Exam 1: week 3 Flashcards
What are some symptoms of a urinary obstruction in males
- increased frequency
- decreased force of stream
- double or triple voiding
- nocturia
- hematuria
- hematospermia
How would you teach a patient to do a self testicular exam
Palpate scrotum for any abnormal growths, masses, or pain
- look in front of a mirror
- roll the testicle between fingers
- best if done after a warm shower
What should the nurse know about the aging male
- testosterone decreases
- erectile dysfunction
- hyperplasia of prostate (can cause urinary obstruction)
How do you sterilize a male
Vasectomy
- clip vas deferens
- local anesthetic
- outpatient procedure
- 100% effective
- permanent
- reversal 30-85% effective
How long do you have to wait to have sex after a vasectomy to ensure sterility
3 months
- waiting until proximal vas deferens if free of sperm
- need 2 sperm free samples to confirm
What are some post-procedure teachings the nurse will give a patient post vasectomy
- there will be discomfort and swelling
- use ice packs
- support the scrotum with a pillow or sling
What is prostatitis and what treatment do we give
Inflammation of the prostate
treatment includes antibiotics to relieve pain and spasm
What are the different types of prostatitis
- acute bacterial
- chronic bacterial
- chronic prostatitis/chronic pelvic pain syndrome
- asymptomatic inflammatory
What are the symptoms of acute bacterial prostatitis
sudden onset of:
- dysuria
- perineal pain
What are the symptoms of chronic bacterial prostatitis
typically asymptomatic
What are the symptoms of chronic prostatitis/chronic pelvic pain syndrome
GU symptoms with no bacteria in urine (rules out UTI)
How is asymptomatic inflammatory prostatitis diagnosed
incidentally, elevated prostate-specific antigen
What is benign prostatic hyperplasia
Enlarged prostate
- affects 50% of men above 40 years old
- develops gradually
- causes urinary obstruction
What are the symptoms of benign prostatic hyperplasia
- urinary hesitancy (dribbling, weak stream)
- dysuria
- incomplete bladder emptying
- urinary retention
- UTI
What are some prostatic diagnostic tests that can be done
- prostate-specific antigen tests
- ultrasound
- prostate fluid/tissue analysis
- sexual function tests
What is the normal level for prostate-specific antigen
4.0 ng/mL
- increased in BPH, prostatitis, and prostate cancer
What is TURP
transurethral resection of the prostate
- take out the prostate through the urethra
What medication class is used to alleviate symptoms of benign prostatic hyperplasia
5-alpha reductase inhibitors
- reduce the size of the prostate
- relax the prostate to allow urine to flow
What are some 5-alpha reductase inhibitors that reduce the size of the prostate
Also increases hair growth
- Proscar (finasteride) “Propecia”
- Avodart (dutasteride)
- Jalyn (dutasteride/tamsulosin)
What are some 5-alpha reductase inhibitors that relax the prostate to allow urine flow
Also used for hypertension
- Uroxatral (alfuzosin)
- Cardura (doxazosin)
- Flowmax (tamsulosin)
- Hytrin (terazosin)
- Rapaflow (silodosin)
What is included in post-op care for a patient who underwent TURP
- Assess for shock/hemorrhage
- continuous bladder irrigation (3-way catheter)
- monitor vitals
- monitor I&O after removal of catheter
- avoid consumption of large amounts of fluid initially
- avoid anticholinergic, antihistamine and decongestant medications
What are some expected findings in a patient who underwent TURP
- reddish-pink urine for 24 hours
- dribbling and urinary leakage after removal of catheter
What are the risk factors for prostate cancer
- Getting older (biggest risk factor)
- genetics
- African American race
What are the symptoms of prostate cancer
- few or no symptoms at the beginning
- urinary obstruction
- urinary urgency/frequency
- urinary retention
- back pain that may radiate down leg
- blood in urine or semen
- painful ejaculation
