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BPH, References: Ignatavicius, D., Workman, L., Rebar, C., &…
BPH
Patient Education
frequent ejaculation releases retained prostatic fluid, thereby decreasing size of the prostate
avoid drinking large amounts of fluid at one time, and urinate when the urge is initially felt
avoid bladder stimulants (caffeine, alcohol)
avoid meds that cause decreased bladder tone (anticholinergics, decongestants, antihistamines)
medication is used for conservative treatment of BPH
Assessment
International Prostate Symptom Score (I-PSS) is used to determine severity
s/s
urinary frequency, urgency, hesitancy, incontinence, incomplete emptying of the bladder, dribbling post void, nocturia, diminished force of stream, straining with urination, hematuria
urinary stasis and persistent urinary retention lead to frequent UTIs
back flow of urine into ureters and kidney can lead to kidney damage
labs
UA and culture, CBC, BUN and creatinine, PSA, culture and sensitivity of prostate fluid
diagnostics
digital rectal exam, transrectal ultrasound with needle aspiration biopsy, early prostate cancer antigen
Pathophysiology
As males age, the prostate gland enlarges, when this enlargement causes urinary dysfunction it is called BPH
BPH can impair urine getting out, making the client susceptible to infection and retention
risk factors:
increased age, smoking, chronic alcohol use, sedentary lifestyle, obesity, Western diet (high fat, protein, carbs, low fiber), diabetes, heart disease
Interventions
meds
DHT lowering meds (finasteride)
alpha blocking agents (flowmax)
procedures
transurethral needle ablation, transurethral microwave therapy, prostatic stent, interstitial laser coagulation, electrovaporization of the prostate, surgical resection, transurethral incision of the prostate, holmium laser enucleation of the prostate, TURP
References:
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing: Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute