(^376) Medical-Surgical Nursing Demystified
- Nocturia—need to get up at night to urinate due to pressure on bladder
- Decrease in force of urinary stream
- Intermittent stream of urination
- Hematuria
INTERPRETING TEST RESULTS
- Urography shows high volume of post-void residual urine.
- PSA (prostate-specific antigen) may be mildly elevated.
- Prostate ultrasound shows hypertrophy.
- Digital rectal exam reveals fullness of prostate and loss of median sulcus
(midline groove between the two lateral lobes of the prostate). - Urinalysis may show microscopic hematuria.
- BUN and creatinine levels may elevate, if renal function is impaired.
TREATMENT
- Administer alpha 1 -blockers for symptom relief:
- doxazosin
- tamsulosin
- terazosin
- Monitor blood pressure; hypotension may be side effect of some alpha 1 -
blockers. - Administer finasteride to relieve symptoms by shrinking prostate gland.
- Monitor PSA levels periodically.
- Monitor renal function.
- Surgical removal of prostate tissue to relieve pressure.
- Continuous bladder irrigation postoperatively.
- Administer antispasmodics for patients experiencing bladder spasms.
NURSING DIAGNOSIS
- Risk for impaired urinary elimination
- Urinary retention
- Risk for urge urinary incontinence