Honan-Chapter 34: Nursing Management: Patients With Male Reproductive Disorders
A 60-year-old patient is complaining of difficulty sustaining his erections. The nurse is aware that he suffered a myocardial infarction approximately 3 months ago. What teaching is relevant to his concern? Select all that apply. A. If he increases his physical activity, his function will improve. B. Function may improve as his medications are adjusted. C. He should avoid the strain with sexual activity. D. Men with a heart attack in the preceding 6 months cannot use PDE medications. E. His complaint is purely psychological.
A. If he increases his physical activity, his function will improve. B. Function may improve as his medications are adjusted. D. Men with a heart attack in the preceding 6 months cannot use PDE medications. RATIONALE The fact that he had an MI is a clear indicator that CVD is contributing to his organic ED, and while his ED cannot be reversed, he may see improvement as his lifestyle adjusts to a new level of activity and he stabilizes on medications.
A 55-year-old man has been diagnosed with prostate cancer. On what factors do his treatment options depend? Select all that apply. A. Staging of the tumor B. Patient preference C. Patient diet D. Patient age E. Size of his prostate
A. Staging of the tumor B. Patient preference D. Patient age RATIONALE Treatment options for patients diagnosed with prostate cancer depend on the staging of the tumor, patient preference, and patient age. Diet and size of the prostate gland have no impact of the options for prostate cancer treatment.
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy? A. Using a reliable method of contraception for several weeks. B. Applying warm compresses to the scrotum for the first 24 hours C. Taking a prescribed opioid analgesic for pain relief D. Resuming sexual activity in 24 to 48 hours
A. Using a reliable method of contraception for several weeks. RATIONALE It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week.
A 50-year-old man is being treated presumptively for acute prostatitis. He asks the nurse why the course of antibiotics is so long. What is the nurse's best response? A. His infection is resistant to most antibiotics. B. Most antibiotics diffuse poorly from the plasma into the prostatic fluid. C. Most of the antibiotic is excreted in the urine, requiring a longer course. D. His liver is preventing the antibiotic from working effectively. E. Men of his age need a prolonged antibiotic course.
B. Most antibiotics diffuse poorly from the plasma into the prostatic fluid. RATIONALE Due to the nature of the prostate gland; antibiotics do not reach high concentrations without a longer course of treatment.
A client with erectile dysfunction who had a penile implant inserted has been taught how to identify malfunction of the device. Which of the following if stated by the client as indicative of malfunction would indicate to the nurse that the client has understood the teaching? A. Erosion of penile or urethral tissue B. Underinflation or bulging of the cylinders during inflation C. Erosion of scrotal, bowel, or bladder tissue D. Migration of the cylinders, pump, or reservoir from their intended location
B. Underinflation or bulging of the cylinders during inflation RATIONALE Malfunction of the device is characterized by the underinflation, bulging of the cylinders during inflation, and a loss of fluid from the implant. Erosion of penile or urethral tissue occurs due to a mis-sized implant, pressure, or friction of the implanted cylinders. Erosion of scrotal, bowel, or bladder tissue occurs if an implant with a fluid reservoir is used. Migration of the cylinders, pump, or reservoir from their intended location is accompanied by pain, tenderness, and dysfunction of components that are part of the device.
A 45-year-old man complains of a painless swelling in his scrotum. The nurse assesses the patient for which condition? A. Prostatitis B. Hydronephrosis C. Varicocele D. Priapism E. Hypospadias
C. Varicocele RATIONALE Only varicocele causes painless swelling to the scrotum.
A 58-year-old patient has had a prostatectomy. The nurse is preparing him for discharge. What information is important for the nurse to incorporate in the teaching plan? A. Do not interrupt the stream after starting to void. B. Increased activity is permitted. C. Limit fluid intake to prevent hypervolemia. D. Note that spicy foods, alcohol, and coffee may cause bladder discomfort. E. He should expect immediate return of his erectile function.
D. Note that spicy foods, alcohol, and coffee may cause bladder discomfort. RATIONALE The patient should be told that spicy foods, alcohol, and coffee may cause bladder discomfort. The patient teaching plan for discharge should include that the patient try to interrupt the urinary stream after starting to void, wait a few seconds, and then continue to void. The patient should avoid long motor trips and strenuous exercise, which increase the tendency to bleed. The patient needs to maintain fluid intake to avoid dehydration, which increases the tendency for a blood clot to form and obstruct the flow of urine. Erectile function can return slowly for as much as 30 to 36 months.
