ch 54 male repro disorders

Question 1

S+S benign prostatic hyperplasia (BPH)/prostate cancer (5)

Answer 1

(lower UTI symptoms: )

• decrease force of urination
• nocturia/increased frequency of urination
• overflow incontinence
• dribbling at end of urination
• sensation of incomplete bladder emptying

Question 2

complications untreated BPH (5)

Answer 2

• kidney stones
• bladder damage
• pyelonephritis
• UTIs
• renal failure (postrenal cause)

Question 3

Dx BPH/prostate cancer (6)

Answer 3

• digital rectal exam
• urine culture and sensitivity
• post void residuals
• cancer: blood PSA level (<4=normal)
• cancer: gleason score
• cystourethroscopy

Question 4

major risk factor bladder cancer

Answer 4

smoking

Question 5

meds for BPH if they have complications or more severe S+S (2)

Answer 5

• alpha blockers (relax smooth muscle lining of urethra)

- alpha reductase inhibitors (shrink prostate)

Question 6

common med ending for alpha blockers

Answer 6

-zosine

Question 7

admin consideration for alpha blockers for BPH (2)

Answer 7

• watch for orthostatic hypoTN

- measure bp before giving (lowers bp)

Question 8

SE alpha blockers (6)

Answer 8

• hypoTN
• tachycardia
• dizziness
• fatigue
• sexual dysfunction
• fainting

Question 9

common med ending for alpha reductase inhibitors

Answer 9

-asteride

Question 10

important nursing consideration for alpha reductase inhibitors for BPH (2)

Answer 10

• women who are pregnant/want to become pregnant shouldn’t handle these meds (can cause birth defects)
• takes 12 weeks to see full benefit of meds

Question 11

meds that pts with BPH shouldn’t take (3)

Answer 11

• anticholinergics
• antihistamines
• decongestants
• all can cause urinary retention

Question 12

surgical options BPH (3)

Answer 12

• transurethral microwave heat treatment
• laser prostate ablation
• TURP (transurethral resection of prostate)

Question 13

TURP postop care (3)

Answer 13

• triple lumen catheter with continuous irrigation
• immediate postop pink-red urine is ok
• keep track of I&Os (murphy drip mL)

Question 14

meds that can help with bladder spasms after TURP (3)

Answer 14

antispasmodics:
- dicyclomine
- flavoxate
- belladonna & opium (B&O suppository)

Question 15

SE antispasmodics (5)

Answer 15

• dry mouth
• increased HR
• dizziness
• constipation
• blurred vision

Question 16

complications post-op TURP (4)

Answer 16

• hemorrhage
• infection
• urinary incontinence
• DVT

Question 17

malignant enlarged prostate

Answer 17

prostate cancer

Question 18

considerations for PSA blood tests when also doing digital rectal exam

Answer 18

get PSA blood test before digital rectal exam (can falsely elevate if taken after exam)

Question 19

Tx prostate cancer (3)

Answer 19

• radiation
• hormone therapy (antitestosterone treatments)
• radical prostatectomy

Question 20

recommendation for how often men should get PSA tests

Answer 20

-start at 50 yo for screening

Question 21

common age testicular cancer

Answer 21

-males 15-35 yo

Question 22

S+S testicular cancer (3)

Answer 22

• painless lump in scrotum
• asymmetry
• feeling of fullness

Question 23

Dx testicular cancer (4)

Answer 23

• AFP and hCG levels
• ultrasound
• CT/MRI
• biopsy of lump

Question 24

Tx testicular cancer (2)

Answer 24

• first line: surgery (orchiectomy)

- chemo/radiation if metastases

Question 25

teaching for men 15-35 yo regarding testicular cancer

Answer 25

- self exams every month | - after warm shower/bath

Question 26

collection of fluid around testicle and spermatic cord

Answer 26

hydrocele

Question 27

cluster of dilated veins in scrotal sac

Answer 27

varicocele

Question 28

S+S hydrocele

Answer 28

- enlarged scrotum | - usually painless

Question 29

Dx hydrocele

Answer 29

aspiration of fluid

Question 30

Tx varicocele

Answer 30

ablation

Question 31

common causes erectile dysfunction (6)

Answer 31

- meds (b blocker) - psych problems - thyroid/hormonal problems (hypothyroidism) - aging - previous prostatectomy - vascular disease (CV, diabetes)

Question 32

what can erectile dysfunction be early warning sign of

Answer 32

CAD | CV disease

Question 33

Tx erectile dysfunction

Answer 33

phosphodiesterase inhibitors | -common ending: -afil

Question 34

SE phosphodiesterase inhibitors for erectile dysfunction Tx (6)

Answer 34

- *priapism (prolonged erection) - headache - flushing - dizziness - nasal congestion - dyspepsia

Question 35

painful erection for 6+ hours, medical emergency

Answer 35

priapism

Question 36

Tx priapism

Answer 36

needle removal of blood from penis

Question 37

contraindication for phosphodiesterase inhibitors

Answer 37

- nitrates (nitroglycerin for CAD) | * profound hypoTN, cardiac arrest

Question 38

important question before giving nitroglycerin to men experiencing chest pain in ER

Answer 38

have you taken phosphodiesterase inhibitor in last 24 hours

Question 39

Tx prostatitis (2)

Answer 39

- antibiotics | - stool softeners

Question 40

S+S prostatitis (2)

Answer 40

- hematuria | - lower UTI symptoms