A 78-year-old male client presents to the emergency department complaining of a history of urinary frequency and a weak urinary stream. Today he complains of extreme pain in the pelvic area. The client urinates 50 mL, and an immediate bladder scan shows a post-void residual urine measurement of 600 mL. The nurse recognizes these symptoms are most likely related to which condition?
Benign prostatic hyperplasia (BPH)
End stage renal disease (ESRD)
Pre-renal acute kidney injury (AKI)
Polycystic kidney disease (PKD)
The Correct Answer is A
A. BPH is a common condition in older men that causes the prostate gland to enlarge, obstructing the urethra and leading to difficulty urinating, urinary retention, and pelvic pain. The symptoms described, including urinary frequency, weak urinary stream, severe pelvic pain, and a significantly elevated post- void residual urine volume, are consistent with BPH.
B. ESRD can cause urinary symptoms. However, the presentation in this case is more consistent with a urinary obstruction, not a kidney failure issue. ESRD typically involves more systemic symptoms like fatigue, edema, and electrolyte imbalances.
C. This is unlikely given the patient's age and lack of significant comorbidities. Additionally, the primary issue appears to be urinary obstruction, not a decrease in renal perfusion.
D. This is a chronic condition that typically presents with flank pain, and it does not usually cause acute urinary retention.
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Related Questions
Correct Answer is C
Explanation
A. These values are within normal ranges.
B. BUN is low, but potassium and creatinine are within normal ranges.
C. Elevated potassium (hyperkalemia), low hemoglobin (anemia), and elevated creatinine are all classic signs of chronic kidney disease.
D. BUN and creatinine are slightly elevated, but not to a level indicative of chronic kidney disease. Potassium is within normal range.
Correct Answer is B
Explanation
A. Patients with PKD may have issues with kidney function over time, which can affect potassium levels. Typically, a high-potassium diet is not recommended for those with kidney problems because it can exacerbate hyperkalemia.
B. Polycystic kidney disease can lead to progressive loss of kidney function, and many patients eventually require dialysis or a kidney transplant as the disease advances and kidney function declines.
C. There is no general recommendation for a vasectomy solely based on having PKD. While PKD is a genetic condition, and individuals with PKD can pass the condition on to their children, there is no requirement for men with PKD to undergo sterilization.
D. People with PKD are potential candidates for kidney transplantation if their kidney function deteriorates to the point where dialysis is required. PKD itself does not disqualify individuals from receiving a kidney transplant.
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