BENIGN PROSTATIC HYPERPLASIA Flashcards

Question

Continuous Bladder Irrigation (Cystoclysis) → Triple Lumen Irrigation Catheter

Answer 1

▪ The balloon is inflated to 35-45mm, it keeps the catheter in place, and puts pressure in the bladder neck to prevent bleeding. ▪ No. 18-22 Fr Catheter

Answer 2

▪ It has greater eyelets to facilitate evacuation of clots. ▪ A 30 to 45 mL retention balloon through the urethra into the bladder

Answer 3

▪ It is a method used to stabilize and secure a urinary catheter that has been inserted into the bladder through the urethra. ➢ The catheter is secured at the abdomen. ▪ The effectiveness of the traction will be assessed every 15-30 minutes. ▪ Notify the physician if the application of traction does not decrease bleeding within 30 minutes

Answer 4

are expected after prostate surgery for the first 24-36 hours. ▪ Urine Color: ➢ Bright red to pink and then to normal amber color. ➢ Rate of infusion is based on the color of drainage. * If UO is still ketchupy in color at the 2nd postop day, rate of infusion increases.

Answer 5

▪ Spasm will decrease intensity in 2 days. ▪ It occurs because of irritation of the bladder (insertion of resectoscope & catheter) ▪ Patient may feel: ➢ Urgency to void – educate the patient that he is with a catheter. ➢ A feeling of pressure or fullness in the bladder. ➢ Bleeding from the urethra around the catheter. ▪ Medications: ➢ To relax the smooth muscle to ease the spasms: Oxybutynin (Priptane) – increases bladder capacity by diminishing bladder muscle contraction. ▪ Relaxation Techniques: ➢ Deep Breathing Exercises ➢ Distraction Therapy * Music, TV, & Communicate the patient to allow her to reminisce happy moments in life. ➢ Visual Imagery

Answer 6

▪ Irrigate catheter if occluded with blood clots as prescribed. ➢ UO should be more than intake (2400) because px has IV fluids, oral fluids, and foods. If UO is less or equal to intake, report to the physician. ▪ Check for patency, kinks, if patient is lying on it, clotted blood. ➢ Distilled water is used to flush the catheter and aspirate it. Do it several times until the solution is clear. * Sterile technique * Patient is in a dorsal recumbent position. * Use linen saver pads ▪ The output should be at least 50mL/greater than hourly flow of irrigation. ▪ Less urinary output indicates obstruction.

Answer 7

→ Stop the irrigation flow to prevent severe bladder distention. → Check for kinks and patency of the tubes for obstruction. → If no output occurs, irrigate it with 30 to 50mL of normal saline/distilled water using a large piston syringe. → If the obstruction is not resolved, call the physician.

Answer 8

→ Monitor the color consistency and amount of urine output. ▪ If dark red colored, increase the flow rate of fluids. ▪ If ketchupy blood is present, obtain the BP and notify the physician. → Monitor vital signs closely for the first 24hours. ▪ ↓ BP & ↑PR ▪ Bleeding is the most common complication within the first 24 hours, and it is normal. → Monitor for hemorrhage evidenced by: ▪ Bloody Urinary Output ▪ Presence of large blood clots ▪ Decreased UO – Decreased blood volume triggers the SNS. It will stimulate the Adrenal Cortex to release Aldosterone and Posterior Pituitary Gland to release Antidiuretic Hormone. Aldosterone will promote sodium reabsorption and water retention, while ADH will promote water retention and prevent urine formation. ▪ Decreased Hemoglobin and Hematocrit. ➢ Normal: Female – 35% to 47%, Male –42% to 57% ▪ Tachycardia and Hypotension → Encourage patient to increase fluid intake of 2.5 to 3L to flush the urinary system, to prevent urinary stasis, and to prevent growth of bacteria. → Keep patient’s urine acidic to preventcalculus formation, so advise patient to eat ascorbic acid rich foods such as citrus fruits, cranberry, green peppers, lemon water, strawberries, and pineapple. → Encourage patient to turn, cough, and deep breath every 2 hours to prevent atelectasis and pneumonia. → Advise patient to do Kegel’s Exercises, to strengthen the pelvic muscle (pubococcygeus muscles) to hold or control the bladder and prevent urinary incontinence. ▪ Exercises such as raising your hips, squats, crunches. ▪ Beneficial: urinary incontinence, premature ejaculation, vaginal and uterine prolapse. ▪ Incontinence can improve for up to 12 months.

Answer 9

→ Increase fluid intake, fibers, and ambulate to increase peristalsis. ▪ Fiber-rich foods: apples, whole grains, chico, guava, prune, pechay, kangkong, and malunggay. → Avoid bladder irritants such as coffee, alcohol, and citrus juice because these has a diuretic effect; therefore, patient won’t be trained. → If constipation occurs, call the physician and ask for a prescription. ▪ Administer laxative such as Psyllium. ➢ It is a bulk-forming laxative that promote large, soft tools by absorbing water into the intestine, increasing fecal bulk and peristalsis. ➢ Nursing interventions: * Teach patient to mic the agent with water immediately before use to avoid GI obstruction. * Advise patient not to swallow the agent in dry form because it can cause abdominal cramping. * Advise patient to avoid inhaling the psyllium dust because it cancause watery eyes, runny nose, and wheezing, * Counsel patient to avoid overuse of laxatives because it can lead to fluid and electrolyte imbalances and drug dependence; instead, suggest exercises to help increase peristalsis. ▪ Avoid enemas or suppository. → Prevent Abdominal and Perineal Pressure to avoid bleeding. ▪ Avoid sitting for long periods. ▪ Avoid heavy lifting of more than 5lbs. ▪ Avoid sexual activity for at least 3 weeks. ▪ Avoid driving for 2 weeks.

BENIGN PROSTATIC HYPERPLASIA Flashcards

(35 cards)