Aging process in males results to hormonal imbalance . The estrogen levels become higher than the androgen levels. This cause hyperplasia of the prostate gland.
The enlargement causes compression of the urethra and base of the bladder. This leads to urinary obstruction.
If untreated, it results to a serious complication – renal failure .
Two processes produce this obstruction: hyperplasia and hypertrophy: Enlargement of the prostate (hyperplasia of the prostate gland) Narrowing of the lumen of the segment of the prostate that courses to the prostate (the prostatic urethra ) When it encroaches upon the bladder neck, it reduces its ability to funnel in response to micturition Growth of the so-called median lobe of the prostate extends into the proximal urethra OBSTRUCTION
Enlargement of the prostate (hyperplasia of the prostate gland) Accompanied by hypertrophy of the smooth muscle of the gland Mechanically adding to the tissue constricting the urethral lumen that courses to the prostate (the prostatic urethra ) Increased muscle tone in the bladder neck reducing then its ability to funnel in response to micturition Increased muscle tone at the proximal (prostatic) urethra EXACERBATION OF URINARY OBSTRUCTION
Nocturia ( frequent voiding at night) the frequent manifestation that occurs.
The other manifestations are frequency, urgency, hesitancy (difficulty in initiating urination, takes few minutes before urine flows), decreased caliber of urinary stream and force, increased residual urine, hematuria, UTI.
Abdominal straining with urination, volume and force of urinary stream.
Sensation that bladder has not completely emptied.
Recurrent urinary tract infection
It is validated by rectal examination, cystoscopy and ultrasound.
- reassure client that ultrasound is painless and not invasive
- fleet enema 45 minutes before procedure
- preop protocol; obtain consent
- urine culture or Gram stain must be negative
- place client in lithotomy position
- urethra is prepared with a water-soluble lubricant containing 2% lidocaine
- ext. Genetelia are prepped w/ antiseptic sol’n e.g., povidone/iodine.
Postoperative Care Cystoscopy – hematuria is expected - instruct client to force fluids - report any frank bleeding or clots in the urine or manifestations of UTI - warm baths and NSAIDS Biopsy – immediately apply pressure to the puncture site - apply sterile dressing - check puncture site for bleeding , V/S - force fluids to promote urination and to prevent clot formation - limited activity for the first 24 hrs.
- reducing urethral obstruction by relaxing smooth muscle w/in the prostate, proximal urethra & bladder neck (Alpha-1-adrenergic blockers)
- 5-alpha-reductase (finasteride (Proscar) and dutasteride)
- TURP, Suprapubic Prostatectomy, Retropubic Prostatectomy, and Perineal Prostatectomy
Nursing Care Promotive - balance and healthy diet - regular exercise - health teachings Preventive - teach men to report any lower urinary tract symptoms that may be indicative of BPH - teach men on how to perform TSE - teach men to practice safer sex to prevent infections of the reproductive organs
- tell client that there is sensation of flushing and warmth, salty taste, nausea. If occurs, take deep, full breath
Intraoparative Care - assess for allergic reactions immediately after injection of the contrast medium (urticaria, itching, diaphoresis, and resp. distress or failure) - antihistamines, steroids and emergency cart must be ready available
Is the type of childhood cancer that begins in the kidney
It is a malignant tumor
Most common type of kidney cancer among children
Can develop in both (bilateral) or in one (unilateral) kidney.
Is only often found after it has grown to a size of 8 oz
Risk factor- hemihypertrphy for children
It accounts for 6% of all childhood cancers. • It generally grows to a large size before it is diagnosed, usually before the child reaches age 5. • The tumor expands the renal parenchyma, and the capsule of the kidney becomes stretched over the surface of the tumor. • Staging if from I (limited to kidney) to IV (matastasis) and stage V, which indicates bilateral involvement (rare). • The tumor may metastasize to the lymph nodes , lungs, liver, and brain.