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Flashcards in OA Elimination Deck (69)
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1

BPH

nonmalignant enlargement of the prostate gland commonly seen in aging men

2

What happens due to BPH?

decreases outflow of urine by obstructing the urethra, causing difficult urination

3

When does BPH usually begin?

40's, but may have no symptoms until later

4

BPH and prostate cancer

BPH not considered precursor to prostate cancer

5

How does BPH begin?

as small nodules in the periurethral glands which are the inner layers of the prostate

6

Hyperplasia

increase in NUMBER of cells

7

Hypertrophy

increase in SIZE of individual cells

8

Hyperplasia and hypertrophy

used interchangeably even though the terms are different

9

Risk factors for BPH

***age
***presence of testes
-AA, Hispanics

10

Clinical manifestations in terms of voiding

-weak urinary stream
-increase time to void
-hesitancy
-incomplete bladder empty
-postvoid dribbing

11

Clinical manifestations in terms of storage

-frequency
-urgency
-incontinence
-nocturia
-dysuria
-bladder pain

12

Complications of BPH

-urinary retention
-incomplete bladder sensation
-bladder distention

13

What can result from bladder distention?

-diverticula
-obstructed ureters
-infection

14

Infection that ascends from bladder to kidneys cause...

-hydroureter
-hydronephrosis

15

hydroureter

distention of the ureter with urine

16

hydronephrosis

accumulation of urine in the renal pelvis as a result of obstructed outflow

17

Types of urinary incontinence

1. stress incontinence
2. urge incontinence
3. reflex incontinence
4. overflow incontinence
5. functional incontinence

18

stress incontinence

loss of small urine amts associated with increased intra-abdominal pressure during sneezing, coughing, lifting.

due to: multiple pregnancies, decreased estrogen levels, short urethra, weak abdominal wall, prostate surgery

19

urge incontinence

involuntary loss of urine associated with a strong urge to void

due to: neuro disorders, detrusor muscle overactivity associated with bladder outlet obstruction or aging

20

reflex incontinence

involuntary loss of urine at predictable intervals when a specific bladder volume is reached

due to: neuro impairment, tissue damage

21

overflow incontinence

inability to empty bladder, resulting in over distention and frequent loss of small amounts of urine

due to: spinal cord injuries below S2, diabetic neuropathy, prostatic hyperplasia, fecal impaction, drugs with anticholinergic effects

22

functional incontinence

incontinence resulting from physical, environmental, or psychosocial causes

due to: confusion/dementia, physical disability or immobility, therapy or sedation, depression, and regression.

23

Evidence-based research shows who needs to be treated for BPH?

Surgical referral if BPH-related complications develop, medical therapy fails, or the patient chooses it.

24

Mild or nonbothersome BPH symptoms...

do not require treatment

25

Bothersome symptoms are...

managed with lifestyle modifications, medications, and surgery

26

First-line medications for BPH

Alpha blockers

27

Evidence-based research shows dietary supplements...

are not recommended for the management of BPH

(palmetto, pygeum, cernilton, beta sitosterols and acupuncture)

28

BPH Nursing Assessment

- >40 yrs should be assessed
- health hx
- physical exam
- dx tests
- IPSS scale

29

Health hx includes...

-risk factors
-pain
-urinary elimination patterns
-hematuria

30

Physical exam includes...

DRE