CASE STUDY:
Ohon Kimathi, 58-year-old male client (DOB: 5/25/1966), presents with complaints of straining to urinate, a weak urine stream, and dribbling at the end of urination for the past three months. He also states he feels he cannot fully empty his bladder. The NP administers the IPSS with results demonstrating moderate symptoms. A digital rectal exam reveals a smooth prostate. The rest of the physical examination is unremarkable. A urinalysis, urine cytology, and multiple labs are ordered, including a PSA blood test. When the results return, there are no signs of infection or cancer. The client is diagnosed with BPH, and medications are considered.
Past Medical History: High Cholesterol
Allergies: None
Medications: atorvastatin (Lipitor) 40mg PO daily
Social History: He has never smoked cigarettes and drinks alcohol twice per month.
Physical Exam:
• Height: 6 feet 1 inch
• Weight: 210 lbs
• Body Mass Index (BMI): 27.7
• Blood Pressure (BP): 117/78
• Heart Rate (HR): 69
• Respiratory Rate (RR): 18 
• Oxygen Saturation (O2 Sat): 98% on RA
• Temperature (TEMP): 98.6 oral
An appropriate prescription for Ohon is:
Name: Ohon Kimathi
Date Of Birth: 5/25/1966
Date Prescribed: Current Date
Rx: tamsulosin (Flomax) 0.4 mg
Disp: 30
Sig: Take one tablet by mouth once daily, 30 minutes after a meal.
Refills (O-4): 4
Dispense as Written:
Generic Substitution Permitted:
• Either Dispense as Written or Generic Substitution Permitted should be checked on every written prescription depending on what is best for each client. Refer to the week 1 lesson for criteria.
Rationale: The client presents with multiple symptoms of urinary retention and a prostate that is smooth. The NP performs additional diagnostic tests to determine if the client is experiencing urinary retention from BPH or other causes. Since there are no signs of other causes, medication for BPH is prescribed. According to the CPG, alpha blockers are indicated as first-line treatments. Tamsulosin, a selective alpha-blocker, is prescribed at the lowest dose (0.4 mg) according to the CPG, and a follow-up visit is indicated in four to twelve weeks to assess for adverse effects (especially sexual dysfunction, a major reason for client dissatisfaction with therapy) and to ensure treatment is working (Lerner et al., 2023; Luu et al., 2021; Rosenthal & Burchum, 2025).

Step 1: Assess the client’s case, the applicable clinical practice guideline (CPG), and the prescription information provided.
Step 2: Answer the discussion prompts below with explanation and detail, providing complete references for all citations. Refer to the lesson for client information.
Include the following sections:
1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
a. Describe your assigned client’s situation. Why are they presenting to the clinic? What medications are they currently taking?
b. Assess the applicable clinical practice guideline (CPG) for your assigned client linked on the same page in the lesson where the client case is located. What treatment is recommended by the CPG for your client’s situation?
c. Discuss your personal professional assessment of the client’s situation provided in the scenario. What pharmacological treatment is necessary and why?
d. Reflect on additional questions you have about your assigned client that may influence treatment. What else do you need to know? What follow-up assessments, labs, or conversations are required to ensure optimal health outcomes?

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