Benign Prostatic Hyperplasia

Question 1

What is BPH?

Answer 1

Noncancerous enlargement (hypertrophy) of the prostate

Question 2

What are the manifestations of BPH? (8)

Answer 2

• Nocturia
• Hematuria
• Urgency
• Frequency
• Retention
• Straining
• Incomplete emptying
• High post-void residual

Question 3

What is the normal post-void residual (PVR) range?

Answer 3

< 50 - 100 mL

Question 4

A ______ should be conducted in the case of extreme retention / inability to void

Answer 4

Bladder scan

Question 5

Inability to void is considered ______

Answer 5

An emergent situation

Question 6

What diagnostic test is the most important indicator for diagnosis of BPH?

Answer 6

Digital rectal exam (DRE)

Question 7

What DRE findings indicate BPH diagnosis? (3)

Answer 7

• Large
• Rubbery
• Non-tender

Question 8

What is the primary intervention for a patient who is unable to void?

Answer 8

Immediate catheterization

Question 9

What procedure is used if catheterization is unable to be used for BPH?

Answer 9

Cystostomy - incision into the bladder

Question 10

What medications are used for the treatment of BPH? (2)

Answer 10

• tamsulosin
• finasteride

Question 11

What is the function of tamsulosin?

Answer 11

Improves urine flow

Question 12

What is the function of finasteride?

Answer 12

Decreases prostate size

Question 13

What complications are associated with BPH? (4)

Answer 13

• UTIs
• Urinary retention
• Hydroureter
• Hydronephrosis

Question 14

What is the primary surgical procedure used for the treatment of BPH?

Answer 14

Transurethral resection of the prostate (TURP)

Question 15

What is TURP?

Answer 15

Removal of the inner portion of the prostate through an endoscope through the urethra

Question 16

Describe pre-op nursing care for BPH surgical resection (4)

Answer 16

• Monitor voiding
• Hold anticoagulants
• Administer enema
• Lithotomy position

Question 17

Describe post-op nursing care for BPH surgical resection (2)

Answer 17

• Maintain fluid balance
• Administer oxybutynin

Question 18

How is fluid balance maintained during BPH post-op care?

Answer 18

3-way foley catheter

Question 19

When using a 3-way foley catheter, irrigate with ______ at a time

Answer 19

50 mL of solution

Question 20

Describe the expected drainage from a 3-way foley catheter

Answer 20

Pink / light red

Question 21

What does bright red catheter drainage indicate?

Answer 21

Arterial bleeding - requires surgery

Question 22

What does dark red catheter drainage indicate?

Answer 22

Venous bleeding

Question 23

The prostate is ______ causing it is bleed easily

Answer 23

Highly vascular

Question 24

What are some causes of pain post-op BPH surgical resection (3)

Answer 24

• Incision site
• Bladder spasms
• Excoriation from catheter size

Question 25

Transurethral resection syndrome is a ______

Answer 25

Rare complication

Question 26

What is the cause of transurethral resection syndrome?

Answer 26

Absorption of irrigation fluid

Question 27

What are the manifestations of transurethral resection syndrome? (4)

Answer 27

• Bradycardia
• Hypotension
• Hyponatremia
• Hypervolemia

Question 28

Describe the treatment of transurethral resection syndrome (2)

Answer 28

• Diuretics
• Hypertonic IV fluid