Block 3 Final: Male Reproductive Disorders
A 32-year-old man scheduled for a unilateral orchiectomy for testicular cancer is admitted to the hospital the morning of surgery. He is accompanied by his wife but does not talk to her and does not initiate interaction with the nurse. The most appropriate action by the nurse is to 1. ask the patient if he has any questions or concerns about the diagnosis and treatment. 2. tell the patient's wife that concerns about sexual function are common with this diagnosis. 3. teach the patient that impotence is rarely a problem after unilateral orchiectomy. 4. document the patient's lack of communication on the chart and continue preoperative care.
Ask the patient if he has any questions or concerns about the diagnosis and treatment; The initial action by the nurse should be assessment for any anxiety or questions about the surgery or postoperative care. The nurse should address the patient, not the spouse, when discussing the diagnosis and any possible concerns. Without further assessment of patient concerns, it is inappropriate for the nurse to initiate teaching. It would be inappropriate for the nurse to provide patient teaching without further assessment of the patient's teaching needs and concerns. Documentation of the patient's lack of interaction is not an adequate nursing action in this situation.
After undergoing transurethral resection of the prostate to treat benign prostatic hyperplasia, a male client returns to the room with continuous bladder irrigation. On the first day after surgery, the client reports bladder pain. What should Nurse Anthony do first? 1. Increase the I.V. flow rate 2. Notify the physician immediately 3. Assess the irrigation catheter for patency and drainage 4. Administer meperidine (Demerol), 50 mg I.M., as prescribed
Assess the irrigation catheter for patency and drainage; Although postoperative pain is expected, the nurse should make sure that other factors, such as an obstructed irrigation catheter, aren't the cause of the pain. After assessing catheter patency, the nurse should administer an analgesic, such as meperidine, as prescribed. Increasing the I.V. flow rate may worsen the pain. Notifying the physician isn't necessary unless the pain is severe or unrelieved by the prescribed medication.
To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH), the nurse will ask the patient about 1. the presence of blood in the urine. 2. any erectile dysfunction (ED). 3. occurrence of a weak urinary stream. 4. lower back and hip pain.
Occurrence of a weak urinary stream; The American Urological Association (AUA) Symptom Index for a patient with BPH asks questions about the force and frequency of urination, nocturia, etc. Blood in the urine, ED, and back or hip pain are not typical symptoms with BPH.
The health care provider orders a blood test for prostate-specific antigen (PSA) when an enlarged prostate is palpated during a routine examination of a 56-year-old man. When the patient asks the nurse the purpose of the test, the nurse's response is based on the knowledge that 1. elevated levels of PSA are indicative of metastatic cancer of the prostate. 2. PSA testing is the "gold standard" for making a diagnosis of prostate cancer. 3. baseline PSA levels are necessary to determine whether treatment is effective. 4. PSA levels are usually elevated in patients with cancer of the prostate.
PSA levels are usually elevated in patients with cancer of the prostate; PSA levels are usually elevated above the normal in patients with prostate cancer. PSA testing does not determine whether metastasis has occurred. A biopsy of the prostate is needed for a definitive diagnosis of prostate cancer. Success of treatment is determined by a fall in PSA to an undetectable level; the patient's baseline PSA is not needed to determine the success of treatment.
Following a radical retropubic prostatectomy for prostate cancer, the patient is incontinent of urine. An appropriate nursing intervention for this patient is to teach the patient 1. pelvic floor muscle training. 2. the use of belladonna and opium suppositories. 3. how to perform intermittent self-catheterization. 4. to restrict oral fluid intake.
Pelvic floor muscle training; Pelvic floor muscle training (Kegel) exercises are recommended to strengthen the pelvic floor muscles and improve urinary control. Belladonna and opium suppositories are used to reduce bladder spasms after surgery. Intermittent self-catheterization may be taught before surgery if the patient has urinary retention, but it will not be useful in reducing incontinence after surgery. The patient should have a daily oral intake of 2 to 3 L.
A 55-year old client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, Nurse Gerry asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal? 1. Transurethral resection of the prostate (TURP) 2. Suprapubic prostatectomy 3. Retropubic prostatectomy 4. Transurethral laser incision of the prostate
Transurethral resection of the prostate (TURP); TURP is the most widely used procedure for prostate gland removal. Because it requires no incision, TURP is especially suitable for men with relatively minor prostatic enlargements and for those who are poor surgical risks. Suprapubic prostatectomy, retropubic prostatectomy, and transurethral laser incision of the prostate are less common procedures; they all require an incision.
When obtaining a focused health history for a patient with possible testicular cancer, the nurse will ask the patient about any history of 1. testicular torsion. 2. STD infection. 3. undescended testicles. 4. testicular trauma.
Undescended testicles; Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STD infection, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.
A patient scheduled for a transurethral resection of the prostate (TURP) for BPH tells the nurse that he has delayed having surgery because he is afraid it will affect his sexual function. When responding to his concern, the nurse explains that 1. with this type of surgery, erectile problems are rare, but retrograde ejaculation may occur. 2. information about penile implants used for ED is available if he is interested. 3. there are many methods of sexual expression that can be alternatives to sexual intercourse. 4. sterility will not be a problem after surgery because sperm production will not be affected.
With this type of surgery, erectile problems are rare, but retrograde ejaculation may occur; Erectile problems are rare, but retrograde ejaculation may occur after TURP. Erectile function is not usually affected by a TURP, so the patient will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the patient has not asked about fertility, reassurance about sperm production does not address his concerns.
