The nurse is examining the abdomen of an older adult male client who expresses suprapubic tenderness on palpation. The client reports that it sometimes feels like there is still pressure in that area after urination. Which additional finding should the nurse expect with continued interview of the client?

Rationale:
A. Observe the next bowel movement for signs of bleeding: Monitoring stool for blood is important if gastrointestinal bleeding is suspected, but normal gurgling bowel sounds do not suggest bleeding. This action is unnecessary based solely on the auscultated finding described.

B. Encourage increased consumption of fiber in the diet: Fiber intake is recommended for promoting healthy bowel habits, but the presence of normal bowel sounds does not indicate a need to change dietary habits unless other issues, like constipation, are reported.

C. Report the hyperactivity to the healthcare provider (HCP): A gurgling sound every ten seconds is considered a normal bowel sound frequency. Hyperactive bowel sounds would be continuous, high-pitched, and frequent; therefore, this finding does not require reporting as abnormal.

D. Document this normal bowel sound activity in the record: Bowel sounds occurring every 5 to 15 seconds are typical for a healthy adult. Hearing a gurgling sound every ten seconds reflects normal gastrointestinal motility and should be documented accurately in the client’s health record.

Rationale:
A. An overactive bladder: Overactive bladder typically presents with urgency, frequency, and sometimes incontinence, but it does not usually cause suprapubic tenderness or the sensation of incomplete bladder emptying. These symptoms are more consistent with urinary retention or bladder outlet obstruction.

B. A cloudy discharge: Cloudy urinary discharge is more indicative of a urinary tract infection (UTI) rather than urinary retention. While infections can cause some bladder discomfort, the client’s description points more specifically to mechanical urinary issues rather than infection.

C. A weak urinary stream: A weak urinary stream is commonly associated with bladder outlet obstruction, often due to benign prostatic hyperplasia (BPH) in older males. The combination of suprapubic tenderness and the feeling of incomplete emptying aligns with urinary retention caused by obstruction, making this the expected additional finding.

D. Black tarry stools: Black tarry stools are usually a sign of gastrointestinal bleeding, particularly from the upper GI tract. They are unrelated to urinary symptoms and would not explain suprapubic tenderness or voiding difficulties described by the client.