Prostatitis

• Behavioral Objective:– Describe etiology, pathophysiology, clinical

manifestations, nursing management and patient education for prostatitis

• Brunner and Suddarth’s Medical Surgical Nursing pg 1750

Prostatitis

Pathophysiology• Inflammation of the

prostate gland cause by infectious agents

• E. coli is the most common

• Microorganisms are usually carried to the prostate from the urethra

Prostatitis

Clinical manifestations• Perineal discomfort• Burning, urgency,

frequency & pain after ejaculations

• Prostate pain• Dysuria• May produce

– Fever and chills– Rectal or low back pain

Prostatitis

Assessment and diagnostic findings

• History• Culture • Histological

examination of the tissue

• D.R.E.– 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• A broad-stectrum antibiotic– Trimethroprim

sulfamethoxazole (Bactrim)

– Cirpfloxacin (Cipro)• Bed rest • Analgesic agents • Antispasmodic medications

Prostatitis

• Bladder sedatives• Sitz baths• Stool softeners– Colace

• Anti-inflammatory

Prostatitis

Nursing process of Patients with Prostatitis• Assessment• Diagnosis– 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. meds2.Comfort measures:

1. Sitz baths3.Fluids:

1. Do not force fluids –

Prosatitis1.AVOID Foods and liquids that have diuretic actions

or that increase Prostatic secretion should be avoided

1. Alcohol2. Coffee3. Tea4. Chocolate5. Cola6. Spices

2.Avoid intercourse 3.Avoid sitting for long periods

Orchitis

• Behavioral Objective– Describe etiology, pathophysiology, clinical

manifestations, nursing management and patient education Orchitis

• Brunner and Suddarth’s Medical Surgical Nursing pg 1769

Orchitis

• Orchitis is an inflammation of the testes.

• Etiology– 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

• Behavioral Objective:– 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– Prostate gland

enlargement urinary obstruction

– Age > 50

Prostatic hypertrophy Benign Prostatic Hyperplasia

Clinical Manifestations– prostate gland

• large • rubbery • non tender

– Urinary retention– Dilation of the ureters

and kidneys– Results in UTI

Prostatic hypertrophy Benign Prostatic Hyperplasia

Assessment and diagnosis• Digital Rectal exam

– 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• Catheterization • Prostatectomy – TURP - Transurerthral Resection of the Prostate

• Laser resection of the prostate. – Ultrasound & Lasers – Tissue vaporizes or necrotic sloughs.

Prostatic hypertrophy Benign Prostatic Hyperplasia

Nursing process• Assessment• Diagnosis / Nursing Interventions– Acute pain related to bladder distention secondary to

enlarged prostate as manifested by complaints of discomfort • 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