Benign Prostatic Hyperplasia FINAL Flashcards
BPH Patho
Prostate gland enlarges –> extends upward into the bladder and inward –> causes bladder outlet obstruction impairing urinary elimination
With aging and increased dihydrotestosterone (DHT) levels, the glandular units in the prostate undergo nodular tissue hyperplasia (an increase in the number of cells).
BPH S/Sx
-Difficulty starting and stopping stream
-Frequency, straining to begin urination, nocturia, hesitancy, force & size of stream, bladder fullness after voiding, postvoid dribbling/leaking
-bladder distention
-International Prostate Symptom Score (I-PSS) questionnaire
BPH Risk factors
- Older age
- Family history
- Smoking, chronic alcohol use
- Obesity, Decreased physical activity
- Diabetes mellitus, heart disease
- Western diet (high fat, high carbs, low fiber)
- Testosterone and other androgen supplements
BPH Meds
-Alpha Blockers- tamsulosin (Flomax)
-5-Alpha Reductase Inhibitors (5-ARI)-finasteride (Propecia, Proscar)
BPH Diagnostics/Labs
- UA or urine culture – increased WBC & bacteria, possibly RBC’s with hematuria (with UTI)
- Serum prostate-specific antigen (PSA) and a serum acid phosphatase level
to rule out prostate cancer - Basic metabolic panel to examine kidney function (BUN and creatinine)
- Transabdominal ultrasound and/or transrectal ultrasound (TRUS)
- MRI
- Digital rectal exam- may reveal enlarged, smooth prostate
Tamsulosin (Flomax) nursing considerations
Assess for orthostatic hypotension, tachycardia, and syncope
Teach to be careful when changing positions
Report any weakness, lightheadedness, or dizziness
BPH Complications
-UTI caused by urinary stasis and retention
-kidney damage caused by backflow of urine
-freq urges to void
-overflow incontinence
Ways to prevent bladder distention
Avoid drinking large amounts of fluid in short period
Avoid alcohol, diuretics, and caffeine
Voiding as soon as urge is felt
Avoid drugs that can cause urinary retention (anticholinergics, antihistamines, and decongestants)
