Transcript Genital-Urinary System

Prostatitis
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Behavioral Objective:
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Describe etiology, pathophysiology, clinical
manifestations, nursing management and
patient education for prostatitis
Brunner and Suddarth’s Medical Surgical
Nursing pg 1750
Prostatitis
Pathophysiology
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Inflammation of the
prostate gland cause by
infectious agents
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E. coli is the most
common
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Microorganisms are
usually carried to the
prostate from the
urethra
Prostatitis
Clinical manifestations
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Perineal discomfort
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Burning, urgency,
frequency & pain after
ejaculations
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Prostate pain
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Dysuria
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May produce
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Fever and chills
Rectal or low back pain
Prostatitis
Assessment and diagnostic
findings
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History
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Culture
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Histological examination
of the tissue
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D.R.E.
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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
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A broad-stectrum antibiotic
– Trimethroprim
sulfamethoxazole
(Bactrim)
– Cirpfloxacin (Cipro)
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Bed rest
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Analgesic agents
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Antispasmodic medications
Prostatitis
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Bladder sedatives
Sitz baths
Stool softeners
– Colace
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Anti-inflammatory
Prostatitis
Nursing process of Patients with Prostatitis
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Assessment
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Diagnosis
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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. meds
2.Comfort measures:
1. Sitz baths
3.Fluids:
1. Do not force fluids –
Prosatitis
1.AVOID Foods and liquids that have diuretic actions
or that increase Prostatic secretion should be
avoided
1. Alcohol
2. Coffee
3. Tea
4. Chocolate
5. Cola
6. Spices
2.Avoid intercourse
3.Avoid sitting for long periods
Orchitis
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Behavioral Objective
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Describe etiology, pathophysiology, clinical
manifestations, nursing management and
patient education Orchitis
Brunner and Suddarth’s Medical Surgical
Nursing pg 1769
Orchitis
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Orchitis is an
inflammation of the
testes.
Etiology
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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
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Behavioral Objective:
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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
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Prostate gland
enlargement
urinary
obstruction
Age > 50
Prostatic hypertrophy
Benign Prostatic Hyperplasia
Clinical Manifestations
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prostate gland
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large
rubbery
non tender
Urinary retention
Dilation of the ureters
and kidneys
Results in UTI
Prostatic hypertrophy
Benign Prostatic Hyperplasia
Assessment and diagnosis
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Digital Rectal exam
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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
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Catheterization
Prostatectomy
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TURP - Transurerthral Resection of the Prostate
Laser resection of the prostate.
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Ultrasound & Lasers
Tissue vaporizes or necrotic  sloughs.
Prostatic hypertrophy
Benign Prostatic Hyperplasia
Nursing process
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Assessment
Diagnosis / Nursing Interventions
– Acute pain related to bladder distention secondary to
enlarged prostate as manifested by complaints of
discomfort
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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