Health Asessment Chapters 20,26,27
vasomotor
'Vasomotor' refers to the 'vasomotor center,' the part of the brain that manages blood pressure. Hormonal changes lead to vasomotor symptoms in menopause
________ is displacement of the urinary meatus to the dorsal surface of the penis
Epispadias
Do you have difficulty attaining or maintaining an erection? Do you have any problem with ejaculation? Do you have pain with ejaculation?
Erectile dysfunction (ED) occurs frequently in adult males and may be attributed to various factors or disorders (e.g., alcohol use, diabetes, depression, antihypertensive medications). Pain with ejaculation may indicate epididymitis
do you have any itching in your public hair area?
Perineal itching is seen with crab lice (Pediculosis pubis)
What are some modifiable factors for penis cancer?
Phimosis, poor personal hygiene, sexual promiscutiy, using tobacco products, and a history of HPV are all modifiable risk factors for penile cancer
malignancy
a dangerous cancerous growth that sheds cells into body fluids and spreads to new locations to start new cancer colonies
Clay-colored stools result from
a lack of bile pigment
Any discharge that comes out of the urinary meatus during a check up should be _________.
cultured
A beaded or thickened cord indicates infection or _____
cysts
posthysterectomy
does not have a uterus
Gonorrhea has
drainage
_________ around piercings indicates infection.
drainage
Lifelong poverty and lower educational level are associated with ______menopause across the world
earlier
Infection of the epididymis. Client usually complains of sudden pain. Scrotum appears enlarged, reddened, and swollen; tender epididymis is palpated. Usually associated with prostatitis or bacterial infection.
epdidymitis
according to Prehn's sign, the physical lifting of the testicles relieves the pain of ______ but not pain caused by testicular torsion.
epididymitis
pain with ejaculation could be attributed to
epididymitis
The urethral meatus is located on the top of the glans (dorsal side); occurs rarely. This condition is a congenital defect.
epispadis
Lack of libido may arise
from psychogenic causes such as depression, endocrine dysfunction, or side effects of medications
Black stools may indicate
gastrointestinal bleeding or the use of iron supplements or Pepto-Bismol
Single or multiple, moist, fleshy papules. Painless. STI caused by the human papillomavirus.
genital warts
Pimple-like lesions from herpes are sometimes detected on the ______ of the penis
glans
What does estrogen increase
glycogen content in vaginal secretions
symptoms of inguinal hernia
groin discomfort, pain in abdominal area, bulging,pain
Vascular problems cause about ______the cases of impotence in men older than 50 years.
half
blood
hematocele
in the anus, Tenderness may indicate_______. Nodules may indicate polyps or cancer. Hardness may indicate scarring or cancer.
hemorrhoids, fistula, or fissure
Red blood in the stool is found with
hemorrhoids, polyps, cancer, or colitis
A bulge or mass may indicate a
hernia
Bulges that appear at the external inguinal ring or at the femoral canal when the client bears down may signal a
hernia
bowel
hernia
scrotal hernia
hernia near the scrotum
What could pain in the penis, scrotum, testes, or groins indicate?
hernia, epididymis inflammation, peyronie's disease, herpes simplex virus, prositis, STI's,
what is syphilitic chancre sometimes misdiagnosed as?
herpes
A 68-year-old man comes to the clinic reporting that he is having difficulty obtaining an erection. When reviewing the patient's history what might the nurse note that contributes to impotence?
history of hypertension
HRT
hormone replacement therapy (estrogen and progesterone)
.Bowel sounds will not be heard over a__________ .
hydrocele
A cyst suggests________ of the spermatic cord.
hydrocele
If the mass remains, place your fingers above the scrotal mass. If you can get your fingers above the mass, suspect _______
hydrocele
water
hydrocele
Enlargement of the scrotum may indicate
hydrocele, hematocele, hernia, or cancer.
Urethral meatus is located underneath the glans (ventral side). This condition is a congenital defect. A groove extends from the meatus to the normal location of the urethral meatus. A ventral view (A) shows the urethra opening on the underside of the penis. In this photo of a baby with hypospadias (B), the urethral opening is on the scrotum.
hypospadias
When the urinary meatus is displaced in a male on the ventral side of the penis, it is known as
hypospadias.
An enlarged scrotal sac may result from fluid
hyrdocele
impotence
inability to achieve an erection
If you cannot push the mass into the abdomen, suspect an_____ ________.
incarcerated hernia.
Palpate for urethral discharge. Gently squeeze the glans between your_____ finger and ______
index, thumb
What does a positive prehn's test mean?
indicates there is pain relief with lifting the affected testicle, which points towards epididymitis
Lumps, swelling, or masses found in the scrotum, genital, or groin area may indicate
infection, hernia, or cancer
urethritis
inflamed urethra
colitis
inflammation of the colon
epididymitis
inflammation of the epididymis that is frequently caused by the spread of infection from the urethra or the bladder
palpate any abonormalties with the shaft of the penis. what can tenderness indicate? also note any hardened areas of the penis.
inflammation or infection
Enlarged or tender lymph nodes may indicate an _______process or ________ of the penis or scrotum.
inflammatory, infection
orchitis
is an inflammation of one or both testicles. It is usually caused by a bacterial infection or by the mumps virus.
What are some older patient considerations to remember with the scrotum?
it enlarges with age
A foreskin that is left in a retracted position leads to venous congestion and edema of the foreskin.
paraphimosis
A foreskin that, once retracted, cannot be returned to cover the glans is called
paraphimosis
Older Adult Considerations Testes may be smaller and feel_______to palpation in older men.
softer
Never use your fingertip—this causes the ______ to tighten and, if forced into the rectum, may cause pain.
sphincter
Poor sphincter tone may be the result of a _____ _______injury, previous surgery, trauma, or a _____ rectum.
spinal cord, prolapsed
what is normal sphincter function when palpating the anus
spincter is loose enough for examination finger to enter
What is abnormal spincter function when palpating the anus
spincter tightens
what are some positions for a male rectal examination
standing or left lateral
Yellow stool suggests increased fat content or
steatorrhea
yellow stool suggests ________ (increased fat content)
steatorrhea
Even in the presence of a hernia, absolute symmetry to inspection may be preserved. The actions of _______ and increasing intra-abdominal pressure cause the hernia to protrude. Hernias will not necessarily be present on CT scans unless this maneuvre is undertaken.
straining
erythema
superficial reddening of the skin, usually in patches, as a result of injury or irritation causing dilatation of the blood capillaries
prostatectomy
surgical procedure for the partial or complete removal of the prostate. It may be performed to treat prostate cancer or BPH
what is prostitis
swelling of the walnut-sized gland (prostate) that produces seminal fluid and narrows the urethra
A thrombosed external hemorrhoid appears ______. It is itchy, painful, and bleeds when the client passes stool.
swollen
hemmorrhoid
swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding
Chancres (red, oval ulcerations) from syphilis and genital warts are sometimes detected under the foreskin. what is this an indication of?
syphilitic chancre
Initially a small, silvery-white papule that develops a red, oval ulceration. Painless. A sign of primary syphilis (a sexually transmitted infection [STI]) that spontaneously regresses. May be misdiagnosed as herpes.
syphilitic chancre
If the client complains of extreme_______ or _______ do not try to push the mass up into the abdomen.
tenderness, nausea
if a prehn's test shows to be negative, what is going on and what must happen?
testicular torsion which is a surgical emergency and must be relieved within 6 hours
Menarche
the first occurrence of menstruation
what are normal findings of the scrotal skin?
thin and rugated, (crinkled) with little hair dispersion. Its color is slightly darker than that of the penis.sebaceous cysts (small, yellowish, firm, nontender, benign nodules) are a normal finding
tenderness and swelling of the scrotal contenets may also indicate_______ of the spermatic cord, ________, or
torsion, epididymis, or strangulation of a hernia
If an abnomal mass was found in the scrotal contents, then what should we do to that scrotum?
transilluminate
Clients from some cultures (e.g., Islam) may insist on having a female nurse for both the nursing history and physical assessment of the female genitalia, anus, and rectum. true/false
true
The normal pubic hair pattern in adults is hair covering the entire groin area, extending to the medial thighs and up the abdomen toward the umbilicus. true/false
true
Palpate the scrotal contents. Palpate each testis and epididymis between your thumb and first_____fingers (Fig. 26-11). Note size, shape, consistency, nodules, masses, and tenderness.
two
The prostate can be palpated on the anterior surface of the rectum by turning the hand fully counterclockwise so that the pad of the index finger faces toward the client's
umbilicus
hypo
under, beneath, below, (ventral)
idiopathic
unknown cause
Black stool may indicate
upper gastrointestinal bleeding
lastly, after auscultating the abnormal scrotal for bowel sounds, try to push it ________ into the abdomen. If the bulge disappears no scrotal hernia is present, but the mass may result from something else.
upward
causes of bph
urinary problems
turia
urine
Prostitis treatment
usually heals itself, but antibiotics may be prescribed
A _______ is an enlargement of the veins within the scrotum, which may cause low sperm production and decreased sperm quality, which can cause infertility.
varicocele
Palpable, tortuous veins of the spermatic cord, epididymis, and vas deferens up to the inguinal ring suggest what?
varicocele
hydro
water
testicular torsion
when the smermatic cord that is attached to the testis is twisted so many times that blood flow is not longer flowing and is often strangulated causes strong onset of pain
A clear or_____ discharge is usually associated with urethritis
white
A ______ discharge is usually associated with gonorrhea
yellow
does age cause an increase in erectile dysfunction
yes
if the scrotum is abnormal will it transilluminate?
yes but only the serous fluids will light up with a red glow, but swellings or masses that are solid or filled with blood, tumors, hernias, or varioceles, will not light up with a red glow
testicular torsion symptoms
severe local pain, nausea and vomiting
If pubertal mutilation has occurred, actual discharge of urine and semen will occur at the location of the______opening.
shaft
If an examination of the upper rectum and sigmoid colon is necessary, a ________ should be performed.
sigmoidoscopy
Palpate the scrotal contents. Palpate each testis and epididymis between your thumb and first_____fingers (Fig. 26-11). Note:
size, shape, consistency, nodules, masses, and tenderness
The foreskin retracts easily. A small amount of whitish material, called_______ , normally accumulates under the foreskin
smegma
The testis should feel
smooth, firm, rubbery, mobile, free of nodules, and rather tender to palpation
An enlarged scrotal sac may result from fluid
(hydrocele), blood (hematocele), bowel (hernia), or tumor (cancer).
In the United States, ages of menarche range from
10.5 to 15.5 years of age
Menarche occurs at about ____ body fat, and____body fat is needed to maintain menstruation.
17, 22
A normal menstrual cycle usually occurs approximately every_____ days.
18-45
A male factor is solely responsible in about_____ of infertile couples
20%
The average length of menstrual blood flow is______days.
3-7
If tension is maintained on the gluteal folds for____ seconds, the anus will dilate normally.
60
About _____ of menopausal women experience hot flashes and night sweats.
60%
What is your usual bowel pattern? Have you noticed any recent change in the pattern? Any pain while passing a bowel movement?
A change in bowel pattern is one of the warning signs of cancer, more evaluation, laboratory tests, and colonoscopy should be done
rectal prolapse
A condition that occurs when part of the large intestine slips outside the anus.
hydrocele
A fluid-filled sac around a testicle, swelling of the scrotum
Do you have or have you had any trouble with fertility?
A male factor is solely responsible in about 20% of infertile couples and contributory in another 30% to 40%
gonorrhea
A sexually transmitted bacterial infection that, if untreated, may cause infertility, spreads by sexual contact
Do you have a heavy, dragging feeling in your scrotum?
A testicular tumor or scrotal hernia
what are abnormal findings of the foreskin
A tight foreskin that cannot be retracted is called phimosis. A foreskin that, once retracted, cannot be returned to cover the glans is called paraphimosis. Chancres (red, oval ulcerations) from syphilis and genital warts are sometimes detected under the foreskin
what are abnormal urethral discharge findings
A yellow discharge is usually associated with gonorrhea. A clear or white discharge is usually associated with urethritis. Any discharge should be cultured
prostatic enlargement
Age-associated prostate gland enlargement that can cause urination difficulty, often called (BPH) benign-prostatic hyperplasia
glycogen
An extensively branched glucose storage polysaccharide found in the liver and muscle of animals; the animal equivalent of starch.
Inspect the size, shape, and position of the scrotum.
Ask the client to hold his penis out of the way. Observe for swelling, lumps, or bulges.
A rubbery or boggy glandular consistency may indicate ___ a common finding in men older than 60 years of age. The gland may feel soft, tender, and boggy from infection.
BPH
Failure of one or both testicles to descend into scrotum. Scrotum appears undeveloped and testis cannot be palpated. Causes increased risk of testicular cancer.
CRYPTORCHIDISM
testicular tumor
Cancer in the male organs that make male hormones and sperm (testicles
what might redness, lesions, or abnormal shape of the glans of the penis indicate?
Chancres (red, oval ulcerations) from syphilis, genital warts, and pimple-like lesions from herpes are sometimes detected on the glans.
Have you noticed any change in the color, odor, or amount of your urine?
Changes in urine color or odor may indicate an infection. Blood in the urine (hematuria) should be referred for medical investigation because this may indicate infection, kidney stones, benign prostatic hypertrophy (BPH), or cancer. A decrease in amount of voided urine may indicate prostate enlargement or kidney problems.
Do you experience constipation?
Constipation may indicate a bowel obstruction, irritable bowel syndrome (IBS) or colon cancer, or the need for dietary counseling.
Do you experience diarrhea? Is the diarrhea associated with any nausea or vomiting?
Diarrhea may signal impaction, gastroenteritis, medication side effect, IBS, IBD, colitis, or indicate the need for dietary counseling.
Do you experience difficulty urinating (i.e., urgency, hesitancy, frequency, or difficulty starting or maintaining a stream)? How many times do you urinate during the night?
Difficulty urinating may indicate an infection or blockage, including prostatic enlargement.
Have you noticed any discharge from your penis? If so, how much? What color is it? What type of odor does it have?
Discharge may indicate an infection
Do you have trouble controlling your bowels?
Fecal incontinence occurs with neurologic disorders and some gastrointestinal infections.
excoriation
Frequent picking can irritate existing sores and even cause new ones to form. This can cause additional scabbing and lead to scarring. This continued picking can develop into a condition called skin-picking disorder
Clusters of pimple-like, clear vesicles that erupt and become ulcers. Painful. Initial lesions of this STI—typically caused by HSV-1 or HSV-2—disappear, and the infection remains dormant for varying periods of time. Recurrences can be frequent or minimally episodic.
HERPES PROGENITALIS
Collection of serous fluid in the scrotum, outside the testes within the tunica vaginalis. Appears as swelling in the scrotum and is usually painless. Usually the examiner can get fingers above this mass during palpation. Will transilluminate (if there is blood in the scrotum, it will not transilluminate and is called a "hematocele").
HYDROCELE
What other symptoms do you experience before or during your period (cramps, bloating, moodiness, breast tenderness)?
Headache, weight gain, mood swings, abdominal cramping, and bloating are common complaints before or during the menstrual period. Some women experience premenstrual syndrome (PMS), in which the symptoms become severe enough to impair the woman's ability to function.
what are some symptoms in vasomotor instability?
Hormonal changes associated with menopause cause several symptoms. Hot flashes, flushing, and night sweats
Are you experiencing any symptoms of menopause
Hormone fluctuations impact vasomotor instability, resulting in symptoms. About 60% of menopausal women experience hot flashes and night sweats. Mood swings, irritability, decreased appetite, vaginal dryness, spotting, and irregular vaginal bleeding may also occur.
__________ is displacement of the urinary meatus to the ventral surface of the penis
Hypospadias
what are abnormal findings of the urinary meatus
Hypospadias is displacement of the urinary meatus to the ventral surface of the penis. Epispadias is displacement of the urinary meatus to the dorsal surface of the penis
Do you ever experience urinary incontinence or dribbling?
Incontinence may occur after prostatectomy. Dribbling may be a sign of overflow incontinence. Other causes of incontinence after prostatectomy are related to age, enlarged prostate or prior benign prostate surgery, diabetes or neurologic diseases, smoking, excessive blood loss during surgery, size or stage of prostate tumor, or radiation after surgery
Have you stopped menstruating or have your periods become irregular? Are you currently taking any contraceptives containing estrogen or progesterone? Do you have any spotting between periods? What symptoms have you experienced?
Irregularities or amenorrhea may be due to pregnancy, depression, ovarian tumors, ovarian cysts, autoimmune disease nutritional and hormonal imbalances, and medications. Cessation of menstruation that is not related to hormonal therapy is termed menopause (see next rationale).
what are we going to inspect the perineal area for?
Lesions Rashes Redness Fissures Thickening of the epithelium lumps ulcers
Have you noticed any lesions on your penis or genital area? If so, do the lesions itch, burn, or sting? Please describe the lesions.
Lesions may be a sign of a sexually transmitted infection (STI) or cancer
Do you have any lumps, swelling, or masses in your scrotum, genital, or groin area? Have you noticed a change in the size of the scrotum?
Lumps, swelling, or masses found in the scrotum, genital, or groin area may indicate infection, hernia, or cancer. Enlargement of the scrotum may indicate hydrocele, hematocele, hernia, or cancer.
_______tends to begin earlier in women living in developed countries and later in women who live in undeveloped countries.
Menarche
if valsalva maneuver is normal
No bulging or lesions appear.
Do you experience any pain or burning when you urinate?
Painful urination may be a sign of urinary tract infection (UTI), prostatitis, or an STI
What is the treatment for herpes?
No cure, antiviral drugs
ED erectile dysfunction
Occurs when a man can't get or keep an erection firm enough for sexual intercourse.
What are symptoms of peyronie's disease
Pain in the penis, a significantly curved erection, pain will interfere with sexual function
what are symptoms of herpes simplex virus
Pain, itching, and small sores appear first. They form ulcers and scabs. After initial infection, genital herpes lies dormant in the body. Symptoms can recur for years
If the client has epididymitis, passive elevation of the testes may relieve the scrotal pain_______.
Prehn sign
Are you on a hormone-replacement therapy (HRT) regimen? If so, what type, and dosage? Are you satisfied with HRT?
Progestin therapy is only needed if the woman is posthysterectomy. There are a few newer reports of the benefits of progesterone for women without a uterus, to balance various physiologic functions (Paoletti, 2010). Studies have shown that in women who use estrogen therapy (ET) alone, there does not seem to be any effect on the risk of colorectal cancer. The American Cancer Society (ACS) (2015) describes findings of studies of women who use estrogen-progestin combination therapy (EPT) and the relationship to colorectal cancer. There is a lower risk of getting colorectal cancer at all, but of those who do get colorectal cancer, the cancers were more advanced (more likely to have spread to lymph nodes or distant sites) than those in the women not taking hormones.
an older man complains that his penis is getting smaller and that his testis are bigger and after an examination you have confirmed that nothing is abnormal. what do you tell this man
Pubic hair may be gray and sparse in older adult clients. In addition, the penis becomes smaller and the testes hang lower in the scrotum in older adult clients
pediculosis publis
Pubic lice, commonly called crabs, are tiny insects found in your genital area. They are a different type of louse from head lice and body lice
what are abnormal findings of the scrotal skin
Rashes, lesions, and inflammation are abnormal findings
A loop of bowel protrudes into the scrotum to create what is known as an indirect inguinal hernia. Hernia appears as swelling in the scrotum. Palpable as a soft mass and fingers cannot get above the mass.
SCROTAL HERNIA
Small (less than 3.5 cm long), soft testes indicate atrophy. Atrophy may result from cirrhosis, hypopituitarism, estrogen administration, extended illness, or the disorder may occur after orchitis. Small (less than 2 cm long), firm testes may indicate Klinefelter syndrome.
SMALL TESTES
rashes, lesions, or lumps of the shaft of the penis may indicate?
STI or cancer
Lesions may indicate
STIs, cancer, or hemorrhoids.
What equiptment is needed for a male examination?
Stool Gown Disposable non-latex gloves Flashlight (for possible transillumination) Stethoscope (for possible auscultation) Water soluble lubricant Specimen card
what is the "normal" for stool.
Stool is normally semi-solid, brown, and free of blood
What are abnormal findings of the scrotum with masses in them that we have to transilluminate?
Swellings or masses that contain serous fluid—hydrocele, spermatocele—light up with a red glow. Swellings or masses that are solid or filled with blood—tumor, hernias, or varicocele—do not light up with a red glow.
hemmorrhoid
Swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding.
what are flu symptoms
Symptoms include fever, chills, muscle aches, cough, congestion, runny nose, headaches, and fatigue,
diabetic neuropathy
Symptoms include pain and numbness in the legs. In more severe cases, symptoms include issues with digestion, the bladder, and controlling heart rate
muscle strain
Symptoms include pain, swelling, muscle spasms, and limited ability to move the muscle.
Initially a small, firm, nontender nodule on the testis. As the tumor grows, the scrotum appears enlarged and the client complains of a heavy feeling. When palpated, the testis feels enlarged and smooth—tumor replaces testis. Will not transilluminate.
TESTICULAR TUMOR
What was the date of your last menstrual period? Do your menstrual cycles occur on a regular schedule? How long do they last? Describe the typical amount of blood flow you have with your periods. Any clotting?
The absence of menstruation, excessive bleeding, or a marked change in menstrual pattern indicates a need to collect more information.
How should we know if the mass inside the patient's scrotum is a strangulated hernia? (the blood supply to the pt's hernia will be cut off)
The client typically complains of extreme tenderness and nausea. If you suspect that the client has a strangulated hernia, refer the client immediately to the physician and prepare him for surgery
what are the normal findings of palpating the shaft of the penis
The penis in a nonerect state is usually soft, flaccid, and nontender
normal scrotal findings
The scrotum varies in size (according to temperature) and shape. The scrotal sac hangs below or at the level of the penis. The left side of the scrotal sac usually hangs lower than the right side.
diabetic neuopathy treatment
Treatment includes managing blood sugar and using medications to control symptoms
Have you started taking any new medications?
Urinating more than one time during the night may indicate prostate abnormalities. Excessive intake of fluids and some medications, such as diuretics, may also cause nocturia.
is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon
Valsalva maneuver
what is the treatment for variocele (scrotal vericose veins)
Varicoceles that cause no symptoms typically require no treatment. Cases in which symptoms occur can be repaired surgically.
Absence of a testis suggests _________ (an undescended testicle)
cryptorchidism
hematocele
a swelling caused by blood collecting in a body cavity
amenorrhea
absence of menstruation
Tenderness and swelling of the scrotum may indicate
acute orchitis
variocele
aka scrotum vericose veins, an enlargement of veins within the scrotum
What can ED be attributed to?
alcohol use, diabetes, depression, antihypertensive medications
For a woman posthysterectomy, taking estrogen_____sometimes alleviates the symptoms of menopause.
alone
Tightened sphincter tone may indicate
anxiety, scarring, or inflammation
Thrombosed hemorrhoids
are typically external hemorrhoids that have no blood flow due to a blood clot in the vein
Chlamydia is
asymptomatic (no symptoms)
If after lying down and the scrotal mass still remains, precede to auscultate the scrotal for ______sounds.
auscultate
Darken the room and shine a light from the _____ of the scrotum through the mass. Look for a _____glow.
back, red
acute orchitis
bacterial inflammation of one or both testicles
gray or tan stool results from the lack of_____pigment
bile
hema
blood
epedidymitis symptoms
blood in semen, penile discharge, painful urination, testicle pain on one side, fever
we refer the patient for an endoscopic examination of the colon if they have what ?
blood in their stool
Constipation may indicate
bowel obstruction, irritable bowel syndrome (IBS) or colon cancer
However, estrogen has been linked to some types of cancer examaples? _________ and it increases the glycogen content in vaginal secretions, predisposing clients to yeast infections.
breast, endometrial
Inspect for inguinal and femoral hernia. Inspect the inguinal and femoral areas for ________. Ask the client to turn head and cough or to bear down as if having a bowel movement, and continue to inspect the areas
bulges
Hemorrhoids or an anal fissure may also be seen in
bulges of red mucous membrane
inguinal hernia
bulging of an organ or tissue through an abnormal opening
what does an increase of glycogen in the vaginal area do
can cause yeast infections
Painless nodules in the scotum may indicate __________.
cancer
tumor
cancer
Appears as hardened nodule or ulcer on the glans. Painless. Occurs primarily in uncircumcised men.
cancer of the glans penis
endometrial cancer
cancerous tumor forms in lining of uterus
Syphilis has a
chancre (painless ulcer)
Absence or scarcity of pubic hair may be seen in clients receiving ___________.
chemotherapy
Document any abnormalities by noting position in relation to a face of a _______.
clock
Pubic hair is ______ than scalp hair.
coarser
fever, chills, and malaise. Has frequent burning, painful dribbling urination with hesitancy that began last night. Has constant lower back pain (9 on scale of 10) that goes to bottom of buttocks and around the front of his hips since last night. Received some relief with Aleve. Also reports pain with defecation and painful ejaculation with intercourse.
just some common problems
Have you recently had a change in your pattern of sexual activity or sexual desire?
libido, needs to be further investigated
If during inspection and palpation of the scrotal contents, you palpated a scrotal mass, ask the client to ____ down
lie
Inspect the scrotal skin. Observe color, integrity, and lesions or rashes. To perform an accurate inspection, you must spread out the scrotal folds (rugae) of skin (Fig. 26-9). ______ the scrotal sac to inspect the posterior skin.
lift
how can a variocele cause infertility
lower sperm production and decrese sperm quality
Refer the client for further evaluation. A mass on or around the scrotum should be considered ______until testing proves otherwise.
malignant
prehn's sign
medical diagnostic indicator that was once believed to help determine whether the presenting testicular pain is caused by acute epididymitis or from testicular torsion.[2] Although elevation of the scrotum when differentiating epididymitis from testicular torsion is of clinical value, Prehn's sign has been shown to be inferior to Doppler ultrasound to rule out testicular torsion.
what are antihypertensive medications
medications that lower blood pressure by different means
Cessation of menstruation that is not related to hormonal therapy is termed
menopause
The absence of ____________ indicates a need to collect more information.
menstruation, excessive bleeding, or a marked change in menstrual pattern
more symptoms of menopause
mood swings, irritability, decreased appetite, vaginal dryness, spotting, and irregular vaginal bleeding may also occur
when you think "orchitis"
mumps
if the scrotum is normal, will in transilluminate?
no
does syphilitic chancre hurt?
no it is painless
what does a negative prehn's sign indicate?
no pain relief with lifting the affected testicle
Palpate each spermatic cord and vas deferens from the epididymis to the inguinal ring. The spermatic cord will lie between your thumb and finger (Fig. 26-12). What should the nurse note?
nodules, swelling, or tenderness
Age is ____ a modifiable risk factor for penile cancer.
not
The scrotal sac appears to droop more in______ men.
older
epi
on, upon, beside
Inflammation of the testes, associated frequently with mumps. Client complains of pain, heaviness, and fever. Scrotum appears enlarged and reddened. Swollen, tender testis is palpated. The examiner may have difficulty differentiating between testis and epididymis.
orchitis
Testes are ________ approximately 3.5 to 5 cm long, 2.5 cm wide, and 2.5 cm deep, and equal bilaterally in size and shape. They are smooth, firm, rubbery, mobile, free of nodules, and rather tender to pressure.
ovoid
Do not apply too much pressure to the testes because this will cause _____.
pain
If severe ______ prevents your entrance to the anus, do not force the examination.
pain
What are symptoms of prostitis
pain in groin, pelvic area, or pain in genitals, sometimes flu-like
If the client is not circumcised, ask him to retract his foreskin (if the client is unable to do so, the nurse may retract it) to allow observation of the glans. This may be _________.
painful
Lice or nit (eggs) infestation at the base of the penis or pubic hair is known as __________. This is commonly referred to as "crabs."
pediculosis pedis
nocturia
peeing at night
Pubertal rites in some cultures include (among many genital mutilations) slitting the penile shaft _________, leaving an opening that may extend the entire length of the shaft
penile subincision
Peyronie's disease
penis that has a fibrous plaque on corpus, restricts symmetrical erection, acts like a tether causing curvature
A painful mass that is hardened and reddened suggests a____________. A swollen skin tag on the anal margin may indicate a_________ in the anal canal. Redness and excoriation may be from scratching an area infected by ____________A small opening in the skin that surrounds the anal opening may be an _________
perianal abscess, fissure, fungi or pinworms, anorectal fistula
During the________period, hormone levels may fluctuate, resulting in menstrual irregularities. Periods may be heavier or may become scant.
perimenopausal
a rectal shelf may indicate a cancerous lesion or_______ . Tenderness may indicate peritoneal inflammation.
peritoneal metastasis
A tight foreskin that cannot be retracted is called
phimosis
the foreskin cannot be retracted over the penis tip.
phimosis
Herpes is associated with clusters of
pimple-like clear vesicles
nodules typically mean
polyps or cancer
Irregularities or amenorrhea may be due to
pregnancy, depression, ovarian tumors, ovarian cysts, autoimmune disease nutritional and hormonal imbalances, and medications.
Some women experience ______, in which the symptoms become severe enough to impair the woman's ability to function.
premenstrual syndrome (PMS)
PSA blood test to detect
prostate cancer
BPH benign prostatic hypertrophy
prostate gland ennlargement
Difficulty urinating may indicate an infection or blockage, including
prostatic enlargement
Palpating the prostate gland prior to drawing a prostate-specific antigen (PSA) will likely raise the_______ level.
psa
Bulges of red mucous membrane may indicate a_______ prolapse
rectal
A peritoneal protrusion into the rectum, called a
rectal shelf
Blood detected in the stool may indicate cancer of the ________Refer the client for an endoscopic examination of the colon.
rectum or colon
occult blood
refers to blood in the feces that is not visibly apparent (unlike other types of blood in stool such as melena or hematochezia) "hidden blood"
Sacrococcygeal
refers to private parts area i think *ask instructer*
Inflammation of the penis and scrotum may be seen in ______syndrome, an idiopathic inflammatory disorder affecting the skin, joints, and mucous membranes.
reiter
The skin of the scrotal sac in older men has fewer ______
rugae
scrotal folds
rugae
in the anus, Tenderness may indicate_______. Nodules may indicate polyps or cancer. Hardness may indicate ____?
scarring or cancer.
what might discoloration of the foreskin of the penis indicate?
scarring or infection
If bowel sounds are auscultated over the scrotal mass, then we should assume that it is a ______?
scrotal hernia
When should you see a doctor? (epididymis inflammation)
scrotal pain and swelling
hydrocele
scrotal swelling caused by a collection of fluid
