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11/8/06
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Page 1318
Urinary Elimination
CONCEPT MAP
JB
68 y.o. male
BPH
assess
Impaired Urinary Elimination (Retention and Overflow Incontinence) r/t bladder neck
obstruction by enlarged prostate gland (aeb dysuria, frequency, nocturia, dribbling,
hesitancy, and bladder distention)
evaluation
nursing intervention
outcome
outcome
Urinary Continence
aeb
Able to start and
stop stream
Empties bladder
completely
Knowledge:
Treatment
Regimen aeb
substantial
Description
of self-care
responsibilities
for ongoing care
Description of
self-monitoring
techniques
nursing
intervention
Outcomes met:
Able to discuss
the correlation
between enlarged
prostate and
urinary difficulties
TURP scheduled
in 2 weeks
evaluation
nursing intervention
activity
activity
activity
Monitor
urinary
elimination,
including
odor,
volume,
and color
Instruct
client to
limit fluids
for 2 to 3
hours
before
bedtime
activity
Help client
select
appropriate
incontinence
garment or
pad for
short-term
management
while more
definitive
treatment is
designed
activity
Limit
ingestion
of bladder
irritants
(e.g., colas,
coffee, tea,
and
chocolate)
Instruct to
drink a
minimum of
1,500 mL
(six 8-ounce
glasses fluids)
per day
Instruct
client or
family
member
to record
urinary
output
activity
activity
activity
Provide enough
time for bladder
emptying
(10 min)
activity
activity
activity
activity
Explain the
pathophysiology
of the disease
and how it
relates to urinary
anatomy and
function
Implement
intermittent
catheterization;
as appropriate
Instruct in ways
to avoid
constipation or
stool impaction
Appraise
current
level of
knowledge
about
benign
prostatic
hypertrophy
Catheterize
for residual
urine, as
appropriate
activity
Describe the
rationale behind
management,
therapy, and
treatment
recommendations
Instruct on
which signs
and
symptoms to
report to the
primary care
provider (e.g.,
burning on
urination,
hematuria,
olliguria)