[Exam 3] Chapter 59: Assessment and Management of Problems R/T Male Reproductive Processes (Page1762-1764, 1171-1178) Flashcards
Benign Prostatic Hyperplasia: What is this?
A noncancerous enlargement or hypertrophy of the prostate. and one of the most common causes of diseases in aging men
Benign Prostatic Hyperplasia: What can this cause?
Bothersome lower urinary tract symptoms that affect quality of life by interfering with normal daily acativites and sleeping
Benign Prostatic Hyperplasia: What age does this occur?
Men older than 40
Benign Prostatic Hyperplasia: What is a critial mediator of prostatic growth?
DHT, dihydrotesterone
Benign Prostatic Hyperplasia: What causes this to occur?
When men have elevated estrogen levels and when prostate tissue becomes for sensitive to estrogen levels and less respopnsive to DHT
Benign Prostatic Hyperplasia: Risk factors for this?
SMoking
Heavy Alcohol
Obesity
REduced Activity
Hypertension
Diabetes/Hypertension
Western Diet (High animal fat and protein diet)
Benign Prostatic Hyperplasia: Common and age-related from what process?
Cell proliferation forms nodules that grow and glandular cells enlarge
Benign Prostatic Hyperplasia: What direction does growth occur?
Inward, pressing on urethra leading to urinary retention
Benign Prostatic Hyperplasia: How long does it take for chcanges to occur?
Occur over long period of time
Benign Prostatic Hyperplasia: Necessary preconditions to have this?
48 or older and must have testes
Benign Prostatic Hyperplasia: This is a result of complex interactions in the body involving what?
Resistance in the prostatic urethra to mechanical and spastic effects , and bladder pressure during voiding
Benign Prostatic Hyperplasia: Obstructive and Irritative symptoms may include ?
Urinary frequency, urgency, nocturia, hestancy to start urinating and decreased and intermittent force of stream
Benign Prostatic Hyperplasia: What are some manifestations as to how this could look?
Urinary symptoms of urinary obstruction, urinary retention (check to see elevated BUN) , urinary tract infections, and decreased bladder contractility
Benign Prostatic Hyperplasia: What complications will this lead into?
Infections of bladder and kidney
Hydroureter and Hydronephrosis
Renal Insufficiency
Benign Prostatic Hyperplasia: Generalized symptoms like this?
Fatigue, Anorexia, N/V, Pelvic Discomfort
Benign Prostatic Hyperplasia: Health history focuses on
unriary tract, previous surgeries, health issues, and family history of prostate disease
Benign Prostatic Hyperplasia: Nursing Diagnosis includes what?
Deficient Knowledge (Avoid Alcohol)
Urinary Retention
RF Infection
RF Imbalance Fluid Volume
Benign Prostatic Hyperplasia: What does a DRE reveal?
Large, rubbery and nontender prostate gland
Benign Prostatic Hyperplasia: Goals for treatment incude what?
Improve urine flow, relieve obstruction, and prevent disease progression
Benign Prostatic Hyperplasia: If ptient admitted on emergency basis because he is unable to void, what immediately happens?
Immediately catheterized
Benign Prostatic Hyperplasia and Medication: Which ones will be used?
Anti-Androgen Agents and Alpha-Adrenergic Antagonists
Benign Prostatic Hyperplasia and Medication: What do Anti-Androgen Agents do?
Cause the prostate to shrink
Benign Prostatic Hyperplasia and Medication: What do Alpha-ADrenergic Antagonists do?
Stop smooth muscle contraction of prostate that may be blocking urethra
Benign Prostatic Hyperplasia and Surgical Interventios: Which one do we need to know?
Transurethral Resection of the Prostate (TURP)
Benign Prostatic Hyperplasia and TURP: What does this involve?
Surgical removal of the inner portion of the prostate through an endoscope inserted through the urethra, no external skin incision is made
Benign Prostatic Hyperplasia and TURP: What can this be performed with?
Ultrasound guidance
Benign Prostatic Hyperplasia and TURP: What happens to the treated tissue?
. Goes into the bladder and vaporizes or become necrotic and sloughs
Benign Prostatic Hyperplasia and TURP: Debrie from procedure comes from?
the bladder
Benign Prostatic Hyperplasia and TURP Diagnoses: What are they?
Anxieety
Acute Pain Pre/Postoperatively
RF Imbalanced Fluid VOlume Postop
Deficient Knowledge
Benign Prostatic Hyperplasia and TURP: Complications and Potential Problems?
Heorrhage and Shock
Infection
DVT
Catheter Obstruction
Comp. With Catheter Removal
Urinary Incontinence
Sexual Dysfunction
Benign Prostatic Hyperplasia and TURP: Major goals before surgery include
adequate preparation and reduction of anxiety and pain
Benign Prostatic Hyperplasia and TURP: Major goals after surgery include
maintenance of lfuid volume balance, relief of pain and discomfort, ability to perform self-care activites, and absence of complications
Benign Prostatic Hyperplasia and TURP: How is the bladder irrigated?
A three way irrigation catheter system is used
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Bag is filled with what?
Sterile solution
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Bag is hooked up to what?
Triple lumen catheter, which rinses out blood and debris that TURP did
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: What does the outflow catheter do?
Collects all the waste that is leaving the body
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: What is the bulb inflation?
A balloon is placed inside the body in order to keep it in place
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: What to watch for?
Make sure it does not get clotted, because fluid will stop flowing and rupture bladder.
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Why do you not want the bag to run dry?
The blood will clot and will not be able to get out
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: With irrigation solution flowing in a lot, what else must you do?
Empty the cather drainage bag regularly as well
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: How to calculate I/O?
Ex: Subtract the 500 mL of the bag from the total 1000 mL in the bag
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Additional complications from this?
Infections
Hemorrhage
Clotting
Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: How will drainage appear immediately following surgery?
REddish pink and then clears to link pink within 24 hours but monitor for Hemorrhage
Benign Prostatic Hyperplasia and TURP: PAtient is advised to discotninue what before surgery?
Aspirin and NSAIDS and PLatelet Inhibitors 10-14 days before surgery
Benign Prostatic Hyperplasia and TURP - Relief of Pain: Monitor what?
Urinary drainage and keep catheter patent
Benign Prostatic Hyperplasia and TURP - Relief of Pain: Assessment of pain may include what?
Bladder spasms that cause feelings of pressure and fullness in bladder, urgency to void, or bleeding from the urethra around the catheter
Benign Prostatic Hyperplasia and TURP - Relief of Pain: What can we give to relieve bladder spasms?
Muscle relaxants
Benign Prostatic Hyperplasia and TURP - Relief of Pain: What other than meds can be done to relieve spasms?
Warm compress or sitz baths
Benign Prostatic Hyperplasia and TURP - Relief of Pain: What meds could be administered?
Analgeics and Antispasmodics (smooth muscle relaxant)
Benign Prostatic Hyperplasia and TURP - Relief of Pain: Encourage patient to do what after surgery?
To walk (need help because people need to hold bags and sterile solution) but avoid sitting for prolonged periods
Benign Prostatic Hyperplasia and TURP - Relief of Pain: They should prevent what?
Constipation (Full bowel can press on bladder and urethra)
Benign Prostatic Hyperplasia and TURP - Relief of Pain: Irrigate catheter to prevent what?
Clot formation
Benign Prostatic Hyperplasia and TURP - Reduction of Anxiety: What can be done for this?
Be sensitive to potentially embarassing and culturally charged issues
Establish professional , trusting relationship
Provide Privacy
Allow patietn to verbalize concern (Worried about impotence, incontinence? Goes away afer 1 year)
Provide and reinforce information
Benign Prostatic Hyperplasia and TURP - Reduction of Anxiety: What can help with incontinence?
Kegel Exercises
Benign Prostatic Hyperplasia and TURP - Interventions: Provide patient education including…
explanations of anatomy and function, diagnostic tests, surgery and the surgical experience
Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: Patient and family education for home care including care of
drainage devices and recognitiona nd prevention of complications
Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: What information should be said about regaining bladder continence?
Control is gradual process (dribbling may continue for up to 1 year depending on type of surgery
Perineal Exercises
Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: What should you avoid?
Straining heavy lifting, long car trips (6-8 weeks)
Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: Diet?
Encourage fluids, avoid coffee, alcohol, and psicy foods
Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: Assessment and referral to what issuses?
Sexual issues
