A 76-year-old with benign prostatic hyperplasia (BPH) is agitated ...

[sheilaspns]

A 76-year-old with benign prostatic hyperplasia (BPH) is agitated and confused, with a markedly distended bladder. Which intervention prescribed by the health care provider should the nurse implement first?
 
  a. Insert a urinary retention catheter.
  b. Schedule an intravenous pyelogram (IVP).
  c. Draw blood for a serum creatinine level.
  d. Administer lorazepam (Ativan) 0.5 mg PO.

Question 2

Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider?
 
  a. Complaint of flank pain
  b. Blood pressure 90/48 mm Hg
  c. Cloudy and foul-smelling urine
  d. Temperature 100.1 F (57.8 C)

[macmac]

Answer to Question 1

ANS: A
The patient's history and clinical manifestations are consistent with acute urinary retention, and the priority action is to relieve the retention by catheterization. The BUN and creatinine measurements can be obtained after the catheter is inserted. The patient's agitation may resolve once the bladder distention is corrected, and sedative drugs should be used cautiously in older patients. The IVP is an appropriate test but does not need to be done urgently.

Answer to Question 2

ANS: B
The low blood pressure indicates that urosepsis and septic shock may be occurring and should be immediately reported. The other findings are typical of pyelonephritis.

[sheilaspns]

Thank you

[macmac]

No problemo