NCP - Nursing Diagnosis of Acute Pain related to BPH

Nursing Care Plan for Benign Prostatic Hyperplasia

BPH is a progressive enlargement of the prostate gland (in general in men older than 50 years) causes various degrees of urethral obstruction and urinary flow restriction (Marilynn, ED, 2000: 671).

The exact cause of the occurrence of BPH as yet unknown. But certainly the prostate gland depends on androgens. Another factor which is closely related to BPH are aging There are several possible causes of factors, among others:

1). Dihydrotestosterone (DHT)
Increased 5 alpha reductase and androgen receptor causes epithelial and stromal hyperplasia of the prostate gland experience.

2). Changes in the balance of estrogen - testosterone
The aging process in men increased estrogen and decreased testosterone resulting in stromal hyperplasia.

3). Interaction stromal - epithelial
Increased epidermal gorwth factor or fibroblast growth factor and transforming growth factor beta reduction causes stromal and epithelial hyperplasia.

4). Reduced cell death
Increased estrogen causes increased longevity stroma and epithelium of the prostate gland.

5). Back resurrection theory (reawakening) of urogenital sinus mesenchyme ability to proliferate and form the prostate tissue.


Symptoms of Benign Prostatic Hyperplasia

Based on the grade, divided into 4 grades as follows:

1st Grade : Congestic

• Patients early months or years of hard-urinary and began straining.
• If micturition was satisfied.
• Urine drips out and poor stream.
• nocturia
• Urine out at night more than normal.
• Longer than normal erection and more libido than normal.
• On hyperemia cytoscopy visible from the internal urethral orifice. Occurs slowly bleeding varices could eventually happen (blooding).

2nd Grade : Residual

• When micturition is hot.
• Nocturia Dysuria gain weight.
• Can not urinate (urinary dissatisfied).
• Infection can occur because of residual urine.
• High heat can occur and chills.
• Pain in the lumbar region (spreading to the kidneys).

3rd Grade : Urinary retention

• Ischuria paradosal.
• Incontinensia paradosal.

4th Grade

• Full bladder.
• Patients feel pain.
• Urine dripped periodically called over flow incontinensia.
• On physical examination, palpation of the lower abdomen to feel there is a tumor, because of a great dam.
• Patients with an infection and high fever can shiver around 40-41 ° C.
• Then the patient could commas.

Nursing Diagnosis for Benign Prostatic Hyperplasia : Acute Pain related to irritation of the bladder mucosa, bladder distension, renal colic, urinary infection.

Goal: Pain is lost / controlled.

Outcomes:
Clients reported pain relief / control, relaxation skills and demonstrate therapeutic activity as indicated for individual situation. Seemed to relax, sleep / rest appropriately.

Nursing Interventions :

1 . Assess pain , note the location , intensity ( scale of 0-10 ) .
R / : sharp pain , intermittent with the urge to urinate / massage urine around the catheter showed spasm of the bladder , which tend to be heavier on the approach TURP ( usually decreases within 48 hours ) .

2 . Maintain patency of the catheter and drainage system . Keep the hose free of grooves and clot .
R / : Maintaining the function of the catheter and drainage system , reduce the risk of distension / bladder spasm .

3 . Maintain bed rest when indicated
R / : Required during the initial phase during the acute phase .

4 . Provide comfort measures ( therapeutic touch , changing position , back massage ) and therapeutic activity .
R / : Reduce muscle tension , back memfokusksn attention and can improve coping skills .

5 . Give soak sit or heating lamps when indicated .
R / : Improving tissue perfusion and improvement of edema and promote healing ( perineal approach ) .

6 . Collaboration in the provision antispasmodic
R / : Eliminates spasm .