Care plan for Benign Prostatic Hyperplasia (BPH)

NURSING DIAGNOSIS FOR BENIGN PROSTATIC HYPERPLASIA- BPH

 Benign prostatic hyperplasia (BPH) 

The prostate gland is surrounded by  the urethra, the tube that carries urine from the bladder out of the body.

1. Acute pain related to bladder distention secondary to enlarged prostate as manifested by         complaints of discomfort caused by inability to void, palpable bladder, no urine out put, restlessness.
2. Urge urinary incontinence related to poor sphincter control as manifested by inappropriate leakage of urine.
3. Impaired urinary elimination related to blockage in urinary tract as manifested by dysuria and decreased urinary out put
4.   Impaired sleeping pattern due to pricking lower abdominal pain and anxiety related to disease condition.
5. Risk for infection related to indwelling catheter, environmental pathogens and urinary stasis
6. Ineffective individual coping related to the diagnosis of BPH
7. Fear related to actual or potential sexual dysfunction and lack of knowledge regarding surgical procedure and postoperative care as manifested by verbalization of fear.
8. Ineffective therapeutic regimen management related to lack of knowledge about prevention of recurrence, diet, fluid requirement, and symptoms of recurrence as manifested by questions that indicate inadequate knowledge

1. Acute pain related to bladder distention secondary to enlarged prostate as manifested by complaints of discomfort caused by inability to void, palpable bladder, no urine out put, restlessness

OUTCOME/ GOAL:

Client will experience relief from pain as evidenced by verbalization of comfort, adequate sleep in the night, vitals within normal limits

INTERVENTIONS

1.       Assess the intensity and site of pain
2.       Provide comfortable position and adequate comfort devices
3.     Teach the client various divertional activities and ask the client to adapt some of those for diverting the thought
4.       Administer analgesics as per doctors advice
5.       Provide calm and pleasant environment to aid rest and sleep
6.       Teach the patient about the relaxation techniques and make him to do it
7.      encourage the patient to divert his mind from pain and to engage in pleasurable activities like taking with others
8.      Do not allow the patient to do strenuous activities. And explain to the patient why those activities are contraindicated.

2. Impaired urinary elimination related to blockage in urinary tract as manifested by dysuria and decreased urinary out put

OUTCOME/ GOAL

Patient will achieve and maintain normal urinary elimination pattern

INTERVENTIONS

1.  Assess the frequency and character of micturition
2. Provide more oral fluids
3. Administer medication as prescribed by doctor
4.  Catheterize the client if possible and take not to force and cause injury to the urethra
5. Monitor intake and output chart
6.  Teach client the importance of hydration
7.   Educate the client regarding the condition and its management
8. Teach various measures that aid voiding and use it effectively
9.  Encourage the client to mobilise himself actively which aid easy elimination
10. Provide primary prevention when necessary

3. Anxiety related to actual or potential sexual dysfunction, and lack of knowledge regarding surgical procedure and postoperative care

Outcome/ goal:    

Client will demonstrate reduced anxiety level 

INTERVENTIONS

1.  Assess the level of anxiety
2. Develop a pleasant interpersonal relationship which aids ventilation of patients feelings
3. Encourage client in expressing her doubts and clarify the doubts
4.  Instruct the client in adopting divertional activities which relieves the clients thought of uncertain outcomes
5. Schedule rest periods, as it will encourage sleep
6. Advice the client to involve in pleasurable activities like talking to others or listening to music
7. Provide psychological support
8. Encourage client in utilizing the rest periods effectively
9.  Educate the client regarding the disease process and its management
10. Teach the client various techniques in relieving themselves from anxiety such as counting the numbers in a descending order or deep breathing exercises

4 . Impaired sleeping pattern due to pricking lower abdominal pain and anxiety related to disease condition.

Outcome/ goal:

Client will achieve a normal sleeping pattern as evidenced by verbalisation of adequacy of sleep in the night

INTERVENTIONS

1.  Assess the cause for the lack of sleep
2. Provide calm and quiet environment that aids sleep
3.  Administer analgesics to alleviate pain
4.  Encourage client to perform the activities
5. Schedule the activities
6.  Advice  the client  to avoid the avoid day time sleeping
7. Encourage  the client to take a cup of milk which enhances sleep
8.  Provide psychological support to alleviate the fear of uncertain outcomes
9. Use the primary prevention when necessary.

5. Risk for infection related to indwelling catheter, environmental pathogens and urinary stasis

  Outcome/ goal:

       Client will be free from infection

INTERVENTIONS

1. Assess for elevation of temperature, cloudy foul smelling urine
2.   Monitor vital signs and observe for fever.
3. Advice client to Maintain proper personal hygiene
4.  Encourage high fluid intake
5.  Maintain intake output chart
6. Administer antibiotics and antipyretics as per doctors advice
7. Teach client regarding the self-care of catheter
8. Encourage the client to have nutritious diet and diet rich protein
9. Provide clean and safe environment
10. Provide catheter care in a clean/ aseptic method
11. Provide primary prevention when necessary

Pharmacological action of eye @nursesoutlook

Pharmacological action of the eye

The penetration of the eye by drugs is restricted by two barriers, the epithelial membrane of the corner and the blood-aqueous humour barrier.the latter is formed by the endothelial of the vessels and the epithelium of the ciliary body.this ciliary barrier has some characteristics in common  with the blood Bra barrier,which is characterised by its right structure.

Drugs for treatment of eyes are usually  administered in three forms

1.topically on the surface of eye

2.by local injection

3.by systemic application

Among the 3 priority  is emphazised  for local application

Local application

Eye drops are usually administered into the conjunctival sac which has capacity of only .01ml.the volume of an eye drop is 0.05ml and therefore usually  4/5 of the volume leaks out immediately  after each closure of eyelid.

The installed drug will be diluted by the tear  fluid and the concentration is usually halved after 1/2 minute due to drainage through the nasolacrimal duct.
The systemic effects  of eye drops  may also occur after absorption from the nasal mucosa. By altering the composition of the diluents the contact time and hence also local absorption can be extended 4-7 times.