Exam 4 - Male & Female GU Flashcards
A client is admitted because of benign prostatic hypertrophy and is scheduled to have a transurethral prostate resection. What assessment data would indicate to the nurse that a complication is developing?
- The client has difficulty emptying his bladder.
- Client states he feels like he cannot empty his bladder.
- The client complains of frequency and nocturia.
- Increasing complaints of flank pain and hematuria.
- Increasing complaints of flank pain and hematuria
Flank pain may be indicative of an infection or a ureteral obstruction causing increased pressure on the renal pelvis. Other options are symptoms of benign prostatic hypertrophy, for which he will be treated while he is in the hospital.
The nurse is discussing testicular self-examination with a male client. What information is important for the nurse to include in the discussion?
- The best time to perform the examination is 24 hours after sexual intercourse.
- The examination should be conducted at the same time each month.
- The client should perform this self-examination every 3 to 4 months.
- When the scrotum is pulled up tight against the body, the testes are easier to palpate.
- The examination should be conducted at the same time each month
The examination should be done at the same time each month to develop a regular routine. After a shower, when the scrotum is warm and the testicles are descended away from the body, is a good time to perform the examination.
The client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client’s problem is related to bacterial prostatitis, the nurse would look at the results of the prostate examination, which should reveal that the prostate gland is:
- Soft and swollden
- Reddened, swollen, and boggy
- Tender and edamatous with ecchymosis
- Tender, indurated, and warm to the touch
- Tender, indurated, and warm to the touch
The client with prostatitis has a swollen and tender prostate gland that is also warm to the touch, firm, and indurated. Systemic systems include fever with chills, perineal and low back pain, and signs of urinary tract infection, which often accompany the disorder.
The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To determine whether the client currently is experiencing difficulty, the nurse asks the client about the presence of which early symptom?
- Nocturia
- Urinary retention
- Urge incontinence
- Decreased force in the stream of urine
- Decreased force in the stream of urine
Decreased force in the stream of urine is an early sign of benign prostatic hyperplasia. The stream later becomes weak and dribbling. The client then may develop hematuria, frequency, urgency, urge incontinence, and nocturia. If untreated, complete obstruction and urinary retention can occur.
The client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client’s vital signs and empties the urinary drainage bag. Which of the following assessment findings would indicate the need to notify the physician?
- Red bloody urine
- Pain related to bladder spasms
- Urinary output of 200 mL higher than intake
- Blood pressure, 100/50 mm Hg; pulse, 130 beats/min
- Blood pressure, 100/50 mm Hg; pulse, 130 beats/min
Frank bleeding (arterial or venous) may occur during the first day after surgery. Some hematuria is usual for several days after surgery. A urinary output of 200 mL more than intake is adequate. Bladder spasms are expected to occur following surgery. A rapid pulse with a low blood pressure is a potential sign of excessive blood loss. The physician should be notified.
Teaching testicular self-examination
- Over the age of 14
- Performed monthly
- Best performed after warm bath or shower (heat relaxes scrotum)
- Cancerous lumps are usually found on the sides of testicle but can show up on the front
- Should not feel pain performing the exam
- Stand in front of a mirror if possible
Clinical manifestations of benign prostatic hypertrophy (BPH)
- Alterations in urination (due to obstruction to flow from enlarged prostate): weak stream, urgency, dysuria, discharge
- Difficulty initiating a stream
- Infection due to urinary retention
Episadias versus hypospadias - where is each located?
- Hypospadias – urethral meatus located on ventral undersurface of penis
- Epispadias – urethral opens on the dorsal (top) aspect of the penis (more disabling)
Most common “invasive” cancer in men
[Comment: basal & squamous skin cancers are most common, but are not usually invasive]
Prostate cancer
- 95% of cases are adenocarcinomas
- Rare in men younger than 50
- Cause unknown
- Contributing factors: genetic, hormonal, dietary
Cryptorchidism - basic pathophysiology. What is it?
- Disorder of testes – 1 or more testes stay in abdominal cavity instead of descending into scrotum
During admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease?
- Diarrhea
- Hypermenorrhea
- Abnormal bleeding
- Abdominal distention
- Abdominal distention
Clinical manifestations of ovarian cancer include abdominal distention, urinary frequency and urgency, pleural effusion, malnutrition, pain and pressure caused by the growing tumor and the effects of urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. Abnormal bleeding, often resulting in hypermenorrhea, is associated with uterine cancer.
The community health nurse is instructing a group of female clients about breast self-examination. The nurse instructs the clients to perform the examination:
- At the onset of menstruation
- Every month during ovulation
- Weekly at the same time of day
- 1 week after menstruation begins
- 1 week after menstruation begins
The breast self-examination should be performed monthly 7 days after the onset of the menstrual period. Performing the examination weekly is not recommended. At the onset of menstruation and during ovulation, hormonal changes occur that may alter breast tissue.
The nurse is discussing the importance of breast self-examination with a client who is being discharged after a vaginal hysterectomy. What is important information for the nurse to give this client?
- Perform breast self-examination 1 week after her normal period
- Examine her breasts on a regular basis about the same time every month
- Breasts should be palpated while in the sitting position
- Use the tips of the fingers to palpate deeply into the breast tissue
- Examine her breasts on a regular basis about the same time every month
Because she no longer has regular periods, the client should pick a date and perform breast self-examination at the same time each month. Self-examination of the breast a week after the normal period is the best time for a woman who still has a menstrual periods because the breast tissue is less glandular a week after the normal period. Breasts are examined lying down and standing, not sitting. The pads of the fingers are used to examine the breast using small circular motions in a spiral pattern or in an up-and-down motion.
Teaching breast self-examination in a pre-menopausal woman & timing
- She should perform a self-examination monthly
- Approximately 7 days after the onset of menstruation
Teaching breast self-examination in a post-menopausal woman
- A woman that does not have a period should examine her breasts on the same day each month
