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Module 4 (MedSurg 2) > Male-specific GU > Flashcards

Male-specific GU Flashcards

1
Q

BPH MEANS

A

Benign Prostatic Hyperplasia

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2
Q

BPH

A

Condition in which the prostate gland increases in size
Outflow of urine from the bladder to the urethra is disrupted

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3
Q

What urine output occurs with BPH

A

low due to obstruction
= Postrenal

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4
Q

The older you get the ______ likely men are to have BPH

A

MORE

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5
Q

BPH Risk factors

A

Aging
Obesity
- Especially increased waist circumference
Lack of physical activity
High amount of dietary animal protein
Alcohol consumption
Erectile dysfunction
Smoking (vasoconstriction)
Diabetes

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6
Q

Initiative s/s of BPH

A

Nocturia (often first recognized symptom)
Frequency
Urgency
Dysuria
Bladder pain
Incontinence

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7
Q

Obstructive s/s of BPH

A

Decreased urinary stream caliber and force
Intermittency
Hesitancy
Dribbling

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8
Q

Complications of BPH

A

Urinary retention (main complication)
Urinary tract infection (UTI)
- sits in bladder and bacteria grows
Overflow incontinence
Hydronephrosis
Acute Kidney Injury (AKI)

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9
Q

Urinary retention shows through

A

bladder distention
sudden pain
inability urinate
post-void residual greater than 200

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10
Q

AKI shows through

A

low GFR
Increased BUN and Creatinine

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11
Q

BPH can increase UTI to

A

urosepsis

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12
Q

What type of pain does BPH pts present?

A

suprapubic and flank
dysuria
High fever

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13
Q

Dx of BPH

A

Detailed H&P
Digital rectal exam (DRE)
Estimates prostate size, symmetry and consistency
Urinalysis/Culture
Prostate-specific antigen (PSA) – r/o cancer
Screens for prostate cancer (high)

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14
Q

During a DRE, what does BPH feel like?

A

smooth
symmetrical

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15
Q

Tx of BPH

A

Catheter insertion, if possible, for retention
Pharmacological interventions
Possible surgery (in severe situations)

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16
Q

Goals of Tx BPH

A

Restore bladder drainage
Relieve the patient’s symptoms
Prevent or treat the complications of BPH

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17
Q

Nursing Management of BPH

A

Active surveillance
Bladder scan
Dietary changes
Medication
Avoid anticholinergics and decongestants (urine retention)
Limit fluids at night
Bladder re-training (timed voiding schedule)
Annual follow up

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18
Q

What nutritional foods need to be decreased with BPH pts

A

caffeine
high fats
meat

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19
Q

Alpha-adrenergic Blockers

A

Relax the smooth muscle that surrounds the urethra
Facilitates urinary flow through the urethra
symptom improvement days to weeks

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20
Q

Adverse effects of Alpha Blockers

A

LOW BP
Abnormal ejaculation
Caution when going for cataract surgery
FLOPPY IRIS SYNDROME

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21
Q

Does Alpha Blockers decrease the size of the prostate?

A

no

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22
Q

Types of Alpha Blockers

A

Silodosin (Rapaflo)
Alfuzosin (Uroxatral)
Doxazosin (Cardura)**
Prazosin (Minipress)
Terazosin (Hytrin)
Tamsulosin (Flomax)**

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23
Q

Quick way to remember Alpha meds

A

-sin goes down and so does BP

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24
Q

5-alpha reductase inhibitors do

A

Shrink enlarged tissue
Reduce the size of the prostate gland
3-6 months for improvement

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25
Q

5-alpha reductase inhibitors have adverse effects

A

Increased risk of high-grade prostate tumor
ED/decreased libido
Gynecomastia (breast enlargement)

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26
Q

5α-Reductase inhibitors do

A

Blocks enzyme necessary for conversion of testosterone to DHT
↓ Size of prostate gland

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27
Q

Which med is more effective for larger prostates with bothersome symptoms?

A

5a-reductase

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28
Q

5a Reductase inhibitor types

A

Finasteride (Proscar)
Dutasteride (Avodart)
Jalyn (finasteride plus tamsulosin)

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29
Q

Surgical Mgmt of BPH

A

Outpatient therapies to invasive
TURP
Stents
tuip
Open Prostatectomy
Transurethral microwave thermotherapy (TUMT)
Transurethral needle ablation (TUNA)
Laser prostatectomy

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30
Q

TURP means

A

Transurethral resection of the prostate

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31
Q

What is used for TURP?

A

Murphy Drip

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32
Q

Is hematuria normal for TURP?

A

Yes

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33
Q

Post-Op for TURP complications

A

Hemorrhage
Bladder spasms
Urinary incontinence
Infection
Occlusions

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34
Q

CBI (continuous bladder irrigation)

A

Remove blood clots
Ensure drainage of urine
Use aseptic technique

35
Q

After TURP we want them to be on what to prevent straining?

A

stool softeners
high fiber diets

36
Q

Bladder spasms are treated with

A

-clamp the fluid because of the blood clot caught
need irrigation

37
Q

Post-Op Care for TURP
care

A

catheter care
kegel
signs of infection observe

38
Q

To manage dribbling and continue social activities after

A

penile clamp
condom catheter
incontinence pads or brief

39
Q

Patho of Prostate CA

A

SLOW growing

40
Q

What is the most common CA in men?

A

prostate CA

41
Q

Prostate CA can metastasize to

A

Lymph node/lung/other organs/bone
High cure when local

42
Q

Prostate CA feels like what during DRE?

A

asymmetrical
rough

43
Q

S/S of Prostate CA

A

BPH symptoms
PSA elevated extreme
DRE – rough and asymmetrical
Dysuria/hematuria
Pain
Perineal
Suprapubic
Rectal

44
Q

Dx of Prostate CA

A

PSA screening HIGH ELEVATED
DRE
Screening recommendation
Age 55-69 should be screened every 2 years
Biopsy - actual dx

45
Q

Tx for Prostate CA

A

Radiation/chemo
Brachytherapy
Cryotherapy and ablative hormone therapy
Chemotherapy
Radical Prostatectomy

46
Q

Post-Op Care for Prostatectomy

A

indwelling catheter inflate to 20-30
site drain
stay in hospital for 1-3 days
increase fiber and stool softeners

47
Q

Complications of Prostatectomy

A

Erectile dysfunction (ED)
Incontinence, urinary retention
Hemorrhage
Infection
Wound dehiscence
DVT/PE

48
Q

The first few months after prostatectomy is more prominent for

A

incontinence

49
Q

With brachytherapy for Prostate CA

A

don’t touch probes and limit time the to them
4-6 ft away with gloves and radioactive gown
no pregnant or children in the room due to radiologic
use separate restroom and flush toilet twice after use

50
Q

Pt Teaching of Brachytherapy

A

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

51
Q

Erectile dysfunction

A

Inability to achieve or maintain an erection sufficient for sexual intercourse
- incidence increases with age

52
Q

Causes of erectile dysfunction

A

systemic, psychologic, or meds
Diabetes, vascular disease, side effects of medication, results of surgery, trauma, stress, depression, and others
avoid smoking and alcohol use

53
Q

Dx of erectile dysfunction

A

pt complaint
assessment DM, CVD, low testosterone levels

54
Q

5(PDE-5) inhibitors use

A

Cause smooth muscle relaxation and increases blood flow

55
Q

5(PDE-5) inhibitors not be used with

A

nitrates (nitroglycerin)
- potentiate hypotension
Alpha
- hypotension priapism, HA, flushing, dyspepsia

56
Q

Priapism

A

erection longer than 4 hours

57
Q

Priapism is a

A

emergency
intracavernosal injection

58
Q

5(PDE-5) inhibitors Types of meds

A

Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)

59
Q

5(PDE-5) inhibitors end in

A

-afil
Phil has erectile dysfunction

60
Q

Other tx in Ed

A

vacuum device
implant or prosthesis (no before scans)
psychosocial

61
Q

Nurses should figure out about a pt with Ed

A

Hx
support or counseling
teach contributing factors
meds
risks
priapism

62
Q

The halflife of 5PDE is

A

long 4-17.5 hours

63
Q

Testicular CA Causes

A

Abnormal testicle development
Exposure to certain chemicals
HIV infection
History of testicular cancer
History of undescended testicle
Infertility
Tobacco use
Down syndrome

64
Q

Testicular CA affects

A

15-35 age males

65
Q

Metastasize to where from Testicular CA

A

Tumors on right side may spread to right side of the lymph nodes
Tumors on left side may spread to back of the abdomen

66
Q

S/S of testicular CA

A

Painless mass in scrotum
Nontender and firm
Later : Dull ache or heavy sensation in lower abdomen, perianal area, or scrotum

67
Q

Dx of Testicular CA

A

Firm scrotum when palpated
-no light through testicles
Ultrasound
Tumor markers (hCG)

68
Q

Tx of Testicular CA

A

Surgery
Chemotherapy
Radiation

69
Q

Orchiectomy

A

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

70
Q

Seminomas

A

Radiation and/or chemotherapy
Very sensitive to radiation therapy

71
Q

Nonseminomas

A

Not responsive to radiation
Removal of lymph nodes
More rapid growth
Chemotherapy

72
Q

Nursing Mgmt of Testicular CA

A

wound care
VS
Teach infection signs, fertility bank, follow up, and self exam monthly

73
Q

Male Breast CA

A

Uncontrolled growth of abnormal cells in breast tissue
Male breast cancer is a rare disease

74
Q

Male Breast CA risks

A

Hyperestrogenism
Family history of breast cancer
Radiation exposure

75
Q

S/S of Male Breast CA

A

Swelling/lump in breast area,
Dimpling of skin or nipple erythema
Nipple discharge
Nipple inversion
Ultrasonography and MRI

76
Q

Dx of Male Breast CA

A

MRI
Ultrasound
Lab studies
Bx
don’t need a mammogram

77
Q

Tx of Male Breast CA

A

Surgery
Chemotherapy
Hormone therapy
Radiation therapy

78
Q

Nursing Mgmt of SURGERY or therapy of Male Breast CA

A

monitor VS
Incision and JP Drain Care
Pain mgmt
emotional support

79
Q

PT teaching of Male Breast CA

A

test positive for BRCA gene mutation should be aware of what breasts look and feel
self-breast exams
clinic exams at 35 for at-risk
monitor for infections

80
Q

Testicular Trauma

A

Result from sports injuries, kicks to the groin, motor vehicle accidents, or falls and injury
85% from blunt trauma
15% from penetrating trauma
1% from degloving (skin off)

81
Q

Scrotal hematoma

A

bleeding into the scrotal wall

82
Q

Is scrotal trauma emergent?

A

if blood supply is compromised

83
Q

Teaching scrotal trauma

A

Sudden onset of scrotal pain, tenderness, swelling, nausea, and/or vomiting
Pain mgmt
Urinary symptoms
Fever (with absence of WBCs or bacteria in urine)

Module 4 (MedSurg 2) (36 decks)

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