What is Benign Prostatic Hyperplasia and how to care for it as a nurse (Nursing Care Plan)

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Nursing Care Plan for Benign Prostatic Hyperplasia

Pathophysiology
A common condition in the aging cycle of men that causes enlargement of the prostate gland that surrounds the urethra. The enlargement of the prostate may cause difficulty urinating, having to urinate more often, especially at night, and a weak urine stream. BPH is not cancer and does not increase the risk of developing cancer.

Etiology
Hormonal imbalances of androgen/estrogen are believed to be responsible for the growth of the prostate.

Desired Outcome
Alleviate urinary symptoms, restore normal urinary function, prevent complications

Benign Prostatic Hyperplasia (BPH) Nursing Care Plan
Subjective Data:
Frequent / urgent need to urinate, especially at night
Difficulty urinating or weak urine stream
Inability to empty the bladder
Dribbling urine after voiding
Incontinence

Objective Data:
Elevated PSA
Enlarged prostate on exam or ultrasound
Inability to pass catheter through urethra
Nursing Interventions and Rationales
Assess and palpate suprapubic area

Assess for bladder distention to suggest fluid retention

Monitor vital signs

Observe for signs of hypertension and infection. Urinary retention may lead to infection which can be evidenced by fever. Fluid retention puts stress on the kidneys and heart and may increase blood pressure and heart rate.

Monitor I & O

Monitor frequency of urination and volume, paying attention to characteristics of urine. Dark, malodorous or bloody urine may indicate further complications.

Encouraged increased fluids if indicated.** limit fluids initially if urinary retention is an issue **

Recommend 3000 mL fluid daily to promote flushing and circulation of fluid through kidneys, bladder and ureters.

Monitor labs / diagnostic tests
Prostate Specific Antigen (PSA)
Digital Rectal Exam (DRE)

PSA- a protein produced by the prostate. Elevations in this blood test may indicate enlargement or inflammation of the prostate.
DRE- this physical exam may be performed if BPH is suspected by inserting a gloved finger into the rectum to palpate the prostate and assess for abnormalities in size and shape.

Administer medications and educate patient of proper use

Alpha-adrenergic antagonists (tamsulosin) – relaxes the smooth muscle of the prostate to allow optimal urine flow
Antispasmodics- (oxybutynin) relieves muscle spasms that restrict the urethra
Antibiotics/antibacterials- may be given prophylactically as indicated to prevent bacterial infection

Insert indwelling catheter as indicated per facility protocol

Indwelling catheter may be required to bypass the prostate and allow urine to flow freely, eliminating fluid retention in the bladder.

Nutrition and lifestyle education

Excess weight can affect the hormone balance in the body. Maintaining a healthy weight through diet and exercise can help lower the risk of developing BPH.

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