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
- Urinary Retention
- Acute Pain
- Risk for Deficient Fluid Volume
- Deficient Knowledge
- See Also and Further Reading
- 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
- Void in sufficient amounts with no palpable bladder distension.
- Demonstrate postvoid residuals of less than 50 mL, with absence of dribbling/overflow.
|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 indicated||Urinary 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:|
||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.|
||Relieves bladder spasms related to irritation by the catheter.|
||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.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans and nursing diagnoses related to reproductive and urinary system disorders:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Renal Failure | 6 Care Plans
- Benign Prostatic Hyperplasia (BPH) | 5 Care Plans
- Chronic Renal Failure | 11 Care Plans
- Hemodialysis | 3 Care Plans
- Hysterectomy (TAHBSO) | 6 Care Plans
- Mastectomy | 14+ Care Plans
- Menopause | 6 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Peritoneal Dialysis | 6 Care Plans
- Prostatectomy | 6 Care Plans
- Urolithiasis (Renal Calculi) | 4 Care Plans
- Urinary Tract Infection | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans