14. May exhibit:Firm mass in lower abdomen (distended bladder), bladder tenderness FOOD/FLUID May report:Anorexia; nausea, vomiting, Recent weight loss PAIN/DISCOMFORT May report:Suprapubic, flank, or back pain; sharp, intense (in acute prostatitis), Low back pain SAFETY May report:Fever
19. Use of antihypertensive or antidepressant medications, OTC cold/allergy medications containing sympathomimetics, urinary antibiotics or antibacterial agents
31. Incontinence Systemic symptoms related to the UT: - Vesicoureteral reflux - Dilatation & hydronephrosis - Renal failure & symptoms of uremia Symptoms unrelated to the UT: - hernias, hemorrhoids and vesical calculus - change in the caliber of bowl movements Symptoms related to complications: - cystitis - pyelonephritis - bladder calculi - micro or gross hematuria.
34. Serum U/E & creatinine: to provide baseline information on renal function & metabolic status.
35. Uroflowmetry: At a volume of 125-150ml, normal individuals have average flow rates of 12ml/sec & peak flow close to 20ml/sec.Mild 11-15 ml/sec Moderate 7 and 10 ml/sec Severe 7ml/sec
50. Assess for and teach patient to report hematuria, signs of infectionPatient education and Health Maintenance NURSING DIAGNOSIS 1. Impaired Urinary Elimination related to obstruction of urethra. Rationale: BPH causes an enlargement that forms like a capsule in the urinary bladder that occludes urine flow causing changes in urinary elimination. The patient experiences manifestations such as frequency, urgency, hesitancy, change in stream, incontinence, retention and nocturia.
60. a-Adrenergic blockers such as doxazosin (Cardura), tamsulosin (FLomax), terazosin (Hytrin) – relax smooth muscle of bladder base and prostate to facilitate voiding.
61. 5 alpha reductase inhibitorFinasteride (Proscar) – antiandrogen effect on prostate cells, reverses or prevents hyperplasia
77. URINARY INCONTINECE Urinary incontinence is unintentional loss of urine that is sufficient enough in frequency and amount to cause physical and/or emotional distress in the person experiencing it. Women are affected by the disorder more frequently than are men; one in 10 women under age 65 suffer from urinary incontinence. Older Americans, too, are more prone to the condition. Twenty percent of Americans over age 65 are incontinent.
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84. Stress test - the patient relaxes, then coughs vigorously as the doctor watches for loss of urine.
85. Urinalysis - urine is tested for evidence of infection, urinary stones, or other contributing causes.
86. Blood tests - blood is taken, sent to a laboratory, and examined for substances related to causes of incontinence.
87. Ultrasound - sound waves are used to visualize the kidneys, ureters, bladder, and urethra.
88. Cystoscopy - a thin tube with a tiny camera is inserted in the urethra and used to see the inside of the urethra and bladder.
94. 3. Situational low self-esteem related to functional impairment. Rationale: One’s self esteem is affected by the ability to function well and relate to others. Functional impairment such as Urinary incontinence could make a person becomes consciouson how pther people react
126. When a clinician encounters a patient with the NS it is important for him to determine the underlying condition, because the course and prognosis will depend on the underlying diseaseNS
143. The initial episode and the subsequent relapses may follow an apparent viral upper respiratory tract infection.
144. Edema is the predominant feature and initially develops around the eyes and lower extremities.
145. With time, the edema becomes generalized and may be associated with an increase in weight, the development of an ascitic or pleural effusion, and a decline in urine output.