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Benign Prostatic Hyperplasia

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Central Mindanao University

COLLEGE OF NURSING
University Town, Musuan, Maramag, 8710 Bukidnon
Tel No. 088-356-1910/13 Tele Fax No. 088-356-1912
Email add: nursing@cmu.edu.ph

Benign Prostatic Hyperplasia

BSN Level IV – Group 3


INTRODUCTION

As a person age the natural


process of wear and tear will occur to
a human body. Where a simple pain
could indicate a serious problem.
Manpower is not to be blame for this
concern but the person itself can point
out why the aftermath of his health
status has deteriorated.
Benign enlargement of the prostate
gland is an extremely common process
that occurs in nearly all men with
functioning testes.
Hyperplasia is a general medical
term referring to excess cell replication.
Benign prostatic hyperplasia is a
noncancerous growth of the prostate
gland.
About 43% of men in their 40s will
have evidence of BPH, as will 50% of
men in their 50s, 75% to 88% in their
80s and nearly 100% of men reaching
the ninth decade of life. Also, increased
serum insulin and elevated fasting
plasma glucose have been associated
with increased prostate size and
increased risk of prostate enlargement.
Patient George, 79-year-old male
who was admitted at Adventist Medical
Center, who was diagnosed with Benign
Prostatic Hyperplasia (BPH) was chosen
for this case study for us to further
understand his case/condition and to help
him for his treatment regimen to prevent
future problems in regards to health,
environment, lifestyle or behavior.
OBJECTIVES OF THE STUDY
General Objectives:
At the end of the exposure in the clinical area,
the nursing students will be able to obtain information,
provide intervention and holistic care to patient’s need.
The goal of this study is to apply appropriate nursing
interventions for patient. Furthermore, the student
nurses should achieve the development of attitude,
enhancement of skills, and attainment of advance
knowledge during and after this study.
Specific Objectives:
Knowledge:
•Identify theoretical causes and clinical
manifestations and trace pathophysiology of
the involved disease.

•Formulate nursing care plans that is


necessary which is specific, measurable,
attainable, realistic and time-bounded for the
optimum health of the patient.
Knowledge:

•Formulate nursing care plans


appropriate to the patient’s priority needs
or problems.

•Formulate nursing diagnoses with


interventions given with their
corresponding rationales
Skills:
•Gather nursing and medical history
accurately.
•Perform physical assessment
systematically.
•Use therapeutic communication during
interaction on data gathering.
•Provide holistic nursing care to the patient.
Attitude:
•Exhibit culturally sensitive approach to the
patient when dealing with their own opinions
and ideas.
•Build rapport to the client to develop trust-
worthiness with the student nurses.
•Appreciate the manifestations of the client
signs and symptoms to the underlying
pathophysiologic process.
NURSING THEORY

Uses the Twenty-One Nursing


Problem Theory of Faye Glenn Abdellah’s.
This theory addresses specific events and
related conditions that have relevance to
health and well-being.
Also uses the theory of Human
Motivation of Abraham Maslow's hierarchy
of needs. This hierarchy suggests that
people are motivated to fulfill basic needs
before moving on to other, more advanced
needs. As a humanist, Maslow believed that
people have an inborn desire to be self-
actualized, that is, to be all they can be.
PATIENT’S PROFILE

Name: Mr. George


Sex : Male
Age: 79 years old
Birthdate: January 22, 1940
Marital Status: Married
Race: Asian
Nationality: Filipino
Religion: Roman Catholic
Address: Purok17, San Jose, Maramag, Bukidnon
PATIENT’S PROFILE
Ethnic group: Cebuano
Occupation: None, Retired Security Guard
Date and Time of Admission: January 28,
2019/ 9AM
Admitting Diagnosis: Obstructive Uropathy,
Diabetes Mellitus, Hypertension
Final Diagnosis: Benign Prostatic Hyperplasia in
Retention
Chief Complaints: Patient experienced painful and
difficulty of urinating, with presence of blood in the urine.
HISTORY OF PRESENT ILLNESS
On January 6, 2019 patient experience painful and
difficult urination and continued for 7 days and was admitted
on January 13, 2019 with the admitting diagnosis of Acute
Pyelonephritis with CAP, an FBC was inserted and the
patient was then discharged on January 19, 2019 and the
FBC was removed and was told to observe his urinary
pattern and to go back for check up on January 24, 2019 but
he failed to return. And on January 28, 2019 he again
experienced a painful and difficulty of urination with
presence of blood in the urine. On January 28, 2019 at 9am
he was again admitted and was scheduled for CystoTURP.
PAST HEALTH HISTORY

Childhood illnesses
During his childhood, the patient had
experienced only common childhood illness like
of cough, fever and cold.
Immunization
As verbalized by the patient he cannot
remembered anything regarding his
immunization and cannot recall if he had any.
PAST HEALTH HISTORY
Surgeries/Hospitalization
1990 - hospitalized due to edema and increased BP,
was diagnosed with Hypertension and was given
medication as maintenance.
2001 - hospitalized due to stroke for two consecutive
times and experienced sudden loss of consciousness.
April 2015 - hospitalized due to fatigue and increased
BP and was diagnosed with Diabetes Mellitus type 2.
PAST HEALTH HISTORY
August 2015 - patient was rushed to Hospital B due to
weakness of right extremities and facial drooping and
was diagnosed Left Hemiplegia Stroke.
October 2015 - admitted due to blurring of eyesight
and was subjected to surgery on his left eye to remove
the cataract.
2016 - experienced cough and had difficulty of
breathing and was again admitted and diagnosed with
Pneumonia.
PAST HEALTH HISTORY

January 13, 2019 - admitted due to painful and


difficulty of urination and was discharged on January
19, 2019 with fair condition and had a final diagnosis
of Benign Prostatic Hyperplasia in Retention.
The significant others had thought about proper
observation and monitoring for any abnormalities and
unusualities to be reported to his physician for further
intervention and to be attended directly.
PAST HEALTH HISTORY
Family History
The patient’s both maternal and patriarchal sides had
a family history of hypertension and diabetes mellitus.
Occupational and Environmental Risk
The patient was old and doesn’t have work due to his
condition and cannot even care for himself. He is at risk for
fall since he doesn’t have enough energy and strength in
doing so. His daily routines was sitting down on his bed, eat
meals, then lying down. He needs assistance when
defecating, dressing, and eating.
Genogram
PHYSICAL ASSESSMENT
General
Client appears thin and weak.
Vital signs are as follows:
T:36.6 PR:86 RR:28 BP:150/100mmHg
Body built is small and frail with evident poor muscle
tone on all extremities.
Patient’s appearance was at stated age.
Clothes appropriate for age, gender, culture and
weather. Clothes are neat and clean.
No breath odor noted.
Facial features were symmetric.
PHYSICAL ASSESSMENT

Skin, Hair, and Nails


The client has no history of skin, hair or nail disease.
No infection and manifestation noted. The patient’s skin is
dry, scaly and with fair skin turgor. Rashes noted at the
back and on his nape. Well-trimmed nails were noted.
Nails are pale.
Head and Neck
The client has no history of high or low thyroid level.
He experienced fatigue and dizziness. No sinus pain.
Eyes
The client has history of poor vision or vision
problems, glaucoma, cataracts, but no ear infection.
Not using of contact lenses or glasses. No redness and
discharge. The client’s outer canthus is aligned with the
auricle. Pupils are asymmetrical when stroked with
light.

Ears
The client has no history of ear or hearing
problems. No ear pain, changes in hearing, tinnitus or
vertigo. No discharges.
Nose, Mouth, Throat and Sinuses
The client has no history of mouth or throat
cancer, sore throat, nasal obstruction, nosebleeds, cold
sores, bleeding or swollen gums. The client has no
enlarged tonsils, or lips. With pinkish oral mucous
membrane.

Thorax and Lungs


Crackles was noted upon auscultation on the
posterior thorax, cough, or sputum. Respiratory rate
was 28 cycles per minute
PHYSICAL ASSESSMENT
Heart and Neck Vessels
The client don’t have a history of congenital heart
problems, myocardial infarction, heart surgery, heart failure,
arrhythmia or murmur. Blood pressure: 150/100 mmHg

Abdominal-Gastrointestinal
The client has a fair appetite. No vomiting and
diarrhea noted. The client’s usual stool color is brown.
Patient’s abdomen is slightly bloated and distended.
hyperresonance heard upon percussion on the right and left
lower quadrant. Dullness is heard over liver and spleen
Abdominal-Urinary
The client has difficulty of urinating and pain,
reddish urine noted. Bladder is distended, and with
tenderness on palpation.

Musculoskeletal
The client is unable to move independently. He
does not use crutches, only wheelchair due to needs
of further assistance, and has limited range of motion
in his lower extremities. Asymmetrical legs, left leg is
warmer than right leg.
Neurological
The client has no history of head or brain injury or
seizures. He is conscious to person surrounded by him
but cannot identify long term memory and time.
Decreased smell and hearing

Male Genitalia
The client has no lesions like rashes, and no
discharges in the genitalia.

Endocrine and Hematological Systems


The patient has abnormal vital signs. Because he is
hypertensive, Diabetic , had pneumonia and problems in
the kidney as well as his ureter.
PATHOPHYSIOLOGY
Nursing Problems

INEFFECTIVE AIRWAY CLEARANCE related to copious and


tenacious tracheobronchial secretions secondary to productive cough
INEFFECTIVE TISSUE PERFUSION related to impaired transport of
oxygen across capillary membrane
IMPAIRED URINARY ELIMINATION related to decreased bladder
capacity and obstruction of urinary pathway
ACTIVITY INTOLERANCE related to imbalance between oxygen
supply and demand
SELF-CARE DEFICIT related to neuromuscular impairment secondary
to right hemiparesis
DISTURBED SENSORY PERCEPTION related to loss of facial/oral
muscle tone control
Nursing Problems

RISK FOR INJURY related to blurry vision


RISK FOR FALL related to older age as evidence by pain in the knee
and body weakness
RISK FOR IMBALANCED NUTRITION: LESS THAN BODY
REQUIREMENTS related to inability to ingest food
DOCUMENTARY
THANK YOU

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