BPH Flashcards
BPH is a common condition in?
men
Hypertrophy is?
non-cancerous enlargement may extend into the bladder.
BPH causes ________ or _______ of the prostatic urethra obstructs urine flow.
- compression
- distortion
What leads to urinary retention with BPH?
diverticulum musculature
What leads to urinary frequency in BPH?
sensitivity of the detrusor muscle
You have an increased risk for _____ with BPH?
UTI
What is the lab to test for BPH?
Prostate- specific antigen (PSA)
others: UA, BMP, renal tests
What are the risk factors for BPH?
Males > 40 yrs, AA, smoking, ETOH, HTN, CAD, DM
Symptoms of BPH:
- urinary retention that leads to frequency, oliguria and anuria
- high voiding pressure which makes urine flow hard to start and difficult to maintain (dribbling)
- decreased urine stream caliber and force
- nocturia and abdominal strain
- recurrent UTI’s
symptoms of a UTI:
dysuria, burning, frequency, urgency, nocturia, incontinence and suprapubic/pelvic pain
Preoperative nursing care for transurethral prostate surgery?
- anxiety related to surgery
- acute pain related to bladder distention
- deficient knowledge related to treatment
Postoperative nursing care for transurethral prostate surgery?
- acute pain lated to incision, catheter placement and bladder spasms
- risk for fluid volume overload related to hypotonic irrigation perioperative and postoperative
- risk for bleeding r/t the vascularity of prostate organ or obstructed catheter.
- risk for DVT, infection and sexual dysfunction
patients with BPH are treated with?
5-alpha reductase inhibitors or androgen inhibitors and alpha adrenergic receptor blockers
herbal remedies show to improve urinary flow symptoms of BPH?
saw palmetto
TURP is the most commonly used surgery but people who are not good candidates may end up getting?
stents
symptoms of FVO?
- JVD
- S3
- crackles
- increase BP
- confusion
- respiratory distress
Hyponatremia symptoms?
- AMS or confusion
- headache
- N/V
- muscle twitching
hemorrhage symptoms:
- decreased bp
- increased HR and RR
- gross hematuria
- restlessness
- pallor
- decreased H/H
obstructed catheter due to _____ _________ as a result of the procedure, over distention of bladder can induce _____ ________ by stretching the prostatic capsule.
- clot formation
- secondary hemorrhage
Assess for?
- lower abdominal distention
- percussion of suprapubic region
- increased dullness
- DVT/ PE
- Infection
TURP infections to assess for?
UTI and epididymis
sexual dysfunction may occur due to?
ED, decreased libido and fatigue
- triple-lumen catheter
- precise I/O, calculate O
- maintain irrigation rate keeps urine pink, free from clot obstruction
- assess for pain, bladder spasms, abd distention
- no sitting for prolonged periods
this is?
continuous bladder irrigation (CBI)
tripe-lumen catheter does?
- irrigation
- tamponade
- drainage
- traction
1st lumen is for?
urinary drainage
2nd lumen is for?
retention balloon
3 lumen is for?
continuous sterile bladder irrigation
1st and 3rd lumen return to?
urinary drainage bag
how do you calculate u/o?
total irritant instilled subtract total output in drainage bag.
CBI output must =
amount infused
to prevent clot retention main pink to clear irrigation if clots are present:
increase irrigation rate
give antispasmodic for?
pain/ bladder spasms
complication with CBI:
resection > 90 risk is higher
TUR syndrome irrigation is absorbed intraoperatively through the prostatic veins.
TUR syndrome symptoms:
- bradycardia
- confusion
- FVO & dilution hyponatremia
self care:
perineal or kegel exercises
straining or heavy lifting after turn could cause
increase in pressure or bleeding
spicy food, etoh, and coffee may?
irritate the bladder
keep the fluids coming to prevent?
clots!
report signs of _____,_____,______ to HCP.
- decreased urinary stream
- distention
- UTI
