SYMPTOM FLOW CHART

Difficulty Voiding

Disease associated BPH Acute Renal Failure

with symptom
Symptom Cluster:  dribbling at the end of  fluid retention causing edema
 minimum of 3 urination and weight gain
 intermittency(stopping and  hematuria
other associated
starting stream several times  change in mental status
s/sx while voiding)  flank pain
 bladder distention
 men

Diagnostics:  History and physical  History and physical

 What will examination examination
 Uroflowmetry  Renal ultrasound
differentiate this
 Transrectal ultrasound  Renal scan
disease  Serum creatinine  Urinalysis
 Lab tests  Cystoscopy  Serum creatinine and BUN level
 Serum electrolytes

Treatment:  Encourage pt to urinate  Diuretic therapy: furosemide

 Independent Fx when first having urge  Antibiotic
 Foley catheter  dialysis
 DependentFx
 Meds: 5a-Reductase
Inhibitors(Proscar), a-
Adrenergic Receptor
Blockers
 Herbal therapy: saw
palmetto
 TURP
 Nsg Implications:  Teach pt to maintain fluid
 Patient/ family intake at a normal level to
avoid dehydration or fluid
Education
overload
 Potential  Acute urinary retention
complications  UTI
 Teach pt to have a low-protein,
moderate-fat, high-
carbohydrate diet
 Teach pt to prevent skin break
down
 Take entire prescription as
directed
 Hypokalemia
 Dysrhythmias
 Permanent kidney damage