Question

The nurse is taking a history of a client who has had benign prostatic hyperplasia (BPH) in the past. To determine whether the client currently is experiencing difficulty, which symptom would the nurse ask the client about? a. Hematuria b. Urinary incontinence c. Urinary retention d. Decreased force in the stream of urine

Short answer

d. Decreased force in the stream of urine

Step-by-step solution

- Understanding BPH

Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. It can cause various urinary symptoms due to the pressure it puts on the urethra and bladder.

- Review Symptoms

Evaluate the typical symptoms of BPH: problems with urination such as difficulty starting urination, weak urine stream, and the need to urinate frequently, especially at night.

- Identify Relevant Symptoms

Consider which of the given options aligns with common symptoms of BPH. Hematuria (blood in urine) and urinary incontinence (lack of bladder control) are not typical symptoms. Urinary retention (inability to empty the bladder completely) and decreased force in the stream of urine are more indicative of BPH.

- Best Answer Selection

Among the given options, the symptom that most directly suggests an ongoing issue with BPH is 'decreased force in the stream of urine.' This is because BPH most commonly causes difficulty in urination, affecting the strength of the urine stream.

Key concepts

Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia (BPH) is a common condition that affects men as they age. It involves the enlargement of the prostate gland, which is located below the bladder and surrounds the urethra. BPH is non-cancerous but can cause significant urinary issues due to the pressure it puts on the urethra and bladder.

The main concerns of BPH revolve around urinary flow and bladder control. As the prostate enlarges, it can obstruct the urethra, making it difficult for urine to pass. Symptoms can include:

• Difficulty starting urination
• Weak or interrupted urinary stream
• Frequent urination, especially at night
• Urgent need to urinate
• Inability to completely empty the bladder

Understanding these symptoms is essential for effectively assessing and managing BPH.

Urinary Complications

Urinary complications are common in men with BPH because the enlarged prostate puts pressure on the urethra, causing a range of issues.

The two most relevant complications to consider in BPH are:

• Urinary Retention: This is the inability to completely empty the bladder. Men with BPH may feel as though their bladder is never fully empty and might experience discomfort due to the retention of urine.
• Decreased Force in the Stream of Urine: This is a hallmark symptom of BPH, where the urine stream becomes weak or dribbly. This occurs because the enlarged prostate gland partially blocks the urethra, reducing the force of the urine stream.

When evaluating urinary symptoms, it is also important to rule out other conditions that may cause similar symptoms, such as infections, bladder stones, or even prostate cancer.

Patient History Taking

Taking a thorough patient history is crucial in evaluating symptoms related to BPH. A good history helps to identify the severity of symptoms and their impact on the patient's quality of life.

When assessing a patient with a history of BPH, focus on the following areas:

• Symptom Onset: Ask when the patient first noticed symptoms and whether they have been worsening over time.
• Specific Symptoms: Inquire about specific symptoms such as difficulty starting urination, weak stream, frequent or urgent urination, and feelings of incomplete bladder emptying.
• Lifestyle Impact: Determine how the symptoms affect the patient's daily activities, sleep, and overall well-being. Nighttime urination (nocturia) can significantly disrupt sleep, leading to daytime fatigue.
• Previous Interventions: Ask about any previous treatments or medications the patient has tried for their BPH and whether they provided any relief.

By taking a detailed history and understanding the patient's experiences, healthcare providers can better tailor their approach to managing BPH and addressing the patient's specific needs.