Urinary Obstruction

Home>Homework Answsers>Nursing homework helpUrinary ObstructionCase StudiesThe 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft.StudiesResultsRoutine laboratory studiesWithin normal limits (WNL)Intravenous pyelogram (IVP)Mild indentation of the interior aspect of the bladder, indicating an enlarged prostateUroflowmetry with total voided flow of 225 mL8 mL/sec (normal: >12 mL/sec)CystometryResting bladder pressure: 35 cm H2O (normal: <40 cm H2O)Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)Electromyography of the pelvic sphincter muscleNormal resting bladder with a positive tonus limbCystoscopyBenign prostatic hypertrophy (BPH)Prostatic acid phosphatase (PAP)0.5 units/L (normal: 0.11-0.60 units/L)Prostate specific antigen (PSA)1.0 ng/mL (normal: <4 ng/mL)Prostate ultrasoundDiffusely enlarged prostate; no localized tumorDiagnostic AnalysisBecause of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.Critical Thinking Questions1. Does BPH predispose this patient to cancer?2. Why are patients with BPH at increased risk for urinary tract infections?3. What would you expect the patient’s PSA level to be after surgery?4. What is the recommended screening guidelines and treatment for BPH?5. What are some alternative treatments / natural homeopathic options for treatment?6 years ago04.07.20195Report issueAnswer(1)Dr R Judy Mark4.7(1k+)4.7(123)ChatPurchase the answer to view itNOT RATEDUrinaryobstruction.docx6 years agoplagiarism checkPurchase $6Bids(62)Miss TutorTutor FaithProCastrol01Amanda SmithTalentedtutorprof.TimetestArizona WriterPsychology Expertbrilliant answersWendy LewisUrgent TutorBill_WilliamsENS. writerAll Works solverkim woodsProf. Celine M.Angelina MayCatherine OwensJessica Luiswangang_aother Questions(10)Assignment 2: What is Gross Domestic Product?Read an article and write a 150 words thesis statementKATE TUTOR ONLY Self-AnalysisPSY/225 Relationships BrochureNeed A++ work with low turnitin scoreHUMN 330 Ethical Issues in the NewsRead the article titled "Husband and Wife Differences in Response to Undesirable Life EventsAMNT 280 1-4 PowerPoint Presentation: The four categories of reciprocating engines.MilestonesRead "Florida Lawsuits Allege Price Gouging," and "They Clapped: Can Price-Gouging Laws Prohibit Scarcity? Summarize the main points and decide which graph (A, B, C, or D) can be used to explain each event and why. Read also in your textbook the article f

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