chapter 34 male reproductive disorders prepu

A nurse is instructing a client in testicular self-examination. Which client statement indicates the need for additional teaching? > "I should do this exam at least once a week." > "A good place to do this is when I'm showering." > "It's normal for one testis to be larger than the other." > "My thumb goes on top and my index and middle fingers go under the testis."

"I should do this exam at least once a week." Testicular self-examination is performed monthly, preferably when warm, such as in the shower. The client should place his thumb on top and his middle and index fingers under the testis. It is normal for one testis to be larger than the other.

A patient on a surgery unit is received continuous bladder irrigation (CBI) to prevent clots in the hours following prostate surgery. Consequently, the nurse is carefully monitoring the patient's intake and output and documenting this hourly. Over the past hour, 3,000 mL of irrigant has infused and 3,150 mL of output has been drained from the patient's collection bag. How should the nurse document this patient's hourly urine output? > 150 mL > 3150 mL > 2850 mL > 75 mL

150 mL The amount of infused irrigant would be deducted from the total output, yielding a urine output of 150 mL.

A patient is 62 years old and weighs 176 pounds. Post prostatectomy, the nurse assesses hourly urine outputs. Select the measurement that would require notification of the health care provider. > 60 mL/hr > 1,680 mL in 24 hours > 25 mL/hr > 360 mL/8 hr shift

25 mL/hr When assessing urinary output, the nurse expects a minimum of 0.5 mL/kg/hr. Therefore, if the patient weighs 80 kg, 40 mL of urine is expected hourly. To calculate the actual urine output, the nurse must consider all irrigating fluids instilled against total urine collection bag drainage.

The nurse is teaching a client about erectile dysfunction medications. The nurse should include that sildenafil is taken how many minutes before intercourse to be effective? > 60 > 15 > 120 > 20

60 Sildenafil needs to be taken orally 30-60 minutes before intercourse. Stimulation is required to achieve an erection.

A middle-aged athlete was diagnosed with a hydrocele several months ago but now requires treatment because of the increasing size of the mass. The nurse who is working with this patient should anticipate what aspect of care? > Administering IV antibiotics > Assessing the patient's scrotal incision > Administering chemotherapy > Teaching the patient to use a leg collection bag for urine output

Assessing the patient's scrotal incision In the surgical treatment of hydrocele, an incision is made through the wall of the scrotum down to the distended tunica vaginalis. The sac is resected and is sutured together to collapse the wall. Chemotherapy, urinary catheterization, and IV antibiotics are not indicated in the treatment of a hydrocele.

A patient has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens? > Continuous inflow and outflow of irrigation solution > Intermittent inflow and continuous outflow of irrigation solution > Continuous inflow and intermittent outflow of irrigation solution > Intermittent flow of irrigation solution and prevention of hemorrhage

Continuous inflow and outflow of irrigation solution When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.

Which age-related change affects the reproductive system? > Increased prostate secretion > Decreased plasma testosterone levels > Testes become soft > Increased patency

Decreased plasma testosterone levels Changes in gonadal function include a decline in plasma testosterone levels and reduced production of progesterone. The testes become smaller and more firm.

A 61-year-old client's elevated prostate screening antigen (PSA) levels and abnormal digital rectal examination (DRE) results prompted thier care provider to refer them for treatment. The patient has subsequently been diagnosed with prostate cancer and is scheduled for surgery. The nurse should recognize that this patient's plan of nursing care should include interventions to address what potential long-term complication of prostate surgery? > Erectile dysfunction > Stress incontinence > Urge incontinence > Abdominal distention

Erectile dysfunction Each treatment for prostate cancer has some incidence of sexual function issues. Incontinence is a less common complication and abdominal distention is not normally associated with prostate surgery.

A client who comes to the clinic complaining of perineal pain, dysuria and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause? > Staphylococcus > Streptococcus > Escherichia coli > Paramyxovirus

Escherichia coli Prostatitis is an inflammation of the prostate gland and is most often caused by microorganisms that reach the prostate by way of the urethra. Escherichia coli and microbes that cause sexually transmitted infections often are responsible. Staphylococcus and streptococcus are not typically a cause of prostatitis. Paramyxovirus is the cause of mumps.

A 48-year-old client recently diagnosed with benign prostatic hyperplasia (BPH) reports consuming serenoa repens (saw palmetto berry). The nurse needs to intervene if the physician orders which treatment? > Terazosin > Finasteride > Sipuleucel-T > Ketoconazole

Finasteride Serenoa repens (saw palmetto berry) should not be used with finasteride. Terazosin is an alpha-adrenergic blocker and can be taken with Serenoa repens. Sipuleucel-T is a therapeutic cancer vaccine. Ketoconazole is an adrenal-ablating drug used to inhibit cytochrome P450 enzymes.

The diagnosis of prostate cancer is confirmed by which of the following? > Histologic exam of tissue > Computed tomography > Bone scan > Magnetic resonance imaging

Histologic exam of tissue The diagnosis of prostate cancer is confirmed by a histologic examination of tissue. Other tests that may be used to establish the extent of the disease include bone scans to detect metastases to the bones, and computed tomography scan to identify metastases in the pelvic lymph nodes.

When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint? > Dark brown urine > Increased effort to void > Narrowing of urinary stream > Nocturia

Increased effort to void The symptoms of BPH appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs.

A patient is recovering in the PACU following a transurethral resection of the prostate (TURP). The patient is receiving continuous bladder irrigation (CBI), and the nurse has observed several clots in the collection bag and tubing. In the last few minutes, output has ceased despite the continued infusion of normal saline through the patient's triple-lumen urinary catheter. How should the nurse respond to this assessment finding? > Slow the rate of CBI to half of the previous rate. > Reposition the patient to a semi-Fowler's position. > Manually irrigate the patient's catheter with normal saline. > Remove the triple-lumen catheter and replace it with a double-lumen catheter.

Manually irrigate the patient's catheter with normal saline The nurse monitors the CBI drainage tubing and irrigates the system as prescribed to relieve any obstruction that may cause discomfort. Usually, if clots impede urinary drainage, the catheter is irrigated with 50 to 60 mL of irrigating fluid at a time. It would be inappropriate to remove the catheter, and it would be ineffective to slow the infusion or reposition the patient.

The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique? > Palpate both testicles simultaneously for comparison. > Palpate each testicle separately, following a warm shower. > Palpate the front of the testicle first, where most tumors are found. > Palpate for a soft, round shape with normal ridges on the testicles.

Palpate each testicle separately, following a warm shower. It is best to examine and palpate each testicle following a warm shower, when the testes are relaxed and not retracted. Because one testicle is normally larger and hangs lower, comparing the two sides is not indicated. Both testes should be oval in shape, smooth, and firm without masses or tenderness. Most tumors are located on the lateral aspect of the testicles.

Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)? > Saw palmetto > Garlic > Ginkgo > Green tea

Saw palmetto Saw palmetto is an herbal product used to treat symptoms associated with BPH.

Students preparing for a test are reviewing the structure and function of the reproductive system. They demonstrate understanding of the material when they identify which of the following as the site of spermatogenesis? > Vas deferens > Testes > Prostate gland > Seminal vesicles

Testes The testes are responsible for producing sperm (spermatogenesis). The vas deferens are the tubes that carry the sperm from the testicles and epididymis to the seminal vesicles, which acts as the reservoir for testicular secretions. The prostate gland produces a secretion that is chemically and physiologically suitable to the needs of the sperm in their passage from the testes.

Which of the following is the only definitive way to diagnose testicular cancer? > Tissue biopsy > Computed tomography of abdomen > Ultrasound > Lactate dehydrogenase levels

Tissue biopsy Tissue biopsy is the only definitive way to determine whether cancer is present, and is performed at the time of surgery rather than as a part of the diagnostic workup, to reduce the risk of promoting spread of cancer. A computed tomography scan of the abdomen and pelvis is performed to determine the extent of the disease in the retroperitoneum and pelvis. Lactate dehydrogenase levels and ultrasound examination to determine the presence and size of the testicular mass may also be done.

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? > Erosion of penile or urethral tissue > Underinflation or bulging of the cylinders during inflation > Erosion of scrotal, bowel, or bladder tissue > Migration of the cylinders, pump, or reservoir from their intended location

Underinflation or bulging of the cylinders during inflation 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 client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate? > Tell the client to try to urinate around the catheter to remove blood clots. > Restrict fluids to prevent the client's bladder from becoming distended. > Prepare to remove the catheter. > Use sterile technique when irrigating the catheter.

Use sterile technique when irrigating the catheter. If the catheter is blocked by blood clots, it may be irrigated according to physician's orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection. Urinating around the catheter can cause painful bladder spasms. The nurse should encourage the client to drink fluids to dilute the urine and maintain urine output. The catheter remains in place for 2 to 4 days after surgery and is removed only with a physician's order.

A client has an edematous glans penis, pain, and an extremely constricted foreskin. What treatment would the physician likely prescribe? > circumcision > narcotic analgesics > increased hygienic measures > scrotal support

circumcision Circumcision is recommended to relieve phimosis and paraphimosis permanently.

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include: > continuous inflow and outflow of irrigation solution. > intermittent inflow and continuous outflow of irrigation solution. > continuous inflow and intermittent outflow of irrigation solution. > intermittent flow of irrigation solution and prevention of hemorrhage.

continuous inflow and outflow of irrigation solution. When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.

The nurse knows that a client being screened for prostate cancer needs further instruction when he makes which statement? > "I understand blood in the urine is the first symptom of prostate cancer." > "I'm concerned that I may have prostate cancer because I have difficulty urinating." > "This back pain I have had for approximately 6 months could be a symptom of prostate cancer." > "It worries me that I continue to experience urinary dribbling."

"I understand blood in the urine is the first symptom of prostate cancer." While blood in the urine can be a sign of prostate cancer, it does not occur frequently with this disease. More common symptoms include difficulty urinating, urinary retention, urinary dribbling, back pain, and urinary/bladder inflammation.

Medical management of BPH includes pharmacologic therapy. Which of the following medications would the nurse expect the health care provider to prescribe for this diagnosis? > Diuretic > Alpha-adrenergic blocker > Analgesic > Antispasmodic

Alpha-adrenergic blocker Alpha-adrenergic blockers relax the smooth muscle of the bladder neck and prostate, improving urine flow and relieving BPH symptoms.

A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take? > Discontinue the irrigations. > Increase the rate of the IV fluids. > Administer a unit of packed red blood cells. > Prepare the patient for an ECG.

Discontinue the irrigations. Transurethral resection syndrome is a rare but potentially serious complication of TURP. Symptoms include lethargy, hypotension, and muscle spasms. The first action the nurse should take is to discontinue irrigation. The other interventions listed are not appropriate.

A patient is diagnosed with prostatitis. Which of the following is the most commonly isolated organism that will be present in this patient's laboratory results? > Staphylococcus aureus > Proteus > Escherichia coli > Pseudomonas

Escherichia coli E. coli is the most commonly isolated organism with prostatitis. Microorganisms are usually carried to the prostate from the urethra.

After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first? > Kegel exercises > Fluid restriction > Artificial sphincter use > Self-catheterization

Kegel exercises Kegel exercises are noninvasive and are recommended as the initial intervention for incontinence. Fluid restriction is useful for the client with increased detrusor contraction related to acidic urine. Artificial sphincter use isn't a primary intervention for post-prostatectomy incontinence. Self-catheterization may be used as a temporary measure but isn't a primary intervention.

The nurse is caring for a patient who had a transurethral resection of the prostate (TURP). The health care provider has ordered continuous bladder irrigation, and the patient is now around 20 hours postoperative. During the nurse's shift assessment, what color urine would the nurse expect to find in the drainage bag? > Red-pink > Tea-colored > Amber > Light pink

Light pink The urine drainage following a TURP usually begins as a reddish pink and then clears to a light pink 24 hours after surgery.

The nurse is reviewing the history of a client with erectile dysfunction. Which of the following would the nurse least likely identify as contributing to the client's condition? > History of type 2 diabetes mellitus for 10 years > Use of metoprolol for treating hypertension > History of depression treated with fluoxetine > New onset of anemia being treated with iron supplements

New onset of anemia being treated with iron supplements Anemia and iron supplements are not associated with erectile dysfunction. Diabetes, depression, and certain medications such as metoprolol and fluoxetine are associated with erectile dysfunction.

Which is an age-related change affecting the reproductive system? > Prostate secretion increases. > Plasma testosterone levels decrease. > Testes become soft. > Patency increases.

Plasma testosterone levels decrease. Changes in gonadal function include a decline in plasma testosterone levels and reduced production of progesterone. The testes become smaller and more firm.

A 30-year-old patient is receiving analgesics and antibiotics for the treatment of epididymitis. The patient normally leads an active lifestyle and is concerned about the effect that his recovery will have on his routines. What should the nurse teach the patient about lifestyle modifications during his recovery? > The patient should try to maintain his normal activity level if possible. > The patient should avoid lifting and sexual activity until his infection is resolved. > The patient should emphasize light weight-bearing activity while recovering to strengthen his core muscles. > The patient should stay on bed rest until his epididymitis has resolved.

The patient should avoid lifting and sexual activity until his infection is resolved The nurse instructs the patient to avoid straining, lifting, and sexual activity until the infection is resolved. He should continue taking analgesic agents and antibiotics as prescribed and using ice packs if necessary to relieve discomfort. He needs to know that it may take 2 to 3 months for the epididymis to return to normal.

A client is to undergo a TURP for BPH. Which statement is accurate with regard to a TURP? > A TURP causes erectile dysfunction. > It is done on an outpatient basis. > Urethral strictures are more frequent for TURP than for nontransurethral procedures. > There is no danger of retrograde ejaculation.

Urethral strictures are more frequent for TURP than for nontransurethral procedures. Urethral strictures are more frequent for TURP than with nontransurethral procedures. TURP rarely causes erectile dysfunction. It requires an overnight stay. There is danger of retrograde ejaculation.

The nurse is caring for client who has had a vasectomy. Which would be most important to include in a teaching plan for this client? > Using a reliable method of contraception for several weeks. > Applying warm compresses to the scrotum for the first 24 hours > Taking a prescribed opioid analgesic for pain relief > Resuming sexual activity in 24 to 48 hours

Using a reliable method of contraception for several weeks. 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 clinical manifestation related to metastasis from prostate cancer is > polyuria. > hip pain. > weight gain. > thrombocytopenia.

hip pain Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, oliguria (decreased urine output), and spontaneous pathologic fractures. These symptoms may be the first indications of prostate cancer.

The nurse monitors a client for symptoms of urethral strictures following a transurethral resection of the prostate (TURP) for the treatment of prostate cancer. Drag words from the choices below to fill in each blank in the following sentence. Client symptoms indicative of this complication that the nurse monitors for following a TURP include _____, _____, and _____. > straining > erectile dysfunction > dysuria > fever > a weak urinary stream

straining, dysuria, a weak urinary stream Urethral strictures is a complication that is associated with a transurethral resection of the prostate (TURP) when implemented for the treatment of prostate cancer. Dysuria, which is painful or difficult urination, is a symptom associated with urethral stricture, a complication associated with TURP. Straining to urinate is a symptom associated with urethral stricture, a complication associated with TURP. A weak urine stream is a symptom associated with urethral stricture, a complication associated with TURP. Fever is a symptom indicative of infection, not urethral stricture after a TURP. Although all postoperative clients are at risk for infection, the risk is significantly decreased with this procedure because there is no abdominal incision. Erectile dysfunction is a complication associated with a TURP and many other surgical procedures for prostate cancer; however, this finding is not a symptom of urethral stricture.

A urologist suspects that a client might have prostate cancer. Which test would be used to make a diagnosis of cancer? > tissue biopsy > prostate-specific antigen > cystoscopy > digital rectal examination

tissue biopsy A needle biopsy of prostatic tissue is obtained to diagnose a definitive cancer of the prostate. The PSA assay is a blood test that, when elevated, may correspond with prostate cancer. However, an elevated PSA does not always indicate a malignancy; it may indicate benign disease or other factors such as an enlarged prostate gland, older age, prostatitis, recent ejaculation, and other innocuous causes. Cystoscopy involves a cystoscope inserted into the urinary meatus to inspect the bladder, prostate, and urethra. This aids in evaluating the degree of encroachment by the prostate on the urethra. A digital rectal examination is performed to assess the prostate for size as well as evidence of tumor.

A nurse is reviewing the history of a client diagnosed with erectile dysfunction. Which information would the nurse interpret as indicating that use of a PDE-5 inhibitor would be contraindicated. > use of nitroglycerin for angina > history of heart attack 2 years ago > hypertension controlled with medications > use of antiseizure medications

use of nitroglycerin for angina PDE-5 inhibitors should not be taken if the client is taking nitrate medications, such as nitroglycerine or isosorbide mononitrate, or if the client has high uncontrolled blood pressure, coronary artery disease, or a heart attack within the past 6 months. Use of antiseizure medications can cause erectile dysfunction.

Which of the following is the most common organism implicated in prostatitis? > Escherichia coli > Staphylococcus aureus > Streptococcus > Methicillin-resistant Staphylococcus aureus

Escherichia coli Escherichia coli is the most commonly isolated organism implicated in prostatitis. Microorganisms are usually carried to the prostate from the urethra. Staphylococcus aureus, Streptococcus, and methicillin-resistant Staphylococcus aureus are not the most common organism implications in prostatitis.

Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction? > Age > Medication use > Sexual history > Undescended testicle

Medication use Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.

Which of the following nursing assessment findings would be most significant in determining sterility in a client? > Uncircumcised penis > Recurrent urinary tract infections (UTI) > Multiple sex partners > Mumps at age 15 years

Mumps at age 15 years Viral mumps infection that occurs after puberty can be the cause of orchitis, which may result in testicular atrophy and sterility. Uncircumcised penis, UTIs, and number of sex partners are not indicated with sterility.

Which should be included as part of the home care instructions for a client with epididymitis and orchitis? > Take prescribed antibiotics > Undertake lifting exercises > Apply ice to the area after scrotal swelling subsides > Resume sexual intercourse

Take prescribed antibiotics Home care for a client with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics and to take Sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and refrain from sexual intercourse until symptoms are relieved.

After teaching about self-care measures to a client who has been diagnosed with prostatitis, the nurse determines that the teaching was successful when the client states which of the following? > "I'll take the antibiotic until all the symptoms are gone." > "If I have discomfort, a cool shower will give me relief." > "I should avoid fluids like coffee and tea." > "I need to make sure that I drink lots of fluid."

"I should avoid fluids like coffee and tea." With prostatitis, the client should avoid foods and liquids with diuretic action such as coffee and tea. He also needs to complete the full course of prescribed antibiotic therapy, not just until the symptoms are gone. Hot sitz baths may be used to promote relief. Fluids are encouraged to satisfy thirst but are not forced because an effective medication level must be maintained in the urine.

A client with erectile dysfunction is being treated with alprostadil urethral suppository. After teaching the client about this treatment, the nurse determines that additional education is needed based on which client statement? > "I can use the medication twice a day." > "I should inject the medication about 20 minutes before intercourse." > "I can have an erection that lasts up to one hour." > "I shouldn't use it if my partner is trying to get pregnant."

"I should inject the medication about 20 minutes before intercourse." The client is using a suppository and as such should insert the suppository into the urethra, not inject it. An alprostadil suppository should be inserted about 20 to 30 minutes before intercourse and should not be used if the partner is pregnant or trying to become pregnant. The erection can last up to one hour.

A client diagnosed with epididymitis is being discharged from the emergency department. Which of the following would be most important for the nurse to include as part of the client's discharge teaching? > "Apply ice to the top of your scrotum to help reduce the swelling." > "Engage in sexual intercourse frequently to help drain the area." > "If you have a fever, call the physician so he can order an antibiotic right away." > "Keep your scrotum elevated on a folded towel until the swelling goes down."

"Keep your scrotum elevated on a folded towel until the swelling goes down." The scrotum is elevated with a folded towel, four tail bandage, or adhesive tape across the upper thighs to relieve pain by lessening the weight of the testes. Ice is applied under the scrotum not on top or leaning against it. Sexual intercourse is to be avoided until symptoms are relieved. Antibiotics are typically prescribed as part of the initial treatment, not when the client develops a fever.

The nurse is teaching a young adult client how to perform testicular self-examination (TSE). The nurse determines that the client has understood the instructions when they state which of the following? > "I'll use my right hand to check the left testicle and the left hand to check the right one." > "The best time to do it is once a month after I take my warm morning shower." > "If the top and back of the testicle feels cordlike, I'll call my physician." > "I should roll the testis in a circular pattern around the palm of my hand."

"The best time to do it is once a month after I take my warm morning shower." TSE is to be performed monthly, usually after a warm bath or shower when the scrotum is more relaxed. Both hands are used to palpate the testis. The index and middle fingers are placed under the testis and the thumb is placed on top. The testis is rolled gently in a horizontal plane between the thumb and fingers. A cordlike structure on the top and back of the testicle is the epididymis. This is normal and does not need to be reported.

A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met? > "I'll have to stay in the hospital for about 3 to 4 days after the surgery." > "I'll have a small incision on my lower abdomen after the procedure." > "The surgeon is going to remove the entire prostate gland." > "The surgeon is going to insert a scope through my urethra to remove a portion of the gland."

"The surgeon is going to insert a scope through my urethra to remove a portion of the gland." TURP involves the surgical removal of the inner portion of the gland through an endoscope inserted through the urethra. There is no external skin incision. Typically, the procedure is performed in an outpatient setting but may require an overnight hospital stay.

A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client? > "You need to take this medication throughout the day to be effective." > "The effects of this medication usually last for up to 48 hours." > "You may experience headache and some flushing with this drug." > "Your blood glucose level might increase when you take this drug."

"You may experience headache and some flushing with this drug." Sildenafil (Viagra) may cause headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. It is taken 30 minutes to 4 hours before sexual activity. It can be taken more than once a day, but doing so will not increase its effect. It should be taken only when the client wants to have intercourse, to a maximal dose of 100 mg/24 hours. The drug may cause low blood glucose levels and abnormal liver function tests.

Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer? > Hormone therapy > Brachytherapy > Teletherapy > Chemotherapy

Brachytherapy Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. Hormone therapy for advanced prostate cancer suppresses androgenic stimuli to the prostate by decreasing the level of circulating plasma testosterone or interrupting the conversion to or binding of DHT. Teletherapy involves 6 to 7 weeks of daily radiation treatments. High-dose ketoconazole (HDK) lowers testosterone through its abilities to decrease both testicular and endocrine production of androgen.

A nurse is working in an oncology treatment center. Which clinical manifestation when reported by a client would the nurse know may be related to metastasis from prostate cancer? > Frequent nighttime urination > Constant hip aching and discomfort > Weight gain of 3 pounds in 1 month > Large amounts of dilute urine when voiding

Constant hip aching and discomfort Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, oliguria, weight loss, weakness, nausea, and spontaneous pathologic fractures. These symptoms may be the first indications of prostate cancer.

A nurse is preparing a presentation for a local senior citizen group about age-related changes in the body systems. Which of the following would the nurse include as associated with the reproductive system? Select all that apply. > Shrinkage of the prostate gland > Decrease in sexual energy level > Loss of testicular firmness > Enlargement of the testes > Thickening of the seminiferous tubules

Decrease in sexual energy level, Loss of testicular firmness, Thickening of the seminiferous tubules Age-related changes in the male reproductive system are associated with decreased sex hormone secretion, especially testosterone. Subsequently, the older man experiences decreased sexual energy, loss of testicular firmness, shrinkage of the testes, enlargement of the prostate gland, and thickening of the seminiferous tubules.

The nurse is providing preoperative care to a client who is to undergo a radical prostatectomy for prostate cancer. The client's plan of care includes the nursing diagnosis of "anxiety related to surgery and its outcome." Which of the following would be most appropriate for the nurse to do? > Tell the client that prostate cancer is very curable if caught early. > Inform the client that risk of recurrence is decreased with this type of surgery. > Ensure privacy when discussing sensitive or embarrassing sexual issues. > Allow the client to assume a passive role in the preparation.

Ensure privacy when discussing sensitive or embarrassing sexual issues. To help reduce anxiety, the nurse should provide clear explanations about the events before, during, and after surgery, reinforcing information already provided by the surgeon. In addition, the nurse should establish a trusting relationship and allow the client to ask questions and verbalize his feelings related to the diagnosis, surgery, and outcomes. Because the surgery involves reproductive issues that the client may find sensitive or embarrassing, the nurse needs to ensure the client's privacy when discussing any of these issues. Telling the client that the cancer is very curable and informing him of a lower risk of recurrence would give the client false reassurance. In addition, anxiety could be increased, especially if the client's cancer is not at an early stage. Regardless of the diagnosis, clients need to participate in their care to foster autonomy and feelings of control over the situation.

A client who comes to the clinic reporting perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause? > Staphylococcus > Streptococcus > Escherichia coli > Paramyxovirus

Escherichia coli Prostatitis is an inflammation of the prostate gland and is most often caused by microorganisms that reach the prostate by way of the urethra. Escherichia coli and microbes that cause sexually transmitted infections often are responsible. Staphylococcus and Streptococcus are not typically a cause of prostatitis. Paramyxovirus is the cause of mumps.

A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged IV pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow? > Evaluating patency of the drainage lumen > Counter-balancing the I.V. pole > Attaching the infusion set to an infusion pump > Collecting a urine specimen before beginning irrigation

Evaluating patency of the drainage lumen The nurse should evaluate patency of the drainage tubing before leaving the client's room. If the lumen is obstructed, the solution infuses into the bladder but isn't eliminated through the drainage tubing, a situation that may cause client injury. Balancing the pole is important; however, the nurse would have had to address this issue immediately after hanging the 2 L bag. Using an I.V. pump isn't necessary for continuous bladder irrigation. Unless specifically ordered, obtaining a urine specimen before beginning continuous bladder irrigation isn't necessary.

Which of the following is an immediate danger after a prostate surgery? > Hemorrhagic shock > Deep vein thrombosis > Catheter obstruction > Sexual dysfunction

Hemorrhagic shock The immediate dangers after prostate surgery are bleeding and hemorrhagic shock. The patient is monitored for major complications such as hemorrhage, infection, deep vein thrombosis, catheter obstruction, and sexual dysfunction.

The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include? > Using a bearing down motion to promote complete bladder emptying when voiding > Performing perineal exercises frequently throughout the day > Engaging in strenuous exercise to strengthen abdominal muscles > Waiting to urinate for 5 to 10 minutes after feeling the initial urge

Performing perineal exercises frequently throughout the day After a prostatectomy, the client should be instructed in how to perform perineal exercises and to perform them hourly throughout the day, each day. In addition, the client should avoid bearing down (straining) to urinate because of the increased risk for hematuria. He should also avoid strenuous exercise, which increases the tendency to rebleed. The client should be instructed to urinate as soon as he feels the first urge to do so.

Which condition is associated with buildup of fibrous plaques in the sheath of the corpus cavernosum, causing curvature of the penis when it is erect? > Bowen's disease > Phimosis > Peyronie's disease > Priapism

Peyronie's disease Peyronie's disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible. Bowen's disease refers to a form of squamous cell carcinoma in situ of the penile shaft. Phimosis refers to the condition in which the foreskin is constricted so that it cannot be retracted over the glans. Priapism refers to an uncontrolled, persistent erection of the penis occurring from either neural or vascular causes.

Nursing students are reviewing information about the reproductive system and normal age-related changes. They demonstrate understanding of the topic when they identify which of the following as occurring? > Secretions of the prostate gland increase. > Testes become heavier in weight. > Spermatogenesis drops significantly > Plasma testosterone levels decrease.

Plasma testosterone levels decrease With aging, plasma testosterone levels decrease, prostatic secretions increase, testes decrease in weight, and spermatogenesis continues.

A patient is scheduled for a transurethral resection (TUR). The nurse is aware that a disadvantage of this surgical approach is: > Recurrent urethral obstruction. > Possible damage to the external sphincter. > Increased hemorrhage from the prostatic venous plexus. > A high incidence of impotence.

Recurrent urethral obstruction There are six operative procedures for prostatic disorders. Recurrent urethral obstruction is a disadvantage of a TUR or TURP. The other disadvantages refer to other surgeries. Refer to Table 34-4 in the text.

The physician orders an alpha-adrenergic blocker for a client with benign prostatic hyperplasia. The nurse understands that this drug acts to achieve which of the following? > Prevent urinary tract infections > Relieve urinary symptoms > Slow the prostatic enlargement > Block testosterone conversion

Relieve urinary symptoms Alpha-adrenergic blockers help relax the muscles in the prostate and relieve urinary symptoms. Androgen hormone inhibitors (also classified as 5-alpha reductase inhibitors) can be used to decrease symptoms and also appear to arrest the progression of prostate enlargement in some clients. These agents inhibit the conversion of testosterone into a potent androgen, causing the gland to shrink.

The student nurse studying the reproductive tract demonstrates understanding movement of testicular secretions when they exit the penis by selecting which pathway? > Epididymis, ejaculatory duct, vas deferens, penis > Seminiferous tubules, epididymis, vas deferens, ejaculatory duct > Vas deferens, epididymis, ejaculatory duct, urethra > Seminiferous tubules, urethra, ejaculatory duct, penis

Seminiferous tubules, epididymis, vas deferens, ejaculatory duct The correct pathway of testicular secretions is seminiferous tubules, epididymis, vas deferens, ejaculatory duct, urethra, and penis.

A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. The surgery is scheduled for the following week. That afternoon, the patient calls the nurse and tells her he wants to cancel the surgery because he thinks he might be better off dead. The nurse asks him why he feels that way. The patient states "My wife won't want to have sex with me anymore. He says he feels like he's spoiled a happy, satisfying sex life with his wife and he starts to cry. Based on these statements, which nursing diagnosis would be most appropriate for creating a plan of care for this patient? > Situational low self-esteem > Inability to function > Social isolation > Risk for loneliness

Situational low self-esteem Because the patient may have difficulty coping with his condition, issues related to body image and sexuality should be addressed. The scenario stated in this case is typical of a patient with situational low self-esteem. The diagnosis of inability to function is a distracter for this question. This patient is at risk for social isolation and loneliness, but there's no indication in the scenario that these diagnoses are present.

After having transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded? > The urine in the drainage bag appears red to pink. > The client reports bladder spasms and the urge to void. > The normal saline irrigant is infusing at a rate of 50 drops/minute. > About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned.

The client reports bladder spasms and the urge to void. Reports of bladder spasms and the urge to void suggest that a blood clot may be occluding the catheter. After TURP, urine normally appears red to pink, and normal saline irrigant usually is infused at a rate of 40 to 60 drops/minute or according to facility protocol. The amount of returned fluid (1,200 ml) should correspond to the amount of instilled fluid, plus the client's urine output (1,000 ml + 200 ml), which reflects catheter patency.

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this medication? > Sexual stimulation is not needed to obtain an erection. > The drug should be taken 1 hour prior to intercourse. > Facial flushing or headache should be reported to the health care provider immediately. > A high dose may result in a permanent change of vision.

The drug should be taken 1 hour prior to intercourse. The patient must have sexual stimulation to create the erection, and the drug should be taken 1 hour before intercourse. Facial flushing, mild headache, indigestion, and runny nose are common side effects of Viagra. The "blue haze" that occurs with the 100-mg dosage is transient and will last for about 1 hour.

When developing an educational program for a group of adolescents about sexually transmitted infections (STIs), what should the nurse inform the group about the single greatest risk factor for contracting an STI? > The type of contraception used > The number of times the person has contact with a partner > The number of sexual partners > Where the patient lives

The number of sexual partners The single greatest risk factor for contracting an STI is the number of sexual partners. As the number of partners increases, so does the risk of exposure to a person infected with an STI.

Following a vasectomy, which is the most important instruction to provide to the client? > Wear a scrotal support until swelling is resolved. > Use a Tylenol as needed for discomfort. > Use another form of birth control until further notice. > Take a day or two to rest and recuperate from the procedure.

Use another form of birth control until further notice. It may take up to 10 ejaculations to clear sperm and prevent impregnation. The client should be instructed to use another form of reliable birth control until a sperm count proves sterility has occurred. Use of Tylenol, scrotal support, and rest are all helpful during the initial recovery period.

The nurse is reviewing a client's medication and health history. Which assessment finding would cause the nurse to question the client's new prescription for the phosphodiesterase inhibitor sildenafil? > Use of nitrates > History of hypertension > Type 2 diabetes > Use of diuretics

Use of nitrates PDE5 inhibitors facilitate penile erection by producing smooth muscle relaxation in the corpora cavernosa via vasodilation of the blood vessels. If a client is using nitrates (which also exhibit vasodilation) hypotension is likely to occur. History of hypertension and diabetes does not interfere with the administration of PDE5 inhibitors. Use of diuretics is not significant.

A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to: > testosterone therapy during childhood. > sexually transmitted disease. > early onset of puberty. > cryptorchidism.

cryptorchidism Cryptorchidism (failure of one or both testes to descend into the scrotum) appears to play a role in testicular cancer, even when corrected surgically. Other significant history findings for testicular cancer include mumps orchitis, inguinal hernia during childhood, and maternal use of diethylstilbestrol or other estrogen-progestin combinations during pregnancy. Testosterone therapy during childhood, sexually transmitted disease, and early onset of puberty aren't risk factors for testicular cancer.

A client reports experiencing nocturia. The nurse obtains a thorough history including current signs and symptoms. What would the client likely include when describing the symptoms? > decrease in the force of urinary stream > painful urination > incontinence > changes in sexual function

decrease in the force of urinary stream The symptoms of benign prostatic hyperplasia (BPH) appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs. Changes in sexual function would not be consistent with BPH.

A 55-year-old client has a PSA level of 4.8 ng/mL. Based on the client's PSA level, which assessment question does the nurse need to ask? > "How often do you include foods high in purines in your diet?" > "When was the last time you experienced ejaculation?" > "Will you remember to schedule your next PSA test in 1 year?" > "Do you wear boxers or briefs?"

"When was the last time you experienced ejaculation?" Values of PSA may increase after ejaculation. PSA levels are measured in nanograms per milliliter. In most laboratories, values less than 4.0 ng/mL are generally considered normal, and values greater than 4.0 ng/mL are considered elevated. Foods high in purines place individuals at risk for gout, but purines do not increase PSA levels. Because the client's PSA level is elevated, further assessment is indicated. Type of underwear affects how close the testes are held to the body and may affect male fertility; type of underwear does not affect PSA levels. Asking whether the client will remember to schedule another test in a year is not as important as asking when the client last experienced ejaculation.

The nurse is preparing a presentation for an older adult group of clients at a senior center. Which of the following would the nurse expect to include when describing the effects of aging on the reproductive system? > The volume and viscosity of seminal fluid increase with age. > Men retain the ability to fertilize ova irrespective of age. > There is a gradual increase in sperm and testosterone production. > The scrotum becomes less pendulous and becomes firm.

Men retain the ability to fertilize ova irrespective of age As men age, they retain the ability to fertilize ova even though there is a gradual decrease in sperm and testosterone production. Along with decreased sperm production, the volume and viscosity of seminal fluid decrease with age. A loss of muscular tone causes the scrotum to become more pendulous.

The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening? > Monthly testicular self-examination (TSE) > Annual digital rectal examination (DRE) after age 35 years > Annual prostate-specific antigen (PSA) testing after age 40 years > Transrectal ultrasound every 5 years after age 50 years

Monthly testicular self-examination (TSE) Screening typically includes monthly TSE starting in adolescence and annual DRE for men older than 50 years. PSA testing along with DRE are used to screen for prostate cancer in men with at least a 10-year life expectancy and for men at high risk, including those with a strong family history of prostate cancer and of African-American ethnicity. Transrectal ultrasound is performed in clients with abnormalities detected by DRE and in those with elevated PSA levels.

Which condition is associated with the buildup of fibrous plaques in the sheath of the corpus cavernosum, causing curvature of the penis when it is erect? > Bowen's disease > Phimosis > Peyronie's disease > Priapism

Peyronie's disease Peyronie's disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible. Bowen's disease refers to a form of squamous cell carcinoma of the penile shaft in situ. Phimosis refers to the condition in which the foreskin is constricted so that it cannot be retracted over the glans. Priapism refers to an uncontrolled, persistent erection of the penis occurring from either neural or vascular causes.

Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)? > Voiding pattern > Size of the prostate > Creatinine clearance > Serum testosterone level

Voiding pattern The client's voiding pattern should be checked to evaluate the effectiveness of alpha-adrenergic blockers. These drugs relax the smooth muscle of the bladder neck and prostate, so the urinary symptoms of BPH are reduced in many clients. These drugs don't affect the size of the prostate, production or metabolism of testosterone, or renal function.

A 59-year-old patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedures because their daughter is 3 months pregnant, and they are concerned about exposing her to radiation. What is the most appropriate teaching the nurse should provide to this family? > The patient should not be in contact with the baby when it is born. > The patient will be in the hospital for a period of a few days after surgery. > The patient and his wife can have sexual intercourse without difficulty. > The patient should avoid close contact with his daughter for 2 months.

The patient should avoid close contact with his daughter for 2 months. Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. The surgeon uses ultrasound guidance to place about 80-100 seeds, and the patient returns home after the procedure. Exposure of others to radiation is minimal, but the patient should avoid close contact with pregnant women and infants for up to 2 months. Radiation safety guidelines include straining urine for seeds and using a condom during sexual intercourse for 2 weeks after implantation to catch seeds that may pass through the urethra.

A client diagnosed with prostate cancer is to receive brachytherapy. Which of the following would the nurse include when discussing this therapy with the client? > Need for daily treatments over a 7- to 8-week period > Use of radioactive seeds implanted into the prostate > Surgical castration to decrease the level of circulating testosterone > Use of probes inserted using ultrasound to freeze the tissue

Use of radioactive seeds implanted into the prostate Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. External beam radiation therapy (teletherapy) involves the use of radiation treatments, usually 5 days/week over 7 to 8 weeks. Surgical castration is a type of androgen-deprivation therapy. Cryosurgery involves the insertion of transperineal probes into the prostate to freeze the tissue directly.

A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse? > Vasectomies should be considered a permanent means of birth control. > Following surgery, sexual intercourse should be avoided for 3 months. > Postoperative discomfort can be relieved with use of warm sitz baths. > Vasectomy can result in permanent impotence.

Vasectomies should be considered a permanent means of birth control. Although attempts to reverse a vasectomy have proven successful, a vasectomy should be considered a permanent means of birth control. Scar formation and/or sperm leakage can interfere with restoration of reproductive effectiveness. Sexual intercourse can be resumed when it is comfortable to do so, usually in about 1 week. Postoperative discomfort should be controlled with application of cold to reduce swelling or use of mild analgesics. On occasion, clients have complained of impotence, but vasectomies have no effect on erection or ejaculation.

A client with a penile implant is to be informed about the possible complications after discharge. Which complication occurs due to a midsized implant, pressure, or friction of the implanted cylinders? > erosion of penile or urethral tissue > migration of the cylinders, pump, and reservoir > erosion of scrotal, bowel, or bladder tissue > malfunction of the device

erosion of penile or urethral tissue Erosion of penile or urethral tissue may occur from a midsized implant, pressure, and friction of the implanted cylinders, which is evidenced by seeing the implant through the skin. Migration of the cylinders, pump, and reservoir is a possible complication but not due to a midsized implant, pressure, or friction of the implanted cylinders. Erosion of scrotal, bowel, or bladder tissue can occur when an implant with a fluid reservoir is used. Malfunction of the device can occur with migration, accidental trauma such as a fall, or aggressive or improper use of the device.

A client asks the nurse what PSA is. The nurse should reply that it stands for: > prostate-specific antigen, which is used to screen for prostate cancer. > protein serum antigen, which is used to determine protein levels. > pneumococcal strep antigen, which is a bacteria that causes pneumonia. > Papanicolaou-specific antigen, which is used to screen for cervical cancer.

prostate-specific antigen, which is used to screen for prostate cancer PSA stands for prostate-specific antigen, which is used to screen for prostate cancer.

A client has been scheduled to undergo a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). The nurse knows that the client understands preoperative teaching when he makes which statement? > "I'm worried my wife will leave me after the TURP because of the side effect of erectile dysfunction." > "I will have my wife come with me to drive me home after the outpatient procedure." > "I understand I may develop urethral strictures as a result of having the TURP." > "I understand there is no danger of retrograde ejaculation following the TURP."

"I understand I may develop urethral strictures as a result of having the TURP." Urethral strictures are more frequent for TURP than with nontransurethral procedures. TURP rarely causes erectile dysfunction. It requires an overnight stay. There is chance of retrograde ejaculation.

A client who is scheduled for a vasectomy tells the nurse, "My partner and I will never have to worry about contraception ever again." Which response by the nurse would be most appropriate? > "This seems important to you. I'm sure you must be so relieved." > "You still need to use a reliable method until the physician checks your semen." > "You don't have to worry about pregnancy, but your risk for a sexually transmitted infection just increased." > "You might not have to worry about contraception, but remember your hormones may be affected."

"You still need to use a reliable method until the physician checks your semen." Fertility remains for a varying time after a vasectomy until the sperm stored distally in the seminal vesicles have been evacuated. Therefore, a reliable method of contraception should be used until the urologist confirms infertility during a follow-up examination of an ejaculate specimen. Telling the client that he must be relieved provides false reassurance. The client needs to be informed about the remaining fertility. Vasectomy does not increase the risk for sexually transmitted infections; however, it does not provide protection from them. Vasectomy usually has no effect on sexual potency, erection, ejaculation, or male hormone production.

A 57-year-old client is being treated in the outpatient community center. The client reports that most nights they wake up twice to urinate. In addition, they report occasional blood in urine. The client's laboratory tests reveal a PSA level of 3.8 ng/mL and a white blood cell (WBC) count of 6,000 mm3. The nurse most likely suspects that the client is experiencing which condition? > Prostatitis > Prostatism > Prostate cancer > Prostatectomy

Prostatism Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, hematuria, and a sensation that the bladder has not completely emptied. PSA and WBC levels are within expected ranges. Prostatitis is an inflammation of the prostate gland. Prostaglandins are physiologically active substances present in tissues with vasodilator properties. Prostatectomy refers to the surgical removal of the prostate gland.

A client comes to the emergency department reporting severe testicular pain that started about 1 hour ago. Examination reveals a thickened spermatic cord, an elevated testis, and testicular tenderness. The nurse would interpret these findings to suggest which of the following? > Epididymitis > Testicular torsion > Orchitis > Testicular cancer

Testicular torsion Testicular torsion is manifested by student pain in the testicle, usually developing over 1 to 2 hours, accompanied by swelling of the scrotum, testicular tenderness, elevated testis, thickened spermatic cord, and a swollen, painful scrotum. Epididymitis is manifested by low-grade fever, chills, and heaviness in the affected testicle developing over 1 to 2 days. Orchitis is manifested by fever, pain, tenderness in one or both testicles, testicular swelling, penile discharge, blood in the semen, and leukocytosis. It is common after an episode of mumps. Testicular cancer is manifested by a lump or mass on the testicle and usually painless enlargement of the testis that appears gradually.

A surgical nurse recognizes the fact that all surgical patients are at risk of developing fluid and electrolyte imbalances in the immediate postoperative period. However, patients who have undergone prostate surgery face a particularly high risk of such problems because of what characteristic of prostate surgery? > Renal function is diminished by manipulation of the genitourinary system. > The surgical site is heavily irrigated during and after surgery. > Hypertonic IV solutions are preferred during prostate surgery. > The patient is normally NPO for 48 to 72 hours prior to surgery.

The surgical site is heavily irrigated during and after surgery. During the postoperative period, the patient is at risk for imbalanced fluid volume due to irrigation of the surgical site during and after surgery. With irrigation of the urinary catheter to prevent its obstruction by blood clots, fluid may be absorbed through the open surgical site and retained, increasing the risk of excessive fluid retention, fluid imbalance, and water intoxication. Hypertonic solutions are not used, and a lengthy NPO period is not required. Prostate surgery does not have a specific effect on renal function.