Assessment

Manifestations Analysis

Difficulty/pain in urination Due to uncontrolled tissue growth, the

-decreased size and force of the urinary cancer compresses urethra or the
stream bladder which causes dysuria

Urinary retention The cancer is large enough to encroach

Oliguria on the bladder neck

Hematuria blood in the urine and semen because

Blood in the semen they are accompanied by an
Painful ejaculation enlarged prostate. The
enlarged prostate can press on the
urethra, which can cause
bladder irritation.

Erectile dysfunction Due to the compression of the nerve

endings
It may also cause by the treatment
itself:
Radiation
Hormone therapy
Surgery

Metastasis
Bones  The cancer is already
 Hip or lower back pain metastasized to bones
 Spontaneous pathologic fractures

 Perineal and rectal discomfort  Due to compression of pudendal

nerve
 Anemia, weakness  Because the cancer already
spread to bones, it affects the
 production of RBC
 Weight loss  Treatment of cancer can cause
alteration of the patients sense of
taste, and can also affect the
patient’s appetite
 Nausea and vomiting  Because of buildup of stomach
acid or stomach contractions due
to loss of appetite (anorexia) and
empty stomach.

Nursing Diagnosis
1. Anxiety related to concern and lack of knowledge about diagnosis, treatment
plan, and prognosis.
Goal: Reduced stress and improved ability to cope
2. Urinary retention related to urethral obstruction secondary to prostatic
enlargement or tumor and loss of bladder tone due to prolonged
distention/retention.
Goal: Improved pattern or urinary elimination
3. Deficiency knowledge related to the diagnosis of cancer, urinary
difficulties, and treatment modalities.
Goal: Understanding of the diagnosis and ability to care for self
4. Imbalanced nutrition less than body requirements related to decreased oral
intake because of anorexia, nausea and vomiting caused by cancer or its
treatment.
Goal: maintain optimal nutritional status
5. Sexual dysfunction related to effects of therapy: chemotherapy, hormonal
therapy, radiation therapy, surgery.
Goal: Ability to resume/enjoy modified sexual functioning
6. Pain related to progression of disease and treatment modalities
Goal: Relief pain
7. Impaired physical mobility and activity intolerance related to tissue
hypoxia, malnutrition, and exhaustion and to spinal cord or nerve
compression from metastases.
Goal: Improved physical mobility
Nursing diagnosis Interventions
1. Anxiety related to concern and  Obtain health history to
 lack of knowledge about
diagnosis, treatment plan, and
prognosis.
2. Urinary retention related to
urethral obstruction secondary to
prostatic enlargement or tumor
and loss of bladder tone due to
prolonged distention/retention.
determine the following:
a. Patient’s concern
b. His level of understanding
of his health problems
c. His past experience with
cancer
d. Whether he knows his
diagnosis of malignancy
and its prognosis
e. His support system and
coping methods
 Provide education about
diagnosis and treatment plan
 Assess his psychological
reaction to his
diagnosis/prognosis and how his
has coped with past stresses
 Provide information about
institutional and community
resources for coping with
prostate cancer: social services,
support groups, community
agencies
 Determine patient’s usual pattern
of urinary function
 Assess for signs and symptoms
of urinary retention:
a. Amount and frequency of
urination
b. Suprapubic retention
c. Complaints of urgency
and discomfort
 Catheterize the patient to
determine amount of residual
urine
 Initiate measures to treat
retention.
a. Encourage assuming
normal position for

3. Deficient knowledge related to
the diagnosis of cancer, urinary
difficulties, and treatment
modalities.
voiding
b. Recommend using
Valsalva maneuver
preoperatively, if not
contraindicated
c. Administer prescribed
cholinergic agent
d. Monitor effects of
medication
 Consult with physician regarding
intermittent or indwelling
catheterization; assist with
procedure as required
 Monitor catheter function;
maintain sterility of closed
system; irrigate as required
 Prepare patient for surgery if
indicated
 Encourage communication with
the patient
 Review the anatomy of the
involved area
 Be specific in selecting
information that is relevant to
the patient’s particular treatment
plan
 Identify ways to reduce pressure
on the operative area after
prostatectomy:
a. Avoid prolonged sitting
(in chair, long automobile
rides), standing and
walking
b. Avoid straining, such as
during exercises, bowel
movement, lifting, and
sexual intercourse
 Familiarize patient with ways of
attaining/maintaining bladder

4. Imbalanced nutrition less than
body requirements related to
decreased oral intake because of
anorexia, nausea and vomiting
caused by cancer or its
treatment.
control
a. Encourage urination every
2 to 3 hours; discourage
voiding when supine
b. Avoid drinking cola and
caffeine beverages; urge a
cutoff time in the evening
for drinking fluids to
minimize frequent voiding
during the night
c. Describe perineal
exercises to be performed
every hour
d. Develop a schedule with
patient that will fit into his
routine
Demonstrate catheter care;
encourage his questions;
stress the importance of
position of urinary receptacle
 Assess the amount of food eaten
 Routinely weight the patient
 Elicit patient’s explanation of
why he is unable to eat more
 Cater to his individual food
preferences
 Recognize effect of medication
or radiation therapy on appetite
 Inform the patient that
alterations in taste can occur
 Use measures to control nausea
and vomiting
a. Administer prescribed
anti-emetics, around the
clock if necessary
b. Provide oral hygiene after
vomiting episodes
c. Provide rest period after
meals

5. Sexual dysfunction related to
effects of therapy:
chemotherapy, hormonal
therapy, radiation therapy,
surgery.
6. Pain related to progression of
disease and treatment modalities
7. Impaired physical mobility
and activity intolerance related
to tissue hypoxia, malnutrition,
and exhaustion and to spinal
 Provide frequent small meals
and a comfortable and pleasant
environment
 Assess the patient’s ability to
obtain and prepare food
 Determine from nursing history
what affect patient’s medical
condition is having on his sexual
functioning
 Inform patient of the effects of
prostate surgery, and its
treatments on sexual function
 Include his partner in developing
understanding and in discovering
alternative, satisfying close
relations with each other
 Evaluate the nature of patient’s
pain, its location and intensity
using pain rating scale
 Avoid activities that aggravate or
worsen pain
 Because pain is usually related
to bone metastasis, ensure that
patient’s bed has a bed board on
a firm mattress. Also protect the
patient from falls/injuries
 Provide support for affected
extremities
 Prepare patient for radiation
therapy if prescribed
 Administer analgesics or opioids
at regular scheduled intervals as
prescribed
 Initiate bowel program to
prevent constipation
 Asses the factors causing limited
mobility (eg, pain,
hypercalcemia, limited exercise
tolerance)
cord or nerve compression from  Provide pain relief by
metastasis. administering prescribed
medications
 Encourage the use of assistive
devices; cane, walker
 Involve significant others in
helping patient with range of
motion exercises, positioning
and walking
 Provide positive reinforcement
for achievement of small gains
 assess nutritional status