Prostatic Hypertrophy is malfunction of the urinary tract resulting from a lesion (benign or malignant) of the prostat gland.
Cancer is a group of many related diseases. These diseases begin in cells, the body's basic unit of life. Cells have many important functions throughout the body.
Normally, cells grow and divide to form new cells in an orderly way. They perform their functions for a while, and then they die. This process helps keep the body healthy.
Sometimes, however, cells do not die. Instead, they keep dividing and creating new cells that the body does not need. They form a mass of tissue, called a growth or tumor.
Tumors can be benign or malignant:
Malignant tumors are cancer. Cells in these tumors are abnormal. They divide without control or order, and they do not die. They can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream and lymphatic system. This is how cancer spreads from the original (primary) cancer site to form new (secondary) tumors in other organs. The spread of cancer is called metastasis.
When prostate cancer spreads (metastasizes) outside the prostate, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, it means that cancer cells may have spread to other parts of the body -- other lymph nodes and other organs, such as the bones, bladder, or rectum. When cancer spreads from its original location to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to the bones, the cancer cells in the new tumor are prostate cancer cells. The disease is metastatic prostate cancer; it is not bone cancer.
Prostate enlarges, bulges upward, block flow of urine from bladder into urethra-------------->obstruction------->hydroureter, hydronephrosis.
3. Risk Factors :
- Changes in estrogen and endrogen levels.
- Men > 50 Years Old
- Genetic tendency
- Hormonal Factors (e.g., Late puberty, higher fertility)
- Diet (high Fat)
- Chemical carcinogens (fertilizer, rubber, cadmium batteries).
a. Subjective Data
- Difficulty starting stream
- Smaller, less forceful
- Inability to void after ingestion of alcohol or exposure to cold
b. Objective Data
- Catheterization for residual urine : 25-50 ML after voiding
- Enlarge prostate on rectal exam.
- Lab data : (Urine : increased RBC and WBC, BLOOD :increased Creatinine)
5. Alalysis/ Nursing Diagnosis
a. Urinary retention related to incomplete emptying
b. Altered urinary elimination related to obstruction
c. Urinary incontinence related to urgency, pressure
d. Anxiety related to potential surgery
e. Body image disturbance related to threat to male identity.
6. Nursing Care Plan
a. Goal : Relieve urinary retention
- Catheterization : release maximum of 1000 mL initially; avoid bladder decompression, wich results in hypotension, bladder spasms, ruptured blood vessels in bladder; empty 200mL every 5 min.
- Patency : Irrigate intermittently or continually, as ordered.
- Fluids : minimum 2000 mL/24 hours.
b. Goal : Health Teaching.
- Preparation for surgery (cystostomy, prostatectomy) :
- Expectations (indwelling catheter------->will feel urge to void)
- Avoid pulling on catheter (this increases bleeding and clots)
- Bladder spasms commons 24-48 hours after surgery, particularly with TUR ans suprapubic approaches.
- Threatening nature of procedure.
- Sally L. Lagerquist, NCLEX-RN Examination Review, 1998
- Dolores F. Saxton, Comprehensive Review Of Nursing For NCLEK-RN, Sixteenth Edition, Mosby, St. louis, Missouri, 1999.
- The lippincott Manual of Nursing Practice, 7th Edition, 2005.
- Nursing Procedures, Springhouse Publishing Co, 3rd, ed, Mosby, 2000
- Pediatric Nursing Procedures, Vicky R.Bowden and Cindy Smith Greenbers, Lippincott Williams and Wolkins Publisher, 2003.