Nursing Care Plan for Benign Prostatic Hyperplasia (BPH)

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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.

 


References

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