CH 55 Clients with disorder of the male reproductive system

Which of the following is the most immediate danger after prostate surgery?

Bleeding

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?

Constant hip aching and discomfort

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."

Surgical removal of a client's testicle and biopsy revealed a stage I tumor confined to the testis. Initially, the client was treated with an aggressive chemotherapy protocol, but, recently, tumor markers have improved and the chemotherapy has been modified. The nurse provides client education about family planning. Which client statement indicates that the client understood the education provided?

"Spermatogenesis eventually resumes months or years after chemotherapy."

A client is prescribed dutasteride as part of treatment for benign prostatic hyperplasia (BPH). When teaching the client about this drug, the nurse integrates knowledge of the drug's action. Which statement best reflects this?

"The drug interferes with testosterone, which causes the prostate to shrink in size.

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?

Escherichia coli

A 29-year-old patient visits his provider because of a lump on his left testicle that is not painful. During a history and physical exam, he mentions another symptom. Which of the following is a significant diagnostic symptom that is suggestive of metastasis?

A backache

A client with a history of hypertension and heart disease is being seen by the urologist because of erectile dysfunction. What would be the most likely cause of the client's erectile dysfunction?

All options are correct. Common causes of ED include neurologic disorder such as spinal cord injury, perineal trauma, testosterone insufficiency, side effects of drug therapy, atherosclerosis, hypertension, and complications of diabetes mellitus. Certain medications such as antihypertensive drugs (e.g., methyldopa, spironolactone), antidepressants, narcotics, and cimetidine can cause sexual dysfunction in men. Atherosclerosis is a common cause of ED. ED may be related to anxiety or depression.

What is included in the home care instructions for a client with epididymitis and orchitis?

All options are correct. Home care for a client with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics, take sitz baths, apply local heat after scrotal swelling subsides, and avoid lifting and straining (e.g., sexual intercourse) until symptoms are relieved.

A client is being seen by an urologist for perineal pain, low back pain, fever lasting 5 days, and painful urination. The physician confirms a diagnosis of prostatitis and orders treatment. During client education, which recommendation does the nurse make?

All options are correct. The nurse instructs the client to avoid caffeine, prolonged sitting, and constipation and regularly to drain the prostate gland through masturbation or intercourse. The nurse instructs the client to comply with antibiotic therapy and use a mild analgesic for pain.

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?

Alpha-adrenergic blocker

A patient is planning to use a negative-pressure (vacuum) device to maintain and sustain an erection. What should the nurse caution the patient about with the use of this device?

Do not leave the constricting band in place for longer than 1 hour to avoid penile injury.

A patient is being treated for prostatitis and the nurse is providing education about the treatment. What should the nurse include in the education of this patient?

Avoid foods and liquids with diuretic action or that increase prostatic secretions.

A health care provider has explained to the client that they have an inflammation of the Cowper glands. Where are the Cowper glands located?

Below the prostate, within the posterior aspect of the urethra

A client presents to the emergency department with paraphimosis. The health care provider is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, the nurse should prepare the client for what intervention?

Circumcision

Which term refers to a failure of one or both or both of the testes to descend into the scrotum?

Cryptorchidism

A client is informed that they have testicular cancer and it requires surgery. During a presurgical appointment, the client admits to feeling devastated that this requires surgery, stating that it will leave them "emasculated" and "a shell of a person." Which issue(s) will the nurse address when planning the client's subsequent care according to the client's statement? Select all that apply.

Disturbed self-image Sexual dysfunction

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?

Ensure privacy when discussing sensitive or embarrassing sexual issues.

A nurse is teaching a client who is older than 50 years about prostate cancer. What teaching should be included by the nurse?

Have a digital rectal examination.

Which of the following may result if prostate cancer invades the urethra or bladder?

Hematuria

An adolescent is identified as having a collection of fluid in the tunica vaginalis of their testes. The nurse knows that this adolescent will receive what medical diagnosis?

Hydrocele

A client has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this client has chronic urinary retention?

Increased blood urea nitrogen (BUN)

A client has returned to the medical-surgical floor from the post-anesthesia care unit (PACU). Upon inspection, the nurse notes leakage around the suprapubic tube. Which action by the nurse is most appropriate?

Inform the urologist of this finding as it is abnormal. After removal of the suprapubic catheter there may be urinary drainage from the stoma site. The urologist should be informed if there is significant leakage around a suprapubic catheter. Some leakage is expected, but larger amounts should be communicated to the care team.

Which statement is accurate regarding sildenafil?

Its side effects include headache, flushing, and dizziness. Side effects of sildenafil include headache, flushing, and dizziness. Is should be taken 30 minutes to 4 hours before intercourse.

A client is 24 hours postoperative following prostatectomy and the urologist has ordered continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag?

Light pink

A health care provider prescribed a luteinizing hormone-releasing hormone (LHRH) agonist to suppress testicular androgen and treat prostate cancer. Which medication is the primary drug of choice?

Lupron

A client confides to the nurse that he cannot engage in sexual activity. The client is 27 years old and has no apparent history of chronic illness that would contribute to erectile dysfunction. What does the nurse know will be ordered for this client to assess sexual functioning?

Nocturnal penile tumescence tests

Which statement should be included in the teaching plan for a client prescribed silde

Only one tablet of the prescribed dose should be taken each day.

A 59-year-old client has opted for hormonal androgen deprivation therapy (ADT) to treat prostate cancer. Which surgical procedures is the client most likely to undergo?

Orchiectomy

A patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort?

Oxybutynin (Ditropan)

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?

Performing perineal exercises frequently throughout the day

An uncircumcised 78-year-old client has presented at the clinic reporting that they cannot retract the foreskin over the glans. On examination, it is noted that the foreskin is very constricted. The nurse should recognize the presence of what health problem?

Phimosis

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.

Prostate biopsy

A 22-year-old client is being discharged home after surgery for testicular cancer. The client is scheduled to begin chemotherapy in 2 weeks. The client tells the nurse that they do not think he can take weeks or months of chemotherapy, stating that they have researched the adverse effects online. What is the most appropriate nursing action for this client at this time?

Provide empathy and encouragement in an effort to foster a positive outlook.

A client has been diagnosed with erectile dysfunction; the cause has been determined to be psychogenic. The client's interdisciplinary plan of care should prioritize which of the following interventions?

Psychotherapy

Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)?

Saw palmetto

A 57-year-old male client reports that when having an erection, the penis curves and becomes painful. The client's diagnosis is identified as severe Peyronie disease. The nurse should prepare the client for what likely treatment modality?

Surgery Surgical removal of mature plaques is used to treat severe Peyronie disease. There is no potential benefit to physical therapy and hydrocortisone injections are not normally used. PDE-5 inhibitors would exacerbate the problem.

A patient is having a DRE in the physician's office and the nurse is to assist in the examination. What can the nurse instruct the client to do to decrease the discomfort from the exam?

Take a deep breath and exhale when the physician inserts a gloved finger into the rectum.

Which should be included as part of the home care instructions for a client with epididymitis and orchitis?

Take prescribed antibiotics

A 57-year-old client goes to his physician for difficulty. The physician prescribes an oral antibiotic for the client who has prostatitis. Which instruction by the nurse about the client's antibiotic use is a priority?

Take the medication until it is completely gone.

A 75-year-old client is being treated for phimosis. When planning this client's care, what health promotion activity is most directly related to the etiology of the client's health problem?

Teaching the client about the importance of hygiene Poor hygiene often contributes to cases of phimosis.

A public health nurse is teaching a health class for students at the local high school. The nurse is teaching them to perform monthly testicular self-examinations. What point would be appropriate to emphasize?

Testicular cancer is a highly curable type of cancer.

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?

Testicular torsion

A nurse is performing an admission assessment on a 40-year-old client who has been admitted for outpatient surgery on the right knee. While taking the client's family history, the client states, "My parent died of prostate cancer at age 48." The nurse should instruct the client on which of the following health promotion activities?

The client should have PSA levels drawn regularly.

A 35-year-old father of three tells the nurse that they want information on a vasectomy. What would the nurse tell the client about ejaculate after a vasectomy?

There is no noticeable decrease in the amount of ejaculate even though it contains no sperm.

Which is the most common type of prostate surgery?

Transurethral resection of the prostate Transurethral resection of the prostate, or TURP, is the most common procedure used and can be carried out through endoscopy.

A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?

Use sterile technique when irrigating the catheter.

The nurse is teaching a client with acute prostatitis about measures to promote comfort and self-care. Which of the following would the nurse include in the teaching plan? Select all that apply.

Use warm sitz baths several times a day. Avoid drinking coffee, tea, and colas. Avoid sitting for prolonged periods.

The nurse recognizes what conditions cause elevated prostate-specific antigen (PSA) levels in the absence of prostate cancer. Select all that apply.

acute urinary retention acute prostatitis benign prostatic hyperplasia (BPH) transurethral resection of the prostate (TURP)

A client, treated for testicular cancer without first collecting and storing sperm, tells the nurse that they are disappointed that they will not be able to have biologic children of their own one day. Which alternative(s) should a nurse suggest to the client? Select all that apply.

adoption foster parenting donor insemination involvement with a youth group

A client has an edematous glans penis, pain, and an extremely constricted foreskin. What treatment would the physician likely prescribe?

circumcision

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:

cryptorchidism.

Following treatment for cancer of the prostate gland, what action would the nurse recommend to manage and minimize the possibility of a recurrence of the primary cancer or metastasis?

have regular PSA levels and repeat lymph node biopsies

The nurse monitors a client for symptoms of urethral strictures following a transurethral resection of the prostate (TURP) for the treatment of prostate cancer.

straining dysuria a weak urinary stream

A urologist suspects that a client might have prostate cancer. Which test would be used to make a diagnosis of cancer?

tissue biopsy