Chapter 53: Assessment and Management of Patients with Male Reproductive Disorders

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 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 nursing student is learning how to perform sexual assessments using the PLISSIT model. According to this model, the student should begin an assessment by doing which of the following?

Asking the client if the client is willing to discuss sexual functioning

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 nurse is providing an educational event to a local men's group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group?

Black

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

A 35-year-old man is seen in the clinic because the client is experiencing recurring episodes of urinary frequency, dysuria, and fever. The nurse should recognize the possibility of what health problem?

Chronic bacterial prostatitis

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

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

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 29-year-old client has just been told that they have testicular cancer and needs to have surgery. During a presurgical appointment, the client admits to feeling devastated that they require surgery, stating that it will leave them "emasculated" and "a shell of a man." The nurse should identify what nursing diagnosis when planning the client's subsequent care?

Disturbed body image related to effects of surgery

A nurse is caring for a 33-year-old male client who has come to the clinic for a physical examination. The client states not having a routine physical in 5 years. The health care provider's digital rectal examination (DRE) reveals "stony" hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what?

Evidence of a more advanced lesion

A nurse is teaching a 53-year-old man about prostate cancer, given the fact that the client has a family history of the disease. What information should the nurse provide to best facilitate the early identification of prostate cancer?

Have a digital rectal examination and prostate-specific antigen (PSA) test done as recommended.

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 who is postoperative day 12 and recovering at home following a laparoscopic prostatectomy has reported that the client is experiencing occasional "dribbling" of urine. How should the nurse best respond to this client's concern?

Inform the client that urinary control is likely to return gradually.

The nurse is assessing urinary output 24 hours after a prostatectomy for a client with continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag?

Light pink

A nurse is planning the postoperative care of a client who is scheduled for radical prostatectomy. What intraoperative position will place the client at particular risk for the development of deep vein thrombosis postoperatively?

Lithotomy position

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

A client has experienced occasional urinary incontinence in the weeks since their prostatectomy. In order to promote continence, the nurse should encourage which of the following?

Pelvic floor exercises

A nurse is assessing a client who presented to the ED with priapism. The student nurse is aware that this condition is classified as a urologic emergency because of the potential for what issue?

Permanent vascular damage

An uncircumcised 78-year-old male 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

A 76-year-old with a diagnosis of penile cancer has been admitted to the medical floor. Because the incidence of penile cancer is so low, the staff educator has been asked to teach about penile cancer. What risk factors should the educator cite in this presentation? Select all that apply.

Phimosis Increasing age Lack of circumcision

A 22-year-old male 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

An 83-year-old client has been prescribed finasteride. When performing client education with this client, the nurse should be sure to tell the client to take what action?

Report the planned use of dietary supplements to the health care provider.

A 55-year-old client with a history of type 1 diabetes presents at the clinic reporting erectile dysfunction. The health care provider 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

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

A 75-year-old male 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

A man comes to the clinic reporting difficulty obtaining an erection. When reviewing the client's history, what might the nurse note that contributes to erectile dysfunction? Select all that apply.

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

A client has just been diagnosed with prostate cancer and is scheduled for brachytherapy the following week. The client and spouse are unsure of having the procedure because their child is 3 months' pregnant. What is the most appropriate teaching the nurse should provide to this family?

The client should avoid close contact with the child for 2 months.

A nurse is performing an admission assessment on a 40-year-old man who has been admitted for outpatient surgery on the right knee. While taking the client's family history, the client states, "My father 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 client has been prescribed sildenafil (Viagra). What should the nurse teach the client about this medication?

The drug should be taken 1 hour prior to intercourse.

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.

A clinic nurse is providing preprocedure education for a man who will undergo a vasectomy. Which of the following measures will enhance healing and comfort? Select all that apply.

Wearing a scrotal support garment Using sitz baths

A nurse practitioner is assessing a 55-year-old male client who reports perineal discomfort, burning, urgency, and frequency with urination. The client states that he has pain with ejaculation. The nurse knows that the client is exhibiting symptoms of:

prostatitis.

A man tells the nurse that their father died of prostate cancer and the client is concerned about their own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurse's response?

A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.

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.

A public health nurse has been asked to provide a health promotion session for men at a wellness center. What should the nurse inform the participants about testicular cancer?

It is highly responsive to treatment.