BPH Flashcards
(27 cards)
Decreasing sexual function
Deceased libido
Slower sexual response
Longer time before sexual arousal can occur again
Increased incidence of gennitourinal tract cancer
Urinary incontinence
Gerontological considerations
Decreased function of the testers
Male hypogonadism
Cancer of the kidney, bladder, prostate, and penis
Cancer risks
Digital rectal examination
DRE
Prostate specific antigen
PSA
Medications
Neurologic disease
BPH
Urinary incontinence
Symptoms related to bladder function and urination
Prostatism
Enlarged prostrate gland Increased urinary frequency Decreased force of urine stream Double or triple voiding Dysuria Nocturia Hematospermia
Causes of obstruction
Diabetes MS STROKE cardiac disease Medications= antihypertensives, anticholesterlemic, psychotrophic medications Stress Use of alcohol
Factors that affect sexual function
Permission Limited information Specific suggestion Intensive therapy -model of sexual assessment and intervention to maybe use divide framework for nursing interventions allows healthcare professionals it was sexual issues with a level of comfort and expertise
PLISSIT
Bringing up the topic Explaining Telling Timing Educate- educate about treatment s/e Recording - include sexuality in the assessment of patient with cancer
BETTER
Used to screen for prostate cancer recommended annually for everyman old are the age of 50 years old
- 45 years of age from men at high risk such as African-Americans and man with strong family history of prostate cancer annually
DRE
- The practitioner uses lube glove finger plays into the rectum assesses : the size shape symmetry
- and consistency of the posterior surface of the prostate gland
- the clinician assess for tenderness of the prostate gland on palpation and for the presents and consistency of any nodules
DRE
Male genitalia are inspected for abnormalities and palpated for masses
•the scrotum is palpated carefully for nodules masses and inflammation examination of the scrotum can reveal such orders as:
Hyrdocele
Inguinal hernia
Testicular torsion
Orchitis
Epididymitis
Tumor of the testis
• The penis is inspected and palpated for ulcerations, nodules inflammation discharge, curvature
TSE
The cells within the prostate gland produces a protein that can be measured in the blood
Prostate specific antigen (PSA)
Prostrate gland enlarges Prostate secretion decreases Testes decrease in weight, atrophy, become softer Pubic hair becomes sparse/stiffer Decline in plasma testosterone Reduced production of progesterone
Changes in older men
Lethargy and confusion Hypotension Tachycardia Nausea vomiting Collapse Headache Muscle spasms Seizures Hyponatremia Hypovolemia Hyperammonemia * caused by neurologic, cardiovascular, electrolyte imbalances, associated with absorption of the solution used to irrigate the surgical during the procedure
TURP resection syndrome
Discontinue irrigation
Administer diuretics
Replace irrigation with NS
Monitor I & O
Differentiate Lethargy and confusion of TUR syndrome from postoperative disorientation and hyponatremia
Assess for pulmonary edema, heart failure
Interventions for Transurethral resection syndrome
e bladder can fill but you are not voiding, so the urine goes up the ureters to the kidneys –
▪ This is a drowning of the kidneys
▪ This is a cause of renal failure
Hydronephrosis
is the most sensitive indicator of renal function
Creatinine
o A sensor picks up the size of the prostate
o Goes up rectum, towards umbilicus to measure the size of the prostate
TRUS – transrectal ultrasound
To identify the presence of cancer cells
They will do an MRI or CT Scan to identify an area that may be cancerous
Prostate biopsy
Assess knowledge and understanding of procedure, clarify- ing information as needed.
• Schedule IVP prior to any ordered barium test or gallbladder studies using contrast material.
• Ask about allergy to seafood, iodine, or radiologic contrast dye. Notify physician or radiologist if allergies are known.
• Verify the presence of a signed consent for the procedure.
• Assess renal and fluid status, including serum osmolality, creatinine, and blood urea nitrogen (BUN) levels. Notify the
physician of any abnormal values.
• Instruct the client to complete ordered pretest bowel prepa-
ration, including prescribed laxative or cathartic (see p. 000) the evening before the test, and an enema or suppository the morning of the test. Withhold food for 8 hours prior to the test; clear liquids are allowed.
As the dye is injected, you may feel a transient flushing or burning sensation, along with possible nausea and a metallic taste.
IVP procedure
using local or general anesthesia. You may feel some pressure or a need to urinate as the scope is inserted through the urethra into the bladder. The procedure takes approximately 30 to 45 minutes.
• Do not attempt to stand without assistance immediately after the procedure as you may feel dizzy or faint.
• Burning on urination for a day or two after the procedure is to be expected.
• Immediately notify the physician if your urine remains bloody for more than three voidings after the procedure, or you develop bright bleeding, low urine output, abdominal or flank pain, chills, or fever.
• Warm sitz baths, analgesic agents, and antispasmodic med- ications may relieve discomfort after the procedure.
• Increase fluid intake to decrease pain and difficulty voiding and reduce the risk of infection.
• Laxatives may be ordered after the procedure to prevent constipation and straining, which may cause urinary tract bleeding.
Cytoscopy
