For the majority of men who are not older than 50, prostatitis is the most prevalent urological verdict. At least one warning sign of prostatitis can be found at more than 30% of men, and more than 15% have symptoms hinting at chronic prostatitis. Prostatitis is an imperative contemplation in a man with perineal discomfort and micturition complications (Taylor, 2003). Acute prostatitis is typically triggered by a rising urinary tract microbial contamination and is pointed out by an unforeseen, feverish sickness with symptoms coming down to the lower genitourinary area.
hudders, leukocytosis, the urinary rate of recurrence, and sporadic bladder block are existing. A rectal inspection characteristically illustrates a marshy, intricately tender prostate (Schlossberg, 2015). Numerous medical conditions have been acknowledged in which the jeopardies of urinary tract infection or indicative exacerbation seem to be expressively amplified. The consciousness of these conditions and proper supervision should reduce the risk of the progress of the suggestive infection and its likeliness for grave complications (Suki, & Massry, 2013).
Subjective Data
Client Complaints: A 60-year-old Hispanic male presents with the chief complaint of decreased urinary flow. The patient has been experiencing this over the past two years, but for the past two weeks, the symptoms have increased significantly.
HPI (History of Present Illness): The current symptoms are similar to what he experienced in the past. However, for the past two weeks, he has had increased nocturia, with decreased strength of urinary flow and slight terminal dysuria. Patient has had no treatment in the past. The nocturia has been very troublesome over the past two weeks.
Yesterday he had significant difficulty in starting his urine flow, and this is interfering with daily activities. He needs to pass urine four to five times every night. He has frequently been urinating and always needs to know if there are bathrooms around. The patient does not complain of any other radiating pain. He has had no treatment or diagnostic work up in the past, but now the symptoms have been increasing in severity. He believes he had a low-grade fever yesterday. He had significant obstructive symptoms two days ago. Gradual worsening of symptoms has compelled him to seek medical help now.
PMH (Past Medical History—include current medications, any known allergies, any history of surgery or hospitalizations): Patient has not sought any medical care for this problem to date. He is being treated for hypertension and hypercholesterolemia. There is no known history of heart disease, but he had been hospitalized five years ago as a suspected case of angina. He was diagnosed with chest wall syndrome for which he was treated and then released. There are no recent hospitalizations and no surgeries.
Significant Family History: He has one sister and one brother. Both are alive and well. There is a remote history of heart disease among his aunts and uncles. The patient is married, and his spouse has excellent general health. He has two grown-up sons who live with their own families. They are 35 and 37 years old, both alive and well.
Social/Personal History (occupation, lifestyle—diet, exercise, substance use): He believes that he gets adequate exercise, eats healthy, and maintains a regular checkup regime with his physician. He is a non-smoker, does not drink, and denies the substance abuse. Patient has a master’s degree in engineering, and his income is $65,000.00 per year. He has an excellent health insurance coverage including a prescription plan. He believes that he is generally healthy. He gets little from social support outside the home or work. The patient is originally from the United States. He lives in a suburban setting. His wife does most of the cooking.
Description of Client’s Support System: His family members lend him countenance and support him in each and every way possible to keep him in a good state
Behavioral or Nonverbal Messages: His perception of self-efficacy is adequate. He has very little stress. The patient is high strung and an over achiever. His perception of self-efficacy is adequate. He has very little stress. The patient is high strung and an over achiever.
Client Awareness of Abilities, Disease Process, Health Care Needs: Although the patient has a master’s in engineering, his knowledge of healthcare is inadequate. Though the patient is educated, he lacks an understanding of resources available to him. Patient has no problems with finances. He has excellent access to healthcare, but most often does not utilize the services to the extent that is expected.
Objective Data
Vital Signs including BMI: BP right arm sitting 140/92; T: 99 po; P:80 and regular; R 18, non-labored; Wt: 200#; Ht: 71”
Physical Assessment Findings: Lymph Nodes: None; Lungs: Clear; Heart: RRR with Grade II/VI systolic murmur heard best at the right sternal border; Carotids: No bruits; Abdomen: Android obesity, non-tender; Rectum: Stool light brown, heme positive. Prostate enlarged, boggy and tender to palpation.; Genital/Pelvic: Circumcised, no penial lesions, masses, or discharge. Testes are descended bilaterally, no tenderness or masses; Extremities, Including Pulses: 2+ pulse throughout, no edema in the lower legs; Neurologic: Not examined.
Lab Tests and Results: PSA: 6.0; CBC: WNL; Chem panel: WNL; Radiological Studies: None; EKG: None
Client’s Support System: His support systems include his wife and friends from work who provide him with the required emotional support. There is no family dysfunction.
Client’s Locus of Control and Readiness to Learn: He believes that he is generally healthy. The patient is not sure what is going on but thinks he may have cancer. He is ready to learn about his illness.
ICD-10 Diagnoses/Client Problems
Disorder of white blood cells, unspecified D72.9
Exposure to tobacco smoke Z58.7
Bipolar affective disorder, current episode mild or moderate depression F31.3
Acute pharyngitis J02
Other specified fever (with chills) R50.8
Dyspnoea (shortness of breath) R06.0
Advanced Practice Nursing Intervention Plan (including interdisciplinary collaboration, community resources, and follow-up plans):
- Prostatitis is typically identified by examining a urine sample and undertaking an inspection of the prostate gland by a medical expert. This checkup comprises a rectal inspection to palpate the prostate gland and feel for aberrations of the gland.
- Rarely, a sample of the prostatic fluid may also be gathered and verified by the doctor. From time to time, a prostate kneading is done to compare the examples of the prostatic fluid both beforehand and afterward this intercession has been done. To complete this process, the medical worker will massage the prostate gland throughout the rectal check.
- For the reason that there is the worry that this technique can release microbes into the blood, this examination is not recommended in cases of acute microbial prostatitis (Nettina, 2013).
- Extra tests that may be attained comprise an ample blood count, an electrolyte pane, blood cultures, a gauze of urethral expulsion if existing, and occasionally a prostate-specific antigen level.
- The prostate-specific antigen examination, which is used as a showing test for the prostate tumor, may similarly be performed in the case of prostatitis.
- Additional tests that may as well be attained, embracing the urodynamic examination in order to find out how well the patient discharges his bladder and if prostatitis is distressing his aptitude to urinate).
- The medic can also draw his attention to the computed tomography (CT) imaging, cystoscopy, and prostate surgery.
- The treatment may be performed longer if the patient is going through recurring incidents. The nature of antibiotic is subject to the microorganisms causing the patient’s prostatitis. The alpha-blockers may be prescribed by the medical worker in order to ease the symptoms. These medications lessen urinary distress and relax bladder muscles.
- Painkillers such as acetaminophen and ibuprofen may benefit in getting rid of the distress, too. Other ways to deal with prostatitis such as high-temperature treatment by means of a microwave device and medications extracted from plants are also being appraised.
- The other ways that would help the patient lessen his discomfort include the evasion of bicycling, regulating the bike seat and putting on padded clothing to reduce the pressure on the prostate.
- One more option would be not to consume any alcohol, caffeine, and food that is peppery and sour. Sitting on a soft cushion or taking warm baths would also be of great assistance to the patient.
- Screen for Depression using the 9-Question Patient Health Questionnaire-Depression Screener.
- Follow up the acute bacteria prostatitis with antibiotics throughout the period of four to six weeks. Examples of this kind of medicine take in terazosin, doxazosin, and tamsulosin.
Conclusion
Prostatitis is a dangerous disease which should be treated immediately in order not to provoke any complications. Upon entering the hospital, the patient was not aware of all the risks he was exposed to. It is worth noting that despite his overall knowledge, study level, and the resources available to him, the patient is not health literate enough. Insufficient communication, in this case, can lead to divergences and an incapability to cooperate. The patient should be treated with the prescribed medications, and the nurse should teach him the basic medical knowledge.
For the reason that nurses are incessantly and evidently present at the patient’s side, nurses are in the exceptional situation to offer the necessary control of patient tutoring and to get the most out of the strong points of respective disciplines for the patient’s eventual advantage. The inspection of the prostate gland and the examination of the urine sample would eventually help in making the diagnosis and prescribing proper medication.
In order to do this, the nurse requires a correct understanding of the skill of each participant of the crew, because skillful teams regularly allude to definite characteristics that let them work well organized. The patient shows an exceptional willingness to learn, as now he understands the dangers and consequences of prostatitis and has got the essential knowledge that every patient should know. The essential nursing skill, in this case, is the wish to work as a crew and acknowledgment of a shared goal.
References
Nettina, S. (2013). The Lippincott Manual of Nursing Practice. Philadelphia: Lippincott Williams & Wilkins.
Schlossberg, D. (2015). Clinical Infectious Disease. Cambridge: Cambridge University Press.
Suki, W., & Massry, S. (2013). Therapy of Renal Diseases and Related Disorders. Berlin: Springer.
Taylor, R. B. (2003). Family Medicine: Principles and Practice (6th ed.). New York: Springer.