NU 386 Final Exam With
Complete Solution
Benign Prostatic hyperplasia (BPH)
Benign growth of cells within the prostate gland
S/S BPH (Benign Prostatic Hyperplasia)
-Frequency
-Decreased force of urinary stream
-Trouble starting to void
-Dribbling after urination
-Feeling like bladder not empty
-Decreased or interrupted urinary stream
-classic sign - long, thin stream of urine
BPH Clinical manifestations
Irritative
-Nocturia
-Frequency
-Urgency
-Dysuria
,-Incontinence
-Bladder Pain
Obstructive
-Decreased stream force
-Difficulty initiating stream
-Intermittency
-Dribbling at end of urination
BPH Risk factors
-Age
-Obesity
-Low physical activity
-Alcohol use
-Smoking
-Diabetes mellitus
-ED
-Family History
BPH etiology and pathophysiology
-Pathophysiology not completely understood
-As men age, their testosterone levels decrease but the DHT levels stay the
same resulting in prostate enlargement
,-Hormonal changes of aging
BPH complications
-Acute retention - Rare
•Tx: Coudé -curve-tipped catheter
-UTI: If untreated lead to sepsis
-If treatment for acute retention is delayed, may lead to:
•hydronephrosis, pyelonephritis, bladder damage
Nursing care for BPH
Prevention of symptoms
-limit alcohol and caffeine intake
-void q2-3hrs at first urge
-do not limit fluids
Diagnostics for BPH
-History and physical
-DRE= Digital rectal exam
-PSA= Prostate specific antigen
-TRUS= transrectal ultrasound of the prostate
-UA w/ culture
-Uroflowmetry= patient urinates in a funnel connected to an electronic
flowmeter
, -Serum creatinine (r/o renal insufficiency)
-Post-void residual
-Uroflowmetry
-Cystoscopy= if uncertain of diagnosis or pre surgery
-Rule out neurogenic bladder
Treatment for BPH
-Active Surveillance
-Drugs
-Minimally invasive
-Invasive
AUA symptom index
Score:
0-7 = Mild
8-19 = Moderate
20-35 = Severe
Active surveillance for BPH
AUA score 0-7
-Annual physical with PCP
-Annual PSA & DRE
Management:
Complete Solution
Benign Prostatic hyperplasia (BPH)
Benign growth of cells within the prostate gland
S/S BPH (Benign Prostatic Hyperplasia)
-Frequency
-Decreased force of urinary stream
-Trouble starting to void
-Dribbling after urination
-Feeling like bladder not empty
-Decreased or interrupted urinary stream
-classic sign - long, thin stream of urine
BPH Clinical manifestations
Irritative
-Nocturia
-Frequency
-Urgency
-Dysuria
,-Incontinence
-Bladder Pain
Obstructive
-Decreased stream force
-Difficulty initiating stream
-Intermittency
-Dribbling at end of urination
BPH Risk factors
-Age
-Obesity
-Low physical activity
-Alcohol use
-Smoking
-Diabetes mellitus
-ED
-Family History
BPH etiology and pathophysiology
-Pathophysiology not completely understood
-As men age, their testosterone levels decrease but the DHT levels stay the
same resulting in prostate enlargement
,-Hormonal changes of aging
BPH complications
-Acute retention - Rare
•Tx: Coudé -curve-tipped catheter
-UTI: If untreated lead to sepsis
-If treatment for acute retention is delayed, may lead to:
•hydronephrosis, pyelonephritis, bladder damage
Nursing care for BPH
Prevention of symptoms
-limit alcohol and caffeine intake
-void q2-3hrs at first urge
-do not limit fluids
Diagnostics for BPH
-History and physical
-DRE= Digital rectal exam
-PSA= Prostate specific antigen
-TRUS= transrectal ultrasound of the prostate
-UA w/ culture
-Uroflowmetry= patient urinates in a funnel connected to an electronic
flowmeter
, -Serum creatinine (r/o renal insufficiency)
-Post-void residual
-Uroflowmetry
-Cystoscopy= if uncertain of diagnosis or pre surgery
-Rule out neurogenic bladder
Treatment for BPH
-Active Surveillance
-Drugs
-Minimally invasive
-Invasive
AUA symptom index
Score:
0-7 = Mild
8-19 = Moderate
20-35 = Severe
Active surveillance for BPH
AUA score 0-7
-Annual physical with PCP
-Annual PSA & DRE
Management:
