Post on 23-Dec-2015
Prostatitis
• Behavioral Objective:– Describe etiology, pathophysiology, clinical
manifestations, nursing management and patient education for prostatitis
• Brunner and Suddarth’s Medical Surgical Nursing pg 1750
Prostatitis
Pathophysiology• Inflammation of the
prostate gland cause by infectious agents
• E. coli is the most common
• Microorganisms are usually carried to the prostate from the urethra
Prostatitis
Clinical manifestations• Perineal discomfort• Burning, urgency,
frequency & pain after ejaculations
• Prostate pain• Dysuria• May produce
– Fever and chills– Rectal or low back pain
Prostatitis
Assessment and diagnostic findings
• History• Culture • Histological
examination of the tissue
• D.R.E.– Swollen, tender & firm
• Divided urinary specimen– Clean glans of penis– Void 10-15ml – 1st container
• Urethral Urine– Without interrupting the urinary stream, collect 50-75 ml
of urine -2nd container • Bladder Urine
– Results:• UA is often + WBC & bacteria present
• Prostatic massage – Prostatic fluid – 3rd container
Prostatitis
Medical management• A broad-stectrum antibiotic– Trimethroprim
sulfamethoxazole (Bactrim)
– Cirpfloxacin (Cipro)• Bed rest • Analgesic agents • Antispasmodic medications
Prostatitis
• Bladder sedatives• Sitz baths• Stool softeners– Colace
• Anti-inflammatory
Prostatitis
Nursing process of Patients with Prostatitis• Assessment• Diagnosis– Pain related to inflammation, bladder spasms, – Urinary retention, related to obstruction– Sexual dysfunction r/t discomfort– Anxiety r/t uncertain outcome
• Planning and Goals
Prostatitis
Nursing process of Patients with Prostatitis• Nursing Interventions
1.Admin. meds2.Comfort measures:
1. Sitz baths3.Fluids:
1. Do not force fluids –
Prosatitis1.AVOID Foods and liquids that have diuretic actions
or that increase Prostatic secretion should be avoided
1. Alcohol2. Coffee3. Tea4. Chocolate5. Cola6. Spices
2.Avoid intercourse 3.Avoid sitting for long periods
Orchitis
• Behavioral Objective– Describe etiology, pathophysiology, clinical
manifestations, nursing management and patient education Orchitis
• Brunner and Suddarth’s Medical Surgical Nursing pg 1769
Orchitis
• Orchitis is an inflammation of the testes.
• Etiology– Mumps– Testicular
congestion– Viral– Parasitic– Trauma
Orchitis
• Signs & Symptoms– Pain– Swollen
Orchitis
Treatment• Rest - bed• Elevate scrotum• Ice pack• Antibiotics?• Analgesics• Anti-inflammatory
Benign Prostatic hyperplasia
• Behavioral Objective:– Describe etiology, pathophysiology, clinical
manifestations, nursing management and patient education for Prostatic hypertrophy / Benign Prostatic Hyperplasia / enlarged prostate
• Brunner and Suddarth’s Medical Surgical Nursing pg 1751-52
Prostatic hypertrophy Benign Prostatic Hyperplasia
Pathophysiology– Prostate gland
enlargement urinary obstruction
– Age > 50
Prostatic hypertrophy Benign Prostatic Hyperplasia
Clinical Manifestations– prostate gland
• large • rubbery • non tender
– Urinary retention– Dilation of the ureters
and kidneys– Results in UTI
Prostatic hypertrophy Benign Prostatic Hyperplasia
Assessment and diagnosis• Digital Rectal exam
– BPH develops in the inner prostate
– Cancer develops on the outside of prostate
• Urinalysis (U/A)• Renal function test• Complete blood studies
(CBC)
Prostatic hypertrophy Benign Prostatic Hyperplasia
Medical Management• Catheterization • Prostatectomy – TURP - Transurerthral Resection of the Prostate
• Laser resection of the prostate. – Ultrasound & Lasers – Tissue vaporizes or necrotic sloughs.
Prostatic hypertrophy Benign Prostatic Hyperplasia
Nursing process• Assessment• Diagnosis / Nursing Interventions– Acute pain related to bladder distention secondary to
enlarged prostate as manifested by complaints of discomfort • Catheter • I & O• Percuss bladder for distention • Maintain patency of catheter• Asses pain
Prostatic hypertrophy Benign Prostatic Hyperplasia
• Risk for infection (urinary tract) related to indwelling catheter, environmental pathogens, and urinary stasis– Assess for elevated temperature; urine cloudy or
foul-smelling– U/A– Enc fluids– Strict aseptic technique
Prostatic hypertrophy Benign Prostatic Hyperplasia
• Fear, related to actual or potential sexual dysfunction, possible diagnosis of cancer, and lack of knowledge regarding surgical procedure and postoperative care as manifested by verbalization of fear about impact of surgery on sexuality, questioning or inaccurate comments about surgical care.– Teach– Assess– Provide opportunity to talk