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benign prostatic hyperplasia, Study Guides, Projects, Research of Nursing

BPH treatment plan with evidence based practice

Typology: Study Guides, Projects, Research

2014/2015

Uploaded on 05/12/2025

batoul-bayram
batoul-bayram 🇺🇸

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Benign Prostatic Hyperplasia (ICD-10: N40.0 – Enlarged prostate without lower urinary tract
symptoms)
Clinical Scenario:
James presents for a routine annual exam. He mentions increasing difficulty initiating urination,
a weak urine stream, and waking up multiple times at night to urinate (nocturia). He denies pain,
blood in urine, or fever. He has no history of urinary tract infections or kidney stones.
Subjective:
Reports symptoms for the past 6 months
No dysuria or hematuria
No weight loss or fatigue
Feels frustrated by nocturia (2–3 times per night)
Denies family history of prostate cancer
Objective:
Vital signs: Stable
Digital Rectal Exam (DRE): Enlarged, smooth, non-tender prostate
Urinalysis: Normal, no infection
PSA: Mildly elevated at 3.5 ng/mL (age-adjusted borderline)
Bladder scan: No post-void residual
Assessment:
Benign Prostatic Hyperplasia (N40.0) with mild-to-moderate lower urinary tract symptoms.
Plan:
1. Lifestyle Modifications:
oLimit evening fluid intake and caffeine
oTimed voiding schedule
2. Pharmacologic Treatment:
oStart Tamsulosin 0.4 mg PO daily (alpha-blocker) to improve urinary flow
oDiscussed potential side effects (e.g., dizziness, retrograde ejaculation)
3. Monitoring:
oRecheck symptoms in 6–8 weeks
oRepeat PSA in 6 months if symptoms persist or worsen
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Benign Prostatic Hyperplasia (ICD-10: N40.0 – Enlarged prostate without lower urinary tract symptoms) Clinical Scenario: James presents for a routine annual exam. He mentions increasing difficulty initiating urination, a weak urine stream, and waking up multiple times at night to urinate (nocturia). He denies pain, blood in urine, or fever. He has no history of urinary tract infections or kidney stones. Subjective:  Reports symptoms for the past 6 months  No dysuria or hematuria  No weight loss or fatigue  Feels frustrated by nocturia (2–3 times per night)  Denies family history of prostate cancer Objective:  Vital signs: Stable  Digital Rectal Exam (DRE): Enlarged, smooth, non-tender prostate  Urinalysis: Normal, no infection  PSA: Mildly elevated at 3.5 ng/mL (age-adjusted borderline)  Bladder scan: No post-void residual Assessment: Benign Prostatic Hyperplasia (N40.0) with mild-to-moderate lower urinary tract symptoms. Plan:

  1. Lifestyle Modifications: o Limit evening fluid intake and caffeine o Timed voiding schedule
  2. Pharmacologic Treatment: o Start Tamsulosin 0.4 mg PO daily (alpha-blocker) to improve urinary flow o Discussed potential side effects (e.g., dizziness, retrograde ejaculation)
  3. Monitoring: o Recheck symptoms in 6–8 weeks o Repeat PSA in 6 months if symptoms persist or worsen
  1. Patient Education: o Discussed signs of worsening (e.g., urinary retention, hematuria) o Reviewed when to seek immediate care
  2. Referral: o Urology referral if no improvement or if complications develop