tract infections or inflammation. It is not synonymous with nocturia, which specifically refers to frequent nighttime urination. Dysuria requires distinct clinical evaluation, including urinalysis, to identify causes like bacterial infection or urethral irritation, making this an incorrect description of the patient’s complaint.

Choice B reason: Nocturia is the medical term for frequent urination at night, disrupting sleep. In elderly patients, it may result from reduced bladder capacity, overactive bladder, or conditions like benign prostatic hyperplasia. This matches the patient’s complaint, as it directly addresses the symptom without implying unrelated issues like pain or incontinence, making it the accurate choice.

Choice C reason: Bladder incontinence involves involuntary urine leakage, distinct from nocturia, which is voluntary urination at night. Incontinence may stem from neurological disorders or weakened pelvic muscles but does not describe the patient’s symptom of frequent nighttime voiding. This choice is incorrect, as it misaligns with the clinical presentation described.

Choice D reason: An inability to void, or urinary retention, is the opposite of nocturia, where the patient voids frequently. Retention may result from obstructions like an enlarged prostate or neurological issues, requiring catheterization or imaging for diagnosis. This choice does not reflect the patient’s symptom of active, frequent urination at night.

Choice A reason: Urinary retention involves inability to empty the bladder, causing overflow, not involuntary leakage during laughing or sneezing, which indicates stress incontinence. Misdiagnosing retention risks inappropriate treatments like catheterization, delaying pelvic exercises or medications, critical for managing stress incontinence and improving quality of life in affected patients.

Choice B reason: Constipation affects bowel function, not urinary control, unlike stress incontinence, where leakage occurs during physical stress like sneezing. Assuming constipation misguides diagnosis, risking neglect of urinary interventions like Kegel exercises, essential for strengthening pelvic muscles and preventing incontinence-related limitations in daily activities.

Choice C reason: Hiatal hernia causes gastrointestinal symptoms like reflux, not urinary leakage during activities, which defines stress incontinence. Misdiagnosing hernia risks overlooking pelvic floor issues, delaying treatments like biofeedback, critical for managing incontinence, reducing activity limitations, and improving comfort in patients with stress-related urine loss.

Choice D reason: Stress incontinence involves involuntary urine leakage during activities like laughing or sneezing due to weakened pelvic floor muscles, common in women. Recognizing this guides interventions like pelvic exercises or surgery, critical for reducing activity limitations, improving quality of life, and addressing physical and emotional impacts in affected patients.