Page 1293 - Saunders Comprehensive Review For NCLEX-RN

2. Hard, pea-sized nodule or irregularities palpated on
rectal examination
3. Gross, painless hematuria
4. Late symptoms such as weight loss, urinary
obstruction, and bone pain radiating from the
lumbosacral area down the leg
5. The prostate-specific antigen level is elevated in
various noncancerous conditions; therefore, it should
not be used as a screening test without a digital rectal
examination. It is routinely used to monitor response
to therapy.
6. Diagnosis is made through biopsy of the prostate
gland.
C. Nonsurgical interventions
1. Prepare the client for hormone manipulation therapy
(androgen suppression therapy) as prescribed or
active surveillance with prostate-specific antigen
(PSA) and digital rectal examination (DRE).
2. Luteinizing hormone may be prescribed to slow the
rate of growth of the tumor.
3. Medication adverse effects include reduced libido, hot
flashes, breast tenderness, osteoporosis, loss of muscle
mass, and weight gain. The client should be informed
of these effects.
4. Pain medication, radiation therapy, corticosteroids,
and bisphosphonates may be prescribed for palliation
of advanced prostate cancer.
5. Prepare the client for external beam radiation or
brachytherapy, which may be prescribed alone or
with surgery, preoperatively or postoperatively, to
reduce the lesion and limit metastasis.
6. Prepare the client for the administration of
chemotherapy in cases of hormone treatment resistant
tumors.
D. Surgical interventions
1. Prepare the client for orchiectomy (palliative), if
prescribed, which will limit the production of
testosterone.
2. Prepare the client for prostatectomy, if prescribed.
3. The radical prostatectomy can be performed via a
retropubic, perineal, or suprapubic approach.
4. Cryosurgical ablation is a minimally invasive
procedure that may be an alternative to radical
prostatectomy; liquid nitrogen freezes the gland, and
the dead cells are absorbed by the body.

E. Transurethral resection of the prostate (TURP) may be

performed for palliation in prostate cancer clients.

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