[Exam 3] Chapter 59: Assessment and Management of Problems R/T Male Reproductive Processes (Page1762-1764, 1171-1178)

Question 1

Benign Prostatic Hyperplasia: What is this?

Answer 1

A noncancerous enlargement or hypertrophy of the prostate. and one of the most common causes of diseases in aging men

Question 2

Benign Prostatic Hyperplasia: What can this cause?

Answer 2

Bothersome lower urinary tract symptoms that affect quality of life by interfering with normal daily acativites and sleeping

Question 3

Benign Prostatic Hyperplasia: What age does this occur?

Answer 3

Men older than 40

Question 4

Benign Prostatic Hyperplasia: What is a critial mediator of prostatic growth?

Answer 4

DHT, dihydrotesterone

Question 5

Benign Prostatic Hyperplasia: What causes this to occur?

Answer 5

When men have elevated estrogen levels and when prostate tissue becomes for sensitive to estrogen levels and less respopnsive to DHT

Question 6

Benign Prostatic Hyperplasia: Risk factors for this?

Answer 6

SMoking

Heavy Alcohol

Obesity

REduced Activity

Hypertension

Diabetes/Hypertension

Western Diet (High animal fat and protein diet)

Question 7

Benign Prostatic Hyperplasia: Common and age-related from what process?

Answer 7

Cell proliferation forms nodules that grow and glandular cells enlarge

Question 8

Benign Prostatic Hyperplasia: What direction does growth occur?

Answer 8

Inward, pressing on urethra leading to urinary retention

Question 9

Benign Prostatic Hyperplasia: How long does it take for chcanges to occur?

Answer 9

Occur over long period of time

Question 10

Benign Prostatic Hyperplasia: Necessary preconditions to have this?

Answer 10

48 or older and must have testes

Question 11

Benign Prostatic Hyperplasia: This is a result of complex interactions in the body involving what?

Answer 11

Resistance in the prostatic urethra to mechanical and spastic effects , and bladder pressure during voiding

Question 12

Benign Prostatic Hyperplasia: Obstructive and Irritative symptoms may include ?

Answer 12

Urinary frequency, urgency, nocturia, hestancy to start urinating and decreased and intermittent force of stream

Question 13

Benign Prostatic Hyperplasia: What are some manifestations as to how this could look?

Answer 13

Urinary symptoms of urinary obstruction, urinary retention (check to see elevated BUN) , urinary tract infections, and decreased bladder contractility

Question 14

Benign Prostatic Hyperplasia: What complications will this lead into?

Answer 14

Infections of bladder and kidney

Hydroureter and Hydronephrosis

Renal Insufficiency

Question 15

Benign Prostatic Hyperplasia: Generalized symptoms like this?

Answer 15

Fatigue, Anorexia, N/V, Pelvic Discomfort

Question 16

Benign Prostatic Hyperplasia: Health history focuses on

Answer 16

unriary tract, previous surgeries, health issues, and family history of prostate disease

Question 17

Benign Prostatic Hyperplasia: Nursing Diagnosis includes what?

Answer 17

Deficient Knowledge (Avoid Alcohol)

Urinary Retention

RF Infection

RF Imbalance Fluid Volume

Question 18

Benign Prostatic Hyperplasia: What does a DRE reveal?

Answer 18

Large, rubbery and nontender prostate gland

Question 19

Benign Prostatic Hyperplasia: Goals for treatment incude what?

Answer 19

Improve urine flow, relieve obstruction, and prevent disease progression

Question 20

Benign Prostatic Hyperplasia: If ptient admitted on emergency basis because he is unable to void, what immediately happens?

Answer 20

Immediately catheterized

Question 21

Benign Prostatic Hyperplasia and Medication: Which ones will be used?

Answer 21

Anti-Androgen Agents and Alpha-Adrenergic Antagonists

Question 22

Benign Prostatic Hyperplasia and Medication: What do Anti-Androgen Agents do?

Answer 22

Cause the prostate to shrink

Question 23

Benign Prostatic Hyperplasia and Medication: What do Alpha-ADrenergic Antagonists do?

Answer 23

Stop smooth muscle contraction of prostate that may be blocking urethra

Question 24

Benign Prostatic Hyperplasia and Surgical Interventios: Which one do we need to know?

Answer 24

Transurethral Resection of the Prostate (TURP)

Question 25

Benign Prostatic Hyperplasia and TURP: What does this involve?

Answer 25

Surgical removal of the inner portion of the prostate through an endoscope inserted through the urethra, no external skin incision is made

Question 26

Benign Prostatic Hyperplasia and TURP: What can this be performed with?

Answer 26

Ultrasound guidance

Question 27

Benign Prostatic Hyperplasia and TURP: What happens to the treated tissue?

Answer 27

. Goes into the bladder and vaporizes or become necrotic and sloughs

Question 28

Benign Prostatic Hyperplasia and TURP: Debrie from procedure comes from?

Answer 28

the bladder

Question 29

Benign Prostatic Hyperplasia and TURP Diagnoses: What are they?

Answer 29

Anxieety Acute Pain Pre/Postoperatively RF Imbalanced Fluid VOlume Postop Deficient Knowledge

Question 30

Benign Prostatic Hyperplasia and TURP: Complications and Potential Problems?

Answer 30

Heorrhage and Shock Infection DVT Catheter Obstruction Comp. With Catheter Removal Urinary Incontinence Sexual Dysfunction

Question 31

Benign Prostatic Hyperplasia and TURP: Major goals before surgery include

Answer 31

adequate preparation and reduction of anxiety and pain

Question 32

Benign Prostatic Hyperplasia and TURP: Major goals after surgery include

Answer 32

maintenance of lfuid volume balance, relief of pain and discomfort, ability to perform self-care activites, and absence of complications

Question 33

Benign Prostatic Hyperplasia and TURP: How is the bladder irrigated?

Answer 33

A three way irrigation catheter system is used

Question 34

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Bag is filled with what?

Answer 34

Sterile solution

Question 35

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Bag is hooked up to what?

Answer 35

Triple lumen catheter, which rinses out blood and debris that TURP did

Question 36

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: What does the outflow catheter do?

Answer 36

Collects all the waste that is leaving the body

Question 37

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: What is the bulb inflation?

Answer 37

A balloon is placed inside the body in order to keep it in place

Question 38

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: What to watch for?

Answer 38

Make sure it does not get clotted, because fluid will stop flowing and rupture bladder.

Question 39

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Why do you not want the bag to run dry?

Answer 39

The blood will clot and will not be able to get out

Question 40

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: With irrigation solution flowing in a lot, what else must you do?

Answer 40

Empty the cather drainage bag regularly as well

Question 41

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: How to calculate I/O?

Answer 41

Ex: Subtract the 500 mL of the bag from the total 1000 mL in the bag

Question 42

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: Additional complications from this?

Answer 42

Infections Hemorrhage Clotting

Question 43

Benign Prostatic Hyperplasia and TURP - Three-Way System for Bladder Irrigation: How will drainage appear immediately following surgery?

Answer 43

REddish pink and then clears to link pink within 24 hours but monitor for Hemorrhage

Question 44

Benign Prostatic Hyperplasia and TURP: PAtient is advised to discotninue what before surgery?

Answer 44

Aspirin and NSAIDS and PLatelet Inhibitors 10-14 days before surgery

Question 45

Benign Prostatic Hyperplasia and TURP - Relief of Pain: Monitor what?

Answer 45

Urinary drainage and keep catheter patent

Question 46

Benign Prostatic Hyperplasia and TURP - Relief of Pain: Assessment of pain may include what?

Answer 46

Bladder spasms that cause feelings of pressure and fullness in bladder, urgency to void, or bleeding from the urethra around the catheter

Question 47

Benign Prostatic Hyperplasia and TURP - Relief of Pain: What can we give to relieve bladder spasms?

Answer 47

Muscle relaxants

Question 48

Benign Prostatic Hyperplasia and TURP - Relief of Pain: What other than meds can be done to relieve spasms?

Answer 48

Warm compress or sitz baths

Question 49

Benign Prostatic Hyperplasia and TURP - Relief of Pain: What meds could be administered?

Answer 49

Analgeics and Antispasmodics (smooth muscle relaxant)

Question 50

Benign Prostatic Hyperplasia and TURP - Relief of Pain: Encourage patient to do what after surgery?

Answer 50

To walk (need help because people need to hold bags and sterile solution) but avoid sitting for prolonged periods

Question 51

Benign Prostatic Hyperplasia and TURP - Relief of Pain: They should prevent what?

Answer 51

Constipation (Full bowel can press on bladder and urethra)

Question 52

Benign Prostatic Hyperplasia and TURP - Relief of Pain: Irrigate catheter to prevent what?

Answer 52

Clot formation

Question 53

Benign Prostatic Hyperplasia and TURP - Reduction of Anxiety: What can be done for this?

Answer 53

Be sensitive to potentially embarassing and culturally charged issues Establish professional , trusting relationship Provide Privacy Allow patietn to verbalize concern (Worried about impotence, incontinence? Goes away afer 1 year) Provide and reinforce information

Question 54

Benign Prostatic Hyperplasia and TURP - Reduction of Anxiety: What can help with incontinence?

Answer 54

Kegel Exercises

Question 55

Benign Prostatic Hyperplasia and TURP - Interventions: Provide patient education including...

Answer 55

explanations of anatomy and function, diagnostic tests, surgery and the surgical experience

Question 56

Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: Patient and family education for home care including care of

Answer 56

drainage devices and recognitiona nd prevention of complications

Question 57

Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: What information should be said about regaining bladder continence?

Answer 57

Control is gradual process (dribbling may continue for up to 1 year depending on type of surgery Perineal Exercises

Question 58

Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: What should you avoid?

Answer 58

Straining heavy lifting, long car trips (6-8 weeks)

Question 59

Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: Diet?

Answer 59

Encourage fluids, avoid coffee, alcohol, and psicy foods

Question 60

Benign Prostatic Hyperplasia and TURP - Rehab and Home Care: Assessment and referral to what issuses?

Answer 60

Sexual issues