Question

3. Activity: Develop a plan of care for a 55 year old male patient who has prostate cancer.

a. Assessment, (1) Nursing diagnosis, Plan (2 short term and 2 long term goals), Implementation, Evaluation.

b. Create a list of dietary recommendations (4) for men that could possibly decrease their risk for development of prostate cancer.

c. You are the nurse caring for a 34-year old male who has just been diagnosed with testicular cancer. Your patient has been married for 3 years, and has a 1-year old daughter. The patient states to you, "I am afraid I am going to die, but I cannot miss work to have surgery. My wife is not employed, and stays home with our daughter." Instruct students to devise a list of 5 appropriate nursing responses to this statement that will address the patient's concerns of dying, and supporting his family.

d. Discuss Finasteride (Proscar) and assess its safety profile. Create a list of 3 nursing interventions that would support delivering this medication safely to a patient.

e. Provide 3 teaching points for a patient who is being discharged after TURP.

Notes:

Be sure to include citation.

Review ADPIE. Make sure 2 short term and 2 long term goals are included which are SMART. Review SMART.

Address all components of the question(s) to receive full credit.

Answer 1

A)

Here are six (6) nursing care plans (NCP) and nursing care plan for prostatectomy:

• Impaired Urinary Elimination.
• Risk for Deficient Fluid Volume.
• Risk for Infection.
• Acute Pain.
• Risk for Sexual Dysfunction.
• Deficient Knowledge.
• Other Possible Nursing Care Plans

Prostate cancer is diagnosed using a combination of prostate-specific androgen (PSA) blood testing, digital rectal examination (DRE), biopsy and magnetic resonance imaging (MRI) scan; a bone scan may be used for staging.

B) Dietary changes

• Regularly eating foods high in fat, especially animal fat, may increase prostate cancer risk. However, no prospective studies, meaning studies that look at men who follow either high-fat or low-fat diets and then measure the total number of men in each group diagnosed with prostate cancer, have yet shown that diets high in animal fat raise the risk of prostate cancer.

• A diet high in vegetables, fruits, and legumes, such as beans and peas, may lower the risk of prostate cancer. It is unclear which nutrients are directly responsible. Although lycopene, the nutrient found in tomatoes and other vegetables, has been shown to be associated with a lower risk of prostate cancer, the data have not proven that there is a relationship between lycopene and preventing cancer.

• Currently no specific vitamins, minerals, or other supplements have been shown in clinical trials to prevent prostate cancer. Talk with your doctor before taking any supplements to prevent prostate cancer.

• Specific changes to eating behaviors may not stop or slow the development of prostate cancer. It is possible such changes would need to be made early in life to have an effect.

C)

• Provide respite care for family members who need a break.

• Order appropriate medical supplies needed by the patient.

• Perform patient assessments.

• Create a plan of care for all caregivers to follow.

• Provide sensitive care and emotional support

D) PROSCAR (finasteride), a synthetic 4-azasteroid compound, is a specific inhibitor of steroid Type II 5α-reductase, an intracellular enzyme that converts the androgen testosterone into 5α- dihydrotestosterone (DHT).

Finasteride is 4-azaandrost-1-ene-17-carboxamide, N-(1,1-dimethylethyl)-3-oxo-,(5α,17ß)-. The empirical formula of finasteride is C23H36N2O2 and its molecular weight is 372.55.

Effects On Prostate Specific Antigen(PSA) And The Use Of PSA In Prostate Cancer Detection

In clinical studies, PROSCAR reduced serum PSA concentration by approximately 50% within six months of treatment. This decrease is predictable over the entire range of PSA values in patients with symptomatic BPH, although it may vary in individuals

E) It's common to feel tired and under the weather for a week or two after having a TURP. Most men are up and about after this time, but you'll need to take things easy for up to 2 months. For the first few weeks, you shouldn't lift or move any heavy objects (including shopping) or do any strenuous exercise.

After TURP, up to 30%–40% of patients may experience urinary incontinence in the early postoperative period; however, the incidence of late incontinence that persists for more than 6 months is only 0.5%–1%.