Patient’s lifestyle
Dear Jillian
I find your post very insightful. At the same time, I think that some of your assertions are not entirely true. For example, you have indicated that you would recommend antibiotics for the urinary tract infections suffered by the patient in question as a result of his benign prostatic hyperplasia (BPH). From the case study, the symptoms associated with BPH are affecting the patient’s quality of life, as evidenced in the way he is forced to keep waking up several times during the night to urinate. The symptoms suffered by the patient in question demonstrate that his BPH has reached the acute stage. According to Foo (2017), acute BPH entails recurrent urinary tract infections and bothersome symptoms, such as chronic or acute retention of urine. In your treatment plan for the patient, you have recommended only antibiotics. However, a patient with BPH may need to be presented with the option of surgery (Foo, 2017). Besides, the specific drugs you recommend for the management of complications or symptoms associated with BPH should be determined by the results of various tests you have suggested in your differential diagnosis. For example, Nunes, Manzano, Truzzi, Nardi, Silvinato, Bernardo (2016) argue that a combination of iSARs and alpha-blockers are effective for patients with severe to moderate LUTS characterized by reduced maximum urinary flow and increased prostate volume. As such, you can only be certain of the specific group of drugs you will recommend to your patient once you have access to the results of the test you have ordered.
At the same time, you seem to have ignored one crucial detail pertaining to the patient’s lifestyle. The case scenario indicates that the patient is a banker by profession. Thus, he is likely to have a sedentary lifestyle. A sedentary lifestyle is a major risk factor for the development of benign prostatic hyperplasia (Lim, 2017). As such, you should incorporate non-pharmacological interventions when developing the treatment plan for the patient in question, such as regular exercises. Besides, the patient’s BPH may have reached severe levels to the point that it has resulted in renal damage. However, you have not entertained the idea that the patient has a renal problem. On this note, renal loss is one of the causes of hypomagnesemia (Assadi, 2010). As such, you may consider assessing the patient serum magnesium levels in case his condition deteriorates or points to him having renal problems.
Besides, you have stated that a biopsy is not necessary for confirming if your patient has prostate cancer or not. High PSA levels may be as a result of various conditions, including BPH. As such, the only way to conclusively diagnose the cause of the elevated PSA levels in patients is to conduct a biopsy (Marroquin, 2011).). Thus, a biopsy is very important when examining the patient in question since he already has signs consistent with BPH.
References
Assadi, F. (2010). Hypomagnesemia: An evidence-based approach to clinical cases. Iranian Journal of Kidney Diseases, 4(1), 13–19.
Foo, K. T. (2017). Pathophysiology of clinical benign prostatic hyperplasia. Asian journal of Urology, 4(3), 152-157.
Lim, K. B. (2017). Epidemiology of clinical benign prostatic hyperplasia. Asian journal of Urology, 4(3), 148-151.
Marroquin, J. M. (2011). To screen or not to screen: ongoing debate in the early detection of prostate cancer. Clinical Journal of Oncology Nursing, 15(1), 97.
Nunes, R. V., Manzano, J., Truzzi, J. C., Nardi, A., Silvinato, A., Bernardo, M. W. (2016). Treatment of benign prostatic hyperplasia. Rev Assoc Med, 63 (2): 95-99.