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Benign Prostatic Hypertrophy (Complications: (Recurrent urinary tract…
Benign Prostatic Hypertrophy
Causes:
Exact cause unknown
Possible link to Hormonal changes
Risk Factors:
Advance Age
Intact Testes
Abdominal Obesity (possible worsening of symptoms)
Family history of BPH
Incidence:
Prevalence of BPH in men ages 51 to 60 is 40% to 50% and increases to over 80% in men older than age 80
Black men have the highest incidence of BPH, followed by white, Hispanic, Native American, and Asian men
BPH rarely occurs in men younger than 40. Approximately 50% of men older than 60 and 90% of men 80 and older exhibit signs of BPH.
Physical Findings:
Visible midline mass above the symphysis pubis
Distended bladder
Enlarged prostate on digital rectal examination
Complications:
Recurrent urinary tract infections (UTIs)
Renal insufficiency
Acute kidney injury or chronic kidney disease
Acute or chronic urinary retention
Prostatitis
Hematuria
Bladder calculi
Vesicoureteral reflux
Bladder diverticula
Laboratory
Blood urea nitrogen level test and creatinine level (serum) levels may be elevated, suggesting impaired kidney function.
Bacterial count that exceeds 100,000/mm3 may reveal hematuria, pyuria, and UTI.
Prostate-specific antigen test (PSA)
Pathophysiology
peri-urethral glandular tissue changes
epithelial and stromal cells proliferate and accumulate
compression of prostatic urethra obstructs urine outflow
diverticulum musculature may develop
sensitivity of the detrusor muscle contributes to urinary frequency
which may lead to urinary retention
causing enlargement of gland, which may extend the bladder
Diagnostic Procedures
Pressure flow studies
cystourethroscopy
prostate biopsy
Imaging
Ultrasonography
excretory urography
transrectal ultrasonography
Postvoid residual urine volume via bladder scanning
Nursing DX
Urinary Retention r/t genitourinary blockage AEB a small amount of voiding
Outcome
: Patient will void an adequate amount within 4 hours after nursing interventions during the nurse's shift
Interventions
:
Assess bladder fullness every 2 hours
Teach the patient methods to improve emptying the bladder
Monitor intake and output as indicated by the patient's condition
Acute Pain r/t distended bladder AEB inability to urinate
Outcome: Patient will verbalize a decrease in pain to a mild level of 3 after nursing interventions
Interventions:
Assess the patient's pain.
Assist the patient into a comfortable position.
Provide nonpharmacologic comfort measures.
Anxiety r/t major changes in life situation (health) AEB patient verbalizing feelings of anxiety
Outcome: Patient will learn and demonstrate effective coping behavior.
Interventions:
Assess for signs and symptoms of anxiety.
Encourage the patient to verbalize his anxieties, concerns, and fears.
Explain all tests and procedures to the patient using clear, simple explanations.
Risk Reduction:
Implementing a healthy lifestyle may be one way to help decrease the risk of developing or worsening Benign Prostatic Hypertrophy. Increased physical activity and eating a healthy diet by avoiding highly processed foods and turning to lean proteins, vegetables, fruits and whole grains may help mitigate Benign Prostatic Hypertrophy symptoms.
Overview
: Prostate gland enlargement that compresses the urethra, causing overt urinary obstruction