ATI CBC LEVEL 2 STUDY GUIDE - NOTES FROM ATI BOOKS |Verified!!| #New Release

ATI CBC LEVEL 2 STUDY GUIDE - NOTES FROM ATI BOOKS |Verified!!| #New Release BENIGN PROSTATIC HYPERPLASIA *Ans* RISK FACTORS: - AGE - SMOKING/CHRONIC ALCOHOL USE - OBESITY/SEDENTARY LIFESTYLE - DIET HIGH IN FAT, CARBS, PROTEIN AND LOW IN FIBER - DIABETES MELLITUS, HEART DISEASE BPH MANIFESTATIONS *Ans* Pts typically report: - urinary frequency, urinary urgency, urinary hesitancy or incontinence - incomplete emptying of bladder, dribbling post void, NOCTURIA, decreased urinary stream, straining w/urination, HEMATURIA URINARY STASIS AND PERSISTENT URINARY RETENTION LEAD TO FREQ UTIs * If BPH persists, back flow of urine can lead to KIDNEY DAMAGE BPH LAB TESTS *Ans* Urinalysis and culture: ELEVATED WBC, hematuria, and bacteria w/UTI CBC: WBCs, RBCs may be decreased BUN/CREATININE: Elevated w/kidney damage PSA, culture, and sensitivity of prostatic fluid (can be performed during digital rectal exam) BPH DIAGNOSTIC PROCEDURES *Ans* Digital rectal exam: Enlarged/smooth prostate Early prostate cancer antigen BPH MEDS *Ans* DHT-lowering meds (finasteride) * Decreases production of testosterone often causing decrease in size of prostate - Can take 6 months before effects are seen - Impotence and decrease in libido possible adverse effects - REPORT breast enlargement to provider - Teratogenic, potentially absorbed through skin Alpha-blocking agents (tamsulosin) * Can cause relaxation of the bladder outlet and prostate gland - Re-establish a stronger urine flow - Tachycardia, syncope, postural hypotension may occur. CHANGE POSITIONS SLOWLY - Use w/cimetidine can increase hypotensive effect TURP CONSIDERATIONS *Ans* MOST COMMON surgical procedure for BPH Performed using resectoscope inserted through urethra and trims excess prostatic tissue - Epidural and spinal anesthesia PREOP: Carefully assess cardiovascular, respiratory, and renal systems; ensure that pt fully understands the procedure and what to expect post op POSTOP: - Usually includes indwelling 3 way cath - Adjust rate of CBI if bright red or ketchup like bleeding w/clots is observed. Contact surgeon if unable to dislodge clot - PINK-TINGED URINE NORMAL - Pt may have continuous urge to urinate due to the balloon. Tell pt not to void around cath - Monitor for bleeding (PERSISTENT BRIGHT RED, UNRESPONSIVE TO INCREASED CBI or REDUCED HGB levels) - Assist pt to ambulate ASAP - MEDS TO ADMINISTER: analgesics, antispasmodics, antibiotics, stool softeners - Administer/provide increased fluids - Color of urine should progress to amber in 2-3 days, expected output is 150-200 mL every 3-4 hrs BPH POST OP CLIENT EDUCATION *Ans* Avoid heavy lifting, strenuous exercise, straining, and sexual intercourse for usually 2-6 weeks Drink 12 or more 8 oz glasses of water each day AVOID NSAID