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

Ch 23:Male genitalia and rectal exam Flashcards

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
Q

Give lifespan considerations for your older adult

Incontinence
Hormone
Libido
Pendulous
What increases(Two) give percentages
A

Stool incontinence
-Due to loss of sphincter control

⬇️testosterone, libido, sex function

⬆️ BPH, ED
-ED: 50% = 50’s//75% = 70’s

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26
Q

What is vital to remain in cultural considerations

A

It is vital to remain non-judge mental about cultural considerations like practices and beliefs

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27
Q

What has been noted as a rise in the last 10 years

How do you want to address this rise

A

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

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28
Q

What is Vital you want to teach about the Prince Albert piercing

A

Prince Albert piercing can cause loss of sensation because of Nerve damage to penis

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29
Q

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

A

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

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30
Q

What is a Epididymitis

What assessment type is epididymitis

Give signs and symptoms of epididymitis

A

Epididymitis is the information of the epididymis

Epididymitis = emergency assessment

Signs and symptoms:
-fever 
- redness
-Swelling
31
Q

What are UTIs most closely associated with in men

A

UTIs most commonly associated with indwelling Foley catheters in men

32
Q

What are signs of symptoms a man may have rectal bleeding

What along with rectal bleeding can cause the hospitalization of a patient

A

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
Q

What kind of assessment is a strangulated hernia briefly describe it

A

Strangulated hernia = emergency assessment

Strangulated hernia is one small intestine pushes through the muscle and then the muscle clamped down cutting off blood

34
Q

Give the major differences between to Testicular torsion and epididymitis

A

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
Q

Describe the difference between hypospadias and epispadias

Describe phimosis

A

Hypospadias: BOTTOM meatus opening venntral

Epispadias: TOP Meatus opening dorsal

Phimosis is the inability to retract foreskin
-commonly occurs during first 6 years

36
Q

In relation to subjective data what is relevant personal history you should collect

A 
Any chronic illness
 CA
surgeries 
STI/UTI
DM
37
Q

When collecting medical and surgical history what is vital for subjective data

What is orchiopexy

A

Any circumcision, vasectomy, orchiopexy

Orchiopexy: surgical procedure to remove undescended testicle (Cryptorchidism) and method for resolving testicular torsion

38
Q

When obtaining sexual history what is vital to collect



A

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
Q

Give the 5 P’s to assess when assessing sexual history

A

5 P’s

  1. Partners
  2. Practices
  3. Protection
  4. Past STI
  5. Prevention of pregnancy
40
Q

What are medication’s collected during the subjective data that can cause ED

A

Cardiac meds/HTN RX/diuretics

Hypoglycemics

41
Q

What are the risk factors for testicular cancer

A

20-34 YOA***

Caucasian***

Hx of cryptorchidism

personal/familial Hx CA

42
Q

What are health goals related to male genitalia and rectal assessments

A

Decreased prostate cancer cases

Increase family planning especially male involvement in preventing pregnancy

Decrease injury to genitalia

Decrease STI

43
Q

How do you teach your patient the testicular self exam

-optimal time/where
-technique
-Normal findings
-what to do if abnormal finding


A

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
Q

Give the signs and symptoms of bladder cancer (same for mail in women)

A

#1 S&S: hematuria without pain

45
Q

Give common signs and symptoms Related to the male genitalia and rectal Assessment

A 
Pain 
difficulties with urination :BPH
 ED 
penile lesions 
discharge 
scrotal enlargement
46
Q

Within penile pain what are a few conditions men may develop

A
  • testicular torsion
  • Epididymitis
  •  hydrocele: fluid in scrotum
  • chlamydia/gonorrhea
  • Orchitis: bacterial infection
47
Q

Impatient with ED what signs with a illicit

A

No erection
Erection without simulation
Curvature
Priapism: prolong painful erections



48
Q

In relation to penile lesions what is

  • chancre
  • How does herpes II present on the penis
A

Lesions:

Chancre: =Syphilis painless lesions

Herpes II presents with vesicles/warts along penis/glans

49
Q

What disease causes discharge to be omitted from the penis

-what does discharge look like what are other signs and symptoms

A

Gonorrhea causes discharge to be admitted from penis

-Thick yellow urine discharge rectal pain and rash

50
Q

What is the main cause of Scrotal enlargement what does it feel like

A

One of the main causes of scrotum enlargement is Hydrocele

Feels like a dull aching in the groin

51
Q

What does flank pain with microscopic hematuria indicate

What do you do as an assessment

A

Flank pain with microscopic hematuria could indicate renal calculi do CVA

52
Q 
Give lesbian considerations for your older adults

Rectal reflex
Urine changes
ED
A

Older adults have
Rectal reflexed reduced
BPH present
Changes in sexual function leading to more cases of ED

53
Q

What cultural consideration group has the highest incidence of prostate cancer

A

African-Americans have the highest incidence of prostate cancer

54
Q

What cultural consideration group has the highest incidence of testicular cancer

A

Caucasians have the highest incidence of testicular cancer

55
Q

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

A

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
Q

When noting the penis during the comprehensive physical assessment what is a common finding in those who are uncircumcised

A

During assessment in those who are uncircumcised look for

Smegma
-White cheesy substance usually present after retracting foreskin (around corona)

57
Q

What do you want to assess for when looking at a glans and meatus

A

When assessing glans and meatus access for epispadias or hypospadias

58
Q

Where do you assess for hernias

A

Assess for hernias in the inguinal ans femoral regions

59
Q

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

A

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
Q

What is the normal finding in testicles

A

Testicles egg shaped, rubbery, firm

61
Q

What is the normal finding in the vas deferens

A

The vas deferens is smooth and cord like

62
Q

When conducting the prostate exam what is a secondary test you want to conduct with the stool

A

Post prostate exam conduct Hemoccult (guaiac) test

63
Q

Give a technique for the Hemoccult guaiac test

Guve abnorm findings

A

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
Q

What may cause a false negative Hemoccult guaiac test

A

Vitamin C

65
Q

What are pubic changes associated with your older adults

A

In your older adults pubic hair thins turns gray

Testes smaller, softer

sac presents with less Rugae

66
Q

Who has a darker scrotum and anal area in relation to cultural considerations

A

African-Americans have darker scrotum an anal Areas

67
Q

What are risks associated with with men who have sex with men

What do you always want to offer Gay men

A

Men who have sex with men have an increased risk of :
-HIV and genital herpes

Always offer STI screenings at annual visits

68
Q

When doing the assessment what do you perform first

A

When doing Gen and rectal assessments always perform least invasive procedure first

69
Q

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

A

UA, culture and sensitivity, CVA, sonograms

If patient has known infection catch a clean catch/midstream urine for culture and sensitivity

70
Q

What are signs and symptoms of a UTI in a man

A

Uti:

  • fever/chills
  • CVA pain
  • Dysuria/frequency
71
Q

Give nursing outcomes related to male genitalia and rectal assessments

A

Patient will remain free of infection

patient will be continent of urine

72
Q

Give nursing interventions related to male genital and rectal assessments

A

Teach to care for infection prone sites

teach pelvic floor strengthening exercises
-Incontinence

73
Q

Give the nursing diagnosis associated with male Genitalia and rectal assessments

A

 ineffective sexuality pattern

Risk for infection

Urinary retention

Health Assessment (20 decks)

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