Prostat cancer shamsadin

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Prostat cancer shamsadin

  1. 1. ‫بسم ا الرحمن‬ ‫الرحيم‬ Nursing management forpatient with prostate cancer prepared by; Shamsadeen A. Mohammad 2010-2011
  2. 2. What is the Prostate?1. A male sex gland2. The size of a walnut below the bladder and infront of the rectum3. Produces the fluid that is part of semen
  3. 3. What is Prostate Cancer?• To understand prostate cancer, we need to understand cancer because prostate cancer is cancer that starts in the prostate gland. They have three main characteristics:• A cancerous cells natural process of growth and death is uncontrolled• A cancerous cell has lost its normal structure and, consequently, its ability to function as it should• A cancerous cell can escape the area in which it first grew and invade other parts of the body
  4. 4. Risk factors for prostate cancer.Age – Found mainly in men over age 55. Average age of diagnosis is 70 .Family History – Men’s risk is higher if father or brother is diagnosed before the age of 60
  5. 5. Risk Factors continued• Race – Prostate cancer is found more often in African American men then White men. It is less common in Asian and American Indian men• Dietary factors – Evidence suggests that a diet high in fat may increase the risk of prostate cancer and diets high in fruits and vegetables decrease the risk
  6. 6. Sign and Symptoms1. need to urinate often, especially at night.2. intense need to urinate (urgency).3. difficulty in starting or stopping the urine flow.4. inability to urinate .5. weak, decreased or interrupted urine stream .6. a sense of incompletely emptying the bladder.7. burning or pain during urination.8. blood in the urine or semen.9. painful ejaculation.
  7. 7. pathophysiologyThe pathophysiology of prostate cancer is poorly understood,Although prostate cancer typically manifests in men older than 65 years, Prostatic intraepithelial neoplasia (PIN) is the histologic entity widely considered to be the most likely precursor of invasive prostate cancer. genetic abnormalities that affect the androgen receptor(AR)and other molecules that are involved in cell survival and apoptosis(programmed cell death)
  8. 8. Nodular prostate
  9. 9. There are a four stage of prostate cancer
  10. 10. Tests for Prostate Cancer:1. The Digital Rectal Exam (DRE).2. Ct scan3. PSA - Prostate Specific Antigen.normal range(<4ng/ml).4. Beckman Coulters Hybritech free PSA (fPSA) test.5. PSA density test.6. Telomerase.7. Ultra sound
  11. 11. Prostate examProstate Cancer1. Asymmetric shape .2. Hard consistency.3. Discrete nodule may be palpable.4. Median sulcus often obscured. Note: Hard areas of prostate are not always cancerous but may indicate conditions such as prostatic stones or chronic inflammation.
  12. 12. Treatment.Laparoscopic Prostatectomy – Removal of entire prostate gland and nerves using a minimally invasive surgery.Radical Prostatectomy – Removal of entire prostate gland and nerves.Radiation Therapy – High-energy rays to kill or shrink cancer cells .Expectant Therapy – Regularly scheduled screenings
  13. 13. Treatment continue.Cryosurgery – freezes abnormal cells of the prostate with a metal probe.Hormone Therapy – Decreases the androgen (testosterone) levels in the body.Chemotherapy – Anticancer drugs injected into a vein or taken by mouth.TUPR-transe urethral prostate resection
  14. 14. Complication and side effect of prostectomy;1. Bleeding2. Infection3. Infertility4. Incontinence5. Erectile dysfunction6. death
  15. 15. ASSESSMENTSubjective data Objective dataMedications: General: Older adult male;Testosterone pelvic lymphadenopathy (late sign).supplements; use of any Urinary: Distended bladder onmedications affecting palpation; unilaterally hard,urinary tract such as enlarged, fixed prostate onmorphine, rectal examination.anticholinerqics, and Musculoskeletal:tricyclic antidepressants. Pathologic fractures (metastasis).
  16. 16. 1-NURSING DIAGNOSIS:Urinary retention related to urethral obstruction secondary to prostatic enlargement or tumor and loss of bladder tone due to prolonged distention.PLANNING: Improved pattern of urinary elimination.IMPLEMENTATION:1-Determine patients usual pattern of urinary function.2-Assess for signs and symptoms of urinary retention.3-Catheterize the patient to determine amount of residual urine.4- Monitor catheter function.5-Prepare patient for surgery if indicated.6- Consult with physician regarding intermittent or indwelling.EVALUATION: Voids at normal intervals.
  17. 17. 2.NURSING DIAGNOSIS: Pain related to progression of disease and treatment modalities. PLANNING: Relief of pain.IMPLEMENTATION:1. Evaluate nature of patient’s pain, its location and intensity using pain rating scale.2. Avoid activities that aggravate or worsen pain.3. Provide support for affected extremities.4. Administer analgesics or opioids at regularly scheduled intervals as prescribed. EVALUATION:1. Reports relief of pain.2. Expects exacerbations, reports their quality and intensity, and obtain relief.3. Uses pain relief strategies appropriately and effectively.4. Identifies strategies to avoid complications of analgesic use (e.g. constipation).
  18. 18. 3-NURSING DIAGNOSIS:Impaired nutrition, less than body requirement related to decreased oral intake because of anorexia.PLANNING: Maintain optimal nutritional status.IMPLEMENTATION:1. Assess the amount of food eaten.2. Routinely weigh patient.3. Elicit patient’s explanation of why he is unable to eat more.4. Recognize effect of medication or radiation therapy on appetite.EVALUATION:1- Responds positively to his favorite foods.2- Assumes responsibility for his oral hygiene.3- Reports his absence of nausea and vomiting.4- Notes increase in weight after improved appetite.
  19. 19. 4-NURSING DIAGNOSIS:Anxiety related to concern and lack of knowledge about the diagnosis.PLANNING: Reduced stress and improved ability to copeIMPLEMENTATION:1-Obtain health history.2-Provide education about diagnosis and treatment plan.3-Assess his psychological reaction to his diagnosis.EVALUATION:1-Appears relaxed.2- States that anxiety has been reduced and relieved.3-Engages in open communication with others.
  20. 20. 5-NURSING DIAGNOSIS:Sexual dysfunction related to effects of therapy.PLANNING: Ability to resumeenjoy modified sexual functioning.IMPLEMENTATION:1. Determine from nursing history what effect patients medical condition is having on his sexual functioning.2. Inform patient of the effects of prostate surgery, orchiectomy, chemotherapy, irradiation, and hormonal therapy on sexual function.EVALUATION:1. Describes the reasons for changes in sexual functioning.2. Discusses with appropriate health care personal alternative approaches and methods of sexual expression.
  21. 21. References;1. TEXT BOOK OF MEDICAL SURGICAL NURSING,BRUNNER&SUDADARTH,ELEVEN EDITION{PAGE1740-1769}2. WWW.CANADACA PROSTATE.COM;17-10-20103. LAPROSCOPIC UROLOGIC SURGURY IN MALIGNANCIES,JEAN DE LAROSSETI,{133-176}.4. CURRENT MEDICAL DIAGNOSIS AND TREATMENT,2008,STEFEN.J.MACFEE5. National Prostate Cancer Coalition www.npcc.org

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