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Health Assessment > Ch 23:Male genitalia and rectal exam > Flashcards

Ch 23:Male genitalia and rectal exam Flashcards

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1
Q

Because of the intimacy of the genital exam what are 3 things you want to do for the patient

A
  1. Provide privacy
    2. Remain culturally sensitive
  2. Have a chaperone if requested
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2
Q

During a physical exam (of male genitalia) when there is an educational opportunity what do you want to teach

A

Teach health promotion and risk reduction.

(I.e: testicular self examination )

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3
Q

What are the two functions of a penis

A

1.urine excretion

  1. Penetration for intercourse
    
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4
Q

Locate:

  • Root
  • Shaft
  • Glans
A

Route: deep within perineum

Shaft: body; the skin that we see

Glands: head

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5
Q

What are the three distensible (Extendable) structures

What is the function of the bulb

A
  1. 2 Corpoa carnivosa
    - forms the sides of the penis
  2. Dorsum= TOP
  3. Corpus spongiosum
    - forms bulb

Bulb: for erection and ejaculation

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6
Q

Give the other name for the prepuce

What is the prepuce

A

Prepuce = foreskin

Hood (light-skinned) covers glans 

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7
Q

Give the definition of the scrotum

Give the three parts of the sacs

What happens to the sack

  • with increased temperature
  • with decreased temperature
A 
Wrinkled pouch with two sacs containing

1. Testes
2. Epididymis
3. Spermatic cord

Hot temp: sac relaxes
Cold temp: sac rise is closer to body

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8
Q

What is the term for the development of sperm

What is the optimal temperature for the development of sperm

A

Spermatogenesis = development of sperm

Optimal temperature: 2 to 5° below body temp

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9
Q

Give the description of what phimosis is

When does it typically occur

What can cause

A

phimosis
-inability to retract for skin

Typically occurs first 6 years of life

Can cause obstructed urinary flow

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10
Q

What do the testes produce

What are normal testicular findings

A

Testes produce sperm and testosterone

Normal:

  • egg shaped
  • rubbery
  • firm
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11
Q

Within the ducts:

What is the function of the epididymides
Other name for vas deferens + function

Where does sperm come from

A

Epididymides:
-storage and maturation of sperm

Vas deferens (ductus deferens):
-transports sperm

Sperm comes out from the ejaculatory duct


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12
Q

Give the definition of semen and what it is needed for

What does the prostate emit

A

Semen:
-provides alkaline medium needed for sperm motility and survival

 Prosty emits majority of ejaculatiry fluid 

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13
Q

What is the meatus

Give to abnormal findings

During the physical assessment how do you assess the meatus

A

Meatus: opening of urethra

 abnormal findings:
1. Hypospadias: Opening of urethra located ventrally ( BOTTOM)

2.epidspadias: opening of urethra located dorsally (TOP)

A sesame aegis but I have a patient compress glans 

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14
Q

What do you note if a patient has a urethral stricture

What causes a urethral stricture

A

In a urethra structure you note:

  • scar tissue
  • construction of urethra ***

Urethral stricture is caused by STDs

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15
Q

What are two common developments after 40

Give signs and symptoms for BPH

What do you wanna do to assess prostate cancer

A

To common developments after 40:

  • BPH
  • prostate cancer

BPH signs and symptoms:

  • straining to void
  • Hesitancy
  • nocturia
  • dribbling

When assessing for prostate cancer do
A digital rectal exam and PSA

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16
Q

When a man gets a vasectomy what is cut in removed

A

When getting a vasectomy the VAS DEFERENS is cut and removed

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17
Q

 What makes up the terminal end of the G.I. tract And how long is it

What do the rectal valves support

A

The rectum and anus make up the terminal end of the G.I. tract, about 5 inches

Rectal valves support feces well flatus (farts) arr being expelled 

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18
Q

Where do the anal canal and Anus extend from ->to

A

Anal canal and anus extend from anorectal junction to anus

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19
Q

What is another name for the rectal columns

what are they

what happens when they are destrnded 

A

Rectal columns a.k.a. “Internal hemorrhoidal plexus”

Rectal columns are complex system of veins and arteries

Rectal columns when distended create hemorrhoids

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20
Q

What does voluntary control for defication relax?

What does the sensation to poop mean and what does it cause

A

Voluntary control when pooping relaxes the external sphincters

Sensation to poop means the rectum is filling with stool and it relaxes internal sphincters

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21
Q

Describe the anal canal pain perception

(Upper and lower)

A

Anal canal pain perception:

  • upper: insensitive to stimuli
  • Lower- sensitive to stimuli
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22
Q

What are common lifespan considerations for your newborns

1st poop
Control
Stool

A

In newborns:
-newborn‘s first poop (meconium) within 24 hours of birth

  • have involuntary control of internal/external sphincters
  • have a stool every feeding until 12-18 months
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23
Q

For your newborns what are the benefits of circumcision

A

Circumcision Decrease his risk of UTI

Circumcision Decrease risk of HIV

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24
Q

 Through tanner scale how do the male genitalia develop

A

Using Tanner scale:

-Scrotal skin begins Finn then become more Pendulous active and secrete Testosterone

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25
Give lifespan considerations for your older adult ``` Incontinence Hormone Libido Pendulous What increases(Two) give percentages ```
Stool incontinence -Due to loss of sphincter control ⬇️testosterone, libido, sex function ⬆️ BPH, ED -ED: 50% = 50’s//75% = 70’s
26
What is vital to remain in cultural considerations
It is vital to remain non-judge mental about cultural considerations like practices and beliefs
27
What has been noted as a rise in the last 10 years How do you want to address this rise
An increase in genital piercings and tattoos have increased in the last 10 years If genital piercings/tattoos teach: —Piercing care: S & S of infection
28
What is Vital you want to teach about the Prince Albert piercing
Prince Albert piercing can cause loss of sensation because of Nerve damage to penis
29
Among urgent assessments what do you assume if a patient complains of scrotal pain What kind of assessment is this What can this lead to
If patient complains of scrotal pain always assume testicular torsion!!!  testicular torsion = emergency assessment To see what ocean can lead to a cute ischemia causing gangrene to testicles
30
What is a Epididymitis What assessment type is epididymitis Give signs and symptoms of epididymitis
Epididymitis is the information of the epididymis ``` Epididymitis = emergency assessment  Signs and symptoms: -fever - redness -Swelling ```
31
What are UTIs most closely associated with in men
UTIs most commonly associated with indwelling Foley catheters in men
32
What are signs of symptoms a man may have rectal bleeding What along with rectal bleeding can cause the hospitalization of a patient
Signs and symptoms amen me have a rectal bleed: - shortness of breath - extreme fatigue - laboratory anemia When a man has a rectal bleed and is on anticoagulance they may need hospitalizations
33
What kind of assessment is a strangulated hernia briefly describe it
Strangulated hernia = emergency assessment Strangulated hernia is one small intestine pushes through the muscle and then the muscle clamped down cutting off blood
34
Give the major differences between to Testicular torsion and epididymitis
Testicular torsion * acute pain * RARE fever but 50% N/V *  Requires surgery * elevating does not help - rare urethral symptoms Epididymitis * gradual pain * no N/V but FEVER 50% * requires antibiotics * elevating help reduce - Most common presents with urethralsymptoms
35
Describe the difference between hypospadias and epispadias Describe phimosis
Hypospadias: BOTTOM meatus opening venntral Epispadias: TOP Meatus opening dorsal Phimosis is the inability to retract foreskin -commonly occurs during first 6 years
36
In relation to subjective data what is relevant personal history you should collect
``` Any chronic illness CA surgeries STI/UTI DM ```
37
When collecting medical and surgical history what is vital for subjective data What is orchiopexy
Any circumcision, vasectomy, orchiopexy Orchiopexy: surgical procedure to remove undescended testicle (Cryptorchidism) and method for resolving testicular torsion
38
When obtaining sexual history what is vital to collect 
Sexual history: -unprotected sex 🚹🚹 or 🚹🚺 -Types of sex (route) - 5 P’s 1. Partners 2. Practices 3. Protection 4. Past STI 5. Prevention of pregnancy
39
Give the 5 P’s to assess when assessing sexual history
5 P’s 1. Partners 2. Practices 3. Protection 4. Past STI 5. Prevention of pregnancy
40
What are medication’s collected during the subjective data that can cause ED
Cardiac meds/HTN RX/diuretics | Hypoglycemics
41
What are the risk factors for testicular cancer
20-34 YOA*** Caucasian*** Hx of cryptorchidism personal/familial Hx CA
42
What are health goals related to male genitalia and rectal assessments
Decreased prostate cancer cases Increase family planning especially male involvement in preventing pregnancy  Decrease injury to genitalia Decrease STI
43
How do you teach your patient the testicular self exam -optimal time/where -technique -Normal findings -what to do if abnormal finding 
Testicular self exam - Best post warm shower/front of mirror  - using 2hands with one test at a time palpate between thumbs and first index and middle fingers - norm: egg shaped, rubbery, firm If abnormal finding (Lump) make appointment with urologist
44
Give the signs and symptoms of bladder cancer (same for mail in women)
#1 S&S: hematuria without pain
45
Give common signs and symptoms Related to the male genitalia and rectal Assessment
``` Pain difficulties with urination :BPH ED penile lesions discharge scrotal enlargement ```
46
Within penile pain what are a few conditions men may develop
- testicular torsion - Epididymitis -  hydrocele: fluid in scrotum - chlamydia/gonorrhea - Orchitis: bacterial infection
47
Impatient with ED what signs with a illicit
No erection Erection without simulation Curvature Priapism: prolong painful erections 
48
In relation to penile lesions what is - chancre - How does herpes II present on the penis
Lesions: Chancre: =Syphilis painless lesions Herpes II presents with vesicles/warts along penis/glans
49
What disease causes discharge to be omitted from the penis -what does discharge look like what are other signs and symptoms
Gonorrhea causes discharge to be admitted from penis -Thick yellow urine discharge rectal pain and rash
50
What is the main cause of Scrotal enlargement what does it feel like
One of the main causes of scrotum enlargement is Hydrocele Feels like a dull aching in the groin
51
What does flank pain with microscopic hematuria indicate What do you do as an assessment
Flank pain with microscopic hematuria could indicate renal calculi do CVA
52
``` Give lesbian considerations for your older adults  Rectal reflex Urine changes ED ```
Older adults have Rectal reflexed reduced BPH present Changes in sexual function leading to more cases of ED
53
What cultural consideration group has the highest incidence of prostate cancer
African-Americans have the highest incidence of prostate cancer
54
What cultural consideration group has the highest incidence of testicular cancer
Caucasians have the highest incidence of testicular cancer
55
Upon doing Genital and rectal assessment what do you always want to ask for What do you examine last Exam changes for a child Exam changes for adolescence
During a genital and rectal exam - always ask for permission - examine genitalia last - have parent present if child - Give the option to have parent present if adolescent 
56
When noting the penis during the comprehensive physical assessment what is a common finding in those who are uncircumcised
During assessment in those who are uncircumcised look for Smegma -White cheesy substance usually present after retracting foreskin (around corona)
57
What do you want to assess for when looking at a glans and meatus
When assessing glans and meatus access for epispadias or hypospadias
58
Where do you assess for hernias
Assess for hernias in the inguinal ans femoral regions
59
when doing a perianal and rectal exam how do you position - a healthy patient - an older patient Give the technique Give what you are assessing for
Position healthy patient bent over table Position older patient in Sims position Technique: Spread buttocks Have patient bear down Assess for any tenderness, swelling/redness, warts, fishers (tears) any masses
60
What is the normal finding in testicles
Testicles egg shaped, rubbery, firm
61
What is the normal finding in the vas deferens
The vas deferens is smooth and cord like
62
When conducting the prostate exam what is a secondary test you want to conduct with the stool
Post prostate exam conduct Hemoccult (guaiac) test
63
Give a technique for the Hemoccult guaiac test Guve abnorm findings
Dab stool into two boxes put two drops of solution in each box wait 30 to 60 seconds Abnormal findings blue discoloration indicating colorectal disease
64
What may cause a false negative Hemoccult guaiac test
Vitamin C
65
What are pubic changes associated with your older adults
In your older adults pubic hair thins turns gray Testes smaller, softer sac presents with less Rugae
66
Who has a darker scrotum and anal area in relation to cultural considerations
African-Americans have darker scrotum an anal Areas
67
What are risks associated with with men who have sex with men What do you always want to offer Gay men
Men who have sex with men have an increased risk of : -HIV and genital herpes Always offer STI screenings at annual visits
68
When doing the assessment what do you perform first
When doing Gen and rectal assessments always perform least invasive procedure first
69
What are a few diagnostic/lab tests conducted during the chin at all and recto assessments What test Is conducted if patient has known infection
UA, culture and sensitivity, CVA, sonograms If patient has known infection catch a clean catch/midstream urine for culture and sensitivity
70
What are signs and symptoms of a UTI in a man
Uti: - fever/chills - CVA pain - Dysuria/frequency
71
Give nursing outcomes related to male genitalia and rectal assessments
Patient will remain free of infection patient will be continent of urine
72
Give nursing interventions related to male genital and rectal assessments
Teach to care for infection prone sites teach pelvic floor strengthening exercises -Incontinence
73
Give the nursing diagnosis associated with male Genitalia and rectal assessments
 ineffective sexuality pattern Risk for infection Urinary retention

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