Exam 1 Material : Renal Benign Prostatic Hyperplasia Flashcards
What is benign prostate hyperplasia?
Benign enlargement of prostate gland.
It will eventually cause urethral obstruction
What are the risk factors for developing BPH?
Age relatedhormonalchanges
( Decreased testosterone hormones and higher proportion of estrogen levels as males age)
Obesity,sedentarylifestyle
Alcohol,smoking
DM
Erectiledysfunction
Family history
What are the clinical manifestations of BPH?
Gradual onset
Nocturia (first usual symptom)
Urinary frequency, urgency, incontinence
Dysuria, bladder pain
Urinary retention
Difficulty initiating urination, intermittency
Dribbling at end of voiding
What are the complications that can arise from BPH?
UTIs, pyelonephritis, bladder damage,renal failure (from hydronephrosis)
Acute retention = must be treated immediately. Who hasn’t voided every 3 to 4 hours. Can lead to renal failure.
Renal Calculi = increased risk for stone formation and UTI and sepsis
What diagnostic tests can be done for BPH?
DRE (digital rectal exam)
PSA (prostate specific antigen)
UA and culture
Creatinine
Transrectal ultrasound (TRUS) = Visualizes prostate
What medications can be given for BPH?
1) 5α-Reductase inhibitors- finasteride (Proscar)
Reduces prostate size. Also reduces PSA levels by almost half.
Can take about 6 months to show effectiveness
Must take consistently.
2) α-Adrenergic receptor blockers- tamsulosin (Flomax)
Does NOT reduce prostate size.
Helps relieve urinary symptoms by causing prostate smooth muscle relaxation.
Can take 2-3 weeks for results
What occurs during Transurethral Resection of Prostate (TURP) procedure?
Gold standard surgery for BPH.
Removal and cauterization of prostate tissue through urethra.
During the surgery and post op, Continuous Bladder irrigation and Large 3-way Foley are used in order to prevent clots.
What patient teaching should be done for patients that underwent TURP?
Avoid anything that can increase abdominal pressure (ie: No heavy lifting, careful when sitting and walking, prevent constipation)
Don’t have sex for at least 4-6 weeks.
Take stool softeners.
Open prostatectomy is another surgical procedure that can be done. What should the nurse be aware of?
Can cause nerve damage which can lead to ED
Keep the dressing clean, dry and intact
What are the post op care for Open prostatectomy surgery patients?
Catheter removed in 2-4 days => Foley care, leg bag
Drains (JP)
Urinary incontinence or dribbling (may last several weeks) => Kegel exercises
ED (possible with open surgery), retrograde ejaculation (ejaculation goes back into the bladder and make the urine turn cloudy)
Incision care (open prostatectomy)
Daily Stool softeners
Avoid heavy lifting (>10 lbs)
Drink 2-3 L of fluid
Showers ok; NO tub baths
