Reference no: EM133846021

Question

Mr. Bahr is a 59-year-old man who is undergoing an annual physical today. His past medical history includes hypertension which is well controlled with losartan (Cozaar), 50 mg taken once daily. During his last annual physical, his blood pressure was 128/78, and he had no concerns other than having to wake up to urinate once in the middle of the night. During today's visit, his blood pressure is 126/80. He tells the nurse that he now has to get up three to four times every night to urinate.

Mr. Bahr shares with the nurse that he has difficulty starting a stream of urine, that the flow of urine feels "weak," and that he frequently experiences dribbling at the end of urination. His primary care provider performs a physical assessment, including a digital rectal examination that reveals a large prostate. The nurse notes that the patient had a PSA blood test drawn last year with the results showing 1 ng/mL. The provider orders a new PSA blood test.

Mr. Bahr's PSA level is 12 ng/mL. A needle biopsy that was performed confirmed a diagnosis of stage III prostate cancer. The provider discusses radical prostatectomy, radiation, and hormonal therapy as options. Mr. Bahr chooses to have the radical prostatectomy procedure.

1. What are the abnormals and their clinical significance?

2. Prioritize the top 3 abnormals.

3. List the 5 most important interventions for the top priority (from question #2) and provide the rationale for each intervention.

4. What are 3 potential complications that could happen with this client?

5. Postoperatively, what complications should the nurse recognize that require immediate intervention?

6. (Opinion Question) Mr. Bahr's condition is stable following the open radical prostatectomy procedure and is discharged. What information should be included in this patient's discharge instructions? Include information regarding potential long-term issues the patient may experience as a result of the surgical procedure.