Benign Prostatic Hyperplasia FINAL

Question 1

BPH Patho

Answer 1

Prostate gland enlarges –> extends upward into the bladder and inward –> causes bladder outlet obstruction impairing urinary elimination

With aging and increased dihydrotestosterone (DHT) levels, the glandular units in the prostate undergo nodular tissue hyperplasia (an increase in the number of cells).

Question 2

BPH S/Sx

Answer 2

-Difficulty starting and stopping stream
-Frequency, straining to begin urination, nocturia, hesitancy, force & size of stream, bladder fullness after voiding, postvoid dribbling/leaking
-bladder distention
-International Prostate Symptom Score (I-PSS) questionnaire

Question 3

BPH Risk factors

Answer 3

• Older age
• Family history
• Smoking, chronic alcohol use
• Obesity, Decreased physical activity
• Diabetes mellitus, heart disease
• Western diet (high fat, high carbs, low fiber)
• Testosterone and other androgen supplements

Question 4

BPH Meds

Answer 4

-Alpha Blockers- tamsulosin (Flomax)
-5-Alpha Reductase Inhibitors (5-ARI)-finasteride (Propecia, Proscar)

Question 5

BPH Diagnostics/Labs

Answer 5

• UA or urine culture – increased WBC & bacteria, possibly RBC’s with hematuria (with UTI)
• Serum prostate-specific antigen (PSA) and a serum acid phosphatase level
  to rule out prostate cancer
• Basic metabolic panel to examine kidney function (BUN and creatinine)
• Transabdominal ultrasound and/or transrectal ultrasound (TRUS)
• MRI
• Digital rectal exam- may reveal enlarged, smooth prostate

Question 6

Tamsulosin (Flomax) nursing considerations

Answer 6

Assess for orthostatic hypotension, tachycardia, and syncope

Teach to be careful when changing positions

Report any weakness, lightheadedness, or dizziness

Question 7

BPH Complications

Answer 7

-UTI caused by urinary stasis and retention
-kidney damage caused by backflow of urine
-freq urges to void
-overflow incontinence

Question 7

Ways to prevent bladder distention

Answer 7

Avoid drinking large amounts of fluid in short period
Avoid alcohol, diuretics, and caffeine
Voiding as soon as urge is felt
Avoid drugs that can cause urinary retention (anticholinergics, antihistamines, and decongestants)