Exam 3 Male GU Flashcards
A specific antigen produced by the cells of the prostate capsule and periurethral glands. Increased in both Prostate Cancer and BPH
Prostate specific antigen
<4.0ng/mL is normal
If PSA is increased in both BPH and Prostate Cancer, how do you tell which it is?
Serum Acid Phosphatase is elevated when a malignancy has metastisized. Check serum acid phosphatase along with PSA and a digital rectal exam when screening for prostate cancer
Finasteride (Proscar)
shrink prostate gland and improve urinary flow
may be combined with doxazosin (Cardura)
5-alpha reductase inhibitors: blocks body’s production of male hormone that causes the prostate the enlarge (DTH)
also treats male pattern baldness
Terazosin hydrocloride (Hytrin) Doxazosin (Cardura)
alpha 1 adrenergic blocker (Blocks NE) to relax veins and arteries, muscles of prostate and bladder neck, making it easier to urinate. also treats htn and may cause dizziness or fainting (may take at bedtime to reduce adverse symptoms)
What is significant pt teaching about Avodart?
Do not donate blood until 6 months after final dose
transfusion may go to a pregnant female and cause miscarriage or birth defects; also hepatotoxic
Which meds may cause urinary retention?
anticholinergics, antihistamines, decongestants
What dietary considerations go with BPH?
increase lycopene (tomatoes and beets, apples and cranberries) increase fiber
which herb is thought to be helpful in BPH?
saw palmetto
What is a nursing consideration for patients receiving epidural or spinal anesthesia?
may cause respiratory paralysis, artifcial ventilation may be required until the effects of the anesthesia wear off
what is a disadvantage to a TURP?
only small pieces of the prostrate gland are removed-remaining prostate tissue may continue to grow and cause uriniary obstruction, requiring more TURPS
Why is surgery time limited in a TURP?
the nonconducting agent, glycine, can cause damage to surrounding tissue after prolonged exposure. The grounding ESU pad and nonconducting fluid are needed to prevent the electrical current from disturbing surrounding tissues–>TUR syndrome
Is TUR syndrome an issue if performing a bipolar TURP?
no, saline can be used for irrigation, no grounding pad or glycine required!
Laser prostate surgery benefits?
"Greenlight" or KTP procedure decreased bloodloss elimination of TUR syndrome ability to treat larger glands ability to treat pts who are actively on anticoag therapy for unrelated diagnoses
When do you increase the irrigation fluid rate when using continuous bladder irrigation?
the irrigation rate should be increased when the drainage becomes bright red.
What do you treat bladder spasms with (esp. post op of a prostatectomy)?
B&O Belladonna and opium
A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner
radionuclide bone scan
a surgical procedure to remove one or both testicles to decrease male hormone production
Orchiectomy
Which chronic disease has a high occurrence of ED associated with it?
Diabetes Mellitus-40% of male diabetics have ED
what is priaprism?
prolonged erection
a slow form of testicular cancer usually found in men in their 30s and 40s. The cancer is usually just in the testes, but it can spread to the lymph nodes. This type is very sensitive to radiation therapy
Seminoma
the more common type of testicular cancer tends to grow more quickly and is often made up of more than one type of cell: choriocarcinoma, embryonal carcinoma, teratoma, yolk sac tumor
Nonseminoma
Are the testicular tumors called stromal tumors (Leydig or Sertoli) cancerous?
No, and they usually occur in childhood
What does presence of beta HCG indicate?
always a malignancy
a blood chemistry study, usually part of a liver panel, useful in assessing liver and pulmonary disease. This is produced by ALL TUMORS, and normal range is 48-115
LDH
“tells you where on the map!”
this diagnostic lab is not diagnostic on its own, but can differentiate the source for tumor among liver, bone, and germ cell origin. It helps confirm malignancy in a small number of paitents
PLAP
placental Alkaline Phosphatase
the medical condition of a male not having any measurable level of sperm in his semen. Many forms are amenable with treatment
azoospermia
semem with a low concentration of sperm, a common finding in male infertility
oligospermia
constricted prepuce that cannot be retracted over the glans-this is an emergency requiring circumcision
Phimosis and Paraphimosis
tell pt to take a warm bath to allow dressing to loosen
barbiturate sleeping medication
what can cause priapism?
thrombosis of veins of corpora cavernosa leukemia sickle cell disease DM malignancies abnormal reflex some drugs
How do you treat priapism?
urologic emergency meperidine warm enemas urinary or suprapubic catheterization large-bore needle or surgical intervention
epididymitis
The epididymis is a long, tightly coiled tube located behind each testicle that connects the testicle to the ductus deferens and stores sperm.
Acute epididymitis is inflammation of the epididymis, causing pain and swelling of the scrotum. Most cases are caused by sexually transmitted bacterial infections occurring in men age 19 to 35 years old.
Chronic epididymitis refers to inflammation characterized by persistent testicular pain in the absence of scrotal swelling. This condition is usually more difficult to treat and may result in long-term pain.
