Question

Clifford Allen is a 64-year-old male who has been married to his wife, Pam, for 40 years. They live with their 24-year-old son, Gary, who was born with Down syndrome. Mr. Allen is a middle manager for a small manufacturing company where he has worked for the last 20 years. Overall, Mr. Allen is in good health, although he has been undergoing treatment recently for BPH. He has a history of depression for which he does not seek treatment because he fears the social stigma connected to the diagnosis. Mr. Allen has been considering retiring within the next few years so he and his wife can travel, but mostly to escape his stressful work environment. He enjoys bowling and is involved in activities at church. He and his wife walk each evening after supper. One evening while bowling, he notices that his bladder feels somewhat full. Mr. Allen calls to make an appointment to see his urologist for a follow up examination. He has been taking finasteride (Proscar) for the last 6 months but does not believe it has been particularly effective. He still has trouble urinating and believes that his symptoms are worse than before he started taking the drug. When he sees the urologist 2 weeks later, he reports that he often feels his bladder is full after voiding, he has difficulty starting his stream, and his stream is weak once started. He gets up frequently at night to void. His score on the American Urological Association Symptom Index is 28, up from 18 six months ago. The urologist confirms that the medication has not been effective and schedules further tests, including a uroflowmetry test, a postvoid residual test, a PSA blood test, and a urinalysis. Results from the uroflowmetry and postvoid residual test show a significant obstruction of urinary flow. The PSA is negative, and the urinalysis is consistent with bladder inflammation. A TURP is recommended in the upcoming weeks.

1. What teaching will the nurse prepare regarding postoperative self-care?

Answer 1

TURP - Transurethral resection of prostate.

Post-operative self care teaching of patients after TURP are :-

- Drink plenty of fluids around 2-3 litres a day .

- No strenuous activities for 6weeks because it causes increased abdominal pressure.

- provide perineal care after every bowel movements

- check for excessive bleeding and for unbearable pain it might be due to clots etc and timely inform the physician.

- advice the patient to do kegal exercises to strengthen the muscles of perineum.

- Inform the patient that it will take months to have control on incontinence.

- Teach the patient to monitor the input and output of fluids and about TURP syndrome .

- patient can go to the office after 6weeks and drive cars themself until the patient has any problem

- patient should take high biological protein , carbohydrates and fats and,vitamin rich diet for effective healing of the wound .

- patient should come for the follow up with the Physician on the given date.

- Teach the patient signs of infection like inflammation, redness,warmth, discharge of pus etc at the surgical site .If any signs are present then patient must reach the hospital without any delay.