A nurse is teaching a patient with Parkinson's disease about dietary practices.
What signs and symptoms are potential complications related to this disease? Select all that apply.

Choice A rationale

While deficits in mobility can indirectly impact urinary habits, leading to issues like delayed toileting, they are not a primary physiological cause of the specific symptoms of frequency, retention, and dribbling in an elderly male. These symptoms often stem from underlying anatomical or functional changes within the genitourinary system itself.

Choice B rationale

Prostate enlargement, specifically benign prostatic hyperplasia (BPH), is a very common condition in elderly males. The enlarged prostate gland compresses the urethra, leading to increased urinary frequency due to bladder irritation, urinary retention due to outflow obstruction, and dribbling as a result of incomplete bladder emptying. This is a direct physiological cause.

Choice C rationale

While some changes in urinary patterns can occur with aging, urinary retention and dribbling are not considered "normal" symptoms. They indicate a potential underlying pathology requiring investigation, not just an expected part of the aging process. Normal aging might involve slight increases in frequency but not significant retention.

Choice D rationale

Coughing or sneezing can sometimes lead to stress incontinence in individuals with weakened pelvic floor muscles, resulting in involuntary urine leakage. However, this differs from the symptoms of urinary retention and dribbling, which are more indicative of an obstructive process within the urinary tract.

Choice A rationale

Inserting an indwelling urinary catheter prematurely without assessing for bladder distension or attempting other less invasive interventions is not the first step. Catheterization carries risks like infection and trauma. A bladder scan provides objective data to guide further interventions.

Choice B rationale

Positioning the patient on their left side is not a primary intervention for urinary retention after catheter removal. While position can sometimes aid voiding, it is not a direct solution for a patient who has not voided for 8 hours and does not address the underlying issue of bladder fullness.

Choice C rationale

Performing a bladder scan is the most appropriate next nursing action. A bladder scan non-invasively measures the volume of urine in the bladder. If the bladder volume is significant (e.g., >200-400 mL, normal post-void residual is <50-100 mL), it indicates urinary retention, guiding further interventions.

Choice D rationale

Instructing the patient to drink fluids without assessing for bladder distension can exacerbate the problem if the patient is already experiencing retention. Increasing fluid intake without adequate outflow can lead to overdistension of the bladder, causing further discomfort and potential bladder damage.