Obstructive Uropathy secondary to Benign Prostatic Hyperplasia.pptx

7/25/2019 Obstructive Uropathy secondary to Benign Prostatic Hyperplasia.pptx

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Obstructive UropathyBenign Prostatic

Hyperplasia


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To gain extensive knowledge and enhunderstanding in regards to ObstructUropathy and its correlation to BenigProstatic Hyperplasia, especially in ge

cases. n order to achieve this, co!prehension ananalysis were done throughout the coursecase presentation, in adherence to the "ollspeci#c ob$ectives%

&'( OB)*+T*


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Understanding o" the basics in regards to the case- its deetiologies, signs and sy!pto!s

Presentation o" the patients data, including the de!ograpertinent patient health history,

+ogni/ance o" the disease process at hand with regards tcondition o" the patient, identi#cation o" risks and correlas0sx and intrinsic0extrinsic "actors "or the pathophysiologye!erge.

1raw co!parisons "ro! the anato!y and physiology to tpathophysiology

'nalysis o" the diagnostic studies and associating it to thprocess

denti#cation o" proble!s present- discussion o" the treat

presentation o" appropriate nursing care plans and discha

P*+3+ OB)*+T*


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This case study revolved around a !algeriatric patient a4icted with a diseasis dee!ed co!!on to his age group.enescence is a li"e process in which aare bound to go through in our lives. n

our bodily and !ental "unction tend todeteriorate overti!e.

O*5*6


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Obstructive uropathy is structural or "unhindrance o" nor!al urine 7ow, so!eti!leading to renal dys"unction 8obstructivenephropathy9. y!pto!s, less likely in cobstruction, !ay include pain radiating t

T:: to T:2 der!ato!es and abnor!al v8e.g., di;culty voiding, anuria, nocturia, polyuria9. Obstructive uropathy is a veryter! in itsel". t has an array o" causes.

(T5O1U+TO(


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&any conditions can cause obstructiveuropathy, which !ay be acute or chron

partial or co!plete, and unilateral or bThe !ost co!!on causes di


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Proxi!al to the obstruction, e


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=lobally, benign prostatic hyperplasia a !illion !ales as o" 2>:> 8?@ o" the popThe prostate gets larger in !ost !en as theyolder. 3or a sy!pto!A"ree !an o" ? years, to" developing BPH over the next C> years is ncidence rates increase "ro! C cases per :>

!anAyears at age DEF years, to CG cases p!anAyears by the age o" DEF years. 6hile prevalence rate is 2.@ "or !en aged DEFincreases to 2@ by the age o" G> year


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's !en get older, the prostate also beco!es enlarged. Tprocess is called benign 8nonAcancerous9 enlarge!ent o" prostate or benign prostatic hyperplasia 8BPH9. 's such, tprostate can cause co!pression o" the urethra at that levresulting in bladder sy!pto!s. BPH related bladder sy!pvery co!!on- it is esti!ated that about >@ o" !en oveo" ?D will su


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Bladder sy!pto!s associated with proenlarge!ent are called lower urinary tsy!pto!s. This can be divided into twgroups E voiding sy!pto!s and storagsy!pto!s. The voiding sy!pto!s are by the obstruction "ro! the enlarged

prostate. 6hen this happens, the bladdbeco!e overactive secondary to theobstruction and result in storage sy!p


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n advanced cases, BPH can also cause !ore co!plicated sy!They are%

'cute urinary retention%

The patient blocks up co!pletely and cannot pass urine. ' urincatheter would have to be inserted to drain the bladder.

Blood in the urine 8he!aturia9%

'n enlarged prostate o"ten has engorged vessels which can blebladder and gets !ixed in with the urine. This can be precipitatstraining 8eg. constipation9 or being on blood thinning !edicato"ten scary and alar!ing "or the patient. " severe, a patient woto be ad!itted "or continuous bladder washout 8a closed cathewhich allows 7uid to be trickled into the bladder and drained atti!e E this can stop "urther bleeding in the urine9.


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('&*% Patient PP

B5TH 1'T*% (ove!ber :D, :FC>B5TH PJ'+*% ta. &onica, urigao del (orte

'=*% G years old

*K% &ale

'115*% Purok C, &agsaysay, ta. &onica, urigao del

+J T'TU% &arried+TL*(HP% 3ilipino

5*J=O(% 5o!an +atholic

1'T* '(1 T&* O3 '1&O(% (ove!ber C, 2>:D, G%:

+H*3 +O&PJ'(T% canty Urine, Unable to 1e"ecate "or

'&TT(= 1'=(O% 3unctional +onstipation

1*&O=5'PH+ P5O3J


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Past Health History-

Patient recalled having experiencillnesses such as cough and colds, "during his younger years. He exper

hypertension during his adult yearsspecifc details given) and he has a!aintenance !edication o" &etrophas no allergies in "ood and !edica

P*5T(*(T P'T*(T HT


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History o" Present llness

The client was ad!itted because o" 3un+onstipation and co!plaints o" canty Ur

One week prior to ad!ission, the patienexperienced di;culty in urination and ac

a dis#guration o" the abdo!en. Two daysad!ission, the patient experienced shortabdo!inal pain , loss o" appetite, and vo!s!all a!ounts, with warranting di;culty urination.

P*5T(*(T P'T*(T HT


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ocial History (enlisted the help o the sother)

The patient lives in Purok C, &agsa&onica, urigao del (orte. He has D8C sons, 2 daughters9, all o" the! h

own "a!ily. He lives with his wi"e, aactive !e!ber o" the church. The pdoes not s!oke, and only drinks alhas a good relationship with his pe

P*5T(*(T P'T*(T HT


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ital igns

Blood Pressure% :>0F> !!Hg

Pulse 5ate% GF bp!

5espiratory 5ate% C: cp!

Te!perature% C.:o+

PHM+'J *K'&('TO


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Overall 'ppearance

Patient has a skinny body build, withslight distention o" the lower abdo!inPatient has !ini!al body odor and sligbreath odor. Patient is weak and restle

&ental tatus

Patient is responsive but incoherent thoughts. s in an irritable !ood, disorti!e and place.

PHM+'J *K'&('TO


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Head 8kull, calp and Hair9Patients head is round, proportionate tothe body, nor!ocephalic and sy!!etricareas. (o noted "or!ation o" !asses, nodepressions upon palpation. Patient hascoarse hair, receding hairline noted, and

To signs o" lice in"estation observed. 3ace

The "ace appears rough and the skin loois sy!!etrical in "acial !ove!ents upo=ri!ace noted at ti!es.

PHM+'J *K'&('TO


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*yes

The eyes appeared sunken, pupround and reactive to lightacco!!odation, slightly asy!!ecloudy white sclera. Tearing is pre

con$unctiva appeared s!ooth yetcolor.

(ose

(o discharges, no 7aring noted.

PHM+'J *K'&('TO


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&outh

+happed and slightly pale lips, no so!outh noted. o!eti!es uses !outh to

*ars

Parallel, and sy!!etrical. (o dischobserved. +artilage is #r! to touchcolor is sa!e as the surroundings.

PHM+'J *K'&('TO


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kin

Patient has poor skin turgor, relative +ool to touch. Has light brown skin coloo" skin noted

(ails

Pale nailbeds, convex in shape andHas slightly poor capillary re#ll o"

PHM+'J *K'&('TO


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Jungs

Has crackles sounds upon auscultatioproductive cough, sy!!etrical chest ex

Heart

Has nor!al heart sounds, and regular r

Peripheries% noted weak radial pulse

PHM+'J *K'&('TO


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'bdo!en

(o bowel !ove!ents, with 7atus. 1istention o" the abdo!

noted, pain upon palpation noted as evidenced by gri!acincues.

Back and torso

(oted redness, bed creases "or!ation, skin discoloration

areas9, pressure wound 8N!! in si/e9 near the spinal areawar!th were noted in assessing the back. houlders are hu

*xtre!ities

y!!etrical in si/e and shape, weakness noted. (o presede"or!ities.

PHM+'J *K'&('TO

=O51O( TMPOJO=M O3 H*


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Health Perception and Health &anage!ent Pattern

The patient has poor knowledge about his conditionrelating to aging, he o"ten uttered words o" wanting twas scheduled "or an ultrasound on (ove!ber D, 2>:transported there at :>%C>'& o" that day.

(utritional and &etabolic Pattern

The wi"e o" the patient verbali/ed that the patient e

day be"ore occurrence o" illness, he would casually eavegetables, but !ostly red !eat. Prior to ad!ission, eats about once or twice a day, in s!all a!ounts. 1ieporridges and soups. Patient only drinks water "or ADbe"ore ad!ission, and on ad!ission, he usually drink82D!J0glass9 a day

=O51O( TMPOJO=M O3 H*P'TT*5(



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*li!ination Pattern

Patient usually de"ecates once everyday or #ve ti!esurinates AD ti!es a day be"ore ad!ission, prior to ad!experienced abnor!al "reIuencies o" urination 8"reIuennight but in s!all a!ounts9 O recalls the color o" the ustreaks. Upon ad!ission, patient has not been able to ddays, but with 89 3latus, and has a urine output o" lessshi"t 8scant9. Patient is attached to 3B+, 89 UO.

'ctivity and *xercise

Patient cannot any!ore per"or! strenuous activities dBe"ore ad!ission, patient is able to walk and !ove arouad!ission, patient is unable to !ove on his own and neusually uses !outh to breathe while trying to !ove ext




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leep Pattern

Be"ore ad!ission, patient was able to sleep "oa day, including naps. On ad!ission, patient ca"or about CA hours, as he is restless

+ognitiveAPerceptual Pattern

Patient used to read newspapers "or leisure b

ad!ission. On ad!ission, patient is disorientedplace and person.

el"APerception and el" +oncept Pattern

The patient is observed to be in a !elancholipatient is incoherent with his thoughts and wor




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5ole and 5elationships Pattern

The wi"e o" the patient verbali/epatient is a "a!ilyAoriented persongood ties with neighbors.

exuality and 5eproductive Patter

(ot able to per"or! sexual activto age.




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+oping tress Pattern

The patient is being surrounded byones who always give hi! !oral suphis experiences, he occasionally s!ilhis wi"e talks to hi!, but o"tenti!es $

alues and Belie" Pattern

The patient is a religious person. Ththe patient verbali/ed that their "a!igo to church every unday and alway


5**6 O3 '('TO&M '(


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Urine production and eli!ination are one o" the

i!portant !echanis!s o" body ho!eostasisall body syste!s are directly or indirectly a


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5**6 O3 '('TO&M '(


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3U(+TO(

5egulation o" the volu!e o" blood by or conservation o" water.

5egulation o" the electrolyte content blood by the excretion or conservatio

!inerals.

5egulation o" the acidAbase balance oby excretion or conservation o" ions

5egulation o" all o" the above in tissue

5**6 O3 '('TO&M '(PHMOJO=M 8U5('5M MT

5**6 O3 '('TO&M '(


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idneys

Ureter

Bladder

Urethra



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5**6 O3 '('TO&M '(


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idneys

A is to separate urea, !ineral salts, and other waste products "ro! the b

A #ltering out wastes to be excreted

urine.A regulating BP

A regulating an acidAbase balance

A sti!ulating 5B+ production


iewed internally the kidney has an outer layer o" o


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iewed internally, the kidney has an outer layer o" ocortex which surrounds the inner !edulla.

The !edulla consists o" a nu!ber o" !edullary pyrana!ed because o" their triangular shape. These arein appearance because they contain !icroscopic cotubes called nephrons, the "unctional unit o" the kid

Urine is !ade by the nephrons and drains into tiny ducts within the !edullary pyra!ids. The collecting!erge at the base o" the pyra!ids to "or! the rena

3ro! the papilla, urine drains into cuplike structuresthe !a$or and !inor calyces. 3ro! the calyces the drains into the wider open space o" the renal pelvisacts like a "unnel draining the urine out o" the kidne

the ureter


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Urine "or!ed in each nephron drains down t


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Urine "or!ed in each nephron drains down tcollecting ducts and into the renal pelvis.

Urine exits the kidneys via the right and le"t

which deliver urine to the bladder by peristacontractions o" their !uscle walls, and also gravity.

's the bladder #lls with urine, its walls expa

6hen it is "ull, re7exes are sti!ulated which!icturition, or going "or a wee. Urine is expethrough a s!all tube called the urethra whicto the exterior o" the body.

5**6 O3 '('TO&M '(


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Bladder

A store urine

A expels urine into the urethra 8&ic

Urethra

A is the passageway through whichdischarged "ro! the body


5**6 O3 '('TO&M '(


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Other parts%

(ephrons E "unctional unit o" kidney. kidney is "or!ed o" about one !illion

=lo!erulus E #lters the blood

Bow!ans +apsule E is a large doublecup. t lies in the renal cortex

Tubular +o!ponent E necessary subsbeing reabsorbed


5**6 O3 '('TO&M '(


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Joop o" Henle E create a concentration gradie

!edulla o" the kidney.A reabsorb water and i!portant nutrients in

5enal ein E a blood vessel that carries deoxyblood out o" the kidneys

5enal 'rtery E supply clean, oxygenArich blookidneys

'drenal =land 8uprarenal =land9 E located okidneys and is essential "or balancing salt anthe body



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The prostate is a s!all !uscular glandlocated in"erior to the urinary bladder i

pelvic body cavity. t is shaped like a rocone or a "unnel with its base pointedsuperiorly toward the urinary bladder. Tprostate surrounds the urethra as it ex

bladder and !erges with the ductus deat the e$aculatory duct.


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everal distinct lobes !ake up the structure o" the prostate%

On the anterior end o" the prostate are the two lateral lobes, which

rounded and shaped like orange slices when viewed in a transversThe lateral lobes are the largest lobes and !eet at the !idline o" tprostate.

Posterior and !edial to the lateral lobes is the !uch s!aller antertriangle o" #bro!uscular tissue $ust anterior to the urethra. The #btissue o" the anterior lobe contracts to expel se!en during e$acula

The !edian lobe is "ound $ust posterior to the urethra along the !

prostate. The !edian lobe contains the e$aculatory ducts o" the prThe posterior lobe "or!s a thin layer o" tissue posterior to the !edand the lateral lobes.


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everal distinct lobes !ake up the structure o" the prostate%

On the anterior end o" the prostate are the two lateral lobes, which

rounded and shaped like orange slices when viewed in a transversThe lateral lobes are the largest lobes and !eet at the !idline o" tprostate.

Posterior and !edial to the lateral lobes is the !uch s!aller antertriangle o" #bro!uscular tissue $ust anterior to the urethra. The #btissue o" the anterior lobe contracts to expel se!en during e$acula

The !edian lobe is "ound $ust posterior to the urethra along the !

prostate. The !edian lobe contains the e$aculatory ducts o" the prThe posterior lobe "or!s a thin layer o" tissue posterior to the !edand the lateral lobes.


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Urine released "ro! the urinary bladder is carrieurethra to the bodys exterior. Under nor!al conurine in the urethra passes through the prostateco!plications whatsoever. The prostate enlarge

throughout a !ans li"eti!e, potentially leadingrestriction or blockage o" the urethra by the ti!reaches his #"ties or sixties. 'n enlarged prostatlead to di;culty urinating or eventually even an

to urinate. There are !any treat!ents "or an enprostate including !edications, li"estyle changeprostatecto!y, the surgical re!oval o" the pros

P'THOPHMOJO=M


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's the prostate enlarges, the surrounding capit "ro! radially expanding, potentially resultinco!pression. However, obstructionAinduced bdys"unction contributes signi#cantly to ObstruUropathy. The bladder wall beco!es thickenedirritable when it is "orced to hypertrophy and iown contractile "orce. n the physiological poin

the prostate enlarges, it co!presses the ureth

preventing the out7ow o" urine and contributinco!!on lower urinary tract

sy!pto!s.

P'THOPHMOJO=M


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.

PATHOPHYSIOLOG

+OU5* ( TH* 6'51


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Upon ad!ission patient was unab

de"ecate "or C days, during last enpatient was unable to de"ecate "or

Patient is not able to !ove due toweakness

Patient o"tenti!es ga/e into the c

Patient see!s disconnected to hissurroundings at ti!es

+OU5* ( TH* 6'51

J'BO5'TO5M 5*UJT


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He!atology% ::0C0:D- F%>F

J'BO5'TO5M 5*UJT

Component Result Normal Values He!oglobin :D.: :2.>A:G.>g0dJ

He!atocrit . 2AD@

5B+ .?> .>A?.>x:>:20J

6B+ :2.G .DA:>.>x:>F0J nd

Platelet :D :D>AD>x:>F0J

Jy!phocyte ::.> :AD@

J'BO5'TO5M 5*UJT


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Blood +he!istry% ::00:D- ::%2

J'BO5'TO5M 5*UJT

Component Result Normal Values =lucose 83B9 F.G >A:>D!g0dJ

Uric 'cid ?.> C.DA.2!g0dJ

+holesterol :>C :>A22>!g0dJ

Triglyceride DF >A2>>!g0dJ

H1J A +holesterol : C>AD!g0dJ

J1J A +holesterol D>.2 >A:C>!g0dJ

J'BO5'TO5M 5*UJT


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Blood +he!istry% ::0C0:D- ::%>D

J'BO5'TO5M 5*UJT

Test Result Normal Values

Creatinine 1.68mg/dL 0.731.36mg/dL5en

J'BO5'TO5M 5*UJT


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Blood +he!istry% ::0D0:D- :2%>D

J'BO5'TO5M 5*UJT

Test Result Normal Values

Creatinine 1.!"mg/dL 0.731.36mg/dL5en

J'BO5'TO5M 5*UJT


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Urinalysis% ::0C0:D- ::%>D

J'BO5'TO5M 5*UJT

C#L#R$Mellow

TR%N&'%R(NC)$ +loudy

p*$ ?.>

&'(CI+IC ,R%VIT)$ :.>:D

-C$ >A2

RC$ 2>A2D hp" E iso!orphicblood.

('IT*(LI%L C(LL&$ &odera

%CT(RI%$ (one

J'BO5'TO5M 5*UJT


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Ultrasound% ::0D0:D- :>%C>

J'BO5'TO5M 5*UJT


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1rug tudy

N%( (C*%NI& #+%CI#N INIC%TI#N/C#NTR%INIC%TI#N &I( (++(CT&

=eneric (a!e% nhibits the action ndication%T t t d

+(%


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5anitidine 8D>>!gTT IG9

+lassi#cation%'ntiAulcer agents

o" hista!ine at theH2 receptor sitelocated pri!arily ingastric parietalcells, resulting in

inhibition o" gastricacid secretion. naddition, ranitidinebis!uth citrate hasso!e antibacterialaction against H.pylori.

Treat!ent andprevention o"heartburn, acidindigestion, and soursto!ach.

+ontraindicated% Hypersensitivity,

+rossAsensitivity!ay occur- so!eoral liIuids containalcohol and shouldbe avoided inpatients withknown intolerance

+on"usion,di//iness,drowsiness,hallucinations,headache

Q +%'rrhyth!iasQ =%'ltered taste, blacktongue,constipation, darkstools, diarrhea,drugAinduced

hepatitis, nauseaQ =U%1ecreased sper!count, i!potenceQ *(1O%=yneco!astiaQ H*&'T%'granulocytosis,

'plastic 'ne!ia

N%( (C*%NI& #+%CI#N INIC%TI#N/C#NTR%INIC%TI#N &I( (++(CT&

=eneric (a!e% nhibits the action y!pto!atict "

eru! prolactin


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1o!peridone8:>!g tab T19

+lassi#cation%'ntidopa!inergic

'ntie!etic

o" hista!ine at theH2 receptor sitelocated pri!arily ingastric parietalcells, resulting in

inhibition o" gastricacid secretion. naddition, ranitidinebis!uth citrate hasso!e antibacterialaction against H.pylori.

!anage!ent o" uppergastrointestinal!otility disordersassociated withchronic and subacutegastritis and diabetic

gastroparesis.

+ontraindicated inpatients withknown sensitivityor intolerance tothe drug.1o!peridone

should not be usedwhenevergastrointestinalsti!ulation !ightbe dangerous, i.e.,gastrointestinalhe!orrhage,!echanical

obstruction or

level !ay increaseresulting ingalactorrhoea in"e!ales8increasingo" !ilk production,

probably byincreasing prolactinproduction by thepituitary gland9 Sless "reIuentlygynaeco!astia in!ales.

=astrointestinal82.@9%abdo!inalcra!ps, diarrhea,regurgitation,changesinappetite, nausea,

N%( (C*%NI& #+%CI#N

INIC%TI#N/C#NTR%INIC%TI#N

&I( (++(CT&

=eneric (a!e%J l 8C>++

Potent centrald i

Os!otic e


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Jactulose 8C>++I:29

+lassi#cation%gastrointestinal

agent-hyperos!oticlaxative

dopa!ine receptorantagonist.tructurally relatedto procaina!idebut has little

antiarrhyth!ic oranesthetic activity.*xact !echanis!o" action not clearbut appears tosensiti/e = s!ooth!uscle to e


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&etoclopra!ide 8:a!p TT IG9

+lassi#cation%gastrointestinal

agent- prokineticagent 8=sti!ulant9

dopa!ine receptorantagonist.tructurally relatedto procaina!idebut has little

antiarrhyth!ic oranesthetic activity.*xact !echanis!o" action not clearbut appears tosensiti/e = s!ooth!uscle to e


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+e"uroxi!e 82D>!g TT I?9

+lassi#cation%'ntibiotic

cephalosporin thatinhibits cellAwallsynthesis,pro!oting os!oticinstability- usually

bactericidal.

in"ections o" theurinary and lowerrespiratory tracts,treptococcuspneu!oniae and .pyogenes,

Hae!ophillusin7uen/ae,taphylococcusaureus, *scherichiacoli.+ontraindicated% +ontraindicated in

patientshypersensitive todrug.

Use cautiously inpatientshypersensitive topenicillin becauseo" possibility o"crossAsensitivitywith other betaAlacta! antibiotics.

Use with caution

in breastA"eedin

Thro!bophlebitis8 site9-

=%1iarrhea, nausea,

antibioticAassociated colitis.

kin%5ash, pruritus,urticaria.


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(U5(= +'5* PJ'(

%&&(&&(NT I%,N#&I& (&IR(#2TC#(

INT(RV(NTI#N&

Ob$ective%1istended

Urinary 5etentionr0t prostate

6ithin hours o"rendering

*ncourage patientto void every 2


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A 1istendedabdo!en noted- canty a!ounts

o" urine uponchecking 3B+

patency

ub$ectiveA 1i;culty inurination asverbali/ed by O

r0t prostateenlarge!entsecondary tobladder distention

renderingappropriatenursinginterventions, thepatient will void in

su;cient a!ountswith less palpablebladder distension.

to void every 2Ehr and when urgeis noted.

Percuss andpalpate

suprapubic area. *ncourage oral

7uids up to :>>>!J daily, withincardiac tolerance,i" indicated.

&onitor vital signsclosely. Observe

"or hypertension,peripheral0dependent ede!a,changes in!entation. 6eighdaily. &aintainaccurate SO 82D>C>>cc9

&onitor lab %&&(&&(NT I%,N#&I& (&IR(

#2TC#(INT(RV(NTI#N&

Provide cathetercare note an any


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care, note an anyaccu!ulations onthe tube. (oteIuality o" 7ow

'd!inister

!edications asindicated%'ntibiotics andantibacterials.

rrigate catheteras indicated, i"there is notedobstruction in

tube. +heckcatheter o"ten8every 2 to Chours9.

%&&(&&(NT I%,N#&I& (&IR(#2TC#(

INT(RV(NTI#N&

Ob$ective%3acial gri!acing

'cute Pain r0tbladder distention


'ssess pain,noting location


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3acial gri!acingand restlessnessnoted

'bdo!inal and

suprapubicdistention present

ub$ective%(onverbal cues o"pain

bladder distentionas evidenced byrestlessness andgri!acing

renderingappropriatenursinginterventions, thepatient is expected

to show signs o"relie" "ro! pain, isable to "ully rest.

noting location,intensity 8scale o">E:>9, duration.

5eco!!endbedrest i" pain

recurs asindicated. Provide co!"ort

!easures, e.g.,back tapping,helping patientturn to sides orassu!e position o

co!"ort. uggest use o"

relaxation0deepAbreathingexercises,diversionalactivities, enlistingthe help o" the O

Provide %&&(&&(NT I%,N#&I& (&IR(

#2TC#(INT(RV(NTI#N&

Ob$ective%A nability to !ove

- !paired kinntegrity r0t

6ithin ? hours o"rendering

denti"y underlyingconditions "or


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nability to !ovewhole body- Breathing

through !outhwhile atte!pting

to !oveextre!ities- =eneral body

weaknessA Poor skin turgorrelative to agingA (oted redness,bed creases

"or!ation, skindiscoloration8bluish on so!eareas9, pressurewound 8N!! insi/e9 and !oistwar!th at his back

ntegrity r0tphysicali!!obili/ation2o diseaseprocess as

!ani"ested bygeneral bodyweakness,pressure wound,and poor skinturgor


to participate inprevention!easures "or theti!ely healing o"wounds withoutgettingco!plications

conditions "orappropriateinterventions to"ollow

(ote general

debilitation,reduced extent o"!obility, changesin skin and !ass,proble!s with sel"care and i!pairedcognition

(ote skin color,

texture and turgorPalpate "or lesionsits si/e,te!perature andhydration.

Per"or! turning tosidesevery 2 hours

&aintain

appropriate %&&(&&(NT I%,N#&I& (&IR(

#2TC#(INT(RV(NTI#N&

Ob$ective%A nability to !ove

- !paired kinntegrity r0t

6ithin ? hours o"rendering

denti"y underlyingconditions "or


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nability to !ovewhole body- Breathing

through !outhwhile atte!pting

to !oveextre!ities- =eneral body

weaknessA Poor skin turgorrelative to agingA (oted redness,bed creases

"or!ation, skindiscoloration8bluish on so!eareas9, pressurewound 8N!! insi/e9 and !oistwar!th at his back

ntegrity r0tphysicali!!obili/ation2o diseaseprocess as

!ani"ested bygeneral bodyweakness,pressure wound,and poor skinturgor


to participate inprevention!easures "or theti!ely healing o"wounds withoutgettingco!plications

conditions "orappropriateinterventions to"ollow

(ote general

debilitation,reduced extent o"!obility, changesin skin and !ass,proble!s with sel"care and i!pairedcognition

(ote skin color,

texture and turgorPalpate "or lesionsits si/e,te!perature andhydration.

Per"or! turning tosidesevery 2 hours

&aintain

appropriate %&&(&&(NT I%,N#&I& (&IR(

#2TC#(INT(RV(NTI#N&

Ob$ective%Jab results

- 5isk "or 3luidolu!e


&onitor input andespecially output


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Jab results- +loudy urine- He!aturia

8blood in theurine9

-

ncreasedcreatinine levels8:.F29

3laky skin, weakradial pulse,slightly poorcapillary re#ll 8

secs.9

olu!e1e#ciency r0trenaldys"unction as!ani"ested by

laboratory#ndings o"cloudy urine,he!aturia, andincreasedcreatinine levels8:.F29


to !aintainadeIuatehydration asevidenced bystable vital signs,palpable peripheralpulses, goodcapillary re#ll

especially outputcare"ully, takenote o" a!ountsand noti"y i" .

&onitor BP, pulse.

*valuate capillaryre#ll Pro!ote bedrest

with headelevated, to"acilitate propercirculation

*ncourage

increased oralintake based onindividual needs.

'd!inister 7uidsas ordered,regulating it toordered rate. +heckpatency "orassurance o" 7uids

assin

1ischarge Plan


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&*1+'TO(

'dvice patient to adhere to the !egiven by the doctor.

1ischarge Plan


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*(5O(&*(T

Teach i!portance o" environ!entacleanliness to the signi#cant other,patient has i!paired skin integrity,

i!portant to avoid occurrence o"co!plications and in"ections sinceObstructive Uropathy in itsel" is

1ischarge Plan


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T5*'T&*(T

" no surgical procedures were donenoninvasive0phar!acologic intervent!adeV Teach O catheteri/ation onceo" urination persists0recurs. Present t

clearly, the !aterials needed and higi!portance o" sterility. " condition woadvise to seek hospitali/ation and resurgical procedures.

1ischarge Plan


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Health Teachings

Teach patient the i!portance o"!aintaining adeIuate hydration to recurrence o" constipation and urinproble!s

&ini!i/e long hours o" sitting as a


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OutAPatient 3ollow Up +are

nstruct the patient to seek or retexperiencing any signs and sy!ptosevere abdo!inal pain, he!aturia,

in urination

1ischarge Plan


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1*T

&oderating the consu!ption o" aand ca

Obstructive Uropathy secondary to Benign Prostatic Hyperplasia.pptx

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