Treatment For Benign Prostatic Hyperplasia
Treatment for BPH involves pharmacologic and surgical interventions and they are the following:
Nursing Care Plan Bph 2
Nursing Diagnosis: Impaired Urinary Elimination related to frequent urination and urgency secondary to BPH as evidenced by dysuria and urinary frequency
Desired Outcome: The patient will be able to achieve normal pattern of urinary elimination.
| BPH Nursing Interventions | |
| Assess the patients current pattern of elimination and compare with his/her normal pattern/ | To establish baseline data on urinary elimination 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. |
| Palpate the bladder and observe for bladder distention. | To check for bladder distention and bladder retention. |
| Encourage the patient to void every 2 to 3 hours. | To facilitate flushing of bacteria from the bladder and avoid urine accumulation. |
| Teach the patient some lifestyle changes related to UTI prevention, including proper hygiene, adequate oral hydration , and avoidance of undergarments that have non-breathing materials or are constricting/ tight-fitting. | Good oral hydration results to more urine production leading to flushing of bacteria from the bladder once the urine is eliminated. Undergarments that are made of non-breathing materials or are tight-fitting promote moisture formation. This encourages bacterial growth. |
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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Prostate Needle Biopsy Nursing Care
The diagnosis of prostate cancer can only be confirmed by histological examination of tissue removed surgically. Fine needle aspiration is a quick, generally painless method done either transrectally or transperineally to obtain prostate cells for cytological examination and to determine the stage of disease that may be present. The procedure typically causes a very brief uncomfortable sensation each time the spring-loaded needle takes a sample. Nurses are involved in the diagnostic process when caring for a patient who has undergone prostate biopsy.
Prostate needle biopsy.
The nurseâs role in the process of obtaining a needle biopsy involves:
- Managing procedure setup
- Patency of urinary drainage system
- Catheter care and wound care
During the home visit, the nurse also reinforces previous education, assesses the patient and familyâs ability to manage required care, encourages ambulation and perineal muscle exercises as prescribed, answers questions, and provides emotional support .
Benign Prostatic Hyperplasia Nursing Care Plans
Benign prostatic hyperplasia or benign prostatic hypertrophy is characterized by progressive enlargement of the prostate gland , causing varying degrees of urethral obstruction and restriction of urinary flow. Depending on the size of the enlarged prostate, age and health of the patient, and the extent of obstruction, BPH is treated symptomatically or surgically.
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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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Prostate Cancer Nursing Care Plans Diagnosis And Interventions
Prostate Cancer NCLEX Review and Nursing Care Plans
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.
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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.
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:
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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.
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.
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Detection And Prevention Of Cancer
Nurses and physicians have traditionally been involved with tertiary prevention, the care, and rehabilitation of patients after cancer diagnosis and treatment, but the American Cancer Society, the National Cancer Institute, clinicians, and researchers also place emphasis on primary and secondary prevention of cancer.
- Primary prevention. Primary prevention is concerned with reducing risks of disease through health promotion strategies.
- Secondary prevention. Secondary prevention programs promote screening and early detection activities such as breast and testicular self-examination and Papanicolaou tests.
Risk For/fluid Volume Deficit
Fluid volume deficit is another risk factor that the nurse should place in priority for patients with cancer. This is due to the massive nausea and vomiting that the patient is experiencing, especially after chemotherapy sessions. Assessment of the patient for a present or risk problem for fluid volume deficit may yield:
Actual problem for Fluid Volume Deficit
- Poor skin turgor
Possible Nursing Diagnoses
Fluid Volume Deficit
Fluid Volume Deficit related to excessive losses as evidenced by .
Fluid Volume Deficit related to an inability to take the recommended fluid intake as evidenced by
Risk for Fluid Volume Deficit
Risk for Fluid Volume Deficit related to intake less than recommended
Risk for Fluid Volume Deficit related to excessive losses through
Desired Outcomes
After rendering nursing interventions, the patient is expected to:
- Display adequate fluid balance, as evidenced by
- Increase fluid intake to restore appropriate fluid balance
- Reduced, if not eliminate, the risk for fluid volume deficit
**NOTE: All interventions marked with asterisks are done for patients with the diagnosis Risk for Fluid Volume Deficit, while entries marked with are implemented for patients with the diagnosis Fluid Volume Deficit.
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Nursing Considerations For Prostate Cancer Survivorship Care
Prostate cancer is the most common cancer among those assigned male at birth, with one in eight diagnosed during their lifetime. But with five-year survival rates of 90%, its also one of the most successful cancers to treat, making survivorship care even more important.
Many patients live with the disease or receive long-term maintenance therapies, and patients often have comorbidities prior to diagnosis. With the advancements in treatment, many are outliving their prostate cancer diagnosis and their death is related to other comorbidities. Survivorship care requires an interprofessional approach that involves primary care, urology, and oncology specialists to address the wide range of late and long-term effects and comorbidities.
Nursing Care Of Patients With Cancer
The outlook for patients with cancer has greatly improved because of scientific and technologic advances.
Maintaining Tissue Integrity
- Stomatitis. Assessment of the patientâs subjective experience and an objective assessment of the oropharyngeal tissues and teeth are important and for the treatment of oral mucositis, Palifermin , a synthetic form of human keratinocyte growth factor, could be administered.
- Radiation-associated skin impairment. Nursing care for patients with impaired skin reactions includes maintaining skin integrity, cleansing the skin, promoting comfort, reducing pain, preventing additional trauma, and preventing and managing infection.
- Alopecia. Nurses provide information about hair loss and support the patient and family in coping with changes in body image.
- Malignant skin lesions. Nursing care includes cleansing the skin, reducing superficial bacteria, controlling bleeding, reducing odor, protecting the skin from further trauma, and relieving pain.
Promoting Nutrition
- Anorexia. Anorexia may occur because people feel full after eating only a small amount of food.
- Malabsorption. Surgical intervention may change peristaltic patterns, later gastrointestinal secretions, and reduce the absorptive surfaces of the gastrointestinal mucosa, all leading to malabsorption.
- Cachexia. Nurses assess patients who are at risk of altered nutritional intake so that appropriate measures may be instituted prior to nutritional decline.
Relieving Pain
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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.
Prostate Cancer: Survivorship Care Case Study Care Plan And Commentaries
Michelle Delcioppo
This case study highlights the patients status in care plan format and is followed by commentaries from expert nurse clinicians about their approach to manage the patients long-term or chronic cancer care symptoms. Finally, an additional expert nurse clinician summarizes the care plan and commentaries, emphasizing takeaways about the patient, the commentaries, and additional recommendations to manage the patient. As can happen in clinical practice, the patients care plan is intentionally incomplete and does not include all pertinent information. Responding to an incomplete care plan, the nurse clinicians offer comprehensive strategies to manage the patients status and symptoms. For all commentaries, each clinician reviewed the care plan and did not review each others commentary. The summary commentary speaks to the patients status, care plan, and nurse commentaries.
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Risk For Altered Family Processes
Alteration in family processes may occur in patient with cancer because of the change ins roles individuals in a family may face during the disease process. It can be an actual nursing problem or a problem that is at risk for occurring. This is a nursing diagnosis that includes not only the patient, but also sometimes involve family members and significant others.
Assessment
Assessment of the Risk for Altered Family Processes usually reveals the following conditions present:
- Change in communication patterns within the family
- Varying roles performed by members of the family
- Disrupted routines in the family
- Diagnosis of cancer/terminal cancer
- Potential loss of a loved one due to cancer.
Desired Outcomes
At the end of nursing interventions, the patient and/or significant other is expected to:
- Verbalize feelings about changes in family processes
- Participate in interventions to help resolve issues
- Find meaning in the experience that the patient/SO is going through
- Develop mechanisms needed for coping and adjusting to the current situation.
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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Prostatectomy Nursing Care Plans
Prostatectomy is the surgical removal of the prostate wherein the procedure could include all or part . Prostatectomy is indicated in the treatment of benign prostatic hyperplasia while radical prostatectomy is indicated in the treatment of prostate cancer.
- Transurethral resection of the prostate : Obstructive prostatic tissue of the medial lobe surrounding the urethra is removed by means of a cystoscope/resectoscope introduced through the urethra.
- Suprapubic/open prostatectomy: Indicated for masses exceeding 60 g . Obstructing prostatic tissue is removed through a low midline incision made through the bladder. This approach is preferred if bladder stones are present.
- Retropubic prostatectomy: Hypertrophied prostatic tissue mass is removed through a low abdominal incision without opening the bladder. This approach may be used if the tumor is limited.
- Perineal prostatectomy: Large prostatic masses low in the pelvic area are removed through an incision between the scrotum and the rectum. This more radical procedure is done for larger tumors/presence of nerve invasion and may result in impotence.
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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