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Nursing > Male Reproductive Disorders > Flashcards

Male Reproductive Disorders Flashcards

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1
Q

Benign Prostatic Hyperplasia (BPH)

A

a common, noncancerous enlargement of the prostate gland

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2
Q

What is the most common diagnosis by a urologist for men ages 45-74?

A

BPH

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3
Q

What race is more likely to develop BPH? who is least likely?

A
  • Caucasian and African American men are more likely

- Asian men are least likely

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4
Q

What is the prostate?

A

-Donut/walnut shaped gland located b/t the bladder and the penis

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5
Q

What surrounds the urethra for men?

A

the prostate gland

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6
Q

What does the prostate do?

A

Assists in controlling the flow of urine

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7
Q

What happens as the prostate enlarges?

A

As the prostate enlarges it pinches off the urethra and affects the flow of urine

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8
Q

What is the cause of BPH?

A
  • NO known cause

- Theories are: smoking, HTN, Heart disease, Diabetes, or alcohol consumption

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9
Q

How may the increase of estrogen enlarge the prostate?

A

increased estrogen means there is an increase in cell growth which can lead to enlargement

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10
Q

Minor S/S of BPH

A
  • difficulty beginning urination
  • Weak stream
  • hesitancy
  • Dribbling of urine upon completion
  • “Start Stop” stream
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11
Q

Mild S/S of BPH

A
  • Urgency/Frequency
  • Incomplete bladder emptying
  • Nocturia
  • Incontinence
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12
Q

Moderate S/S of BPH

A
  • Bladder Outlet Obstruction
  • Bladder Stones
  • UTI
  • Acute Urinary Retention
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13
Q

Severe S/S BPH

A
  • Increased renal pressure
  • Hydronephrosis
  • Hydroureters
  • Pyelonephritis
  • Acute Kidney Injury
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14
Q

How is a diagnosis of BPH made?

A
  • based on symptoms
  • Confirmed w/ digital rectal exam
  • increase in Prostate Specific Antigen
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15
Q

Treatment options for BPH

A
  • “Watch and Wait”
  • Annual physicals
  • Medications/Herbal remedies
  • Surgery
  • Catheterization
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16
Q

Watch and Wait Method

A
  • used w/ minimal, not bothersome symptoms
  • annual follow up w/ rectal exam
  • if symptoms worsen they should go and see the doctor
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17
Q

What should the nurse educate someone w/ BPH on?

A
  • Avoid OTC antihistamines and decongestants
  • Limit caffeine and alcohol intake
  • Limit fluid intake, especially 1-2 hours before bed
  • Empty the bladder when the urge is felt
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18
Q

What medications are typically prescribed for BPH?

A
  • Alpha Adrenergic Blockers

- 5 Alpha Reductase Inhibitors

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19
Q

Alpha Adrenergic Blockers

A

Helps the smooth muscles of the prostate to relax, reducing constriction of the urethra and improving urine

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20
Q

5-Alpha Reductase Inhibitors

A

prevents the conversion of testosterone into DHT, shrinking enlarged prostate tissue that may be constricting the urethra

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21
Q

What are some examples of 5-Alpha Reductase Inhibitors?

A

Proscar and Avodart

22
Q

What are some Herbal Remedies for BPH?

A
  • Saw palmetto
  • African plum
  • Cernilton
  • South African star grass
23
Q

What type of catheter would be used for a man with BPH?

A

Coude Catheter

24
Q

When are you NOT allowed to remove a patient’s catheter?

A

When it was placed by the urologist

25
Q

Saw Palmetto

A

acts as a 5-Alpha Reductase Inhibitor w/o any sexual complications

26
Q

African Plum

A

has been found to treat urinary symptoms like frequency and urgency

27
Q

Cernilton

A

works as an Alpha-Adrenergic blocker and helps to improve urine flow

28
Q

South African Star Grass

A

help to eliminate urinary symptom

29
Q

If the prostate enlargement is SMALL what is the best surgical option?

A

Transurethral Resection of the Prostate (TURP)

30
Q

If the enlargement is SMALL to MODERATE what is the best surgical option?

A

Transurethral Incision of the Prostate (TUIP)

31
Q

If the enlargement is LARGE what is the best surgical option?

A

Prostatectomy

32
Q

TURP

A

a scope is passed through the urethra into the prostate and a cutting tool is used to remove the inner portion of the prostate

33
Q

What might the patient expect after a TURP?

A
  • urinary catheter in place for 3-5 days
  • Continual bladder irrigation for the 1st 24-36 hours
  • Blood tinged urine
  • Urgency, frequency, and/or urinary spasms for the 1st 6-8 weeks
34
Q

What is some postop teaching for a patient after their TURP?

A
  • increase fluid intake
  • High fiber diet
  • Do NOT resume blood thinning meds unless told to by doctor
  • Avoid strenuous activity
  • Avoid driving
  • Notify doc if unable to urinate or blood in urine becomes super thick
35
Q

What should the nurse do for postop TURP patient?

A
  • Maintain catheter patency
  • Monitor urine
  • Monitor for signs of hyponatremia
  • Avoid Enemas and Rectal tubes
  • Use urinary analgesics/antispasmodics as prescribed
  • Monitor for urinary retention after catheter removal
36
Q

What are some complications that may occur with a TURP?

A
  • Hemorrhage
  • Urethral Stricture
  • TUR (TURP) Syndrome
37
Q

TUR Syndrome

A

hyponatremia/hypervolemia caused from the absorption of large amounts of fluid that are used to flush the surgical area during the procedure

38
Q

Urethral Stricture

A
  • Decreased urine stream
  • Incomplete bladder emptying
  • Spraying of the urine
  • difficulty, straining, or pain w/ urinating
  • increased urge
  • UTI
39
Q

TUIP

A

incisions are made into the prostate and bladder neck to relieve pressure on the urethra

40
Q

Prostatectomy

A

robotic, laparoscopic, open

  • all or parts of the prostate are removed
  • radical or simple
41
Q

Radical Prostatectomy

A

all of the prostate is removed

42
Q

Simple Prostatectomy

A

only the obstructing portion is removed

43
Q

What are some potential complications of a prostatectomy?

A
  • Urethral strictures
  • Infection
  • Hemorrhage
  • Retrograde ejaculation
  • Erectile disfunction
  • Incontinence
  • DVT
44
Q

Nursing Care for postop prostatectomy

A

Assessments:

  • severity of BPH symptoms
  • safety concerns
  • vital signs
  • Distended abdomen
  • bladder scan
  • S/S UTI
  • patient anxiety
  • Understanding of procedure and potential complications
45
Q

Nursing Actions postop prostatectomy

A
  • Catheterize/bladder scan
  • Medicate as ordered
  • Strict I&O
  • Bladder spasms
46
Q

What would the nurse teach a prostatectomy patient?

A
  • Decrease fluid intake 1-2 hours before bedtime
  • Actions/side effects of medication
  • When to follow up w/ doc
  • When to call doc
  • What to expect
47
Q

What should the nurse monitor for after a prostatectomy?

A
  • Gross hematuria
  • tachypnea/tachycardia
  • Hypotension
  • Anxiety/restlessness
  • Pallor
  • Decreasing hemoglobin/hematocrit
48
Q

What would the nurse do if clots are blocking the catheter tubing?

A
  • Irrigate w/ 50-60 mL of sterile water/saline

- Make sure you pull out what you put in

49
Q

Discharge Instructions

A
  • Kegel exercises
  • Avoid strenuous exercises
  • Increase fluids and high fiber diet
  • Avoid long trips
50
Q

What complications should the patient report to the doctor after discharge?

A
  • Gross hematuria
  • Blood clots
  • Difficulty w/ urination
  • Fever >101
  • Uncontrollable pain
  • Catheter falling out

Nursing (21 decks)

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