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Module 4 > Male Genito-urinary System > Flashcards

Male Genito-urinary System Flashcards

1
Q

Benign prostatic hyperplasia (BPH)

A

Large prostate gland (pinches urethra)

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2
Q

Risk factors of BPH

A

Aging
Obesity
Especially increased waist circumference
Lack of physical activity
High amount of dietary animal protein
Alcohol consumption
Erectile dysfunction
Smoking diabetes

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3
Q

Complications of BPH

A

Urinary retention *
UTI
Overflow incontinence
Hydronephrosis

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4
Q

Urinary retention post void residual

A

> 200 cc

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5
Q

Signs of urinary retention

A

Bladder distinction
Sudden pain and inability to urinate
Post void residual >200cc
AKI
UTI
fever,Dysuria,Suprapubic pain , flank pain

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6
Q

Clinical manifestations of BPH

A

Nocturia
Frequency
Urgency
Dysuria
Bladder pain
Incontinence
Decreased urinary stream caliber and force
Intermittency
Hesitancy
Dribbling

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7
Q

Diagnostic studies of BPH

A

Detailed H&P
Digital rectal exam
Urinalysis/culture
Prostate-specific antigen (PSA)

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8
Q

Digital rectal exam (DRE)

A

Estimates prostate size , symmetry and consistency

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9
Q

Prostate specific antigen (PSA)

A

Screens for prostate cancer

May be elevated PSA to rule out cancer

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10
Q

Treatment BPH

A

Catheter insertion if possible
Pharmacological interventions
Possible surgery (in severe situations)
Least invasive to most

If needed they will put Catheter but will try not to intervene

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11
Q

What will you see in DRE

A

Smooth , symmetrical consistency and visual rectal exam BPH

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12
Q

Goals for BPH

A

Restore bladder drainage
Relieve the pt symptoms
Prevent or treat the complications of BPH

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13
Q

Nursing management bph

A

Active surveillance
Bladder scan
Dietary changes
Meds (avoid anticholinergics and decongestants)
Limit fluids at night
Bladder re training (timed voiding schedule)
Annual follow up

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14
Q

Pharmacological management for BPH

A

Alphaadrenergic blockers
, 5 alpha reductase inhibitors, 5a- reductase inhibitors

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15
Q

Alpha adrenergic blockers

A

Relax smooth muscle that surrounds the urethra

Facilitate urinary flow

Watch for hypotension
Does not shrink prostate

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16
Q

Adverse effects of adrenergic blockers

A

Abnormal ejaculation
Caution using when going for cataract surgery (delays healing) , floppy iris syndrome

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17
Q

Alpha adrenergic blocker meds

A

Tamsulosin
Doxazosin

(All end in sin bp drop)

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18
Q

5 a reductase inhibitors

A

Shrink prostate
Blocks enzyme necessary for conversion of tester one to DHT

Takes 3-6 months for improvement

High risk for developing prostate tumor

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19
Q

5 a reductase inhibitors side effects

A

Erectile dysfunction, decrease libido ,gyecomastia (male breast enlargement)

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20
Q

5a reductase inhibitors

A

Finasteride
Dutasteride
Jalyn (finasteride plus Tamsulosin)

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21
Q

Surgical management

A

TURP

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22
Q

TURP

A

Transurethral resection of the prostate

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23
Q

Post op care for TURP

A

Assess for hemorrhage
Bladder spasms
Urinary incontinence
Infection
Stool softeners and high fiber diet to prevent straining
Treat bladder spasms
Catherter care
Teach kegel excercse

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24
Q

What do blade spasms tell you post op TURP?

A

Too much fluid sitting in bladder and something is occluding it from draining.

Physician well order to irrigate it but if not clamp fluid and call doctor

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25
Q

Continuous bladder irrigation (CBI)

A

Remove blood clots
Ensure drainage of urine
Use aseptic technique

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26
Q

What can post turn pt use

A

Return to urinary continence
Refer to continence clinic if not normal within 12 months
Use penile clamp , condemn catheter, incontinence pads or briefs to manage dribbling and continue socialization activities

27
Q

Prostate cancer

A

Slow growing cancer

28
Q

Where does prostate cancer metastasize

A

Lymph node /lung/other organs/bone, spine*

High cure rate when localized can respond well when advanced

29
Q

If a pt is hemorrhaging

A

You would see low BP high hr

30
Q

Clinical manifestation of BPH

A

BPH symptoms
PSA elevated
DRE
Dysuria /hematuria
Paine (perineal Suprapubic rectal)

31
Q

When DRE is done on prostate how is it?

A

Rough and asymmetrical

32
Q

Diagnostic studies

A

PSA screening
DRE
Biopsy

33
Q

Screening BPH recommendations

A

Age 55-69 should be screened every 2 years

34
Q

Treatment PSC

A

Radiation
Brachytherapy
Cryotherapy and ablative hormone therapy
Chemotherapy

35
Q

Surgical management of PSC

A

Radical prostatectomy

36
Q

Prostatectomy

A

Retropubic
Perineal

37
Q

Problem for retropubic

A

Not all pt qualify especially obese pt and more tissue being there

38
Q

Perineal risk

A

Infection , bowel movement (increase fiber teaching)

39
Q

Post op prostatectomy

A

Indwelling Cather
Surgical site drain
Hospital stay 1-3 days

40
Q

Complications of prostatectomy

A

Erectile dysfunction
Incontinence, urinary retention
Hemorrhage *
Infection*
Wound dehiscence*
DVT /PE

41
Q

What do we want to teach about incontinence during the first few months post prostatectomy

A

May be more prominent but as time goes on the gain muscles and regain strength

42
Q

Catheter balloon for prostatectomy

A

20-30 ml

43
Q

Brachytherapy

A

Usually done out pt
One and done situation
Caution- dont touch probes and limit amount of time not to be in room. Educate pregnant individual or children to stay out of room

Wear gloves and radiogown

44
Q

Nursing management

A

Meds (chemo drugandstool softener)
Wound care /bladder irrigation
(E coli risk for perineal pt )

45
Q

Pt teaching prostate cancer

A

Annual check up PSA /DRE
Brachytherapy radiation exposure
Signs of infection
Prevention

46
Q

Erectile dysfunction causes

A

Diabetes , vascular disease, side effects of meds, result of surgery , trauma, stress, depression and others
Avoid smoking and alcohol use

47
Q

How to manage erectile dysfunctions

A

Medication
Surgical
Psychosocial

( if pt is depressed look into therapy)

48
Q

5 (PDE -5 )inhibitors

A

Not created for ED
Causes smooth muscle relaxation and increase blood flow

  • do not combine with nitrate /nitroglycerin or alpha blockers of any form
    (Can potentiate hypotensive effects of nitrate)
49
Q

5(PDE-5) inhibitors

A

Adverse effects -hypotension, priapism(long erection 3-4 hours) , headache, flushing , dyspepsia

Priapism ** why we should treat not to take double dose)

50
Q

Priapism

A

Medical emergency go to ER to get relieved

Long erection 3-4 hours

51
Q

5(PDE-5 ) inhibitors meds

A

Sildenafil
Vardenafil
Tadalafil
FIL HAS AN ERECTILE DISFUNCTION

52
Q

Nursing management non surgical erectile dysfunction

A

Vacuum device

53
Q

Surgical management erectile dysfunction

A

Implant or penileprosthesis

54
Q

Testicular cancer causes

A

Abnormal testicle development
History of down syndrom
HIV
History of testicular cancer
Infertility
Tobacco use
Undescended testicle history
Exposure to chemicals

55
Q

Patho testicular cancer

A

Age 15-35
Can metastasize to other locations
If it’s on the right, spreads to the right and so on

56
Q

Clinical manifestations of testicular cancer

A

PAINLESS mass in scrotum
Non tender and firm
Dull ache or heavy sense action in lower abdomen , perinatal area or scrotum

57
Q

Diagnostic studies testicular cancer

A

Palpations of scrotal content (firm does not transilluminate)
Ultrasound
Lab (tumor markersO
AFP LDH
HCG

58
Q

TREATMENT testicular

A

Surgery
Chemo therapy
Radiation

59
Q

Orchiecctomy

A

Surgical removal of affected testis, spermatic cord , and regional lymph nodes

60
Q

Seminomas

A

Do better with radiation and or chemo

61
Q

Nonseminomas

A

Not responsive to radiation
Removal of lymph nodes
Chemotherapy *

Tend to be rapid growth

62
Q

Nursing management testicular cancer

A

Wound care
Vitals
Teaching s/s of infection
Fertility options
Follow up
Self exams months

63
Q

Teaching for trauma

A

Sudden onset of scrotal pain, tenderness, swelling n/v
Urinary cympoms
Fever(absence WBC or bacteria in urine )

Seek medical care!!^

Post surgical care/drain management

Module 4 (47 decks)

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