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NURSING 3 > Male reproductive disorders > Flashcards

Male reproductive disorders Flashcards

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1
Q

What is erectile dysfunction

A

Inability to achieve or maintain an erection sufficient for satisfactory sexual activity

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2
Q

Erectile dysfunction involves what

A

Sympathetic and parasympathetic components

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3
Q

What are psychogenic causes of ED

A

anxiety, fatigue, depression, pressure to perform

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4
Q

What are organic causes of ED

A

occlusive vascular disease, endocrine disease, neurologic disorders, trauma, alcohol and medications

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5
Q

ED - assessment

A

Thorough - physical, neuro, labs

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6
Q

ED clinical manifestations

A

decrease frequency of erections
Inability to achieve a firm erection
rapid detumescence (subsidence of erection)

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7
Q

Medical management of ED

A

Phosphodiesterase-5 inhibitors (viagra)
– complication - priapism

Penile implants

    • semigrid rid (constant)
    • inflatable (comes and goes)
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8
Q

Viagra - teaching considerations

A

Take 1 hour prior to sexual sexual activity

Can NOT take with nitrates!!! - will induce hypotension

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9
Q

Describe disorders of ejaculation

A

The spectrum of disorders of ejaculation responses ranges from occasional ejaculation through intercourse or self-stimulation to complete inability to ejaculate under any circumstances.

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10
Q

Disorders of ejaculation - treatment

A

depends on severity of the ejaculation problem

Behavioral therapies – include the partner
Pharmacologic and behavioral therapy together may be effective.

Chemical, vibratory, and electrical methods of stimulation have been used with some success.

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11
Q

Disorders of ejaculation - causes

A

Neurologic disorders (e.g., spinal cord injury, multiple sclerosis, neuropathy secondary to diabetes)

Surgery (prostatectomy)

Medications

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12
Q

What is prostatitis

A

Inflammation of the prostate gland

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13
Q

What is the most common cause of prostatitis

A

E. Coli

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14
Q

How do you know if its prostatitis or a UTI?

A

prostatitis - very tender and swollen prostate

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15
Q

Prostatitis causes what in men?

A

UTIs

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16
Q

Prostatitis: clinical manifestations

A 
Perineal discomfort
Dysuria 
Urgency/frequency
Pain with or after ejaculation
Sepsis-like fever, chills, low back pain
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17
Q

Prostatitis: medical management

A 
CBC, urine culture 
Avoid septicemia
PSA (already elevated, not reliable)
abx
Relief of symptoms
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18
Q

Prostatitis: nursing management

A

Avoid cycling (repetitive perineal trauma)
Hot sitz baths (10-20 minutes) multiple times a day
Hydration
Avoid sitting for long periods of time

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19
Q

Benign prostatic hyperplasia (BPH)

A

Prostate gland enlarge and obstructs the outflow of urine

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20
Q

BPH cause

A

unknown - smoking, alcohol, heart disease, diabetes

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21
Q

BPH - clinical manifestations

A 
Frequency of urination
Nocturia 
Urgency
Hesitancy in starting urination
Abdominal straining with urination

Decrease in the volume and force of the urinary stream, interruption of the urinary stream, dribbling

Sensation of incomplete emptying, possible acute urinary retention, and recurrent UTIs

DRE may reveal a large, rubbery, and nontender prostate gland, although the size of the prostate correlates poorly with symptom report

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22
Q

BPH medical management

A

Urinary retention – catheter inserted (Coude)
Alpha-adrenergic blocker – Tamsulosin
Surgical – TURP, balloon dilation

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23
Q

BPH nursing management

A

intake and output

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24
Q

Risk factors for prostate cancer

A

Highest in AA men
>65 years
Familial disposition
Diet - excessive red meat or high-fat dairy products

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25
Q

TURP (transurethral resection of the prostate)

A

pushed back the part of the prostate that was pushing on ureter

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26
Q

TURP - advantages

A 
avoids abdomonal incision
safer for patients with surgical risk
shorter hospitalization and recovery periods
lower morbidity rate
causes less pain
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27
Q

TURP disadvantages

A

Recurrent osbtruction, urethra trauma, stricture may develop
Delayed bleeding may occur
Retrograde ejaculation due to removal of prostatic tissue at the bladder neck, which causes the seminal fluid to flow backward into the bladder

28
Q

TURP - nursing implications

A 
Monitor for TUR syndrome 
Monitor for hemorrhage
Observe for s/s urethral stricture 
Monitor urinary output 
Bladder spasms
29
Q

What are s/s urethral stricture

A

dysuria, straining, weak urinary stream

30
Q

What is TUR syndrome?

A

Transurethral resection syndrome (TUR) - complication of TURP

31
Q

What are causes of TUR

A

Neuro
CV
Electrolyte (hyponatremia, hypo-osmality, hypovolemia)

32
Q

TUR s/s

A 
Lethargy and confusion
Hypertension
Tachycardia
Nausea and vomiting
Visual disturbances
Headache
Muscle spasms
Seizures
33
Q

TUR interventions

A

During the operative procedure, normal saline cannot be used at it conducts electricity
– intraoperative irrigating solution of glycine, sarbitol/mannitol, or water is discontinued and replaced with normal saline

    • administer diuretics
    • monitor i&o
    • monitor the patient VS and LOC
    • differentiate the lethargy and confusion of TUR syndrome from postoperative disorientation and hyponatremia
    • maintain safety during times of confusion
    • assess lung and heart sounds for indications of pulmonary edema, heart failure, or both (fluid already presents in profound hyponatremia)
34
Q

TURP output

A

When assessing the output, you will follow the tube to the middle point of the tube/line, not just what is in the drainage bag

35
Q

Prostate cancer

A

PSA and DRE = most effective

36
Q

Prostate cancer clinical manifestations - late signs

A

hematuria, urinary obstruction - signs that it has invaded

37
Q

Clinical manifestations that prostate cancer has metastasized

A

hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, oliguria (less than 400mL/day)

38
Q

Prostate cancer - prostectomy concerns

A

prostate is really deep in pelvis and surrounded by a lot of vascular tissue, so the we are concerned about hemorrhage during and after

septicemia, renal issues, respiratory

39
Q

Radical prostectomy includes removal of what

A

prostate, lymph nodes, some seminal vesicles

40
Q

Prostate cancer - radiation

A

could do brachytherapy

  • inflammation or rectum
  • ED
41
Q

Prostate cancer - hormonal therapy

A

suppressing androgens

– decreasing how much testosterone is circulating in body

42
Q

Prostate cancer - complications

A

sexual function – psychological

43
Q

What are radiation complications for prostate cancer

A

cystitis, diarrhea, ED, proctitis (inflammation of rectum

44
Q

Orchitis

A

inflammation of testes

tx. = rest, ice, elevation (cannot compress), abx, pain meds., antiinflammatories, avoid straining and sexual activity

45
Q

Epididymitis

A

swollen and painful duct

most common cause = chlamydia
s/s = soreness, unilateral pain

46
Q

Testicular cancer most common age

A

15-40 years old

47
Q

Testicular cancer - risk factors

A

Undistended testicles, familial cancer, history of cancer

48
Q

Testicular cancer s/s

A

Going to feel a mass or lump on testicle - usually painless

49
Q

Testicular cancer treatment

A

removal of teste
chemo
radiation

50
Q

Hydrocele

A

Collection of fluid in testes

51
Q

Hydrocele treatment

A

If severe - incision to drain fluid

abx

52
Q

What are we worried about with hydrocele

A

Hematoma

53
Q

Varicole

A

dilation of vein in penis

54
Q

Varicole treatment

A

scrotal supporter

55
Q

Phimosis

A

Foreskin is constricted cannot be retracted over the glans

56
Q

Phimosis cause

A

congenitally or inflammation

Poorly controlled diabetes and obesity are contributing factors

57
Q

Phimosis treatment

A

Tx – circumcision or dorsal slit

58
Q

Paraphimosis

A

Foreskin is retracted behind the glans that causes narrowness and subsequent edema
- true emergency

59
Q

Paraphimosis

A

Uncircumcised male - they pull the skin back but do not return it do respected position

60
Q

Paraphimosis treatment

A

firmly compress glans to reduce the size them moving the foreskin forward

61
Q

Priapism

A

Erection that is large, hard and painful

62
Q

Priapism cause

A

nature or vascular

63
Q

Why is a priapism an emergency

A

venous compromise

64
Q

What patients are prone to priapism

A

sickle cell disease patients

65
Q

When is priapism considered a urologic emergency

A

If it lasts longer than 4 hours

NURSING 3 (16 decks)

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