Prostate Flashcards Preview

Foundations Clinical > Prostate > Flashcards

Flashcards in Prostate Deck (24):
1

Rectal Exam

Make sure pts void before rectal exam. They’ll feel like they have to urinate even if they don’t have to.

2

Prostate Carcinoma

-Stone hard, regular fixed nodules. As prostate gland grows, it obstructs the urethra so they have trouble urinating.
-Normal prostate is moveable

3

Bladder stones

Bladder stones can develop when urine sits in the bladder. Overflow incontinence occurs. It causes dribbling of urine. The inability to void is an emergency.

4

You do which test to determine which organ and what antibiotics to use, and if the antibiotic is working?

Culture and sensitivity

5

PSA: prostate specific antigen

P-rostate-specific antigen (PSA) is a protein produced by the prostate and found in the blood.
-If the PSA level is high for your age or is steadily increasing (with or without an abnormal physical exam), a biopsy may be recommended.

6

What tests kidney function?

BUN and Creatinine

7

Why do a C&S of prostatic fluid?

To check for prostatitis

8

First line therapy for BPH and why

5-alpha reductase inhibitor (5-ARI), because high DHT levels cause prostate to enlarge. These drugs block the conversion of testosterone to DHT, so levels fall and the prostate shrinks. It takes a long time for a pt to feel effects. Maybe 6 months>leads to noncompliance. Tell them not to stop. SE: erectile dysfunction, decreased libido, dizziness, orthostatic hypotension
-Dutasteride (Avodart), Finasteride (Proscar)

9

Alpha-1 selective blocking agents for BPH

Alpha 1s are in smooth muscle of prostate glands, also in peripheral muscle vessels. Causes smooth muscle relaxation and vasoconstriction. Take pill at bedtime to sleep through bad
SE: Don’t take viagra bc it also vasoconstricts, it could be nonreversible.
-Tamulosin (Flomax), Doxazosin (Cardura), Terazosin (Hytrin

10

CAM therapy for BPH

Saw palmetto extract: studies haven't shown effectiveness. Make sure pt knows that if they take that it may not work. Warn them about drug interactions.

11

Thermotherapy for BPH

Outpatient technique using heat to destroy tissue, temporary fix. .p. 1635

12

Hydronephrosis

Swelling of fluid backing up in kidneys

13

TURP

Transurethral Resection of the Prostate
-Surgeon inserts a resectoscope through the urethra and into the bladder and removes pieces of tissue from the prostate gland.
-Not a permanent fix. It could grow again and have to be removed again.
*Turps don’t cause sexual dysfunction, neither does prostatectomy

14

Preop for TURP

-Correct misconceptions
-Assess anxiety
-Anesthesia – usually epidural and spinal anesthesia
-Prepare pt for postop indwelling uretheral catheter and urge to void

15

2 misconceptions with prostate surgery

Erectile dysfunction (nerves) and incontinence (sphincters)

16

Post op for TURP

see p. 1636 Chart 75-1
Critical Rescue – monitor urine output, VS, pain

17

Arterial bleed

Bright red urine, not good, may have clots in it. Admin more fluid to flush it out, call surgeon if it doesn’t stop. Venous blood would be brown.

18

Where can prostate cancer spread?

Lymph nodes, lungs, pelvis, and liver.

19

What increases the risk for prostate cancer?

Family history in first degree relatives

20

Assessment of Prostate Cancer

Bladder outlet obstruction symptoms
Hematuria
Nocturia
Pain during intercourse
Other pain (bone pain – pelvis, spine, hips)
Unexpected weight loss
Swollen lymph nodes in groin
Digital Rectal Exam
Psychosocial assessment
PSA
Transrectal ultrasound

21

Early stage Prostate Cancer

“Watchful waiting”
-TURP if obstruction
-Surgery for cure

22

Home care and management for Prostate Cancer

-Collaborate with case manager, home care nurse, and other care providers
-Urinary catheter care p. 1641
-Activity
-Shower, don’t bathe
-Refer to health care resources
-American Cancer Society’s Man to Man program
-Us TOO International (www.ustoo.com)
-Prostate Cancer and Support Network
-Prostate Cancer Foundation
-National Prostate Cancer Coalition

23

Advanced dz Prostate Cancer

Palliative surgery: bilateral orchiectomy

24

Nonsurgical management for Prostate Cancer

-Radiation Therapy
-Drug Therapy
-Hormone Therapy
-Chemotherapy