Info

Medication or Drug Class

Dosage

Description

Rationale

Phenoxybenzamine Finasteride

10 mg PO bid 5 mg PO qd

Alpha-adrenergic blocker

5-alpha reductase inhibitor

Blocks effects of postganglionic synapses at the smooth muscle and exocrine glands; improvement of urinary flow in 75% of patients

Shrinks prostate gland and improves urine flow

Other Medications: Prazosin, alfuzosin, doxazosin

Independent

Patients with severe alterations in urinary elimination may require a catheter to assist with emptying the bladder. Never force a urinary catheter into the urethra. If there is resistance during insertion, stop the catheterization procedure and notify the physician. Monitor the patient for bleeding and discomfort during insertion. In addition, assess the patient for signs of shock from postobstruction diuresis after catheter insertion. Ensure adequate fluid balance. Encourage the patient to drink at least 2 L of fluid per day to prevent stasis and infection from a decreased intake. Encourage the patient to avoid the following medications, which may worsen the symptoms: anticholinergics, decongestants (over-the-counter and prescribed), tranquilizers, alcohol, and antidepressants.

Evaluate the patient's and partner's feelings about the risk for sexual dysfunction. Retrograde ejaculation or sterility may occur after surgery. Explain alternative sexual practices, and answer the patient's questions. Some patients would prefer to talk to a person of the same gender when discussing sexual matters. Provide supportive care of the patient and significant others, and make referrals for sexual counseling if appropriate.

126 Bladder Cancer

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