Med 2 Reproductive test

What are risk factors for prostate cancer?

Cause unknown, but related to increased testosterone, high-fat diet, family history

In which group is it most important for the client to understand the importance of an annual Papanicolaou test?

Clients infected with the human papillomavirus (HPV)

Which of the following is the most common organism implicated in prostatitis?

Escherichia coli

What should we teach clients who have a history of cryptorchidism?

Teach to perform testicular self-examination monthly, preferably in the shower - due to risk of developing testicular cancer -Teach to consult a physician if they consistently detect a mass that is changing in a testis

What does cryptorchidism place the client at increased risk for?

Testicular cancer

A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make?

Testicular cancer is a highly curable type of cancer.

Varicocele

dilation of the spermatic veins; feels like a "bag of worms" -Hydrocele & spermatocele are often not significant and don't require treatment

What is considered infertility

fewer than 20 million spermatozoa per milliliter

Which is the second most frequently reportable communicable disease in the United States?

gonorrhea

Phimosis

inability to retract the foreskin

Who is at risk for getting torsion of the spermatic cord ?

individuals with spermatic cords that are congenitally unsupported

Epididymitis

inflammation of the epididymis

Prostatitis

inflammation of the prostate gland -Most often caused by bacteria that enter the urethra

Orchitis

inflammation of the testes

What is BPH?

is an increased number of cells in prostate, causing prostate to become enlarged

Why would a sitz bath be helpful

it's soothing to perineal and buttocks area

Hydrocele

lymphatic fluid collection between testis and the scrotal sac

Which statement holds true? Untreated genital warts:

may resolve on their own, remain unchanged, or increase in size or number.

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."

How is prostatitis treated?

- therapy for up to 30 days -Mild analgesics for pain -Sitz baths

What is included in the nursing care for prostatitis?

-Administer above medications and treatment as ordered -Educate on need for sexual partner to be treated as well -Teach to avoid caffeine, prolonged sitting, and constipation -Teach to regularly drain the prostate gland through masturbation or intercourse -Teach to make sure to take all of the prescribed antibiotic

What nursing care is included for testicular torsion?

-Assess pain and administer prescribed analgesic -After surgery, apply jockstrap for client to use out of bed -Assess dressing for signs of drainage -Administer antibiotics if ordered -Report any sudden onset of pain to physician

What things might you ask when obtaining a sexual history on a client?

-Risk factors for STI's -Contraceptive use -Ability to achieve or sustain an erection -Pain during intercourse -premature ejaculation -inability of partner to conceive -prior GU treatment: drugs, testing, surgeries, ect.

List the important information about sildenafil (Viagra).

-Sildenafil (Viagra), along with other PDE5 inhibitors, is used in treatment of ED -It is to be taken just prior to sexual activity -Don't take with nitrates (e.g., nitroglycerin) - can increase risk of hypotension Side effects: -Headaches -Facial flushing -Visual changes -Priapism - erection that lasts for hours

What surgical procedures are included for BPH?

-TURP; TUIP -TULIP; TUNA -Prostatectomy

How are testicular self-exams performed?

-Use both hands to palpate. A normal testicle is smooth and uniform. -With index and middle fingers under the testis and the thumb on top, roll the testis gently in a horizontal plane between the thumb and fingers (A). -Feel for a small lump or abnormality. -Follow the same procedure and palpate upward along the testis (B). -Locate and palpate the epididymis (C), a cordlike structure on the top and back of the testicle that stores and transports sperm. Also, locate and palpate the spermatic cord. -Repeat the examination for the other testis, epididymis, and spermatic cord. It is normal to find that one testis is larger than the other.

What can a varicocele cause? How is it treated?

-Varicoceles are thought to be a cause of male infertility & may be surgically repaired

What are the causes of epididymitis and orchitis?

-infectious agent causing prostatitis -infection in the body -noninfectious epididymitis (long-term indwelling catheter, genitourinary procedures like cystoscopy or prostatectomy) -orchitis without epididymitis involvement associated with viral mumps after puberty - may cause sterility

What are the signs/symptoms of epididymitis and orchitis?

-pain -swelling in inguinal area and scrotum -fever; chills

A nurse is teaching a health class to a group of clients likely to be at highest risk for gonorrhea. What is the age range of the clients?

15 to 24 years

What is the normal sperm count

2 to 6 mL Average sperm count per ejaculation = 60 to 100 million

A client who has developed a painless penile ulcer is diagnosed with syphilis. What is the typical span of time between infection and developing symptoms with syphilis?

21 days

What is a complication of a TURP that affects 66% to 75% of clients?

After a TURP, between 66% and 75% of clients experience retrograde ejaculation, in which the semen is deposited in the bladder rather than discharging through the urethra at the time of orgasm, rendering the client sterile.

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

Who gets affected by testicular cancer? Who is at increased risk?

Common cancer in younger males - average age at diagnosis is 33 years

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea has presented at the clinic. The student knows that the care plan for this patient should be include what in the treatment of gonorrhea?

Concurrent treatment for chlamydia

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

A male patient comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention?

Foul-smelling discharge from the penis

A male client reports urethral pain and a creamy yellow, bloody discharge from the penis. The nurse associates these characteristics with which of the following sexually transmitted infections?

Gonorrhea

The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection?

Gonorrhea

A nurse is teaching a male 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 sexually transmitted infections (STIs) could be transmitted perinatally?

Herpes simplex

The nurse is talking to a client who has come to the doctor's office to ensure that the client's sexually transmitted infection (STI) has been successfully treated. Which statement by the client requires further instruction?

It's great that I don't have to worry about having this infection again because I'm now immune to it

A nurse is assisting with a physical examination of a male client. Which of the following signs and symptoms is most clearly suggestive of primary genital herpes?

Itching, pain, and the emergence of pustules on the penis

Which statement is accurate regarding sildenafil?

Its side effects include headache, flushing, and dizziness.

List the preoperative and postoperative nursing care involved with patients who have undergone testicular surgery/orchiectomy.

Preoperative: -Provide emotional support - issues with body image and sexuality; use therapeutic communication techniques -Provide preop education and typical preop care Postoperative: -Implement typical postoperative care -Apply scrotal support -Manage drains (JP drains, etc.) -Prophylactic antibiotics -Assessment of pain and administration of analgesics

What is priapism and what causes it?

Priapism - a persistent erection without sexual stimulation Caused by - vascular problems, medical condition, or side effect of medication

A patient comes to the clinic with complaints of a painless sore on her lip 2 weeks after she had oral sex with her boyfriend. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in?

Primary

A patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer?

Prostate biopsy

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

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

Testicular cancer is a highly curable type of cancer.

The nurse is assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual partners in the past 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented?

The client will require treatment for the secondary stage of syphilis.

Which of the following is the only definitive test that can determine if cancer of the testis is present?

Tissue biopsy

What is included in the treatment for prostate cancer?

Treatment: -Observation or "watchful waiting" -Radiation - external or internal; brachytherapy -Hormone therapy - see Drug Therapy Table 55-2 on page 1031 in textbook Surgery: -Cryotherapy - destroy prostate by freezing -Prostatectomy -Orchidectomy - to eliminate production of testosterone -May use a combination of the above therapies

How does prostate cancer spread?

Untreated cells spread to pelvic nodes and bones of the pelvis and lumbar spine

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.

What is erectile dysfunction ?

also known as impotence

Escherichia coli

and microbes that causes STIs are common culprits -May also be caused by psychosexual problem: have a psychological basis

Which is the fastest spreading bacterial STI in the United States?

chlamydia

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.

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.

What diagnostic studies are done for BPH and what do they typically show?

-DRE - enlarged gland -Cystoscopy - shows extent of effect on urethra -IVP, blood chemistry tests - show damage to upper urinary tract due to retention -PSA - may be slightly elevated -transrectal ultrasound - indicates size of prostate & whether malignancy may be present

What are the signs/symptoms of ED?

-Difficulty in achieving or maintaining an erection -Insufficient rigidity of erection

A client expresses concerns about future reproduction after a surgery and treatment for cancer of the testes has proceeded without first collecting and storing sperm. Which alternatives should a nurse suggest to the client?

-donor insemination -adoption -foster parenting

What are the s/s of prostate cancer?

-frequent urination -nocturia -dysuria -hematuria -hemospermia (blood in the semen) -erectile dysfunction -back pain, pain down leg -may be the first symptom of metastasis

What are the signs/symptoms of prostatitis?

-glandular swelling, tenderness -perineal pain -unusual sensation prior to or after ejaculation -low back pain -fever -dysuria -urethral discharge

What three issues are associated with erectile dysfunction

-inability to achieve erection -inability to achieve erection that is rigid enough for sex -inability to sustain erection for satisfactory period of time

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?

-use warm sitz baths several times a day -avoid drinking coffee, tea, and colas -avoid sitting for prolonged periods

Which client is most likely to develop prostate cancer according to a nurse working at a health screening at the local mall?

A 56-year-old African American man

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?

A painless genital ulcer that appeared about 3 weeks after unprotected sex

What is a sitz bath

A procedure whereby patient's perineal area/buttocks are submerged in warm water

A 28-year-old sexually active male presented to a clinic because he was concerned about a round, painless sore on the shaft of his penis that had appeared 2 days prior to his visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. The nurse should tell the patient:

An antibiotic injection is the best treatment since the lesion has just occurred.

How is cryptorchidism treated?

Androgen therapy - human chorionic gonadotropin (hCG) -Stimulates testes to release testosterone, promoting descent into the scrotum Orchiopexy - surgery to secure the testes in the scrotum -Typically performed between 1-2 years of age -If not corrected, risk of cancer is 20% to 40%

A client with a trichomoniasis infection is prescribed metronidazole. Which teaching will the nurse provide to the client about this medication?

Avoid all alcohol for 24 hours after taking the medication.

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

The following outcome appears on the plan of care for a client with genital herpes: "Client demonstrates knowledge about measures to reduce the risk of transmission and recurrences." Which of the following, if reported by the client, would support achievement of this outcome?

Consistently uses condoms with sexual activity

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

Cryptorchidism

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 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 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.

What drugs are used in the treatment of BPH & how do they work?

Drug therapy with alpha adrenergic blockers to relax muscles and relieve urinary symptoms: -Terazosin (Hytrin) -Tamsulosin (Flomax) Drug therapy with 5-alpha reductase inhibitors to halt enlargement and relieve symptoms: Finasteride (Proscar)

A client is diagnosed with herpes simplex. Which statement about herpes simplex infection is true?

During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature birth.

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

The nurse instructs a client with genital herpes on self-care management. Which client statement indicates that teaching has been effective?

I will not touch the lesions when they occur.

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.

The nurse is demonstrating the technique for performing a testicular self examination (TSE) to a group of men for a company health fair. One of the men asks the nurse at what age a man should begin performing TSE. What is the best answer by the nurse?

It should begin in adolescence

The nurse recognizes the client is in which stage of syphilis when the client has no signs or symptoms of syphilis?

Latency

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

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

Which instruction should be given to a woman newly diagnosed with genital herpes?

Limit stress and emotional upset as much as possible.

The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client?

Many people with chlamydia won't have symptoms for up to 3 weeks after being infected.

What causes phimosis/paraphimosis?

Often times these are caused by small foreskin or chronic inflammation of the glans due to poor hygiene or infection

Which term refers to the surgical removal of one or both testes?

Orchiectomy

What causes ED?

Patho: -Due to ineffective: -Neurologic stimulation -Blood flow to the penile tissue -Trapping of venous blood to sustain erection Caused by: spinal cord injury, trauma, insufficient testosterone, drug side effect, atherosclerosis, hypertension, diabetes mellitus, anxiety/depression

Culture and sensitivity testing of a swab taken from a chancre on the penis of a 27-year-old man has confirmed the presence of Treponema pallidum. The nurse providing care for the patient should anticipate administering which of the following drugs?

Penicillin

Which of the following is the medication of choice for early syphilis?

Penicillin G benzathine

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

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

The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department?

Positive gonorrhea

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.

Which of the following is considered first-line treatment for prostate cancer?

Radical prostatectomy

A client in the clinic is being treated with podofilox resin for genital warts. What should the nurse teach the client about this medication regimen?

Several repeated treatments will likely be needed.

To confirm a diagnosis of syphilis, the nurse would identify the gram-negative bacteria, Treponema palladium, on the laboratory report. The nurse knows that this bacteria is classified among:

Spirochetes

A client expresses concerns about future reproduction after a surgery to correct the cancer of the testes. For this client, treatment proceeded without first collecting and storing sperm. Which alternative should the nurse suggest to the client?

Suggest donor insemination or adoption

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.

The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session?

The effect of the vaccination is optimized if it is administered before the child becomes sexually active.

When developing an educational program for a group of adolescents about sexually transmitted infections (STIs), what should the nurse inform the group about the single greatest risk factor for contracting an STI?

The number of sexual partners

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea who has presented at the clinic. The student should include which of the following in the care plan for this patient?

The patient should also be treated for chlamydia.

The nurse is meeting with the mother of an 11-year-old girl to provide decision making support and education regarding human papillomavirus (HPV) vaccination. The mother states, "I am confused about why my 11 year old needs to be protected from a sexually transmitted infection. She is so young and not sexually active. Why does she need the vaccination now?" What is the nurse's best response?

The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination

Which is the most common type of prostate surgery?

Transurethral resection of the prostate

A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient?

Treatment is aimed at relieving symptoms.

A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient?

Treatment is focused on relieving symptoms.

What is cryptorchidism?

a condition in which one or both of the testes fail to descend into the scrotum -Born with one or both testes not in scrotum -Normally testes drop into scrotum before birth -Unknown cause; asymptomatic -During childhood or puberty, testes may find their way into the scrotum without treatment -Impact on sperm production, fertility - must have at least one testis in the scrotum to ensure production of sperm

What is a vasectomy

a minor surgical procedure to ligate the vas deferens -results in permanent sterilization by interrupting the pathway that transports sperm -procedure has no effect on erection or ejaculation -May take a few weeks before the ejaculatory fluid is free of sperm - use contraception until that time -May wish to bank sperm prior to procedure

A 23-year-old sexually active woman is having a yearly check-up. The nurse advises the client that she should be screened for chlamydia:

annually.

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

What is the torsion of the spermatic cord

rotation of the testicle that twists the spermatic cord, reducing or obstructing blood flow to the testicle

Transillumination

shining a light through the scrotum to determine density of the scrotal tissue

Spermatocele

sperm-containing cyst of the epididymis

digital rectal examination (DRE)

to assess the size of the prostate and for evidence of tumors **Annual DREs are recommended for men older than 40 to 50 years old**

What is included in the treatment for testicular cancer?

treatment depends on the stage of the disease -Autologous bone marrow transplantation -Sperm banking Surgery: -Radical inguinal orchiectomy -Spermatic cord ligation -Radical retroperitoneal lymph node dissection -Chemotherapy; radiation

What nursing interventions are included for patients with BPH who have undergone surgery?

-Catheterization prior to surgery typical - may need a coude catheter or suprapubic catheter -Deep breathing & leg exercises -Continuous bladder irrigation for at least 24 hours after surgery

How is phimosis treated?

-Circumcision - surgical removal of foreskin -Education to wash under the foreskin daily & seek care if unable to retract the foreskin tissue

What are the signs/symptoms of priapism?

-Discomfort -Prolonged erection with interference of blood flow -Altered urinary elimination -Tissue damage if longer than 6 hours

What does BPH lead to?

-Enlarged prostate causes a narrowing of the urethra where it passed through the prostate -interferes with emptying of the bladder and can cause urinary retention

What is included in the nursing care of patients with prostate cancer?

-If client has surgery, may need indwelling catheter for a period of time (10 - 14 days) - educate on proper care and cleansing to prevent infection -Teach pelvic floor (Kegel) exercises to aid with possible incontinence, which can be a complication -Teach that it may take from 3-12 months for sexual potency to return - may need to use alternate forms of intimacy -Monitor PSA levels and other testing results -Administer prescribed medications and treatments - hormone therapy, etc.

What are the signs/symptoms of testicular torsion?

-Immediate surgery is necessary to prevent atrophy and preserve fertility -A prophylactic surgery may be performed on the opposite site

What are testicular tumors called that form in the sperm-forming cells?

-Incidence higher in those with history of cryptorchidism -Believed to involve early degeneration of cells in undescended testis or testes, creating abnormal cellular changes -Nearly all tumors involve the sperm-forming cells and are called seminomas or nonseminomas

What is testosterone?

-Male sex hormone -affects the development and maintenance of secondary male sex characteristics -aids in spermatogenesis

A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met?

The surgeon is going to insert a scope through my urethra to remove a portion of the gland.

An adolescent informs the school nurse that she is afraid of contracting an STI but her boyfriend does not want to use condoms. What is the best response by the nurse?

The use of condoms is one of the best ways to reduce the risk of acquiring an STI.

What is included in the home care teaching post orchiectomy?

-Drink plenty of fluids, eat a well-balanced diet, avoid constipation. -Obtain adequate rest; avoid heavy lifting. -Wash the incision with soap and warm water. Report any redness, drainage, pain, or swelling of the incision or scrotum. -Take prescribed medication exactly as directed. -Perform self-examination of the remaining testicle every month and immediately report any changes. -Seek care if any of the following occur: fever, chills, adverse drug effects, weight loss, or anorexia. -If sperm banked - teach that normal pregnancies have occurred with sperm stored until they are 55 years of age.

What diagnostic findings are present in prostate cancer? Describe significance of the PSA.

-DRE - prostatic nodule palpated -PSA - Normal value is 1 to 1.5 ng/mL. A value greater than 4 ng/mL requires further investigation; greater than 10 ng/mL indicates malignancy; greater than 80 ng/mL indicates metastatic disease. -Transrectal ultrasound - confirms presence of a mass -Radiographs, MRI, CT, elevated serum acid phosphatase - used to detect metastasis -IVP - detects kidney damage caused by obstruction & retention

List the diagnostic testing techniques commonly used to evaluate male reproductive system & things you would educate the patient on.

Transrectal ultrasonography - lubricated probe inserted into rectum to view prostate -Used when prostate is enlarged or PSA is elevated -Administer enema prior to test Cystoscopy - scope inserted into urethral meatus to inspect bladder, prostate and urethra -Will experience bladder fullness & strong urge to void -May have small amount of bleeding post-procedure -Will be given prophylactic antibiotics - take as prescribed Prostate tissue biopsy - needle biopsy to diagnose prostate cancer when DRE or PSA are abnormal -Administer enema prior to procedure -Sitz baths and mild analgesic may be used for discomfort -Prophylactic antibiotic will be given - take as prescribed Cultures - urethral secretions, prostatic fluid, skin lesions or urine Fertility tests -Semen analysis: sperm count, motility and abnormalities of sperm -Measurement of plasma LH - necessary for release of testosterone from testes Tumor markers - substances made by abnormal tissues (cancerous cells) and released into the circulation Prostate-specific antigen (PSA): blood test that detects prostate cancer

Describe the tests that may be done to evaluate for ED.

-Nocturnal penile tumescence and rigidity test -Vascular ultrasound studies

What are the signs/symptoms of phimosis/paraphimosis?

-Pain with erection and intercourse -Difficulty cleaning under foreskin -Painful swelling of glans -Edema -Urinary retention

How is priapism treated?

-Vasoconstrictive medications: -Terbutaline (Brethine) -Phenylephrine (Neo-Synephrine) -Draining trapped blood with needle -Emergency surgery to shunt blood away from penis -Nursing care focuses on providing emotional support

What is included in the nursing care for epididymitis and orchitis?

-Elevate the scrotum with a commercial scrotal suspensory or with a folded towel, a four-tail bandage, or adhesive tape across the upper thighs -Place an ice bag under the tender scrotum & avoid keeping the cold bag constantly next to the skin because it may damage tissue. Use routine of 60 minutes on, 30 minutes off -Encourage fluid intake. -Take full course of antibiotics -Sitz baths & heat application after swelling subsides -Avoid lifting & intercourse until symptoms relieved -Advocate for immunizations against mumps and other infectious diseases

Paraphimosis

strangulation of the glans from an inability to replace the retracted foreskin

What are the signs/symptoms of testicular cancer?

-scrotal swelling - increase in size of one testicle -hard, nontender nodule -abdominal pain; ache in the groin -general weakness -testicular aching or heaviness

What should the nurse educate the client on after having a vasectomy?

-Expect some bruising and incisional soreness. -Apply ice packs to the scrotum to reduce swelling; remove the cold application after 20 minutes and replace again after the tissue rewarms. -Take a mild analgesic, such as aspirin or acetaminophen. -Wear an athletic support for several days for comfort. -Resume usual activities in 2 to 3 days, but avoid strenuous exercise for up to 5 days. -Resume sexual activity when comfort allows, usually in 1 week. -Use a reliable method of contraception until the physician indicates that sperm no longer are present, which may be determined after 10 or more ejaculations. -Report severe pain, fever, or swelling at the top of the testes.

What techniques are used to obtain physical assessment data of the male reproductive system?

-Inspect external genitalia looking for skin abnormalities or urethral discharge -Palpate testes for tumors -Transillumination - shining a light through the scrotum to determine density of the scrotal tissue -Digital rectal examination (DRE) - to assess the size of the prostate and for evidence of tumors Annual DREs are recommended for men older than 40 to 50 years.

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

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

What is included in the nursing care for ED?

-Instruct on technique, frequency, and side effects of self-injected vasodilators -Post-implant - assess for pain, swelling, bleeding and infection -Educate on possible complications after surgery: ~Erosion of penile tissue from implant ~Erosion of scrotal, bowel or bladder tissue if implant with reservoir is used ~Migration of implant or reservoir ~Malfunction of implant - underinflation, loss of fluid

What is the antidote for priapism?

-Pseudoephedrine immediate release (Sudafed) is the antidote for erections lasting more than 2 hours & patient's using drugs for ED should have this on hand. -Healthcare providers should be contacted when an erection lasts for 3 hours or the pseudoephedrine does not work after 1 hour.

How can a patient maintain optimal bladder emptying?

-Void often and assist bladder emptying by leaning forward on toilet and "bearing down" (Valsalva maneuver), or pressing down on the bladder while seated on the toilet (Credé's maneuver). -Drink frequent small volumes of oral fluids so that the bladder does not become extremely full at any one time. -Limit alcohol and caffeine, which increase the urgency to urinate. -Limit the use of cough, cold, or allergy medications containing decongestants, which can interfere with urination. -Note any signs and symptoms of acute urinary obstruction and urinary infection such as distended bladder, lower abdominal discomfort, inability to urinate, small and frequent urination, fever and chills, and flank pain that indicate a need for medical attention.

How are epididymitis and orchitis treated?

-bed rest -scrotal elevation -local cold application (ice packs) -analgesics/anti-inflammatory agents -antibiotic therapy -epididymectomy procedure

How does illness affect sexuality?

-body image changes can occur -if patients have a negative body image they may withdraw from care or family -be aware of facial expressions, lack of touch

A client is being seen by an urologist for perineal pain, low back pain, fever lasting 5 days, and painful urination. The diagnosis of prostatitis is confirmed. What teaching should the nurse include?

-complete the prescribed antibiotic treatment -avoid prolonged sitting -regularly drain the gland -avoid caffeine products

What are the signs/symptoms of BPH?

-gradual onset with difficulty urinating, narrow stream -difficulty emptying bladder -nocturia -urgency -retained urine can cause cystitis (UTI)

When should men be screened for prostate cancer?

Annual screening at 50 years of age - PSA & DRE -At age 45 years for African Americans and those with first-degree family history in someone <65 years of age

A nurse practitioner who works for Planned Parenthood is responsible for health education seminars. During these presentations, the nurse always discusses the symptoms of the most common STI among young, sexually active people. This is:

Human papillomavirus.

What is leuprolide (Lupron)? What significant information should the nurse know and educate about Lupron?

-Leuprolide (Lupron) is a hormone therapy drug used to treat prostate cancer -It initially stimulates and then inhibits FSH and LH -The end result is suppression of testosterone -It is given IM or subcutaneously Side effects: GI upset, insomnia, constipation, gynecomastia