Ch 59 Male Reproductive Disorders

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 understand I may develop urethral strictures as a result of having the TURP."

A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?

"I've had trouble getting started when I urinate, often straining to do so."

A client is prescribed dutasteride (Avodart) 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 client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client?

"You may experience headache and some flushing with this drug."

As treatment of erectile dysfunction, Viagra is taken how many minutes before intercourse to be effective?

60

A client has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The client has a continuous bladder irrigation system in place. The client reports bladder spasms. What is the most appropriate nursing action to relieve the discomfort of the client?

Administer a smooth-muscle relaxant as ordered.

A client who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurse's response?

All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction.

A client comes to the emergency department complaining of moderate to severe testicular pain and tenderness. Both testicles are swollen and a penile discharge is present. The client is diagnosed with viral orchitis. Which of the following would the nurse include in this client's plan of care?

Applying ice to the scrotum

Which of the following medication classifications are associated with erectile dysfunction? Select all that apply.

Antifungals Antipsychotics Beta blockers Antiseizure agents Antispasmodics

During a routine office visit, a client mentions difficulty maintaining an erection. While reviewing the client's medical history, the nurse notes the client's medication history. Which medication would the nurse interpret as a potential cause of erectile dysfunction? Select all that apply.

Clonidine Lorazepam Nadolol Fluoxetine

A nurse is providing care for a client who has recently been admitted to the postsurgical unit from PACU following a transurethral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?

Closely monitoring the input and output of the bladder irrigation system

A client with erectile dysfunction has been prescribed a PDE5 inhibitor. What would the nurse include in the client education?

Depending on the drug, most are taken "on demand" 15 minutes, 1/2 hour, to 1 hour before sexual activity.

The nurse is leading a workshop on sexual health for men. The nurse should describe what organic causes of erectile dysfunction? Select all that apply.

Diabetes Testosterone deficiency Parkinsonism

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

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

A 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH) reports consuming <i>Serenoa repens</i> (saw palmetto berry). The nurse needs to intervene if the physician orders which treatment?

Finasteride

The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?

Finasteride (Proscar)

In a client with benign prostatic hyperplasia (BPH), which assessment finding provides the best indication of urinary retention?

Frequency

A nurse is reviewing the history of a client who is experiencing difficulty sustaining an erection. Which of the following might the nurse suspect as a possible contributing factor?

Hypertension

The nurse is obtaining a health history from a 58-year-old client stating that he is having difficulty obtaining an erection during sexual activity. The client asks how an "erectile medication" works and if there are any side effects to the medication. The nurse explains the action of the medication and directions for use and warns of which side effect related to the client's history?

Hypotension with nitrate use

The nurse is obtaining a medication history from a client who is reporting erectile dysfunction. Which medication would the nurse identify as being least likely to contribute to the client's condition?

Ibuprofen

When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint?

Increased effort to void

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

Which of the following would a nurse include in a teaching plan for a client with benign prostatic hyperplasia who is not yet a candidate for surgery?

Maintaining optimal bladder emptying

Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?

Medication use

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?

New onset of anemia being treated with iron supplements

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 his sexual functioning?

Nocturnal penile tumescence tests

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?

The client has a history of hypertension. The client drinks five to six alcoholic drinks per day

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

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?

Relieve urinary symptoms

A nurse is reviewing a journal article about benign prostatic hyperplasia and possible risk factors associated with this condition. Which factor would the nurse most likely find as playing a role in increasing a man's risk for this condition? Select all that apply.

Smoking Hypertension Diabetes

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

Take prescribed antibiotics

A patient comes to the emergency department and tells the nurse, "I took a pill to help me perform and then passed out." The nurse is assessing the patient and finds a nitroglycerin patch on his back. What is the first intervention the nurse must perform?

Take the patient's blood pressure.

Which therapy uses low-level radiofrequencies to produce localized heat that destroys prostate tissue?

Transurethral needle ablation

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.

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

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.

The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is called

prostatism

An client with a history of hypertension is being seen by the urologist due to erectile dysfunction. Results from the client's nocturnal penile tumescence test measured several spontaneous erections while the client slept. What does this indicate?

psychological etiology

A client with erectile dysfunction has opted to self-administer a urethral suppository as a means to produce an erection. Which of the following agents would most likely be used?

Alprostadil

A 55-year-old client with a history of type 1 diabetes presents at the clinic reporting erectile dysfunction. The physician prescribes tadalafil to be taken 1 hour before sexual intercourse. The nurse reviews the client's history prior to instructing the client on the use of this medication. What disorder will contraindicate the use of tadalafil?

Retinopathy

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

Saw palmetto

A client has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been 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

Which of the following should be included when teaching a client about the management of benign prostatic hyperplasia (BPH)? Select all that apply.

Do not delay the urge to void. Schedule digital rectal exams.

After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true?

Erectile dysfunction may be due to testosterone insufficiency.

A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal?

Transurethral resection of the prostate (TURP)

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?

Underinflation or bulging of the cylinders during inflation

A client is to undergo a TURP for BPH. Which statement is accurate with regard to a TURP?

Urethral strictures are more frequent for TURP than for nontransurethral procedures.

The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following?

Light yellow and clear

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 client reports bladder spasms and the urge to void.