Chapter 66: Coordinating Care for Male Patients With Reproductive and Breast Disorders
A patient is concerned about becoming impotent because of the inability to sustain an erection and a history of a sexually transmitted infection as a young adult. What is the nurse's best response to this patient's concerns? 1. "An occasional incident like this is normal and common, and there is no reason to be concerned." 2. "Sexually transmitted infections may result in sexual problems in adults." 3. "Erectile dysfunction is the correct term for the inability to achieve or sustain an erection." 4. "The medical diagnosis of erectile dysfunction is not made until the man has erection difficulties in 25% or more of his interactions."
"An occasional incident like this is normal and common, and there is no reason to be concerned." This patient is concerned about his masculinity and sexual abilities. The correct answer at this point is to tell him that it is common and normal for men to experience occasional erectile difficulties.
A nursing instructor is teaching a group of student nurses about the cultural implications of prostate cancer. Which statement will the nursing instructor include in the teaching session? 1) "African-American men are at lowest risk for prostate cancer." 2) "Asian- and Native American men have the highest risk for developing prostate cancer." 3) "Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer." 4) "A diet low in dairy increases a man's risk for developing prostate cancer."
"Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer." Approximately one in eight men ages 70 and older will be diagnosed with prostate cancer.
A patient asks for a prescription for tadalafil (Cialis). What would be important for the nurse know prior to planning interventions for this patient? 1) "Do you have diabetes mellitus?" 2) "Do you take blood pressure medication?" 3) "Do you have any sexually transmitted infections?" 4) "Do you use nitroglycerine?"
"Do you use nitroglycerine?" Combining tadalafil (Cialis) with nitroglycerine can lead to serious hypotension.
During a health history, the nurse learns that a patient has a recent onset of impotence. Which question will help identify a potential cause of this manifestation? 1) "Does this occur often?" 2) "For what diseases and disorders have you been treated?" 3) "Are you on any medications?" 4) "How does your partner feel about this problem?"
"For what diseases and disorders have you been treated?" A patient's health history can provide clues to the underlying cause of impotence. The question "for what diseases and disorders have you been treated" would provide the nurse
The nurse is caring for a patient diagnosed with benign prostatic hyperplasia (BPH) who is experiencing an increase in symptoms. Which statement by the patient would best explain the source of the increased symptoms? 1) "I have decreased oral intake at night." 2) "I recently had a vasectomy." 3) "I am using an over-the-counter cold medication for a cold." 4) "I am taking over-the-counter saw palmetto."
"I am using an over-the-counter cold medication for a cold." Use of cold medications can increase symptoms because of their anticholinergic properties.
The nurse is instructing a patient about the medication sildenafil (Viagra). Which patient statement indicates teaching has been effective? 1) "Viagra should be taken with food." 2) "I can take Viagra anywhere from one to six hours before sex." 3) "I can take only one pill in a 24-hour period." 4) "Grapefruit juice will decrease the effects of Viagra."
"I can take only one pill in a 24-hour period." Taking only one pill in a 24-hour period is the recommended dosing for sildenafil (Viagra).
A patient reports getting up to urinate several times a night and difficulty starting a stream of urine. After medical testing is completed, a diagnosis of benign prostatic hyperplasia (BPH) is made. After conducting teaching regarding BPH, which statement by the patient indicates the need for further education? 1) "Alpha blockers can be used to control my symptoms." 2) "I know I will get cancer of the prostate because of this." 3) "As my condition progresses, I may need to consider surgical management." 4) "There are nonsurgical treatment options available."
"I know I will get cancer of the prostate because of this." BPH is benign condition that does not necessarily progress to cancer. It is caused by an increase in size of the prostate gland and is seen in older males.
The nurse is preparing to discharge a patient recovering from prostate surgery for cancer. What should the nurse emphasize when providing discharge instructions for this patient? 1) "You may drive yourself home." 2) "Avoid strenuous activity and heavy lifting for two weeks." 3) "It is quite common to notice blood in your urine following this type of surgery." 4) "Reduce your fluid intake so you won't need to void as often."
"It is quite common to notice blood in your urine following this type of surgery." Blood in the urine is fairly common after surgery.
A nurse is caring for a patient who is prescribed a selective phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction. The nurse should include which statement when educating the patient regarding this medication? 1) "You should take this medication about 30 minutes before sexual activity." 2) "The action of this medication will last up to 36 hours." 3) "This medication will enhance erections with or without sexual stimulation." 4) "This medication should not be taken more than twice daily."
"The action of this medication will last up to 36 hours." Sildenafil citrate (Viagra), vardenafil hydrochloride (Levitra), tadalafil (Cialis), and avanafil (Stendra) are all selective phosphodiesterase type 5 inhibitors used in the treatment of erectile dysfunction. The nurse should tell the patient that the action of this medication will last up to 36 hours.
The nurse is caring for a patient who returns to the unit following transurethral resection of the prostate due to prostate cancer with a three-way Foley catheter in place. The patient states that he has the urge to urinate and wants the catheter removed. Which response by the nurse is the most appropriate? 1) "This must be a complication, because the Foley catheter is supposed to evacuate clots that cause the sensation you are describing." 2) "The spasm is an unexpected finding because the procedure does not invade the urethra." 3) "The sensation is caused by the silicone used in the catheter. I will speak to the doctor about switching to a different catheter." 4) "This is an expected sensation, but the Foley catheter must remain in place."
"This is an expected sensation, but the Foley catheter must remain in place." Patients with a three-way Foley catheter usually complain of sensations of having to void despite the presence of the catheter. This urge to void is caused by the pressure exerted by the balloon in the internal sphincter of the blad
A patient is scheduled to undergo a prostate biopsy. The patient asks the nurse what is expected immediately following the procedure. Which response by the nurse is the most appropriate? 1) "You will need to avoid strenuous activity for 24 hours." 2) "Your sexual partners will need to be notified." 3) "You will likely experience discomfort for 24-48 hours after the procedure." 4) "You will not have any restrictions following the biopsy."
"You will likely experience discomfort for 24-48 hours after the procedure." The patient may experience discomfort for one to two days after the procedure.
The nurse is caring for a male patient of Japanese descent who is experiencing urinary retention. The patient asks the nurse if it is possible that he is experiencing benign prostatic hyperplasia (BPH). Which response by the nurse is the most appropriate? 1) "No, you are not old enough to have BPH." 2) "Your symptoms are not consistent with BPH." 3) "Your provider will run some tests; however, you are considered low-risk for BPH." 4) "Where did you get an idea that you might have BPH?"
"Your provider will run some tests; however, you are considered low-risk for BPH." The nurse must always provide honest responses to patient questions. Telling the patient that the provider will run tests but due to his ethnicity, he is considered low-risk for developing BPH is the most appropriate response.
The nurse is caring for a patient who has a continuous bladder irrigation running following a prostatectomy. During the shift, a total of 1500 mL of irrigant is infused. The Foley bag is emptied twice for the shift with totals of 850 mL and 950 mL. What is the patient's actual urine output for the shift? 1.300 mL 2.250 mL 3.100 mL 4.950 mL
300 mL The total infused is 1500 mL. The total drained is 1800 mL. The total, or true output, is 300mL greater than the input.
The nurse is providing care to a patient who is diagnosed with benign prostatic hyperplasia (BPH). Which items in the patient's health history may have contributed to this diagnosis? Select all that apply. 1) 70 years of age 2) Diet high in milk 3) Excessive exercise 4) Diet high in meat and fats 5) African-American ethnicity
70 years of age Diet high in meat and fats African-American ethnicity
The nurse is conducting a health history with a patient diagnosed with erectile dysfunction. Which finding could provide a possible cause for the patient's problem? 1) Blood pressure of 118/68 mmHg 2) Body mass index (BMI) of 24.5 3) Alcohol intake of four to six beers each day 4) Plays golf twice a week
Alcohol intake of four to six beers each day The risk factors for erectile dysfunction are numerous. They include advancing age, diseases such as heart disease and diabetes, trauma, and the use of prescription or illicit drugs. Excessive use of alcohol can also result in erectile dysfunction.
A nurse is treating a patient with diabetes mellitus who reports erectile dysfunction (ED). Which hormonal cause contributes to ED? 1) Increased prolactin levels 2) Decreased aldosterone levels 3) Decreased circulating catecholamines 4) Decreased thyroid-stimulating hormone
Decreased thyroid-stimulating hormone Hormonal causes of ED include decreased testosterone, decreased prolactin, and alterations in thyroid function. A decrease in thyroid-stimulating hormone (TSH) would be a cause of this disorder.
The nurse is assessing a patient for symptoms of prostate cancer. Which symptoms would indicate the patient is experiencing an enlarged prostate? 1) Dysuria 2) Nerve pain 3) Bone pain 4) Bowel dysfunction
Dysuria Symptoms of an enlarged prostate include hematuria, dysuria, reduction in urinary stream, nocturia, frequency of urination, and abnormal size of prostate on digital exam.
A nurse is screening a patient for prostate cancer. Which assessment findings would cause the nurse to suspect that the patient has prostate cancer? Select all that apply. 1) Fatigue 2) Back pain 3) Hematuria 4) Scrotal edema 5) Upper extremity weakness
Fatigue Back pain Hematuria
The nurse is providing follow-up care for a patient was recently diagnosed with benign prostatic hyperplasia (BPH). Which nursing diagnosis is the priority for the nurse to include in the patient's plan of care? 1) Chronic Pain 2) Impaired Urinary Elimination 3) Constipation 4) Diarrhea
Impaired Urinary Elimination The priority diagnosis for a patient diagnosed with BPH is Impaired Urinary Elimination.
While receiving discharge teaching, an adult patient recovering from a prostatectomy is distressed to learn that episodes of incontinence may occur. Which should the nurse teach the patient to help minimize incontinence? 1) Proper administration of incontinence medication 2) Steps to change the Foley catheter bag every day 3) Fluid restriction 4) Kegel exercises
Kegel exercises Urinary incontinence after surgery is not unexpected. Teaching the patient Kegel exercises is the best way to help him eliminate or reduce occasions of stress incontinence.
A patient is recovering from minimally invasive surgery due to a diagnosis of benign prostatic hyperplasia (BPH). After assessing the patient, the nurse expects which outcome for this patient? 1) Bowel continence 2) Absence of pain 3) No postoperative treatment 4) Urinary continence
No postoperative treatment After surgery and removal of the catheter, the patient should return to urinary continence as expected.
A patient with prostate cancer is being discharged from the hospital. Which educational topic is inappropriate for this patient? 1) Provide information on doses of complementary herbs 2) Teach the patient and his family noninvasive methods of pain control 3) Stress the importance of keeping patient appointments with health-care providers 4) Provide the patient and the patient's family information on support groups
Provide information on doses of complementary herbs The nurse does not have authorization to provide information on doses of complementary herbs.
A male patient tells the nurse that he has no idea why his wife wants to stay married to him because he has not been able to "perform" sexually since his prostate surgery. Which diagnosis would be appropriate for this patient? 1) Ineffective Coping 2) Situational Low Self-Esteem 3) Hormonal Imbalance 4) Sexual Dysfunction
Situational Low Self-Esteem The patient may or may not be experiencing ineffective coping.
The nurse is caring for a patient with erectile dysfunction (ED). Which medication should the nurse anticipate being prescribed for this patient? Select all that apply. 1) Tadalafil (Cialis) 2) Sildenafil (Viagra) 3) Buspirone (BuSpar) 4) Vardenafil (Levitra) 5) Methylphenidate (Ritalin)
Tadalafil (Cialis) Sildenafil (Viagra) Vardenafil (Levitra)
A patient is recovering from prostate surgery on a medical-surgical unit. The patient will be ready for discharge within the next few days. Which teaching point is appropriate for this patient? 1) The patient should not drive for six weeks after surgery. 2) The patient should call the health-care provider immediately for any pain. 3) The patient should increase the fiber in his diet. 4) The patient should avoid heavy lifting for two weeks after surgery.
The patient should increase the fiber in his diet. The patient should be encouraged to increase the fiber in his diet, as straining for bowel movements after surgery can cause increased pressure in the prostate area. The patient and family are taught good dietary habits to keep bowel movements regular and soft.
The nurse is preparing an educational program on risk factors for the development of prostate cancer. Which information will the nurse include as being the greatest risk factor for developing prostate cancer? 1) The patient's age 2) A family history 3) A history of a vasectomy 4) A diet high in fat
The patient's age The greatest risk for developing prostate cancer is age. Prostate cancer affects one out of every eight men over the age of 60.
The nurse is planning care for a patient with erectile dysfunction. What should the nurse include in this patient's plan of care? 1) Names of psychologists with experience in treating the disorder 2) Types of devices and surgeries available to help with the disorder 3) Reason for disorder as being side effect of prescribed medication 4) Information on exact cause
Types of devices and surgeries available to help with the disorder When planning the care of a patient with erectile dysfunction, the nurse should include information on medications
The nurse is providing care to a patient who is diagnosed with mild benign prostatic hyperplasia (BPH). Which lifestyle change is appropriate for this patient? 1) Increasing caffeine intake 2) Decreasing alcohol intake 3) Urinating at first urge 4) Using over-the-counter antihistamines
Urinating at first urge A patient who is diagnosed with mild BPH is often treated with lifestyle changes and a "wait and see" approach. Urinating at first urge is a lifestyle change that is appropriate for this patient.