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Combating prostate cancer is a difficult affair, and is sure to be stressful to the patient as well as his immediate family members. For patients, providing prostate cancer care can be difficult. Since the disease usually affects the aged, nurses for prostate cancer patients are also hard to find. The nurses may have to take the patient to various prostate cancer tests, too. In such situations, Portea can provide care to patients in the early stages or those recovering from the treatment procedures at late stages.
Ongoing Screening And Prevention
Prostate cancer survivors are at greatest risk for disease recurrence in the first five years after treatment, in addition to secondary cancers. Providers should consider screening for individuals who may be candidates for genetic testing, especially those with indications of a hereditary cancer syndrome based on personal and family history.
Lifestyle recommendations include lifelong smoking and alcohol cessation. Advise patients to maintain a diet high in fruits, vegetables, and whole grains and low in fat, processed foods, and red meat and include an intake of at least 600 IU of vitamin D per day. Patients should engage in regular exercise and maintain a healthy body weight.
Cancer survivors should follow recommended cancer screening guidelines and other screening recommendations. Those with a smoking history may be candidates for a lung cancer screening program.
Nursing Care Plan For Prostate Cancer 3
Nursing Diagnosis: Risk for Deficient Fluid Volume related to difficulty controlling bleeding, restricted intake preoperatively, post-obstructive diuresis, and vascular nature of surgical area secondary to prostate cancer.
Desired Outcomes:
- The patient will demonstrate adequate hydration as evidenced by stable vital signs, palpable peripheral pulses, excellent capillary refill, moist mucosal membranes, and urine output within the normal range.
- The patient will demonstrate the absence of active bleeding.
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Nursing Diagnosis Prostate Cancer
Nursing Diagnosis: Impaired Urinary Elimination related to mechanical obstruction , catheter/balloon pressure and irritation, loss of bladder tone due to preoperative overdistension or prolonged decompression secondary to prostate cancer as evidenced by urgency, hesitation, dysuria, incontinence, retention, suprapubic soreness, and bladder fullness
Desired Outcomes:
Nursing Care Plan For Prostate Cancer 4
Nursing Diagnosis: Anticipatory Grieving related to change in lifestyle, anticipated loss of physiological well-being , and perceived potential death of patient secondary to prostate cancer as evidenced by alterations in eating habits, changes in sleep pattern, level of activity, libido and communication patterns, and denial of possible loss, stifled emotions and rage.
Desired Outcomes:
- The patient will recognize and express emotions appropriately.
- The patient will continue with his/her daily routine, thinking ahead and planning for the future one day at a time.
- The patient will express their understanding of the dying process and sentiments of being supported in grief work.
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Treatment For Benign Prostatic Hyperplasia
Treatment for BPH involves pharmacologic and surgical interventions and they are the following:
Common Signs Of Cancer
- A lump or thickening in the breast or testicles are indicative signs for further investigation.
- A change in a wart or mole may be reflective of melanoma or squamous carcinoma.
- A persistent skin sore that does not heal may be indicative of melanoma.
- A change in bowel or bladder habits, such as constipation, chronic
- diarrhea, abdominal pain, rectal or urinary bleeding indicating gastrointestinal cancer.
- A persistent cough or coughing up blood, indicating bronchial tree damage.
- Constant indigestion or trouble swallowing, are common signs of colon, stomach, or esophagus cancer.
- Unexplained weight loss, as cancer cells use up the patient energy source without him/her knowing it.
- Unusual bleeding or vaginal discharge may be signs of uterine, endometrial or cervical cancer.
- Chronic fatigue, a symptom often accompanied by rapidly progressing cancers.
Due to the multiple health issues and problems that a patient with cancer may have in the duration of the disease, you may encounter the need to implement several nursing care plans. These nursing care plan may include but are not limited to:
- Risk for/Fluid Volume Deficit
These nursing diagnoses are discussed in detail below.
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Stages Of Prostate Cancer
A staging method can help the doctor determine how far cancer has spread.
Prostate cancer is staged using the American Joint Committee on Cancer TMN staging system. The system, like many other types of cancer, stages it by:
- the tumors size or location
- involvement of lymph nodes
Prostate cancer has 4 stages with stage 4 being the most advanced stage of the disease.
Nursing Care Plan For Cancer 2
- Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to abdominal pain and cramping secondary to cancer, as evidenced by abdominal cramping, stomach pain, bloating, weight loss, nausea and vomiting, and loss of appetite
Desired Outcome: The patient will be able to achieve weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.
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Causes And Risk Factors Of Benign Prostatic Hyperplasia
In normal urination, urine flows out outwards the urethra unobstructed. In BPH,, the prostate enlarges, thereby obstructing the urethra by decreasing its diameter and consequently blocking urine flow.
The real cause of BPH is not clear but is often associated with older men. With these, it has been concluded that increasing age and dropping testosterone levels plays a major role for its development.
The risk factors of BPH include the following:
- Aging Men aged 40 may have enlarged prostates but will not experience symptoms. Men aged 60 may develop moderate symptoms. Those 80 and above may experience sever symptoms.
- Family history having relatives with BPH has been linked to the development of BPH latter in life
- Diabetes and heart disease Diabetes and use of beta blockers predisposes patients to BPH
- Obesity and sedentary lifestyle play a role in BPH development.
Risk Factors For Prostate Cancer
The exact cause of prostate cancer is not known, but certain factors are known to increase the risk. These include:
- Age: Age is the greatest risk factor, and prostate cancer risk increases with age.
- Close relatives with prostate cancer: Having a blood-relative father or brother increases risk, and having several other close relatives with prostate cancer increases risk even higher.
- Family history of breast cancer: Having a family history of genes that increase the risk of breast cancer or family history of breast cancer raises the risk for prostate cancer.
- Ethnicity: Black men have a somewhat higher risk.
- Obesity: Obesity raises the risk of prostate cancer, although studies have shown mixed results. In obese patients, the cancer is more likely to be more aggressive and more likely to return after initial treatment.
- Vitamin E: Dietary supplements with a high level of vitamin E have been shown to increase risk 17% if taken over many years. No biological mechanism has been proposed to explain the increase.
No high-quality studies have been done that show that diet influences risk .
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Diagnosis Of Benign Prostatic Hyperplasia
Diagnosing BPH involves a variety of techniques and are listed below:
- Digital rectal examination DRE is the most significant part of a physical exam when diagnosing BPH. The healthcare provider can easily assess for size, contour, presence of nodules or areas suggestive of malignancy, just by performing this exam.
Laboratory studies involves the following:
- Urinalysis utilized to assess for presence of bacteria, blood, WBCs, protein or glucose that can suggest for urinary retention caused by BPH.
- Urine culture Utilized to exclude infections of the urinary tract when abnormal findings where first detected in urinalysis
- Prostate-specific antigen PSA is an enzyme and cancer marker for Prostate cancer. Though BPH does not cause prostate cancer, men with the former diagnosis are also at risk for the latter.
- Electrolytes, Blood urea nitrogen and creatinine These studies are useful to evaluate renal health, especially for those patients who have high post void residual urine volumes.
- Ultrasound Ultrasound of the whole abdomen, including the kidneys and thru the transrectal approach will help to evaluate the bladder, prostate size, and signs of renal insufficiency.
- Endoscopy of the lower urinary tract Involves the direct visualization of the structures to assess for internal structures.
Other tests include:
Abnormal Substances In Urine
At times, abnormal urine contains substances that are not normally found inside blood vessels, and these signs can be used to detect the disease. Common examples are protein, glucose, and blood, which can be easily identified due to their different colors .
The nurse should also be aware that many other conditions can cause impairment in urinary elimination, including:
- Urethral stricture
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Magnetic Resonance Imaging Scan
Like CT scans, MRI scans show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays.
MRI images are very useful in showing cancer that has spread outside of the bladder into nearby tissues or lymph nodes. A special MRI of the kidneys, ureters, and bladder, known as an MRI urogram, can be used instead of an IVP to look at the upper part of the urinary system.
Cancer Nursing Care Plan And Nanda Guidelines
Cancer is a potentially fatal disease caused mainly by environmental factors that mutate genes encoding critical cell-regulatory proteins. The resultant aberrant cell behavior leads to expansive masses of abnormal cells that destroy surrounding normal tissue and can spread to vital organs resulting in disseminated disease, commonly a harbinger of Imminent patient death.
Most types of a cancer cells clumps together to form a mass or tumor. When a cell breaks away from the tumor, it can be swept into the lymph system or bloodstream and carried to other parts of the body where new tumors can be formed.
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Treatment For Prostate Cancer
Based on the age, health status, and cancer stage, the doctor will establish a suitable treatment strategy to treat and control prostate cancer:
If the cancer is non-aggressive, the doctor may propose active surveillance, often known as careful waiting. If the doctor decides to use active surveillance to monitor cancer, they will assess the PSA every six months and perform an annual DRE. They may also repeat the biopsy and imaging 1 to 3 years following the first diagnosis.
When just observing the disease, the doctor actively observes the symptoms to see if treatment is required.
More aggressive cancers may be treated with different methods, such as:
- radiosurgery with stereotactic accuracy
Doctors use risk categories to guide the therapy if the prostate cancer has not advanced to stage 1-3. Advanced phases, on the other hand, may require more or less treatment. Other factors, such as age and overall health, may also play a role. Chemotherapy is performed after hormonal therapy has failed to address the condition.
Nursing Care Plan Bph 3
Nursing Diagnosis: Disturbed Sleep Pattern related to nocturia secondary to BPH as evidenced by verbalization of inability to sleep, delayed sleep onset, bladder pain or discomfort, frequent urination, restlessness, and irritability
Desired Outcome: The patient will report an improved rest/sleep pattern and verbalize feeling well-rested.
| BPH Nursing Interventions | Rationales |
| Assess the patients current pattern of sleep and rest and compare with his/her normal pattern. | To establish baseline data on rest/sleep pattern. |
| Administer the prescribed medications for BPH, such as Alpha-adrenergic receptor blockers, 5-alpha reductase inhibitors, and phosphodiesterase-5 enzyme inhibitors. | To treat the underlying disease. |
| Encourage the patient to limit oral hydration during nighttime. Advise the patient to avoid caffeine-containing drinks in the evening. | To reduce urinary frequency during bed time. Caffeine blocks sleep-inducing chemicals produced in the brain, thereby increasing level of alertness. |
| Reduce sleep disturbance in the environment such as room temperature, noise and light. Provide comfort measures such as back rub, warm bath, and relaxation techniques. | To provide a sleep-conducive environment. |
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Prostate Cancer Nursing Care Plans Diagnosis And Interventions
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Prostate cancer is the most often diagnosed cancer in men around the world. The American Cancer Society predicts that 268,490 men in the United States will be newly diagnosed with prostate cancer in 2022.
The prostate is a tiny gland that lies behind the bladder and surrounds the urethra in a mans lower abdomen and is controlled by the hormone testosterone.
Prostate cancer occurs when an abnormal, malignant growth of cells, known as a tumor, arises in the prostate. As the disease progresses, these tumor cells have the potential to spread to other parts of the body.
Because the cancer is made up of prostate cells in these circumstances, it is still called prostate cancer.
How Is Prostate Cancer Diagnosed
A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope.
A biopsy is a procedure that can be used to diagnose prostate cancer. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.
A Gleason score is determined when the biopsy tissue is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2 to 10. The lower the score, the less likely it is that the cancer will spread.
A biopsy is the main tool for diagnosing prostate cancer, but a doctor can use other tools to help make sure the biopsy is made in the right place. For example, doctors may use transrectal ultrasound or magnetic resonance imaging to help guide the biopsy. With transrectal ultrasound, a probe the size of a finger is inserted into the rectum and high-energy sound waves are bounced off the prostate to create a picture of the prostate called a sonogram. MRI uses magnets and radio waves to produce images on a computer. MRI does not use any radiation.
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Prostate Cancer: A Guide To Diagnosis
Key learning points:
Prostate cancer is the most common cancer in men
Current diagnostic tests for prostate cancer can give false negatives and false positives and are therefore currently unsuitable for a national screening programme
Men need support to make an informed decision on whether or not to be tested for prostate cancer
Prostate cancer is the most common cancer in men. Every year over 44,000 men are diagnosed with the disease in the UK and it kills more than 10,000. With no national screening programme, diagnosing prostate cancer remains one of the biggest challenges facing health professionals.
Nurses play a vital role in ensuring that all men concerned about prostate cancer are armed with the information they need to make an informed decision about testing.
Signs and symptoms
Most early stage prostate cancers do not cause any symptoms, mostly because either the tumour is small or in the outer part of the prostate and is therefore not putting any pressure on the urethra.
Risk factors
Due to the fact that most men with early stage prostate cancer will not have any symptoms, being aware of a mans risk is essential. There are three key risk factors to think about:
1. What is the mans ethnicity?
We know that in the UK one in four black men will be diagnosed with prostate cancer, which is double the risk of a white man .
2. Does he have a family history of prostate cancer?
3. How old is he?
What to do after an assessment?
The pros and cons of the PSA test
Radiation Therapy Nursing Care
For patients receiving radiation therapy, the nurse:
- Advises the patient to report a fever over 100 °F and burning or difficulty with urination, excessive bleeding or clots in the urine, or rectal bleeding
- Monitors for adverse skin changes and provides skin care for those receiving external beam radiation therapy, stressing the importance of maintaining skin integrity, including:
- Cleansing the skin with mild soap and water
- Promotion of comfort and pain reduction
- Prevention of additional trauma
- Prevention and management of infection
- Promotion of a moist wound-healing environment
- Avoiding application of lotions, perfumes, or powders to the treatment area
- Protecting the skin in the treatment area from sunlight and extreme cold
- Wearing soft, nonrestrictive cotton clothing directly over the treatment area
Patients who are receiving low-dose-rate brachytherapy with temporary implants must have limited exposure to others. If hospitalized, the patient should be placed in a private room, and visits with others should be limited to 10 to 30 minutes. Patients should be monitored for burning sensations, excessive perspiration, chills and fever, nausea and vomiting, or diarrhea.
For men who are discharged following permanent seed implantation, patient and family education includes:
CASE
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