Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3512 - Class 7-12 > Week 9 - BPH > Flashcards

Week 9 - BPH Flashcards

1
Q

what is benign protastic hyperplasia (BPH

A
  • enlargement of the prostate gland d/t an increase in the number of epithelial cells & amt of stromal tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are causes of BPH

A
  • thought to be associated w endocrine changes associated w aging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are risk factors for BPH (4)

A
  • FHx
  • enviro
  • diet
  • obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe the impact that diet has on BPH

A
  • high in fruits & veggies = lower risk

- high in zinc, butter, and margarin = higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does BPH lead to

A
  • compression of the urethra = partial or complete obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

the symptoms of BPH result from?

A
  • urinary obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe symptoms of BPH

A
  • gradual onset
  • may not be noticed until BPH has been present for some time
  • early symptoms = minimal bc bladder can compensate for a small amt of resistance
  • symptoms worsen as degree of urethral obstruction increases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 2 groups of symptoms of BPH

A
  • obstructive

- irritative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are obstructive symptoms of BPH (4)

A
  • decrease in calibre and force of urinary stream
  • difficulty in voiding
  • intermittency (stoppinf and starting the stream several times while voiding)
  • dribbing at the end of urination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are irritative symptoms of BPH (6)

A
  • urinaru freq
  • urgency
  • dysuria
  • bladder pain
  • nocturia
  • incont
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

complications d/t BPH result from

A
  • urinary obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are complications of BPH (7)

A
  • acute urinary retention
  • UTI (d/t incomplete bladder emptying)
  • sepsis secondary to UTI
  • calculi in the bladder (d/t alkalinization of residual urine)
  • hydronephrosis
  • pyelonephritis
  • bladder damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is included in diagnostic studies for BPH (10)

A
  • history
  • physical exam
  • digital rectal exam
  • urinalysis w culture
  • PSA lvl
  • creatinine (to rule out renal insufficiency)
  • TRUS
  • uroflowmetry
  • cystourethroscopy
  • post-void residual volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

why is DRE used as a diagnostic for BPH

A
  • the prostate can be palpated using DRE

- can estimate the size, symmetry, and consistency of the prostate gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe the prostate gland during BPH (3)

A
  • symmetrically enlarged
  • firm
  • smooth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is PSA

A
  • prostate specific antigen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

why is PSA measured w BPH

A
  • to rule out prostate cancer

- however, PSA may be slightly elevated w BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a TRUS scan

A
  • transrectal ultrasonography
  • US that allows for accurate assessment of prostate size
  • helpful in differentiating between BPH and prostate cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is a uroflowmetry? why is it useful?

A
  • study that measures the vol of urine expelled from the bladder per second
  • determines the extent of urethral blockage and thus the type of treatment needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is a cystourethroscopy

A
  • a procedure allowing internal visualization of the urethra and bladder
21
Q

what are the goals of collaborative care for BPH (3)

A
  • restore bladder drainage
  • relieve pt’s symptoms
  • prevent complications of BPH
22
Q

what is treatment of BPH based on

A
  • the degree to which symptoms bother the pt

- presence of complications

23
Q

what is included in collab care for BPH (5)

A
  • “watchful waiting”
  • lifestyle changes
  • drug therapy
  • invasive therapy
  • minimally invasive therapy
24
Q

what lifestyle changes are included in treatment of BPH (4)

A
  • dietary changes
  • avoid certain meds
  • restrict evening fluid intake
  • timed voiding schedule
  • urinate every 2-3 hr and when first feeling the urge
  • maintain fluid intake at normal lvl (prevent dehydration or fluid retention)
25
Q

what dietary changes are included in treatment of BPH (4)

A

decrease:

  • caffeine and alcohol (increase symptoms d/t diruetic effect)
  • artifical sweeteners
  • spicy foods
  • acidic foods
26
Q

what meds should be avoided in a pt w BPH (2)

A
  • decongestants (worsen symptoms bc are alpha adrenergic agonists = sm. m contraction)
  • anticholinergics
27
Q

what meds are used for treatment of BPH (3)

A
  • 5a-reductase inhibitor
  • a-adrenergic receptor blockers
  • herbal therapy
28
Q

how do 5a-reductase inhibitors work as treatment for BPH? what is an example?

A
  • decrease the size of the prostate

ex. finsteride (proscar)

29
Q

how do 5a-reductase inhibitors work as treatment for BPH? what is an example?

A
  • decrease the size of the prostate

ex. finsteride (proscar)

30
Q

how do a-adrenergic receptor blockers work as treatment for BPH? what is an example?

A
  • promote smooth muscle relaxation in the prostate

ex. flomax

31
Q

describe pre-op care for BPH surgery (4)

A
  • urinary drainage must be restored before thru insertion of a urethral catheter (ex. coude)
  • antibiotics before any invasive procedure
  • treat any infections of the urinary tract before surgery
  • inform pt that it may impact sexual functioning
32
Q

what is invasive therapy for treatment of BPH

A
  • involves resection or ablation of the prostate
33
Q

when is invasive treatment indicated for treatment of BPH (4)

A
  • decrease in urine flow sufficient to cause discomfort
  • persistent residual urine
  • acute urinary retention
  • hydronephrosis
34
Q

what can temporarily reduce symptoms of BPH and bypass the obstruction

A
  • intermittent or indwelling cath

should not be used long term tho d/t r/o infection

35
Q

what are 3 examples of invasive therapies for BPH (3)

A
  • transurethral resection of the prostate (TURP)
  • transurethral incision of the prostate (TUIP)
  • prostatectomy
36
Q

what is TURP

A
  • a surgical procedure involving the removal of prostate tissue using a rectoscope inserted thru the urethra
  • considered the gold standard for treatment of obstructive BPH
37
Q

how is TURP performed (3)

A
  • under spinal or general anasthesia
  • no external incision
  • rectoscope inserted thru urethra
38
Q

what is done after TURP

A
  • large, 3-way indwelling cath inserted thru the bladder to provide hemostasis and facilitate urinary drainage
  • for first 24-h, the bladder is irrigated continuously or intermittently
39
Q

why is the bladder irrigated post-TURP

A
  • prevent obstruction from mucus and blood clots

- removes clotted blood from the bladder & ensure drainage of the urine

40
Q

describe how bladder irrigation is done

A
  • instill 50 mL of the irrigating slution (usually NS)

- then withdraw w a syringe to remove clots that may be in the bladder and catheter

41
Q

what are potential complications post-TURP (6)

A
  • bleeding & hemorrhage
  • clot retention
  • bladder spasms
  • urinary incont.
  • infection
  • dilutional hyponatremia d/t irrigation
42
Q

due to the potential complication of bleeding post-TURP, what must pts do

A
  • d/c of aspirin or anticoagulants several days before surgery
43
Q

what is included in post-op care for BPH surgery

A
  • cath and continuous irrigation
  • monitor inflow and outflow of irrigants
  • careful aseptic technique
  • manage pain
  • ## manage bladder spasms
44
Q

ideally, the color of urine drainage post-op is? what color may indicate hemorrhage?

A
  • light pink w no clots

- lrg amts of bright red can indicate hemorrhage

45
Q

if the outflow of irrigants is less than inflow, what should be done (2)

A
  • assess the bladder

- check patency of the cath

46
Q

if the outflow is blocked post-op, what should be done

A
  • stop continuous bladder irrigation and notify the physician
47
Q

blood clots are expected after prostate surgery at which time?

A
  • first 24-36 hours
48
Q

FINISH

A

NURS 3512 - Class 7-12 (49 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions