A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

A) Painful urination: Painful urination, also known as dysuria, is not a typical symptom of BPH. Dysuria is more commonly associated with conditions such as urinary tract infections (UTIs) or urethritis rather than BPH.

B) Urge incontinence: While BPH can cause lower urinary tract symptoms such as urgency and frequency, urge incontinence (involuntary loss of urine associated with a sudden urge to urinate) is not typically a primary symptom of BPH. Urge incontinence is more commonly associated with overactive bladder (OAB) syndrome.

C) Critically elevated prostate-specific antigen (PSA) level: While BPH can cause an elevation in PSA levels, a critically elevated PSA level alone is not a definitive diagnostic finding for BPH. PSA levels can be elevated in various conditions affecting the prostate gland, including BPH, prostate cancer, and prostatitis. Therefore, PSA levels must be interpreted in conjunction with other clinical findings and diagnostic tests to accurately assess prostate health and diagnose specific prostate conditions.

D) Difficulty starting the flow of urine: Benign prostatic hyperplasia (BPH) is characterized by the enlargement of the prostate gland, which can obstruct the flow of urine through the urethra. This obstruction leads to symptoms such as difficulty starting the flow of urine, weak urinary stream, urinary hesitancy, and incomplete bladder emptying. These symptoms occur due to the mechanical obstruction of the urethra by the enlarged prostate gland. Difficulty starting the flow of urine is a hallmark symptom of BPH and is often one of the earliest manifestations experienced by affected individuals.

A) Utilitarianism: Utilitarianism focuses on the greatest good for the greatest number of people. In this scenario, the nurse's decision not to administer the pain medication is not based on maximizing overall benefit but rather on avoiding harm to the individual client.

B) Non-maleficence: Non-maleficence is the ethical principle of doing no harm. The nurse's decision not to administer the pain medication is rooted in the desire to avoid causing harm to the client by potentially hastening their death.

C) Fidelity: Fidelity refers to the obligation to fulfill commitments and responsibilities. While important, fidelity is not directly relevant to the nurse's decision in this scenario.

D) Veracity: Veracity refers to truthfulness and honesty. While honesty is crucial in communicating with the client and their family about their condition and care, it is not the primary ethical principle guiding the nurse's decision in this situation.