Medical Surgical BPH #5

Question

A client asks the nurse how he can be checked for an enlarged prostate. Which is the main way to screen for benign prostate hypertrophy (BPH)?

Answers

  1. Uroflowmetry
    • Rationale:

      This answer is not correct since the test results from uroflowmetry help determine over time if BPH is becoming better or worse. Uroflowmetry involves a machine measuring the strength and amount of urine flow.

  2. BUN and PSA lab studies
    • Rationale:

      This answer is not correct because of the amount of false positive results. Increasing levels of PSA can indicate BPH or prostate cancer.

  3. Digital rectal examination (DRE)
    • Rationale:

      This answer is correct because using the sensory of touch is the best way to assess for an enlarged prostate due to palpating the prostate. By palpating the prostate, the provider can find any abnormalities in the size, shape, or texture that may indicate further testing.

  4. Transrectal ultrasound
    • Rationale:

      This answer is not correct because it is considered more invasive and is usually resolved after DRE has indicated an abnormality in the prostate. During a transrectal ultrasound, a small probe is inserted into the rectum to examine the prostate gland.

Overview

The main way to screen a client for BPH is by a digital rectal examination (DRE). The American Urological Association recommends that men older than 50 years should have a yearly DRE to assess the prostate.

Explanation

Learning Outcomes

The most effective way to screen for BPH is by DRE. DRE uses direct palpation to assess the prostate for enlargement. During DRE, the provider inserts a lubricated gloved finger into the rectum to palpate the prostate for any abnormalities. The provider will assess for the shape, size and texture of the prostate gland. Additional testing may be indicated if findings are abnormal. The next test is typically lab testing of BUN and PSA. Urinary flow tests can evaluate residual urine and determine the flow rate. Then on to the more invasive tests of transrectal ultrasound which will provide visualization of the prostate gland.

Test Taking Tip

Think about the easiest way for a provider to start a prostate screening on a male client. By the use of palpation. By this way, he can immediately assess the need for further testing.

Video Rationale