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Copy of Concept Map NR304

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Cynthia Vargas

on 14 August 2013

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Transcript of Copy of Concept Map NR304

Concept Map NR304
*Proper Hand and Perineal Hygiene
* Proper Care of Indewelling Catheter , s/s of UTI
* Wound Care of incision
assess for s/s of infection
Physical Examination Findings
Medical Diagnosis
Surgical Procedure:
Health Promotion
*Perform Kegel Exercises to enhance sphincter control
*Maintain an oral fluid intake of 2000- 3000 mL/day
*Eat high fiber foods and take stool softners to avoid constipation
*Avoid alcoholic and caffeinated beverages
* Avoid straining with bowel movements
*Avoid strenuous exercises and heavy lifting
Nursing Diagnosis
References
Infection Control
Developmental Level
Psychosocial Integrity
Outcomes/Goals
Radical prostatectomy is removal of all of the prostate gland and tissue around it to treat prostate cancer. This procedure is done when the cancer has not spread and is in the early stage
Central Concept
Pain

1. Acute pain r/t bladder spasms and surgical incision of prostectomy AEB pain 7/10 and abdominal discomfort and tenderness .

2. Impaired Urinary Elimination r/t to effects of surgery on bladder sphincter secondary to postprostatectomy AEB
incontinence
1. Patient will report pain as being relieved or controlled within 8 hours.

2.Patient will be have decreased incontinence by the end of discharge.
Integrity vs Despair
During this stage the individual is content with the life they lived and what they fulfilled and accept death or feel despair and discontent with there life and feel contempt for others.
*A&Ox3
*Abdominal discomfort,tenderness, distended
*Incontinence
*Pain 7/10, r/t bladder spasms and surgical incision
*Bloody Urine (Gross Hematuria)in drainage bag from indewelling catheter
*Increased BP r/t pain
*Increased rate and depth of respirations r/t pain
*Dilated Pupils r/t pain



*Sense of powerlessness r/t inability to care from his wife and having daughter care for him
*Ineffective role performance r/t inability to care from his wife and having daughter care for him
*Situational low self esteem r/t prostatectomy
*Anxiety & Fear r/t his care and his wife's care

Nursing Interventions
Nursing Interventions
1.Assess pts pain level every 2 hours reporting any changes
2.Monitor vital signs every 2 hours
3.Adminster meds as order by physician and assess pain after administration
4.Provide Comfort measures ex. changing bed position, back rub, heat pad
5.Teach pt relaxation techniques and encourage distraction using music or television

1. Maintain patency of catheter and drainage system
2.Percussion / palpation of the suprapubic area every 2 hrs
3.Promote fluid intake of up to 3,000 ml/day
4.Monitor and record I&O along with daily weight
5.Teach patient kegel exercises
Prostate Cancer is abnormal growth of the prostate cells usually the gland cells. This type of cancer is know as adenocarcinoma.
Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. 1 in 6 men will be diagnosed with prostate cancer during his lifetime
Carpenito, L. J. (2010). Handbook of nursing diagnosis. (14
ed., pp. 389-727). Philadelphia: Lippincott Williams and Wilkins.
Liou, L. S., & Zieve, (2011). Prostate cancer. Retrieved from
website: http://www.ncbi.nlm.nih.gov/pubmedhealthPMH0001418/
Potter, P., Perry, A., Stockert, P., & Hall, A. (2009).
Fundamentals of nursing. (8th ed.). St. Louis : Elsevier Mosby.
Radical prostatectomy. Retrieved from http://
www.nlm.nih.gov/medlineplus/ency/article/007300.htm
What is prostate cancer. Retrieved from
http:www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancer
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