BPH (Exam 2) Flashcards
Benign Prostatic Hyperplasia
Gland increase in size, gland grows inward, causing narrowing of urethra and dirupation of urine output
BPH-Clinical Manifestations
Irritative:
-Inflammation or infection
-Nocturia
-Frequency
-Dysuria
-Bladder pain
-Incontinence
Obstructive:
-Increase effort of bladder as it tries to empty through decreased diameter of urethra
-Decrease caliber and force of stream
All symptoms are referred to as LUTS
Mild BPH Treatment
Watchful waiting
Avoid decongestants (pseudoephedrine) and (diphenhydramine)
-Tighten prostate muscles
Restrict evening fluids
Double void (wait then try to go again)
BPH: Drug Therapy
-Finasterid
-Tamsulosin
Combination
BPH: Herbal Therapy
Saw Palmetto (no evidence)
BPH: Invasive Therapy
Transurethral Resection of Prostate
Transurethral resection of Prostate
Gold standard surgical treatment, however, minimally invasive are becoming more common
Removal of prostate tissue
Resectoscope insertion into urethra (tissue is excised)
Anesthesia for TURP
General or spinal anesthesia
Is TURP in patient or outpatient
Inpatient procedure
TURP post procedure
Large 3 way indwelling catheter (30 ml balloon)
Continuous bladder irrigation
Continuous Bladder Irrigation (CBI)
Bags of normal saline hooked up to three way catheter
Purpose to maintain patency with swelling taking place
CBI rate of infusion
Based on color of urine
Blood clots expected first 24-36 hrs
However, large amounts of bright red blood may indicate hemorrhage
Urine flow should continuous be light pink without any clots
CBI: Blood clots are increasing in amount and getting larger, what is the next best nursing action?
Increase infusion
With CBI blood clots are expected with first
24-36 hours
Is there a risk for fluid volume excess with CBI?
No, the Normal Saline is just going into the bladder and back out through catheter
The fluid is not reaching the intravascular space
CBI: I&O’s
Subtract the irrigation solution
