5 Benign Prostatic Hyperplasia (BPH) Nursing Care Plans

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Benign prostatic hyperplasia or benign prostatic hypertrophy is characterized by progressive enlargement of the prostate gland (commonly seen in men older than age 50), causing varying degrees of urethral obstruction and restriction of urinary flow. Depending on the size of the enlarged prostate, age and health of the patient, and the extent of obstruction, BPH is treated symptomatically or surgically.

Nursing Care Plans

Nursing care for patients with benign prostatic hyperplasia includes preparation for surgery (if possible) administration of medications for pain, and relieving urinary retention.

Below are five (5) nursing care plans (NCP) and nursing diagnosis for benign prostatic hyperplasia:

  1. Urinary Retention
  2. Acute Pain
  3. Risk for Deficient Fluid Volume
  4. Fear/Anxiety
  5. Deficient Knowledge
  6. See Also and Further Reading
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Urinary Retention

Nursing Diagnosis

  • Urinary Retention

May be related to

  • Mechanical obstruction; enlarged prostate
  • Decompensation of detrusor musculature
  • Inability of bladder to contract adequately

Possibly evidenced by

  • Frequency, hesitancy, inability to empty bladder completely; incontinence/dribbling
  • Bladder distension, residual urine

Desired Outcomes

  • Void in sufficient amounts with no palpable bladder distension.
  • Demonstrate postvoid residuals of less than 50 mL, with absence of dribbling/overflow.
Nursing InterventionsRationale
Encourage patient to void every 2–4 hr and when urge is noted.May minimize urinary retention and overdistension of the bladder.
Ask patient about stress incontinence when moving, sneezing, coughing, laughing, lifting objects.High urethral pressure inhibits bladder emptying or can inhibit voiding until abdominal pressure increases enough for urine to be involuntarily lost.
Observe urinary stream, noting size and force.Useful in evaluating degree of obstruction and choice of intervention.
Have patient document time and amount of each voiding. Note diminished urinary output. Measure specific gravity as indicatedUrinary retention increases pressure within the ureters and kidneys, which may cause renal insufficiency. Any deficit in blood flow to the kidney impairs its ability to filter and concentrate substances.
Percuss and palpate suprapubic area.A distended bladder can be felt in the suprapubic area.
Encourage oral fluids up to 3000 mL daily, within cardiac tolerance, if indicated.Increased circulating fluid maintains renal perfusion and flushes kidneys, bladder, and ureters of “sediment and bacteria.” Note: Initially, fluids may be restricted to prevent bladder distension until adequate urinary flow is reestablished.
Monitor vital signs closely. Observe for hypertension, peripheral and dependent edema, changes in mentation. Weigh daily. Maintain accurate I&O.Loss of kidney function results in decreased fluid elimination and accumulation of toxic wastes; may progress to complete renal shutdown.
Watch closely for signs of postobstructive diuresis (such as increased urine output and hypotension).May lead to serious dehydration, lower blood volume, shock, electrolyte loss, and anuria.
Provide and encourage meticulous catheter and perineal care.Reduces risk of ascending infection.
Recommend sitz bath as indicated.Promotes muscle relaxation, decreases edema, and may enhance voiding effort.
Administer medications as indicated:
  • Alpha-adrenergic antagonists: tamsulosin (Flomax), prazosin (Minipress), terazosin (Hytrin), doxazosin mesylate (Cardura);
Studies indicate that these drugs may be as effective as Proscar for outflow obstruction and may have fewer side effects in regard to sexual function.
  • Antispasmodics: oxybutynin (Ditropan)
Relieves bladder spasms related to irritation by the catheter.
  • Rectal suppositories (B & O)
Suppositories are absorbed easily through mucosa into bladder tissue to produce muscle relaxation and relieve spasms.
Given to combat infection. May be used prophylactically.
Catheterize for residual urine and leave indwelling catheter as indicated.Although this is usually difficult in a patient with BPH, it relieves and prevents urinary retention and rules out presence of ureteral stricture. Coudé catheter may be required because the curved tip eases passage of the tube through the prostatic urethra. Note: Bladder decompression should be done with caution to observe for sign of adverse reaction such as hematuria (rupture of blood vessels in the mucosa of the overdistended bladder) and syncope (excessive autonomic stimulation).
Check catheter often (every 15 minutes for the first 2 to 3 hours).For patency and urine color.
Often check dressings.For bleeding.
Keep the catheter open.To maintain returns that are clear and light pink.
Watch for septic shock, the most serious complication of prostatic surgery.May cause severe fever, tachycardia, hypotension and other sign of shock.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other care plans and nursing diagnoses related to reproductive and urinary system disorders:

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Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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