Ecologic Model A.

Hypothesis The host factors of the patient have a significant effect on the clients predisposition to develop BPH rather than the environmental factors. Benign enlargement of prostate is commonly occurring in men over 50 years old. It is a gradual enlargement of the prostate gland with the hypertrophy and hyperplasia of normal tissue. B. Predisposing Factors 1. Host male 73 years old diagnosed with Chronic Kidney Disease diagnosed of enlarged prostate family history of hypertension 2. Agent 3. Environment C. Ecologic Model WHEEL

enlarged prostate dx of CKD

73 y/o Hx of hpn

male

D. Analysis The wheel model is a form of ecologic model design ed to deemphasize the agent factor of the ecologic triad. Specifically, our problem focuses on the multiple factors that predispose the client to develop BPH which are mainly due to host factors based on the assessment.

The prostate is the genital organ most commonly affected by benign and malignant neoplasm. Benign enlargement of the prostate gland is an extremely common process that occurs in nearly all men with functioning testes. Hyperplasia is a general medical term referring to excess cell replication. Benign prostatic hyperplasia (BPH) is a noncancerous growth of the prostate gland. It is the most common noncancerous form of cell growth in men and usually begins with microscopic nodules in younger men. It should be noted that BPH is not a precancerous condition. Some studies have suggested that African American men are at higher risk and Asian men at lower risk for BPH than Caucasians, a 2000 study found no greater risk for African Americans and only a slightly lower risk for Asians. Histologic evidence of prostate enlargement begins about the third decade of life and increases proportionally with aging. Some evidence has reported a higher incidence of benign prostatic hyperplasia -- particularly fast-growing BPH -- in men with obesity, heart and circulatory diseases, and type 2 diabetes. Diabetes and hypertension, in any case, worsens urinary tract symptoms in men with BPH. The exact cause of BPH is unknown. Potential risk factors include age, family history, race, ethnicity, and hormonal factors.

E. Conclusion and Recommendation Symptoms of BPH may include: difficulty in starting to pass urine (hesitancy), a weak stream of urine, dribbling after urinating, the need to strain to pass urine, incomplete emptying of bladder, difficulty to control the urination urge, having to get up several times in the night to pass urine, feeling a burning sensation when passing urine. Sometimes a man is unaware of an obstruction until he suddenly cannot urinate at all. This condition is called acute urinary retention. It is a dangerous complication that can damage the kidneys and may require emergency surgery. In general, BPH progresses very slowly and acute urinary retention is very uncommon. Men with BPH at highest risk for this complication tend to be elderly and to have moderate to severe lower voiding symptoms. Taking anti- hypertensive drugs (except for diuretics) or antiarrhythmic drugs may also increase the risk.Diagnostic tests used to confirm Benign Prostatic Hyperplasia include Digital Rectal Exam, Urinalysis, Serum Creatinine, Postvoid Residual Urine, Ultrasound, Urethrocystoscopy.