5 Benign Prostatic Hyperplasia (BPH) Nursing Care Plans


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 diagnoses for benign prostatic hyperplasia:

  1. Urinary Retention
  2. Acute Pain
  3. Risk for Deficient Fluid Volume
  4. Fear/Anxiety
  5. Deficient Knowledge

Urinary Retention

Urinary retention in patients with benign prostatic hyperplasia (BPH) is typically due to mechanical obstruction caused by an enlarged prostate, which makes it difficult for urine to flow through the urethra. If the condition is left untreated, the bladder may become unable to contract efficiently, resulting in incomplete bladder emptying and urinary retention. Additionally, the detrusor muscle that controls bladder contraction may undergo decompensation, leading to further difficulty in emptying the bladder.

Nursing Diagnosis

  • Urinary Retention

May be related to

  • Mechanical obstruction; enlarged prostate
  • Decompensation of detrusor musculature
  • The inability of the bladder to contract adequately

Possibly evidenced by

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

Desired Outcomes

  • The client will void in sufficient amounts with no palpable bladder distension.
  • The client will demonstrate postvoid residuals of less than 50 mL, with the absence of dribbling/overflow.

Nursing Assessment and Rationales

1. Observe the urinary stream, noting size and force.
Useful in evaluating the degree of obstruction and choice of intervention.

2. Percuss and palpate suprapubic area.
A distended bladder can be felt in the suprapubic area.

3. Monitor vital signs closely. Observe for hypertension, peripheral and dependent edema, and 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.

4. Watch closely for signs of post-obstructive diuresis (such as increased urine output and hypotension).
This may lead to serious dehydration, lower blood volume, shock, electrolyte loss, and anuria.

5. Check the catheter often (every 15 minutes for the first 2 to 3 hours).
For patency and urine color.

6. Have the patient document the 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.

7. Watch for septic shock, the most serious complication of prostatic surgery.
May cause severe fever, tachycardia, hypotension, and other sign of shock.

Nursing Interventions and Rationales

1. Encourage the patient to void every 2–4 hr and when the urge is noted.
May minimize urinary retention and overdistension of the bladder.

2. Ask the patient about stress incontinence when moving, sneezing, coughing, laughing, or lifting objects.
High urethral pressure inhibits bladder emptying or can inhibit voiding until abdominal pressure increases enough for urine to be involuntarily lost.

3. 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 re-established.

4. Provide and encourage meticulous catheter and perineal care.
Reduces risk of ascending infection.

5. Recommend sitz bath as indicated.
Promotes muscle relaxation, decreases edema, and may enhance the voiding effort.

6. Administer medications as indicated:

  • 6.1. 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.
  • 6.2. Antispasmodics: oxybutynin (Ditropan)
    Relieves bladder spasms related to irritation by the catheter.
  • 6.3. Rectal suppositories (B & O)
    Suppositories are absorbed easily through the mucosa into bladder tissue to produce muscle relaxation and relieve spasms.
  • 6.4. Antibiotics and antibacterials.
    Given to combat infection. May be used prophylactically.

7. Catheterize for residual urine and leave an indwelling catheter as indicated.
Although this is usually difficult in a patient with BPH, it relieves and prevents urinary retention and rules out the presence of ureteral stricture. A Coudé catheter may be required because the curved tip eases the passage of the tube through the prostatic urethra. Note: Bladder decompression should be done with caution to observe for signs of adverse reaction such as hematuria (rupture of blood vessels in the mucosa of the overdistended bladder) and syncope (excessive autonomic stimulation).

8. Keep the catheter open.
To maintain returns that are clear and light pink.


Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its 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 showing 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.

NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is 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.

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.


Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers.

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