Benign Prostatic Hyperplasia NCP

Subjective:“Nahihirapan akong umihi”Objective:•Bladder Distention•Small, frequent voiding or absence of urine output Urinary Retention related to mechanical obstruction; enlarged prostate BPH is the enlargement of the prostate gland thus causing mechanical obstruction in the passageway of urine. * * •After 8 hours of NI client be able to void in sufficient amounts with no palpable bladder distension. * •Demonstrate techniques/ behaviors to alleviate/ prevent retention •Encourage patient to void every 2–4 hr and when urge is noted.• Ask patient about stress incontinence when moving, sneezing, coughing, laughing, lifting objects.•Have patient document time and amount of each voiding. Note diminished urinary output. Measure specific gravity as indicated.•Percuss/palpate suprapubic area.• Encourage oral fluids up to 3000 mL daily, within cardiac tolerance, if indicated.• Monitor vital signs closely. Observe for hypertension, peripheral/dependent edema, changes in mentation. Weigh daily. Maintain accurate I&O.• Provide/encourage meticulous catheter and perineal care.• Recommend sitz bath as indicated.

• Catheterize for residual urine and leave indwelling catheter as indicated. • May minimize urinary retention/overdistension of the bladder.• High urethral pressure inhibits bladder emptying or can inhibit voiding until abdominal pressure increases enough for urine to be involuntarily lost.•Urinary retention increases pressure within the ureters and kidneys, which may cause renal insufficiency. Any deficit in blood flow to the kidney impairs its ability to filter and concentrate substances.• A distended bladder can be felt in the suprapubic area.• Increased circulating fluid maintains renal perfusion and flushes kidneys, bladder, and ureters of “sediment and bacteria.” Note: Initially, fluids may be restricted to prevent bladder distension until adequate urinary flow is reestablished.• Loss of kidney function results in decreased fluid elimination and accumulation of toxic wastes; may progress to complete renal shutdown.• Reduces risk of ascending infection.• Promotes muscle relaxation, decreases edema, and may enhance voiding effort.• Relieves/prevents urinary retention and rules out presence of ureteral stricture. • Client void sufficiently with no blader distention• Client demonstrate and understood proper techniques to prevent retention

Benign Prostatic Hyperplasia – Nursing Care Plan for Fear/Anxiety

Assessment Nursing Diagnosis Inference Planning Intervention Rationale Evaluation Subjective:“ano ang mangyayare sako pagkatapos ka ini?”(Expressed concerns regarding perceived changes)Objective:•Focus on self•Poor eye contact•Repetitive questioning •Fear/Anxiety related to Change in health status: possibility of surgical procedure/malignancy secondary to BPH •BPH is the enlargement of the prostate gland that causes mechanical obstruction in the passageway of urine. Thus the client will undergo surgical procedure that will cause several changes in his lifestyle. * * •After 8 hours of NI client will ppear relaxed and reports anxiety is reduced to a manageable level. * * •Verbalize accurate knowledge of the situation. * * •Demonstrate appropriate range of feelings and lessened fear. * •Be available to patient. Establish trusting relationship with patient/SO.•Provide information about specific procedures and tests and what to expect afterward, e.g., catheter, bloody urine, bladder irritation. Be aware of how much information patient wants.

•Maintain matter-of-fact attitude in doing procedures/ dealing with patient. Protect patient’s privacy.•Encourage patient/SO to verbalize concerns and feelings.•Reinforce previous information patient has been given. •Demonstrates concern and willingness to help. Encourages discussion of sensitive subjects. •Helps patient understand purpose of what is being done, and reduces concerns associated with the unknown, including fear of cancer. However, overload of information is not helpful and may increase anxiety.• Communicates acceptance and eases patient’s embarrassment.•Defines the problem, providing opportunity to answer questions, clarify misconceptions, and problem-solve solutions.• Allows patient to deal with reality and strengthens trust in caregivers and information presented. •Client appeared more relaxed and be able to managee own fear and anxiety.•Client verbalizes understanding of the situation.