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Management and Treatment

- Watchful waiting: This means monitoring the condition without any active treatment, but making some lifestyle changes such as drinking less fluids at night, avoiding caffeine and alcohol, and urinating when you feel the urge. This option is suitable for men with mild or moderate symptoms who are not bothered by them.

- Medications: There are two main types of drugs that can help reduce the size of the prostate or relax the muscles around it, thus improving the urine flow. They are alpha-blockers (such as tamsulosin, alfuzosin, or doxazosin) and 5-alpha reductase inhibitors (such as finasteride or dutasteride). These medications can have side effects such as dizziness, low blood pressure, sexual dysfunction, or breast enlargement. They may also interact with other drugs, so it is important to consult with your doctor before taking them.

- Minimally invasive procedures: These are techniques that use heat, lasers, or implants to destroy or shrink some of the prostate tissue, thus relieving the obstruction. They are usually done under local anesthesia and have a shorter recovery time than surgery. Some of the examples are transurethral microwave therapy (TUMT), transurethral needle ablation (TUNA), water vapor therapy (Rezum), or prostatic urethral lift (UroLift). These procedures may have risks such as bleeding, infection, urinary retention, or erectile dysfunction.

- Surgery: This is the most effective option for men with severe symptoms or complications such as urinary retention, kidney damage, bladder stones, or recurrent urinary tract infections. Surgery involves removing part or all of the prostate gland through an incision in the abdomen or the urethra. The most common type of surgery is transurethral resection of the prostate (TURP), which uses an electric loop to cut and remove the excess tissue. Other types of surgery are open prostatectomy, holmium laser enucleation of the prostate (HoLEP), or robot-assisted laparoscopic prostatectomy (RALP). Surgery can have complications such as bleeding, infection, urinary incontinence, retrograde ejaculation, or erectile dysfunction.

Questions on Management and Treatment

Correct Answer is B

Explanation

<p>The evaluation of urinary flow rate is typically done through urodynamic studies and flowmetry tests, not the PSA test.</p>

Correct Answer is C

Explanation

Pelvic floor exercises are helpful for strengthening pelvic muscles but are not a primary intervention for relieving urinary retention.

Correct Answer is C

Explanation

A urodynamic study is not used to evaluate the bladder's capacity directly, but it does assess bladder function during voiding.

Correct Answer is A

Explanation

Anticholinergics are used to treat overactive bladder symptoms, which are not specific to BPH-related LUTS.

Correct Answer is A

Explanation

<p>A urinalysis is a general test used to assess the urine&#39;s appearance, specific gravity, and the presence of blood, proteins, and other substances. While it can provide information about kidney function and potential urinary tract infections, it is not specific to BPH.</p>

Correct Answer is A

Explanation

Increased fluid intake may be beneficial for overall bladder health but will not directly relieve the obstruction causing acute urinary retention.Questions

Correct Answer is C

Explanation

TURP does not have a direct impact on fertility, as it does not affect the production or release of sperm.

Correct Answer is A

Explanation

Improved urine flow is an intended outcome of relieving urinary retention with the catheter, not a complication.

Correct Answer is B

Explanation

Inadequate fluid intake may contribute to UTIs, but the primary reason for recurrent UTIs in BPH is the bacterial colonization of the prostate due to urinary retention.

Correct Answer is D

Explanation

This is the correct answer. Clients should be instructed to report any signs of catheter blockage or leakage to their healthcare provider. Catheter blockage can lead to urinary retention, and leakage may indicate a problem with the catheter or the drainage system.

Correct Answer is C

Explanation

Eating a high-protein diet is not specifically indicated for managing urinary frequency and urgency in clients with BPH.Questions

Correct Answer is D

Explanation

<p>This is the correct answer. Hematuria (blood in the urinE. can be associated with BPH due to irritation or trauma to the urinary tract caused by the enlarged prostate. Hematuria may be gross (visiblE. or microscopic and should be further evaluated to determine its cause.</p>

Correct Answer is D

Explanation

This is the correct answer. Alpha-blocker medications used to treat BPH can cause a sudden drop in blood pressure, leading to dizziness. Clients should be educated about this potential side effect and advised to change positions slowly to minimize the risk of falls.

Correct Answer is D

Explanation

This is the correct answer. Residual urine in the bladder after voiding provides a breeding ground for bacteria, increasing the risk of UTIs. In BPH, the enlarged prostate obstructs the urethra, leading to incomplete bladder emptying and the presence of residual urine, which contributes to recurrent UTIs.

Correct Answer is C

Explanation

Urge urinary incontinence is characterized by a sudden, strong urge to urinate, followed by involuntary urine loss. It is not related to the symptoms described in the question.Questions

Correct Answer is D

Explanation

This is the correct answer. Difficulty emptying the bladder is a hallmark symptom of bladder outlet obstruction caused by an enlarged prostate in BPH.

Correct Answer is A

Explanation

Urgency is the sudden and strong need to urinate, and it is not specifically associated with BPH.

Correct Answer is D

Explanation

<p>This is the correct answer. During a transrectal ultrasound (TRUS), a lubricated probe is inserted into the rectum to obtain images of the prostate gland. Some clients may experience mild discomfort or pressure during the procedure, but it is generally well-tolerated.</p>

Correct Answer is B

Explanation

Alpha-blockers do not enhance urine production by the kidneys. They primarily focus on relaxing the smooth muscles to improve urinary flow.Questions

Correct Answer is C

Explanation

Reducing the risk of urinary incontinence is not the primary goal of combination therapy with these medications.Questions

Correct Answer is D

Explanation

This is the correct answer. Hematuria in clients with BPH may be due to the presence of bladder stones. Urinary retention and stasis can lead to the formation of stones in the bladder, which may cause bleeding and hematuria.

Avoiding sitting for extended periods is not a specific activity restriction after a TURP.

Nocturia is the need to wake up at night to urinate.

Contracting the prostate gland is not a desired effect in BPH management.

No explanation

This is the correct answer. Catheterization is necessary to relieve urinary retention and drain the distended bladder.

Increased urine output is not a typical complication of BPH. BPH primarily affects the outflow of urine, resulting in obstructive voiding symptoms.

Prostate cancer may have similar symptoms to BPH but would not present with acute urinary retention and a distended bladder.

<p>This statement is not correct. BPH does not involve the absence of the prostate gland; it is an enlargement of the gland.</p>

Limiting fluid intake at night may cause dehydration and is not recommended. Instead, the client should focus on reducing evening fluid intake to minimize nighttime urine production.Questions

A sedentary lifestyle may contribute to overall health issues but is not a specific risk factor for BPH.

Urinary retention may cause decreased frequency of urination rather than nocturia and frequent nighttime urination.

Administering anticoagulant medications may not be necessary after a TURP unless specifically ordered by the healthcare provider. The nurse should follow the prescribed medication regimen and monitor for bleeding complications.

<p>Urinalysis is a urine test that evaluates the urine&#39;s physical and chemical properties but does not directly assess the size and shape of the prostate gland.</p>

Reduced bladder capacity is not a contributing factor to recurrent UTIs in BPH.

This statement is incorrect. Over-the-counter cold medications containing decongestants can worsen BPH symptoms by constricting blood vessels, including those in the prostate, and can lead to urinary retention.

An enlarged bladder compressing the urethra is not a common symptom of BPH. Instead, it is the enlarged prostate that causes the obstruction.

Urinary urgency is the sudden and strong desire to urinate and is not specifically related to postvoid dribbling.

Invasive surgery is usually reserved for severe cases of BPH that do not respond to conservative management or when complications occur.

This is the correct answer. Difficulty starting a urine stream and a weak urine flow are obstructive voiding symptoms commonly seen in clients with BPH due to the enlargement of the prostate gland, which obstructs the urethra.

Waiting for new symptoms to arise before seeking a follow-up appointment may delay necessary interventions and could lead to worsening of symptoms.

Prostate cancer may cause symptoms similar to BPH, but sudden severe pain in the lower abdomen, groin, and testicles is not a typical presentation of prostate cancer.
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