BPH Flashcards
BPH:
Benign prostatic hyperplasia
No malignant enlargement of the prostrate gland commonly sent in the aging man
T/F
BPH is the most common benign neoplasm in men
True
BPH begins as ____
Small nodules
Androgen
Type of hormone that stimulates the development and maintenance of male sex characteristics
Signals DHT
DHT
Dihydrotestosterone
Mediates prostatic growth
Prostate sensitive to this
Hyperplasia
Increase in the number of cells
Risk Factors:
Age
Testosterone
African American men (more severe and progressive)
Two main risk factors
Age
Testosterone
Medications to avoid
OTC meds
Antihistamines
Decongestants
Phenylephrine
Indications of BPH
Dysuria Frequency Urgency Leakage Decreased force of stream Hesitancy No tutus
Most common diagnostic test for BPH
Digital rectal examination (DRE)
Surgery
TUNA
TURP
TUIP
TURP w/ CBI:
Rate of flow?
Should be maintained to keep the output light pink or colorless
TUNA
Low level radio frequency through twin needles to burn away a region of the enlarged prostate
Improves flow of urine
TURP
Most often used
Remove obstructing prostate tissue
Flushed into bladder
Stored until end of surger
Post op complications of TURP
Hemorrhage
Clot retention
Inability to void
UTI
TUIP
Small incisions made in the smooth muscle where the prostate is attached to the bladder neck
Pharm therapy
Alpha blockers
5-alpha reductive inhibitors
Nonpharmalogic Therapy
Urinate at first urge
Avoid alcohol and caffeine
Drink small amounts of fluid throughout the day enter
avoid drinking fluids within two hours bedtime
avoid over-the-counter’s cold and sinus medication that contains decongestion’s and/or anti-histamines
exercising regularly including pelvic floor exercises
reducing stress
At what age should men be assessed for possible BPH
40 years old
Clinical manifestations that the nurse should expect to observe when assessing a client with BPH
Symptoms of voiding BPH include hesitancy incomplete emptying weak or intermittent urinary stream dribbling at the end of ruination Straining during urination
Clinical manifestations of storage BPH
Frequency and incontinence
True or false
BPH is the most common benign tumor in men and almost all man will develop BPH if they live long enough
True
True or false
Hyper trophy of the detrusor muscle of the bladder to compensate For increased resistance eventually result in bladder instability and decreased bladder capability
True
Natural ways to do about the BPH Without medications
Lifestyle changes that may help clients with mild BPH include avoiding alcohol and caffeine exercising regularly, including Kegel exercises, avoiding drinking fluids within two hours of bedtime, and reducing stress
Post perineal prostatectomy
A client should not use enemas to address constipation due to the proximity of the incision to the anus. This results in a high risk for infection.
A fluid intake 2 to 3 L per day is recommended to prevent UTIs.
Perineal irrigations with sterile normal saline should be down after each bowel movement to help prevent infection infection.
Which instructions and the nurse include to promote healing for a client being discharged post prostate surgery?
Upon discharge the client should be instructed to avoid strenuous activity and heavy lifting, drink food juices, and take stool softeners as ordered, and to avoid sexual activity for at least six weeks after surgery. The client should not drive for at least two weeks. NSAIDs should not be used for at least two weeks after surgery.
Five alpha reductase inhibitor
Dutasteride (Avodart)
Potential adverse effects that the nurse should include in teaching about this medication
Impotence
Decreased libido
Decreased volume of ejaculation
Diagnostic tests for BPH
UA
DRE
PSA
Ultrasound or postvoid cath
Which findings of BPH would support the need for surgery
Urinary retention, hematuria, Bladder stones, and renal insufficiency secondary to be BPH
Which procedure Has the lowest risk for postop retrograde ejaculation
TUIP
TURP
Symptoms of TURP syndrome
TURP Syndrome occurs when the client absorbs the irrigation fluids during and after surgery.
Clinical manifestations are hypo natremia, decreased hematocrit, hypertension, bradycardia, Nausea, and confusion.
Post op TURP
Assess for which complications
During the first 24 to 48 hours after a TURP, the client should be monitored closely for hemorrhage, the presence of large blood clot’s, decreased urinary output, increase bladder spasms, decreased hemoglobin in hematocrit, tachycardia, and hypotension.
Discharge instructions for a client who has undergone prostate surgery
Bleeding
BM
Activity
Sexual intercourse
Which elements of a health history for a client with BPH should be documented
Pain, blood in the urine, wrist factors, and urinary elimination patterns
CBI:
Prevents the nation of blood clots, which can obstruct urinary output.
If the patient has a CB high, assess the catheter in the drainage tube at regular intervals. Maintain the rate of flow of irrigating fluid to keep the output light pink or colorless. Assess the urinary output every 1 to 2 hours for color consistency of them out, and presents that blood clots. Assess the patient for bladder spasms and pain.
