ch 54 male repro disorders Flashcards
S+S benign prostatic hyperplasia (BPH)/prostate cancer (5)
(lower UTI symptoms: )
- decrease force of urination
- nocturia/increased frequency of urination
- overflow incontinence
- dribbling at end of urination
- sensation of incomplete bladder emptying
complications untreated BPH (5)
- kidney stones
- bladder damage
- pyelonephritis
- UTIs
- renal failure (postrenal cause)
Dx BPH/prostate cancer (6)
- digital rectal exam
- urine culture and sensitivity
- post void residuals
- cancer: blood PSA level (<4=normal)
- cancer: gleason score
- cystourethroscopy
major risk factor bladder cancer
smoking
meds for BPH if they have complications or more severe S+S (2)
- alpha blockers (relax smooth muscle lining of urethra)
- alpha reductase inhibitors (shrink prostate)
common med ending for alpha blockers
-zosine
admin consideration for alpha blockers for BPH (2)
- watch for orthostatic hypoTN
- measure bp before giving (lowers bp)
SE alpha blockers (6)
- hypoTN
- tachycardia
- dizziness
- fatigue
- sexual dysfunction
- fainting
common med ending for alpha reductase inhibitors
-asteride
important nursing consideration for alpha reductase inhibitors for BPH (2)
- 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
meds that pts with BPH shouldn’t take (3)
- anticholinergics
- antihistamines
- decongestants
- all can cause urinary retention
surgical options BPH (3)
- transurethral microwave heat treatment
- laser prostate ablation
- TURP (transurethral resection of prostate)
TURP postop care (3)
- triple lumen catheter with continuous irrigation
- immediate postop pink-red urine is ok
- keep track of I&Os (murphy drip mL)
meds that can help with bladder spasms after TURP (3)
antispasmodics:
- dicyclomine
- flavoxate
- belladonna & opium (B&O suppository)
SE antispasmodics (5)
- dry mouth
- increased HR
- dizziness
- constipation
- blurred vision
complications post-op TURP (4)
- hemorrhage
- infection
- urinary incontinence
- DVT
malignant enlarged prostate
prostate cancer
considerations for PSA blood tests when also doing digital rectal exam
get PSA blood test before digital rectal exam (can falsely elevate if taken after exam)
Tx prostate cancer (3)
- radiation
- hormone therapy (antitestosterone treatments)
- radical prostatectomy
recommendation for how often men should get PSA tests
-start at 50 yo for screening
common age testicular cancer
-males 15-35 yo
S+S testicular cancer (3)
- painless lump in scrotum
- asymmetry
- feeling of fullness
Dx testicular cancer (4)
- AFP and hCG levels
- ultrasound
- CT/MRI
- biopsy of lump
Tx testicular cancer (2)
- first line: surgery (orchiectomy)
- chemo/radiation if metastases
teaching for men 15-35 yo regarding testicular cancer
- self exams every month
- after warm shower/bath
collection of fluid around testicle and spermatic cord
hydrocele
cluster of dilated veins in scrotal sac
varicocele
S+S hydrocele
- enlarged scrotum
- usually painless
Dx hydrocele
aspiration of fluid
Tx varicocele
ablation
common causes erectile dysfunction (6)
- meds (b blocker)
- psych problems
- thyroid/hormonal problems (hypothyroidism)
- aging
- previous prostatectomy
- vascular disease (CV, diabetes)
what can erectile dysfunction be early warning sign of
CAD
CV disease
Tx erectile dysfunction
phosphodiesterase inhibitors
-common ending: -afil
SE phosphodiesterase inhibitors for erectile dysfunction Tx (6)
- *priapism (prolonged erection)
- headache
- flushing
- dizziness
- nasal congestion
- dyspepsia
painful erection for 6+ hours, medical emergency
priapism
Tx priapism
needle removal of blood from penis
contraindication for phosphodiesterase inhibitors
- nitrates (nitroglycerin for CAD)
* profound hypoTN, cardiac arrest
important question before giving nitroglycerin to men experiencing chest pain in ER
have you taken phosphodiesterase inhibitor in last 24 hours
Tx prostatitis (2)
- antibiotics
- stool softeners
S+S prostatitis (2)
- hematuria
- lower UTI symptoms
