Ch 41: Drugs Affecting the Male Reproductive System

A woman is diagnosed with pulmonary hypertension. The nurse explains the drug prescribed and the patient states, "That's a drug that used to treat erectile dysfunction." Which drug would this most likely be?

Sildenafil

A female client expresses the desire to suppress her female sex characteristics to facilitate a transition to being male. Which androgen does the nurse anticipate the provider will prescribe?

Testosterone

The nurse is caring for a client who has been prescribed vardenafil. What question should the nurse ask when assessing for therapeutic effects of the drug?

"Have you found that you're better able to get and maintain erections?"

After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states:

"I need to take the pill about an hour before any sexual stimulation."

The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification?

"If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster."

A client has been given a prescription for sildenafil (Viagra) for treatment of erectile dysfunction. The nurse will instruct the client to take this medication at what time prior to the onset of sexual intercourse?

30 minutes

A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective?

"My sperm count should increase."

The nurse is educating a young adult client diagnosed with androgen deficiency about the prescribed testosterone transdermal system, apply two systems (dose of 5 mg) nightly. Which statement made by the client establishes the need for further clarification?

"One transdermal patch is applied to my back, upper arm, or abdomen to dry, clean skin, and the other to my groin."

The nurse is providing education to a client who has been prescribed sildenafil. Which client statement indicates that additional teaching is required?

"Sildenafil can cause hypertension if I use my angina medicine."

A nurse should advise a female client beginning therapy with methyltestosterone for the treatment of inoperable advanced breast carcinoma of which of the following adverse reactions? Select all that apply:

- Acne - Amenorrhea - Facial hair growth

And older client has been prescribed long-term androgen therapy. Which preexisting condition should the nurse monitor regularly to identify signs of exacerbation? Select all that apply.

- Heart failure - Hypertension - Coronary artery disease

What information should the nurse provide a client prescribed testosterone? Select all that apply.

- Testosterone is an androgen sex hormone - It is a component of therapy for certain breast cancers - Testosterone is a class III controlled substance - It is used in the treatment of underdeveloped testes

Testosterone therapy would be recommended for all these patients except for a:

35-year-old male with erectile dysfunction due to diabetes mellitus.

A client diagnosed with erectile dysfunction has been advised to take Viagra. For up to how many hours does the action of the drug persist?

4 hours

A nurse is instructing a client about vardenafil. The nurse would instruct the client to take the drug how many minutes before sexual stimulation?

60 minutes

What effect can administration of androgens have on fetal development?

A female fetus may experience masculinization.

A client has been prescribed a PDE5 inhibitor for penile erectile dysfunction. Medication education should strongly discourage the use of what drug classification while on this medication?

Alpha-blockers

A patient with erectile dysfunction is receiving an injection directly into the cavernosum. The nurse identifies this drug as:

Alprostadil

A client has been receiving long-term testosterone therapy. The nurse would expect to monitor:

Liver function studies

The nurse is aware that a client receiving which category of medication will not be prescribed vardenafil?

Antiarrhythmics

A patient with delayed puberty has been advised to take testosterone transdermal therapy. Which instruction should the nurse provide the patient to help promote an optimal response to this therapy?

Apply immediately after removing the cover.

An older adult client has prided himself in maintaining good health for the entire adult life. For this reason, the recent diagnosis of benign prostatic hypertrophy (BPH) is a source of frustration, and the client asks, "I don't understand why I got this because I've always taken such good care of myself." How would the nurse best respond to the client?

BPH is thought to be a normal part of the male aging process.

The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?

Benign prostatic hypertrophy

A young male patient, age 14, has been prescribed testosterone for delayed onset of puberty. Follow-up care includes a visit to the clinic at least every 6 months for ongoing assessment. It will be most important for the nurse to monitor:

Bone growth

Which would be most important to assess in a client receiving testosterone for a prolonged period of time?

Liver function studies

The nurse is reviewing the history of a client who is to receive testosterone. Which of the following would alert the nurse to the need for close monitoring of the client?

Cardiovascular disease

A client is taking androgens and warfarin. What effect will these two medications have on the client's coagulation?

Coagulation will be decreased.

A client is receiving androgen therapy. Which would cause the nurse the greatest concern?

Elevated liver enzyme levels

The nurse is instructing the parents of an 11-year-old male who has testosterone deficiency. Which symptom, if found in this child, would cause the discontinuation of this medication?

Enlarged penis

A client on long term testosterone therapy is at risk for the development of hepatocellular cancer. The nurse explains to the client that a hepatic function test should be done and evaluated on what schedule during the therapy?

Every 6 months

A student asks the pharmacology instructor what effect the administration of androgens can have on a fetus if administered during pregnancy. What should the instructor respond?

Female child may have masculinized features

An older adult male prescribed anabolic steroids for a deficiency condition has presented with blood pressure above the normal baseline. What might be the cause for an increase in blood pressure associated with anabolic steroid therapy?

Fluid and sodium retention

The nurse is obtaining a history from a 23 year-old client. What symptom would lead the nurse to suspect that the client may be using DHEA?

Hirsutism

When teaching a group of high school students about using anabolic steroids, the nurse would include information that these drugs are classified as which class of controlled substances?

III

A 9 year old child has been prescribed testosterone. What information should the nurse provide the client's parents regarding the continuation of the therapy?

If signs of early puberty are identified the therapy should be stopped

Which would a nurse expect to occur with the administration of anabolic steroids?

Increased red blood cell mass

A male client informs his physician that sildenafil therapy is not working for him. What is mostlikely to be the reason for this and needs to be carefully assessed for by the nurse?

Ingestion of high-fat meal along with the drug

A client with a history of benign prostatic hypertrophy (BPH) is seeking androgenic medication treatment for penile erectile dysfunction. What information should the nurse provide the client regarding this therapy?

It increases the risk for prostate cancer

A male taking anabolic steroids may experience which side effects?

Jaundice

A client who uses a transdermal testosterone gel for the treatment of oligospermia applies the medication first thing in the morning and washes it off before bed. What client education is necessary?

Leave the gel on until the next application is due.

The nurse knows that finasteride is used to treat prostatic hypertrophy, and in smaller doses is used to treat what condition?

Male pattern baldness

A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking:

Nitroglycerin.

After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example?

Oxandrolone

A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?

Practice frequent and thorough skin cleansing.

A 30-year-old debilitated client is receiving anabolic steroids. Which might the client experience?

Priapism

The nurse is scheduled to administer testosterone transdermal patch to a client admitted with primary hypogonadism. What is the priority teaching that would be provided regarding this medication?

Report to primary care provider any leg pain, redness, and swelling right away.

A client is using a transdermal system for androgen administration. Which drug would the client most likely be using?

Testosterone

A male adolescent is prescribed testosterone. In order to help the client deal with the added social stress that the medication may cause, the nurse should discuss which possible adverse effect?

The development of acne

A male client is prescribed sildenafil for the treatment of erectile dysfunction. What mechanism of action of sildenafil causes a sustained erection?

The drug inhibits phosphodiesterase (PDE) type 5, consequently decreasing the metabolism of cGMP.

Headache and flushing are adverse effects associated with PDE 5 inhibitors.

True

After experiencing several months of worsening nocturia, a client has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is the most likely to accompany BPH?

Urinary frequency

A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which assessment?

Weight and measurement of blood pressure

An adult client is suspected of having an androgen deficiency and has spoken with his primary care provider about the possibility of treatment with testosterone. The use of testosterone would be most complicated by the presence of what preexisting health problem?

benign prostatic hypertrophy

A 52-year-old male with type 2 diabetes is using an anabolic steroid for treatment of hormonal deficiency. He is taking the sulfonylurea glyburide to treat his diabetes. The nurse caring for this client would closely monitor his:

blood glucose level.

Which is an example of an androgen that can be used to treat hypogonadism?

fluoxymesterone

A school-age client is taking testosterone injections for treatment of hypogonadism. What related intervention should the nurse include in this client's long-term plan of care?

hand and wrist radiographs every 6 months

A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?

has unstable angina and uses a nitroglycerin patch

A nurse is teaching a class at the local high school on the abuse of anabolic steroids. Which potential adverse reaction should the nurse cite regarding the long-term use of these hormones?

liver tumors.

A client has been prescribed vardenafil. Which medication in the client's history would the nurse be most concerned about?

nitroglycerin

A middle-aged client with erectile dysfunction has sought care and is receiving health education from the nurse. The client has expressed a desire to understand the physiology of the sex hormone production and the sexual response. The nurse should describe the fact that testosterone is normally secreted in response to:

stimulation by luteinizing hormone.

A nurse is educating a group of young sports persons about the adverse effects associated with the use of anabolic steroids. Which of the following would the nurse include as occurring typically only in females?

virilization