Benign prostatic hyperplasia King Saud University Nursing College Benign prostatic hyperplasia Presented by: Ahmed

Content introduction Patient profile Medical history Chief compliance and medical diagnosis BPH lab results treatment Nursing care plan summary

introduction What is BPH ? Where BPH occur in the body ? What is the risk factor for BPH ?

Patient profile: Name : Ibrahim Alqahtani Patient’s NO. : 80-89-02 Age : 85 y/o Sex: male Attending physician : dr. Traifi Diagnosis : BPH

Medical history Not known for any medical problem in the past.

Chief compliance Medical diagnosis: Difficulty for urinate for 3 years associated with Frequent need to urinate , Not able to completely empty the bladder , dribbling & poor stream urine. Benign prostatic hyperplasia (BPH) Or benign prostatic hypertrophy benign enlargement of the prostate (BEP),

anatomy:

BPH Definition : is a growth of the prostate gland that might make it difficult for men to urinate. It is not cancer, but a doctor should check male patients that have difficulty urinating. It might happen to men after the age of 40. Nearly 80% of all men have prostatic hyperplasia at the age of 80

Causes &Risk factors : Causes :Unknown -Aging. -Heredity. -National origin.

Symptoms : Weak urine stream Difficulty starting urination Stopping and starting while urinating Dribbling at the end of urination Straining while urinating Frequent need to urinate Increased frequency of urination at night (nocturia) Urgent need to urinate Not being able to completely empty the bladder Blood in the urine (hematuria) Urinary tract infection

Tests and diagnosis procedure : ECG Urine test Cystoscopy Chest X-ray Ultrasound Prostate-specific antigen (PSA) blood test

Lab results pre post Urea & electrolyte Urea 4.1 (2.9 – 7.5) Creatinine 91 (62- 115) Sodium 134 (135- 145) WBC 5.3 (4-11) RBC 4.2 (4.7 - 6.1 ) HB 12.9 (13 – 18 ) PT 13.1 (11.5- 16.5) PT + INR 0.97 (0.8 – 1.3) PTT 39.4 (26- 36) Prostatic specific antigen 0.815 (normal 0-4) Urea & electrolyte Urea 3.1 (2.9 – 7.5) Creatinine 79 (62- 115) Sodium 135 (135- 145) CBC WBC 6.5 (4-11) RBC 4.03 (4.7 - 6.1 ) HGB 12.2 (13 – 18 )

Complications : -Acute urinary retention (AUR). -Urinary tract infections (UTIs). -Bladder stones. -Bladder damage. -renal failure.

Treatments and drugs Surgery : TURP (transurethral resection of the prostate ) procedure that done to treat enlarged prostate or to evaluate prostate cancer. A TURP is performed by passing a tube into the urethra (the thin tube that urine passes through) and identifying the area where the prostate has grown and is blocking the passage of urine, a condition referred to as benign prostatic hypertrophy, or BPH. A surgeon threads a narrow instrument (resectoscope) into urethra and uses small cutting tools to scrape away excess prostate tissue.

TURP

Microwave therapy

Prostatic stents

Open Prostatectomy

medications Omnic (tamsulasin) 0.4 mg PO OD Proscar (finasteride) 5 mg PO OD Gentamycin 80mg IV Q8 2 dose only Cefroxamine 500mg PO B.D start from second day post operative.

Nursing care plan : Nursing diagnosis: risk of post operative hemorrhage/blockage of catheter. Goal: early detection, prevention & control of hemorrhage.

Nursing interventions: observe for signs/ severity off hemorrhage in the urinary catheter drainage. Administer/ adjust bladder irrigation as required. If clot persists, perform manual irrigation. Record vital signs according to unit protocol. Report abnormal findings to the doctor.

Continuous bladder irrigation

Nursing diagnosis: discomfort due to post operative pain. Goal: patient will verbalize & demonstrate non verbal cues that he/she is free from pain.

Nursing interventions: closely observe for any sings & symptoms of pain. Put the patient in position of optimal comfort that does not compromise the surgery performed. Provide optimal pain relief by giving prescribed analgesic. Assess periodically the effectiveness of the analgesic & inform the doctor if it is ineffective.

Nursing diagnosis: The patient has the potential for developing infection at urinary catheter & IV cannula sites. Goal: early detection & prevention of complications.

Nursing interventions: observe the sites for the early manifestations of infection e.g.: pain .redness & swelling. follow unit policy for care of IV cannula, site & tubing. administer prescribed antibiotics. ensure catheter patency, record amount & characteristic of urinary output.

nursing diagnosis: potential for the development of complications of immobility & thromboembolism. Goal: for the patient not to develop the complications.

Nursing interventions: prevent pressure over potential areas of deep vein thrombosis. Use of anti-embolism stocking peri-operatively as prescribed by doctor. Monitor vital sings for early manifestation. Ensure early mobilization according to unit protocol. Administer anti-coagulant therapy as prescribed.

summary

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