Documente Academic
Documente Profesional
Documente Cultură
Prostate gland is located just below the bladder and infront of the rectum. It is about the
size of the walnut and surrounds part of the urethra. The prostate gland produces fluid
that makes up the semen.
RISK FACTOR
Men
Increasing age
African-American
Hereditary
•CT scan
Stage II
In stage II, cancer is more advanced than in stage I, but has not spread
outside the prostate. The Gleason score can range from 2-10. Stage II
prostate cancer may also be called stage A2, stage B1, or stage B2
Stage III
In stage III, cancer has spread beyond the outer layer of the prostate to
nearby tissues. Cancer may be found in the seminal vesicles. The
Gleason score can range from 2-10. Stage III prostate cancer may also be
called stage C prostate cancer.
Stage IV
In stage IV, cancer has metastasized (spread) to lymph nodes near or far
from the prostate or to other parts of the body, such as the bladder,
rectum, bones, liver, or lungs. Metastatic prostate cancer often spreads to
the bones. The Gleason score can range from 2-10. Stage IV prostate
cancer may also be called stage D1 or stage D2 prostate cancer.
MEDICAL MANAGEMENT
Stage I Treatment
Watchful waiting.
Radical prostatectomy, usually with pelvic lymphadenectomy, with or
without radiation therapy after surgery. It may be possible to remove the
prostate without damaging nerves that are necessary for an erection.
External-beam radiation therapy.
Implant radiation therapy.
A clinical trial of high-intensity focused ultrasound.
A clinical trial of radiation therapy.
A clinical trial evaluating new treatment options.
Stage II Treatment
•Hormone therapy.
•External-beam radiation therapy with or without hormone therapy.
•Radiation therapy or transurethral resection of the prostate as
palliative therapy to relieve symptoms caused by the cancer.
•Watchful waiting.
•A clinical trial of radical prostatectomy with orchiectomy.
NURSING MANAGEMENT:
PREOPERATIVE:
Reducing anxiety- the nurse must establish
communication with the patient to assess his
understanding of the diagnosis and of the planned
surgical procedure. She/he clarifies the nature of
the surgery and expected postoperative outcomes.
She/he also familiarizes the patient with the pre-
and postoperative routines and initiates measure to
reduce anxiety. She/he also provides privacy and
establishes a trusting and professional relationship.
Relieving discomfort- the patient is placed on bed
rest, analgesic agents are administered, and
measures to relieve anxiety are initiated. The nurse
monitors the voiding patterns, watches for bladder
distention, assist with catheterization if indicated.
Providing instruction- the nurse explains what will take
place as the patient is prepared for the diagnosis tests and
then for the surgery. The nurse describes the type of
incision, which varies with the type of surgical approach.
The patient is informed about the type if urinary drainage
system that is expected, the type of anesthesia, and the
recovery room procedure. The patient is instructed about
postoperative use of medications for pain management.
Preparing the patient- elastic compression
stockings are applied before surgery and are
particularly important for prevention of deep vein
thrombosis if the patient is placed in a lithotomy
position during surgery. An enema is usually
administered at home the evening before the
surgery or the morning of surgery to prevent
postoperative straining, which can induce bleeding.
POSTOPERATIVE
Maintaining fluid balance
Relieving pain
Monitoring and managing potential
complications
Promoting home and community-based care
NURSING CARE PLAN
ASSESSMENT
SUBJECTIVE:
Weight loss
Nausea
Vomiting
DIAGNOSIS
After
proper nursing intervention the patient will
maintain optimal nutritional status.
INTERVENTION
1. Assess the amount of food eaten.
2. Weigh patient
3. Ask patient why he is unable to eat.
4. Cater to his individual food preference.
5. Provide frequent small meals and a comfortable
and pleasant environment
RATIONALE
1. To help determine nutrient intake.
2. To monitor changes in weight.
3. His explanation may present easily corrected
practices.
4. He will be more likely to consume larger
servings if food is palatable and appealing.
5. Smaller portion of food are less overwhelming to
the patient
EVALUATION