Ch 26 Assessing Male GU

What care should a nurse take when performing the hands on assessment of the anus, rectum and prostate?

--Listen and watch for signs of discomfort and tensing muscles --explain each step of the examination and encourage the client to relax --use gentle movements with the finger and ensure adequate lubrication

Potential risk factors for HIV/AIDS

--sharing IV needles --mixing of sex and alcohol or drugs indulging in anal --intercourse with men

A nurse is assessing a client who is uncircumcised. The nurse understands that this client is at greater risk for which of the following conditions?

-Cancer of the glans penis -HIV/AIDS

A 55 yr old male presents to the clinic with reports of decreased bowel movements with the passing of hard, dry stool for the past 2 weeks. The client states that he notices a small amount of bleeding from the rectum and on the stool. He has stress at work and drinks a lot of coffee. Which nursing diagnosis can be confirmed with this data?

-Constipation -Risk for Impaired Skin Integrity -Ineffective Health Maintenance

Normal length for testes

4.5 cm ovoid shape* 3.5 to 5 cm long 2.5 cm deep

Which client should a nurse recognize has the highest risk to develop prostate cancer?

A 65 year old caucasian male whose father had prostate cancer at age 55

A client asks the nurse when a colonoscopy is recommended. Which advise by the nurse provides the most appropriate advice?

A flexible sigmoidoscopy should be done every 5 years starting at the age of 50.

During the physical assessment of the anus for a client, the nurse observes a small opening in the skin that surrounds the anal opening. How should the nurse document this finding?

Anorectal fistula

The client is concerned about his risk for developing testicular cancer. Which of the following should the nurse mention as a risk factor for this type of cancer?

Cryptorchidism

A 55 yr old male presents to the clinic with reports of difficulty starting the urine stream, dribbling frequently, and getting up several times a night to urinate. He has decreased his fluid intake to try to control the nighttime urination. The nurse assess a temp of 101.5 F oral, dry skin and mucus membranes and suprapubic tenderness. Which nursing diagnosis can the nurse confirm from this data?

Disturbed sleep pattern

A male client presents to the health care clinic with reports of pain with ejaculation. the nurse should be prepared to inspect which part of the anatomy to determine the likely cause of the clients pain?

Epididymis

Upon inspection of the glans a nurse observes the urethral opening present on the dorsal side of the penis. How should the nurse document this finding?

Epispadias

A nurse examines the anal area of a client and observes the presence of a varicose vein. How should the nurse document this finding?

External hemorrhoid

Black stool can be an indication of what disease process?

GI bleeding

During a health assessment interview a nurse learns that the client has a family history of colorectal cancer. What information should the nurse give client about reducing the risk for colorectal cancer?

Get regular exercise for at least 30 mins consumes foods with adequate folic acid fecal occult blood test (FOBT) should be done regularly

When assessing a client during the physical examination of the genitalia, the nurse palpates the scrotal contents. Which finding should the nurse recognize as an indication that a varicocele is present?

Palpable and tortuous veins

How to perform Testicular self examination (TSE)

Perform TSe once a month stand in front of the mirror and check for scrotal swelling Roll the testis gently in a horizontal plane between thumb and fingers

Foreskin is tight and can't be retracted;

Phimosis

When performing the physical assessment of a client, the nurse notes the presence of a small cyst that contains hair, which is located midline in the sacrococcygeal area and has a palpable sinus tract. How should the nurse document this finding?

Pilonidal cyst

On inspecting a clients external genitalia, a nurse notes that he is uncircumcised. This means that which of the following covers the glans of the penis?

Prepuce

A nurse observes the mucosa of the rectum and the rectal wall of a female client protrudes out through the anal opening. It appears red, doughnut like mass with radiating folds. How should the nurse document this condition of the rectum?

Prolapse

How should the testis feel to the nurses fingers when performing palpation of the scrotal contents?

Rubbery firm smooth

Upon inspection and palpation of the scrotum the nurse discovers a mass. The nurse asks the client to lie down and the bulge remains. Upon auscultation, the nurse finds bowel sounds. The nurse should document this finding as which type of hernia?

Scrotal

During the physical assessment of a clients genitalia, the nurse notes an abnormal mass or swelling. The nurse performs transillumination by shining a light from the back of the scrotum through the mass. In which condition should the nurse see a red glow?

Spermatocele

On inspecting the clients penis the nurse observes a small silvery white papule. Which of the following conditions should the nurse suspect with this client?

Syphilitic Chancre

A nurse is performing palpation of a clients prostate gland. Which of the following indicates proper procedure?

Turn the hand fully counterclockwise so that the pad of the index finger faces the clients umbilicus

How should a nurse proceed with palpation of the anus to best facilitate the exam without causing the client undo discomfort?

ask the client to bear down and place the lubricated finger on the anal opening

A nurse recognizes that which finding is normal upon palpation of the prostate?

contender and rubbery

A nurse examining a clients external genitalia notices that his scrotum and testes draw up and he shivers. The phenomenon is known as which of the following?

cremasteric reflex

A nurse examines the external genitalia of a client and observes that the scrotum is underdeveloped and the testis can't be palpated. How should the nurse document this condition?

cryptorchidism

A male in college presents to the healthcare clinic with complaints of fever, malaise, swelling of the sides of the neck. A blood test confirms the presence of mumps. The nurse should educate the client to report which changes of his genitalia to the health care provider?

feelings of heaviness and pain in the scrotum

What documentation in a clients history should a nurse recognize as an indication that the client has a normal prostate?

heart shaped, smooth with 2 distinct lobes

Which position should a nurse assist a client to assume to ensure comfort during the examination of the anus, rectum, and prostate of a male client?

left lateral

What information should the nurse include in the teaching plan for a client considering a vasectomy?

offers permanent birth control

A nurse prepares a male client for a physical assessment of the external genitalia. Which instruction is appropriate for the nurse to give the client before the examination

reassure him that it is not unusual to have an erection during the examinationP

How should a nurse ask a client to position himself to best facilitate palpation of the left inguinal hernia and inguinal nodes?

stand with the weight shifted to the right leg

A client reports the new onset of mucus in the stool. How should the nurse document this in the clients history?

steatorrhea

During the assessment of a client the nurse recognizes that which of the clients lifestyle practices may predispose the development of an inguinal hernia?

strenuous activity

After discovering an abnormal mass in the scrotum, the nurse performs transillumination of the clients testicles and observes no red glow within scrotal sac. What is this condition?

testicular tumor