A nurse is evaluating a client's laboratory results. The nurse should recognize that an increase in the client's prostate-specific antigen (PSA) laboratory value is indicative of which of the following diagnoses?

Choice A reason: Impaired skin integrity is a significant risk due to the constant exposure of the skin around the stoma to urine, which can lead to irritation and breakdown. Proper skin care and stoma care are essential to prevent complications.
Choice B reason: Disturbed body image is also a risk as the client adjusts to the physical changes and the presence of a stoma, which can impact self-esteem and body perception.
Choice C reason: Fluid volume deficit can occur if the client does not maintain adequate fluid intake or if there is significant leakage from the stoma. Monitoring fluid balance is crucial.
Choice D reason: Anxiety is common as clients adapt to managing a new ostomy, worrying about potential complications, and coping with changes in body function.
Choice E reason: Infection is a risk due to the exposure of the stoma and surrounding skin to bacteria from the urine. Proper hygiene and care are vital to prevent infections.

Choice A reason: Cleaning the inside of the container with a wipe is not part of the standard procedure for collecting a midstream urine sample. The focus should be on maintaining external cleanliness to avoid contamination of the sample.
Choice B reason: Urinating a little then stopping is part of the process, but this statement alone does not indicate a complete understanding of the procedure. The critical aspect is how the client cleans and collects the sample to ensure it is not contaminated.
Choice C reason: Using the cleansing wipe from front to back is the correct procedure for collecting a midstream urine sample. This method helps prevent contamination from bacteria that could be present around the genital area, ensuring a more accurate sample for analysis.
Choice D reason: Using each cleansing wipe twice is not advised as it can lead to contamination. Each wipe should be used only once to maintain hygiene and ensure the accuracy of the urine sample.