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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This method is the most reliable for measuring fluid retention. Weight changes are a direct indicator of fluid balance because fluid retention or loss affects body weight. By comparing the client's current weight to their post-dialysis weight, you can determine the amount of fluid they have retained.
B. Creatinine and blood urea nitrogen (BUN) levels are indicators of kidney function rather than fluid volume status. Elevated levels can indicate worsening kidney function but do not directly measure fluid retention or overload.
C. While assessing skin turgor and peripheral edema can provide some clues about fluid overload, these signs are less precise and subjective compared to weight measurements. Skin turgor changes and edema can be influenced by various factors, including skin elasticity and other conditions, making them less reliable for accurately measuring fluid volume changes since the last dialysis.
D. Crackles in lung sounds can indicate pulmonary congestion due to fluid overload, but this method is not as precise for quantifying the amount of fluid retained. Crackles suggest fluid accumulation in the lungs, which is a sign of more severe fluid overload but does not provide a specific measurement of fluid volume compared to changes in body weight.
Correct Answer is B
Explanation
A. This is incorrect and potentially dangerous. A non-functioning fistula will not provide adequate blood flow for dialysis and can lead to complications.
B. This is the correct action. The nurse should immediately inform the healthcare provider about the compromised fistula. The provider can order further diagnostic tests or interventions as needed.
C. This might improve blood flow temporarily, but it is not a definitive solution and does not address the underlying issue.
D. While warm packs can sometimes improve circulation, it is unlikely to resolve the serious issues found in this case.
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