STUVIA 2024/2025
1. Science
2. Medicine
3. Surgery
PCC 2 Module 4
Anatomy review (View image)
Prostate gland
Normal part of male anatomy
-Surrounds the urethra
Functions
-Urine control
-Produces fluid for semen
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Begins to grow in size around age 25
-Routine diagnostic procedures are recommended to evaluate.
Benign Prostatic Hyperplasia (BPH)
Enlargement of the prostate gland
Causes bladder outlet obstruction
-Obstructs the flow of urine through the urethra
-May cause chronic urinary retention
Symptoms related to BPH are present in about one in four men by age 55, and in half of 75-year-old
men.
Treatment is only necessary if symptoms become bothersome.
Benign Prostatic Hyperplasia (BPH) manifestations
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Urinary frequency/urgency
Difficulty starting and(hesitancy) or continuing urination
Nursing intervention:
Nursing assessment:
(Assess urine elimination patterns)
-Increased urges and frequency
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-Weak stream
-Urine leakage
(Palpate the patient's bladder)
-Bladder Distention
(Observe urine characteristics)
-Dark color
-Foul scent
-Blood
Identify additional signs and symptoms
-HTN
-Edema
-Low back pain
Nursing Interventions:
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(Assess post-void residual(PVR) volume.)
-A PVR of less than 50 mL is considered normal
-Greater than 200 mL is inadequate emptying
-Provide catheterization as ordered
-Provide medication as ordered to Relax the muscles.
-Administer antibiotics as prescribed
Benign Prostatic Hyperplasia (BPH) Non surgical management
Lifestyle Changes:
-Avoid drinking large amounts of fluid at one time
-Avoid caffeine and alcohol due to their diuretic effect
Medications
alpha blockers - relax the muscles near the prostate,
relieves pressure on the urethra
->. Tamsulosin
5α-reductase inhibitor - reduce the size of the prostate
->. Finasteride
Complementary and integrative health
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->. Saw Palmetto
Benign Prostatic Hyperplasia (BPH) Surgical management
Surgical management:
(Transurethral resection of the prostate (TURP) )
-Surgical instrument inserted directly through the urethra to remove prostate tissue
Transurethral resection of the prostate (TURP)
Pre op care:
Post op care:
Pre operative care:
-Reinforce information given to patient by surgeon
-Patient's should stop taking anticoagulants/Aspirin several days before surgery
-Educate regarding indwelling urinary catheter
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Post operative care:
-Patient will have an indwelling catheter and most likely continuous bladder irrigation.
-Monitor vital signs
-Assess for signs of infection
-Check drainage tubing frequently for signs of obstruction
-Assess urine, pain level, urinary output.
Urinary Catheter Care Following TURP
-The urinary tract is susceptible to blockage due to postsurgical bleeding, clots, and tissue debris.
-CBI promotes system patency by reducing the complications associated with urinary tract obstruction
-Closed bladder irrigation permits access to the bladder without disrupting and potentially
contaminating the closed drainage
-The desired outcome of urinary catheter insertion following TURP is to allow the bladder and
prostate to rest following surgery and to maintain catheter patency by flushing tissue, clots, mucous
fragments, and sediment, which can obstruct the catheter and prevent the normal drainage of urine,
tissue debris, and blood
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