Benign prostatic hyperplasia

Presented by:

Ahmed

King Saud University Nursing College

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

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)

Orbenign prostatic

hypertrophy Orbenign enlargement

of the prostate (BEP),

Medical diagnosis:

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

Urea & electrolyteUrea 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)

CBCWBC 6.5 (4-11)

RBC 4.03 (4.7 - 6.1 )

HGB 12.2 (13 – 18 )

pre post

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

Thank you