Benign prostatic hyperplasia (hypertrophy)

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Benign prostatic hyperplasia (hypertrophy)
2013-02-16 16:46:45

Adult MedSurg 2
Show Answers:

  1. What is BPH?
    • In BPH, the prostate gland enlarges sufficiently to compress or distort the urethra and cause some overt urinary obstruction
    • –  Begins with changes in periurethral glandular tissue
    • –  May extend into the bladder (and obstruct urinary outflow) or cause a pouch to form (that retains urine, which may lead to calculus
  2. What are some causes of BPH?
    • • Link between BPH and hormonal activity and aging.
    • – Imbalance in androgen and estrogen levels
    • – High levels of dihydrotestosterone (main prostatic intracellular androgen)

    • • Others
    • – Neoplasm, arteriosclerosis, inflammation, and metabolic or nutritional disturbances
  3. What are some obstructive signs of BPH?
    • – Frequent urination
    • – Nocturia
    • – Incontinence
    • – Possible hematuria
  4. Late signs of obstructive BPH?
    • –  Complete obstruction may follow infection or ingestion (decongestants, tranquilizers, ETOH, antidepressants, or anticholinergics)
    • –  Possible complications include infection, renal insufficiency, hemorrhage, and shock 
  5. How is BPH diagnosed?
    Digital rectal exam. (Yay.) 
  6. T/F: you can go into renal failure due to BPH.
    • True.
  7. What Rx are used to treat BPH?
    Alpha blockers (adrenergic blockers improve urine flow rates. 
  8. What surgical method is used to correct BPH?
    • Trans urethra resection of the prostate, ie TURP.
    • Only if prostate weighs < 2 oz (because that's a lot of jabbin'!)
  9. What are some nursing interventions for BPH?
    • Monitor and record VS, I&O, and daily wt
    • – Monitor for post-obstructive diuresis (increased UO and hypotension)
    • Administer antibiotics as ordered
    • Do not force a transurethral catheter: 
    • assist with suprapubic cystostomy under local anesthetic
    • According to your textbook, how much urine can be drained at one time? 1-1.5L. Do not drain more or you can change intraabdominal pressure and BP will drop.
  10. Nursing care for pt during BPH surgery?
    • Maintain patient comfort
    • Observe for shock and hemorrhage from
    • prostatic bleeding
    •  – Check catheter q 15 min for first 2-3 hours for patency and urine color
    •  – Check dressings for bleeding
    • CBI (continuous bladder irrigation): Keep catheter open at a rate sufficient to maintain returns that are clear and light pink
  11. Post-op pt teaching (BPH)
    • Reassure patient that he will gradually regain urinary control
    • After catheter removal, patient may have frequency, dribbling, and occasional hematuria
    •  • Reinforce limits on activity
    •  – Warn patient against lifting, strenuous exercise, and long car rides
    • – Restrict sexual activity for several weeks
    • Instruct patient to follow prescribed oral antibiotic regimen and tell indications for using gentle laxatives
    • Tell patient to seek medical care immediately if he:
    • – cannot void
    • – passes bloody urine
    • – develops a fever