Mens health chapter 67 iggy

BPH

benign prostatic hyperplasia

hyperplasia

overgrowth of tissue

what occurs in benign prostatic hyperplasia

the prostate enlarges and pushes on the bladder (outlet obstruction) and keeps them from eliminating

how does the tissue grow in benign prostatic hyperplasia

it grows inward which causes narrowing of the urethra

what are some unmodifiable risk factors for benign prostatic hyperplasia

race, genetic susceptibility, and family history of cancer

what are some modifiable risk factors for benign prostatic hyperplasia

obesity and metabolic syndrome, and beverage consumption , coffee and caffeine intake

what may benign prostatic hyperplasia patients have

retention and leaking incontinence , the patient may be embarrassed

what is the percentage of men who are between 51-60 that may get benign prostatic hyperplasia

40=50%

what is the percentage of men the age of older than 80 that may get benign prostatic hyperplasia

80%

what is the cause of benign prostatic hyperplasia

not clear

what race usually needs treatment sooner that suffer from benign prostatic hyperplasia

African American men

health promotion of benign prostatic hyperplasia

teach that it is common and not increased sexual frequency , address modifiable risk factors that can improve overall health

what does the international prostate symptom score look at

assesses nocturia, hesitancy, difficulty starting and continuing urination , weak stream , straining , and if they have post void dribbling or leakage

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also ask if they have any blood in the urine (not part of the I-PSS)

what will the physical assessment look like for benign prostatic hyperplasia

health care provider will do a prostate gland exam

what do you want to rule out with benign prostate hyperplasia

prostatitis (inflammation and possible infection of the prostate)

how may men suffer emotionally with benign prostate hyperplasia

they may feel frustrated or depressed due to them being interrupted by getting up at night to use the restroom, they may feel embarrassed due to dribbling and overflow incontinence, they may have decreased libido and they may feel isolated

benign prostate hyperplasia diagnostic tools

urinalysis and culture (check for infection)

cbc (anemia from hematuria)

BUN (renal function)

psa (prostate acid phospatase)

serum acid phosphate (cancer or if it is metastisized)

biopsy of prostate

culture and sensitivity of the prostatic fluid

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other:

transrectal ultrasound (trus)

bladder ultrasound (for residual)

cystoscopy

what are some nursing diagnosis with benign prostate hyperplasia

urinary retention due to bladder outlet obstruction

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decreased self-esteem due to overflow urinary incontinence and possible sexual dysfunction

goals for a patient with benign prostate hyperplasia

to improve their urinary elimination (surgically and nonsurgically)

nonsurgical ways to improve urinary elimination

behaviour modifications such as decreasing caffinee intake , drug therapy (finasteride, flomax) complementary and intergrative health

surgical ways to improve urinary elimination

TURP or TUIP and minimally invasive surgeries

what is a TURP

gold standard surgery for benign prostate hyperplasia, it is a transurerthral resection of the prostate, a large part of the prostate is removed

care for a patient who has received a TURP

all pts will have a 3 way indwelling catheter for continuous bladder irrigation (you drain fluid and put fluid through , and draining urine) , teach pt they will feel urge to void and their may be traction because a fluid bag will be hooked up, urine may be blood tinged and may have blood clots and tissue.

intervention for a patient with benign prostate hyperplasia

teach to void when the urge occurs , remind them to keep area clean and dry, and use a pad if needed

what can be done with establishing urinary control

kegal exercises

is prostate cancer slow growing or fast growing

slow growing

leading risk factor for prostate cancer

advanced age

what are the two main male hormones

Testosterone and dihydrotestosterone

most common site of metastasis in prostate cancer is

lymph nodes, nearby bone, pelvis, sacrum, lumbar spine, lungs or liver

where does prostate cancer usually occur

periphery of the gland , most of it comes from epithelial cells and posterior lobe and outer portion of gland

risks for prostate cancer

advanced age, first-degree relative with disease, African-American men

what is the most commonly diagnosed non-skin cancer in men in the US

prostate cancer

what cure rate percentage does prostate cancer have if found early

100%

men who are older than this age are at risk for prostate cancer

65

most important way to prevent prostate cancer

screening

at what age should men at higher risk for prostate cancer get screened

at 45

what age should a man with a first-degree relative get screened for prostate cancer

at the age of 40

dietary modifications for patients with prostate cancer

decrease dairy and increasing fruits and vegetables

if the patient has pain that goes to other areas such as in hips or legs for prostate cancer what could this mean

that the cancer is more advanced

what history should you get when assessing for prostate cancer

age, race, family history, nutrition habits, elimination issues, pain, weight loss and changes in sexuality

what is done in a physical assessment in a patient with prostate cancer

may be diagnosed as part of a routine examination, they may have hematuria, pain in pelvis, hips, spine and ribs, weight loss

DRE

a health care provider inserts a gloved, lubricated finger into a man's rectum to feel the prostate for anything abnormal, such as cancer

what does the prostate usually feel when they have cancer

it is usually hard like a stone but the irregularities may be palpated

when a man is diagnosed with prostate cancer what does he usually feel emotionally

fear, anxiety, shock, fear, anger, they may go through a grieving process, and they may have concern with their sexual function

how is prostate cancer diagnosed

check PSA (not specific to diagnose cancer), EPCA-2 (sensitive cancer agent), TRUS

what is a nursing diagnosis for prostate cancer

potential for cancer metastasis due to lack of or inadequate treatment

interventions for prostate cancer

preventing metastasis such as active surveillance, non surgical management such as radiation therapy and drug therapy

radiation therapy for prostate cancer side effects

Erectile dysfunction,, urinary frequency and diarrhea

most common intervention for cure of prostate cancer

surgery (radical prostatectomy - laparoscropic or open)

care after prostate cancer surgery

pain management, indwelling catheter, ambulate as soon as possible, may have erectile dysfunction or urge incontinence

self management for person with prostate cancer

indwelling catheter care, walking short distances, using stool softeners, and showering (do not soak in bathtub), support groups.

what cancer is rare in men

testicular cancer

what age is usually affected with testicular cancer

usually between 20 and 35

cure rate if testicular cancer is detected early

95%

how is testicular cancer usually detected

by testicular self exam

where do germ cell tumors usually arise form

sperm producing cells , they account for most of the testicular cancers

who is at higher risk for someone to get testicular cancer

if they have a undescending teste , someone with HIV or aids, frequent marijuana use or family history

signs and symptoms for testicular cancer

painless, hard swelling or enlargement of testicle

what race is at higher risk for testicular cancer

caucasian

what may a person with testicular cancer feel emotionally

they might be concerned for sexuality and the desire to have children

what is a solution for a patient with prostate cancer to have children in the future

they may be able to save their sperm

diagnostic tools for testicular cancer

AFP, hCG, LDH (common tumor markers), scrotal ultrasound, chest x-ray, CT of chest, abdomen, and pelvis, MRI of the brain (if metastisis is suspected)

non surgical management for patient with testicular cancer

chemotherapy or radiation

surgical management for patient with testicular cancer

orchiectomy (removal of testes)

management of testicular cancer after surgery

scrotal support, sutures removed in 7-10 days, avoid lifting, stair-climbing, and driving for one week, they should continue testicular self examination

what is another name for erectile dysfunction

impotence

two types of erectile dysfunction

organic or psychogenic

psychogenic erectile dysfunction

sudden onset, periods of high stress , male is unable to obtain an erection

organic erectile dysfunction

natural decrease of function

causes of erectile dysfunction

penile disease, trauma, surgery, obesity, psychological conditions , vascular, endocrine, neurological diseases, diabetes, kidney failure

how may erectile dysfunction be diagnosed

doppler ultrasonography

treatment of erectile dysfunction

lifestyle modifications (stress relief), management of medications that may cause ED, penile self injection with prostaglandin E1, drug therapy, psychotherapy, surgery, and vacuum assisted erection devices

medications to treat erectile dysfunction

viagra (sidenanfil) lasts 4-5 hrs , tadalafile can last 24-36 hrs

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not safe to take with cardiac drugs because they can drop BP