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NURSING 3 > Male reproductive disorders > Flashcards

Male reproductive disorders Flashcards

(65 cards)

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1
Q

What is erectile dysfunction

A

Inability to achieve or maintain an erection sufficient for satisfactory sexual activity

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2
Q

Erectile dysfunction involves what

A

Sympathetic and parasympathetic components

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3
Q

What are psychogenic causes of ED

A

anxiety, fatigue, depression, pressure to perform

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4
Q

What are organic causes of ED

A

occlusive vascular disease, endocrine disease, neurologic disorders, trauma, alcohol and medications

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5
Q

ED - assessment

A

Thorough - physical, neuro, labs

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6
Q

ED clinical manifestations

A

decrease frequency of erections
Inability to achieve a firm erection
rapid detumescence (subsidence of erection)

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7
Q

Medical management of ED

A

Phosphodiesterase-5 inhibitors (viagra)
– complication - priapism

Penile implants

    • semigrid rid (constant)
    • inflatable (comes and goes)
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8
Q

Viagra - teaching considerations

A

Take 1 hour prior to sexual sexual activity

Can NOT take with nitrates!!! - will induce hypotension

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9
Q

Describe disorders of ejaculation

A

The spectrum of disorders of ejaculation responses ranges from occasional ejaculation through intercourse or self-stimulation to complete inability to ejaculate under any circumstances.

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10
Q

Disorders of ejaculation - treatment

A

depends on severity of the ejaculation problem

Behavioral therapies – include the partner
Pharmacologic and behavioral therapy together may be effective.

Chemical, vibratory, and electrical methods of stimulation have been used with some success.

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11
Q

Disorders of ejaculation - causes

A

Neurologic disorders (e.g., spinal cord injury, multiple sclerosis, neuropathy secondary to diabetes)

Surgery (prostatectomy)

Medications

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12
Q

What is prostatitis

A

Inflammation of the prostate gland

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13
Q

What is the most common cause of prostatitis

A

E. Coli

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14
Q

How do you know if its prostatitis or a UTI?

A

prostatitis - very tender and swollen prostate

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15
Q

Prostatitis causes what in men?

A

UTIs

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16
Q

Prostatitis: clinical manifestations

A 
Perineal discomfort
Dysuria 
Urgency/frequency
Pain with or after ejaculation
Sepsis-like fever, chills, low back pain
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17
Q

Prostatitis: medical management

A 
CBC, urine culture 
Avoid septicemia
PSA (already elevated, not reliable)
abx
Relief of symptoms
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18
Q

Prostatitis: nursing management

A

Avoid cycling (repetitive perineal trauma)
Hot sitz baths (10-20 minutes) multiple times a day
Hydration
Avoid sitting for long periods of time

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19
Q

Benign prostatic hyperplasia (BPH)

A

Prostate gland enlarge and obstructs the outflow of urine

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20
Q

BPH cause

A

unknown - smoking, alcohol, heart disease, diabetes

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21
Q

BPH - clinical manifestations

A 
Frequency of urination
Nocturia 
Urgency
Hesitancy in starting urination
Abdominal straining with urination

Decrease in the volume and force of the urinary stream, interruption of the urinary stream, dribbling

Sensation of incomplete emptying, possible acute urinary retention, and recurrent UTIs

DRE may reveal a large, rubbery, and nontender prostate gland, although the size of the prostate correlates poorly with symptom report

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22
Q

BPH medical management

A

Urinary retention – catheter inserted (Coude)
Alpha-adrenergic blocker – Tamsulosin
Surgical – TURP, balloon dilation

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23
Q

BPH nursing management

A

intake and output

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24
Q

Risk factors for prostate cancer

A

Highest in AA men
>65 years
Familial disposition
Diet - excessive red meat or high-fat dairy products

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25
TURP (transurethral resection of the prostate)
pushed back the part of the prostate that was pushing on ureter
26
TURP - advantages
``` avoids abdomonal incision safer for patients with surgical risk shorter hospitalization and recovery periods lower morbidity rate causes less pain ```
27
TURP disadvantages
Recurrent osbtruction, urethra trauma, stricture may develop Delayed bleeding may occur Retrograde ejaculation due to removal of prostatic tissue at the bladder neck, which causes the seminal fluid to flow backward into the bladder
28
TURP - nursing implications
``` Monitor for TUR syndrome Monitor for hemorrhage Observe for s/s urethral stricture Monitor urinary output Bladder spasms ```
29
What are s/s urethral stricture
dysuria, straining, weak urinary stream
30
What is TUR syndrome?
Transurethral resection syndrome (TUR) - complication of TURP
31
What are causes of TUR
Neuro CV Electrolyte (hyponatremia, hypo-osmality, hypovolemia)
32
TUR s/s
``` Lethargy and confusion Hypertension Tachycardia Nausea and vomiting Visual disturbances Headache Muscle spasms Seizures ```
33
TUR interventions
During the operative procedure, normal saline cannot be used at it conducts electricity -- intraoperative irrigating solution of glycine, sarbitol/mannitol, or water is discontinued and replaced with normal saline - - administer diuretics - - monitor i&o - - monitor the patient VS and LOC - - differentiate the lethargy and confusion of TUR syndrome from postoperative disorientation and hyponatremia - - maintain safety during times of confusion - - assess lung and heart sounds for indications of pulmonary edema, heart failure, or both (fluid already presents in profound hyponatremia)
34
TURP output
When assessing the output, you will follow the tube to the middle point of the tube/line, not just what is in the drainage bag
35
Prostate cancer
PSA and DRE = most effective
36
Prostate cancer clinical manifestations - late signs
hematuria, urinary obstruction - signs that it has invaded
37
Clinical manifestations that prostate cancer has metastasized
hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, oliguria (less than 400mL/day)
38
Prostate cancer - prostectomy concerns
prostate is really deep in pelvis and surrounded by a lot of vascular tissue, so the we are concerned about hemorrhage during and after septicemia, renal issues, respiratory
39
Radical prostectomy includes removal of what
prostate, lymph nodes, some seminal vesicles
40
Prostate cancer - radiation
could do brachytherapy - inflammation or rectum - ED
41
Prostate cancer - hormonal therapy
suppressing androgens | -- decreasing how much testosterone is circulating in body
42
Prostate cancer - complications
sexual function -- psychological
43
What are radiation complications for prostate cancer
cystitis, diarrhea, ED, proctitis (inflammation of rectum
44
Orchitis
inflammation of testes | tx. = rest, ice, elevation (cannot compress), abx, pain meds., antiinflammatories, avoid straining and sexual activity
45
Epididymitis
swollen and painful duct most common cause = chlamydia s/s = soreness, unilateral pain
46
Testicular cancer most common age
15-40 years old
47
Testicular cancer - risk factors
Undistended testicles, familial cancer, history of cancer
48
Testicular cancer s/s
Going to feel a mass or lump on testicle - usually painless
49
Testicular cancer treatment
removal of teste chemo radiation
50
Hydrocele
Collection of fluid in testes
51
Hydrocele treatment
If severe - incision to drain fluid | abx
52
What are we worried about with hydrocele
Hematoma
53
Varicole
dilation of vein in penis
54
Varicole treatment
scrotal supporter
55
Phimosis
Foreskin is constricted cannot be retracted over the glans
56
Phimosis cause
congenitally or inflammation | Poorly controlled diabetes and obesity are contributing factors
57
Phimosis treatment
Tx – circumcision or dorsal slit
58
Paraphimosis
Foreskin is retracted behind the glans that causes narrowness and subsequent edema - true emergency
59
Paraphimosis
Uncircumcised male - they pull the skin back but do not return it do respected position
60
Paraphimosis treatment
firmly compress glans to reduce the size them moving the foreskin forward
61
Priapism
Erection that is large, hard and painful
62
Priapism cause
nature or vascular
63
Why is a priapism an emergency
venous compromise
64
What patients are prone to priapism
sickle cell disease patients
65
When is priapism considered a urologic emergency
If it lasts longer than 4 hours

NURSING 3 (16 decks)

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