Chapter 54

The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)

How to care for an indwelling urinary catheter

A 22-year-old patient tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction. Which question should the nurse ask to assess for possible etiologic factors in this age group?

"Do you use recreational drugs or drink alcohol?"

The nurse is obtaining the pertinent health history for a man who is being evaluated for infertility. Which question focuses on a possible cause of infertility?

"Do you use medications to improve muscle mass?"

A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, "My symptoms are much worse this week." Which response by the nurse is appropriate?

"Have you taken any over-the-counter (OTC) medications recently?"

To monitor the progression of decreased urinary stream, the nurse should encourage which type of regular screening?

Digital rectal examination (DRE)

The nurse will plan to teach a 67-year-old patient who has been diagnosed with orchitis about

Pain management

A 70-year-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient statement indicates a need for the nurse to provide additional instruction?

"I should call the doctor if I have incontinence at home."

After a vasectomy, what instruction should be included in discharge teaching?

"Use an alternative form of contraception until your semen is sperm free."

The following male patients recently arrived in the emergency department. Which one should the nurse assess first?

A 19-year-old patient who is complaining of severe scrotal pain

Several patients call the urology clinic requesting appointments with the health care provider

A 22-year-old patient who has noticed a firm, nontender lump on his scrotum

The nurse is teaching clinic patients about risk factors for testicular cancer. Which individual is at highest risk for developing testicular cancer?

A 30-yr-old white man with a history of cryptorchidism

A hospitalized older patient reports his foreskin is retracted and will not return to normal. Which action is the priority?

Attempt to move the foreskin over the glans

The nurse is caring for a 62-year-old man after a transurethral resection of the prostate (TURP). Which instructions should the nurse include in the teaching plan?

Avoid straining during defecation

The nurse teaches a 30-year-old man with a family history of prostate cancer about dietary factors associated with prostate cancer. The nurse determines that teaching is successful if the patient selects which menu?

Baked chicken, peas, apple slices, and skim milk

A 73-yr-old male patient admitted for total knee replacement states during the health history interview that he has no problems with urinary elimination except that the "stream is less than it used to be." The nurse should give anticipatory guidance regarding what condition?

Benign prostatic hyperplasia

Which information about continuous bladder irrigation will the nurse teach to a patient who is being admitted for a transurethral resection of the prostate (TURP)?

Bladder irrigation prevents obstruction of the catheter after surgery

The nurse will plan to teach the patient who is incontinent of urine following a radical retropubic prostatectomy to

Do pelvic muscle exercises

The plan of care for a patient immediately after a perineal radical prostatectomy will include decreasing the risk for infection related to

Fecal wound contamination

The nurse will inform a patient with cancer of the prostate that side effects of leuprolide (Lupron) may include

Flushing

To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH), the nurse will ask the patient about

Force of urinary stream

The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that

His interest in sexual activity may decrease while he is taking the medication

The nurse coordinates postoperative care for a 70-yr-old man with osteoarthritis after prostate surgery. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/LVN) (select all that apply.)?

Increase flow of irrigation solution Administer oxybutynin (Ditropan) for bladder spasms

After a transurethral resection of the prostate (TURP), a 64-year-old patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine. Which action should the nurse take first?

Manually instill and then withdraw 50 mL of saline into the catheter

A 53-year-old patient is scheduled for an annual physical examination. The nurse will plan to teach the patient about the purpose of

Prostate specific antigen (PSA) testing

Which task can the nurse delegate to an unlicensed assistive personnel (UAP) in the care of a patient who has recently undergone prostatectomy?

Reporting complaints of pain or bladder spasms

A 71-yr-old patient with a diagnosis of benign prostatic hyperplasia (BPH) has been scheduled for a contact laser technique. What is the primary goal of this intervention?

Resumption of normal urinary drainage

When performing discharge teaching for a patient after a vasectomy, the nurse instructs the patient that he

Should continue to use other methods of birth control for 6 weeks

Which information will the nurse plan to include when teaching a young adult who has a family history of testicular cancer about testicular self-examination?

Testicular self-examination should be done in a warm room

Which action by the unlicensed assistive personnel (UAP) who are assisting with the care of male patients with reproductive problems indicates that the nurse should provide more teaching?

The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter

Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)?

The patient has had a gradual decrease in the force of his urinary stream

The nurse will anticipate that a 61-year-old patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about

Transrectal ultrasonography (TRUS)

The nurse performing a focused examination to determine possible causes of infertility will assess for

Varicocele

The nurse in the clinic notes elevated prostate specific antigen (PSA) levels in the laboratory results of these patients. Which patient's PSA result is not expected to be elevated?

A 48-year-old patient whose father died of metastatic prostate cancer

The nurse in a health clinic receives requests for appointments from several patients. Which patient should be seen by the health care provider first?

A 58-year-old patient who has a painful erection that has lasted more than 6 hours

A male patient complains of fever, dysuria, and cloudy urine. What additional information may indicate that these manifestations may be something other than a urinary tract infection (UTI)?

A very tender prostate gland

A 58-year-old patient with erectile dysfunction (ED) tells the nurse he is interested in using sildenafil (Viagra). Which action should the nurse take first?

Ask the patient about any prescription drugs he is taking

A 27-year-old patient who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is appropriate for the nurse to take?

Ask the patient if he has any questions or concerns about the diagnosis and treatment

A patient who has been diagnosed with stage 2 prostate cancer chooses the option of active surveillance. The nurse will plan to

Schedule the patient for annual prostate-specific antigen testing

The health care provider prescribes the following interventions for a patient with acute prostatitis caused by Escherichia coli. Which intervention should the nurse questions?

Catheterize the patient as needed if symptoms of urinary retention develop

A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because it might affect his ability to have sexual intercourse. Which action should the nurse take?

Clarify that TURP does not commonly affect erection

A patient is one day postoperative after a transurethral resection of the prostate (TURP). Which event is an unexpected finding?

Continuous bladder irrigation (CBI) infusing, but output has decreased

Which information will the nurse teach a patient who has chronic prostatitis?

Intercourse or masturbation will help relieve symptoms

A patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine. Which prescribed therapy should the nurse implement first?

Insert a urinary retention catheter

The patient has a history of cardiovascular disease and has developed erectile dysfunction. He is frustrated because he is taking nitrates and cannot take erectogenic medications. What should the nurse do first?

Obtain a thorough sexual, health, and psychosocial history

A patient tells the nurse that he decided to seek treatment for erectile dysfunction (ED) because his wife "is losing patience with the situation." The nurse's follow-up questions should focus on the man's identified concern with

Role performance

The patient has a low-grade carcinoma on the left lateral aspect of the prostate gland and has been on "watchful waiting" status for 5 years. Six months ago, his last prostate-specific antigen (PSA) level was 5 ng/mL. Which manifestations indicate prostate cancer may be extending and require a change in the plan of care (select all that apply.)?

Serum PSA level 10 ng/mL Nodularity of the prostate gland

A 33-yr-old patient noticed a painless lump and heaviness in his scrotum during testicular self-examination. The nurse should provide the patient information on which diagnostic test?

Ultrasound

The nurse taking a focused health history for a patient with possible testicular cancer will ask the patient about a history of

Undescended testicles