According to William et al. (2013), prostate cancer is the most common malignancy to be diagnosed in men, especially after the age of 65 years. In the early stages, the patient is usually asymptomatic. When the tumor metastasizes, the symptoms manifest as follows;
Hematuria.
Pelvic pain.
Anemia.
Renal failure.
Bone pain with the lumbosacral region being the most common site.
Bladder outlet obstruction-straining, hesitancy, frequency, urgency, and nocturia.
Weight loss.
Risk factors
There are no known causes of prostatic carcinoma. The disease is known to have a few risk factors. The greatest risk factor is increasing age (Dewit et al., 2016). Men over the age of 65 are more at risk. Secondly, men with close relatives such as their brother or father who have/had the malignancy are more predisposed to getting it (Dewit et al., 2016). Thirdly, black men have the highest risk (Dewit et al., 2016) in comparison with all other races, while Asian men have the lowest risk of getting cancer. Fourthly, obesity, and high levels of testosterone have been associated with a higher risk of getting a prostate malignancy. Fifthly, a diet containing high levels of red meat, eggs, dairy, and fat, has been noted to be a positive risk (Chung et al., 2019). Lastly, supplements in the diet that contain Vitamin E, if taken for a long period of time, put men at risk of getting prostate cancer.
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Complications and their pathophysiology
The patient has thrombocytopenia and is at risk of developing symptoms such as epistaxis, gingival bleeding, petechiae, and excessive bleeding from hemorrhages. The white blood cell count is also very much on the lower side at 500. Unfortunately, both thrombocytopenia and leukopenia increase the risk of developing infections and mortality in a patient and should be managed aggressively. Anemia can also occur as a complication and can lead to serious consequences such as impaired hearing, cardiac failure, and fatigue. All these complications are a result of bone marrow injury that occurred due to radiation, which impaired the production of platelets, erythrocytes, and leukocytes. Secondly, he is likely to develop pathological fractures (Khodabukus et al., 2015) at the lower vertebrae, the pelvis, or the femur. These fractures occur because of increased bone resorption and osteoblastic activity that occurs in metastatic disease. Thirdly, he might develop erectile dysfunction as a result of damage to nerves that help with erections during radiation therapy. Lastly, he is also in danger of developing spinal cord compression (Khodabukus et al., 2015) which can be as a result of a vertebrae collapse or pathological fracture or due to the spinal cord being compression by a tumor and is usually an oncological emergency
List three nursing problems and your goals for J.D.
Acute urinary retention and the bladder will need to be drained.
Sexual dysfunction and it would be prudent to address both the emotional aspect of this and treat the erectile dysfunction.
Anxious about the treatment, symptoms, and death. Thus, the main aim will be to allay his fears.
List three nursing interventions for each problem
To drain the bladder, he will need to be catheterized.
To address the sexual dysfunction, first, he needs to be given a chance to speak about all that is worrying him and, if possible, address all the concerns that he has. Then the patient should be referred for sexual counseling as well as to urologist who can help sort the erectile dysfunction with medications.
When he becomes anxious, it will be vital to allow him to do talk about all that is worrying him and address all his concerns and reassure him.
References
Chung, B. H., Horie, S., & Chiong, E. (2019). The incidence, mortality, and risk factors of prostate cancer in Asian men. Prostate InternationaL , 7 (1), 1-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424686/
Dewit, S. C., Stromberg, H., & Dallred, C. (2016). Medical-surgical nursing: Concepts & practice (3rd ed.). Elsevier Health Sciences.
Khodabukus, A. F., Debattista, M., Reynolds, J., Horton, P., Howarth, S., Humphries, B., & Smith, J. C. (2015). Guidelines for the prevention of pathological fractures in palliative care. Cheshire & Merseyside Palliative & End of Life Care Strategic Clinical Network Standards & Guidelines .
Williams, N. S., Bailey, H., Bulstrode, C. J., Love, R. J., & O'Connell, P. R. (2013). Bailey & love's short practice of surgery (26th ed.). CRC Press.
