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38 Cards in this Set
- Front
- Back
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Prostate gland |
small gland located in the front of the rectum and below bladder -common to become enlarged |
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BPH s/s |
-difficulty to start to urinate and to stop -urinate more frequently or at night -sudden or urgent urination -dripping -decrease in urine stream/flow -acute urinary retention (less common and more severe is this does occur) |
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BPH diagnosis |
digital rectal exam (1st exam ) -urine culture and sensitivity -PSA -post void residual (PVR) -uroflowmetry -rectal US -prostate biopsy -cystoscopy |
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PSA |
prostate specific antigen -<7 -not a diagnositc test, can increase with possible prostate cancer -sometimes do this testing before DRE, as that procedure can increase PSA results |
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WATCHFUL WAITING |
first tx recommendation by American Cancer society |
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lifestyle modifications |
fluid restriction; avoid caffeine and spicy food avoid, avoid certain meds, kegal exercises avoid and treat constipation to decrease pressure on the prostate |
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drugs to avoid with BPH |
decongestants, diuretics, antihistamine and anti-depressants. *all meds can cause urinary retention |
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Alpha blockers |
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5 alpha reductase inhibitors |
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effective drug combination |
finasertide (proscar) and doxazosin (cardura) together is more effective that using either drug alone |
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TUMT -transurethral microwave thermotherapy |
1 hour procedure -no ED or incontinence -not a cure -minimally invasive |
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transurethral needle ablation (TUNA) |
low level frequency to burn away parts of enlarged prostate -minimally invasive |
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TURP -transurethral surgery |
no external incision. 1.5hr procedure -go through urethra to remove obstructing tissue *golden standard. |
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open prostatectomy |
only used if prostate is very large and needs to be removed |
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post op complications |
hemorrage, clot retention, infection retrograte (backward ejaculation) |
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nursing care |
teach of disease process- do not take cold medication -assess pt current level of knowledge of disease -explain rationale -s.s to report to provider= burning on urination, hematuria, oliguria |
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pre and post op teaching |
-stop ASA, warfarin and plavix -prostate has increased amount of blood vessels so increased bleeding can occur -maintain catheter traction -teach catheter care (can have 1 day to 1 week depending on bleeding) -tx of bladder spasms and pain |
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continuous bladder irrigation |
Manual irrigation. Used if the patient has an increase in bleeding. *3 urinals- urine should become clear -observe urine color/consistancy -increase fluid intake-help dilute urine and remove clots -complications- hemorrge, clotting of cath, infection, bladder spasms |
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post op teaching expectations |
burning with urination, blood urine. need to increase fluids |
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post op complications to monitor for |
hemorrgahe clotting of catheter infection bladder spasms - meds are avail for this if needed |
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prostate cancer |
most commen type in men 2 leading cause of death -multiple tumors on prostate |
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prostate cancer risk factors |
over age 60 AA men family hx diet- high fat, low veg and fiber infections environment toxins -vit E -vit C- does not help with prevention |
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prostate CA s/s |
unable to void or hard time starting and stopping stream -frequency -weak urine flow -difficulty having erection -blood in urine or semen -frequent pain in the lower back, hips or upper thighs |
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testing for prostate CA |
PSA -digital rectal exam -elevated prostate cancer antigen 3 PCA3 -rectal us and biopsy- antibiotic and enema given before procedure |
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active surveillance |
part of tx plan (like watchful waiting) -slow growing cancer -downside- leaves more time for cancer to spend -way benefits of tx against adverse effects of tx. |
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treatment depends of grading and staging of disease |
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radiation therapy |
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hormone manipulation |
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prostate CA teaching |
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post op care: prostatectomy |
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testicular cancer |
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risk factors |
-undescended testicle (cryptorchidism) -abnormal testicle development -fam hx -age -race |
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symptoms of testicular cancer |
-first sign is painless swelling of one testicle -other s/s would be those of metastasis: back pain (kidneys), cough, hemoptysis or dizziness |
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Diagnosis of testicular cancer |
-US and doppler study when swelling noted (mass vs fluid) -blood tests for tumor markers *human chorionic gonadotropin (HCG) *alpha-fetoprotein (AFP) -tumor markers-bx -biopsy |
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treatment for testicular cancer |
radial orchiectomy chemotherapy radiation- SE temporary- diarrhea, nausea |
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nursing care for early detection for testicular CA |
-begin self exams after puberty -perform monthly in the shower -feel each testes for irregularities (mass or lumps) -should feel smooth and round with the consistency of a hard boiled egg without shell |
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nursing care for impaired urinary elimination |
-monitor elimination (consistency, odor, volume and color) -select appropriate incontinence garment -limit fluids 2-3 hours before bedtime -drink minimum of 1500ml daily -limit ingestion of bladder irritants (cola, coffee, tea, chocolate) -for total incontinence suggest use of condom cath |
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nursing care for urinary retention care |
-instruct client/family member to record urinary output -catheterize for residual urine, prn -implement intermittent cath -provide enough time for bladder emptying (10 min) -avoid constipation and stool impaction |
