w2 Flashcards
Nursing care: BPH
- prostate gland ___creases in size
- prostate gland grows inward, causing ______ of urethra and disruption of _________
- BPH d/t age and influence of ___________
Nursing care: BPH
- prostate gland increases in size
- prostate gland grows inward, causing narrowing of urethra and disruption of UO
- BPH d/t age and influence of androgens
Gonioscopy
Performed when high _____ is found
- determines whether ______ or _______ is present
- allows visualization where iris meets _______ (anterior)
Gonioscopy
Performed when high IOP is found
- determines whether open or closed angle glaucoma is present
- allows visualization where iris meets cornea (anterior)
s/s
- ranges from asymptomatic to acute, sever, inflammatory disease
- men
- asymptomatic and transient, w/ spontaneous resolution within 10 days
- Maybe burning with urination/ejaculation
- urethral discharge
- women
- yellow-green discharge w/ foul odor
- cervix – red, inflamed, strawberry appearance
- bleeding after sex
- dysuria
- vaginal itching
- pain with intercourse
Trichomoniasis
Cataracts
- Issue with the ___ (sits behind pupil)
- normal = changes shape as needed to help focus image and accommodate
- can become _____ and ____ with aging
- __creased visual acuity
- __creased accommodation
Cataracts
Issue with the lens (sits behind pupil)
- normal changes shape as needed to help focus image and accommodate
- can become cloudy and stiff with aging
- decreased visual acuity
- decreased accommodation
Trichomoniasis
- most common nonviral STD
- caused by protozoan parasite = Trichomoniasis vaginalis
- transmission – exposure to sexual fluids during vagina, anal, oral sex
- incubation period – ___ week – ___ months (or longer)
complications
- r/t untreated ________
- more likely to get another STI, esp ____
Trichomoniasis
- most common nonviral STD
- caused by protozoan parasite = Trichomoniasis vaginalis
- transmission – exposure to sexual fluids during vagina, anal, oral sex
- incubation period – 1 week – 3 months (or longer)
complications
- r/t untreated inflammation
- more likely to get another STI, esp HIV
3 eye drop types
- _______
dilates pupils, can see inside eye, increases IOP - _______
constricts pupils and lowers IOP - ________
accommodation paralysis, can see inside eye
- mydriatic
- miotic
- cycloplegic
BPH treatment: based on symptoms
- mild
- Watchful waiting
- Avoid _______ (tighten muscles in prostate = makes its harder for urine to leave bladder)
- Avoid _______ (tighten muscles in prostate = makes its harder for urine to leave bladder)
- Restrict evening fluids – r/t _______
- ______ void – after voiding, wait a moment, and try and void again - drug therapy
- 5 alpha reductase inhibitors – ________
- Alpha blockers – tamsulosin
- Combination therapy - herbal therapy
- Saw palmetto – no supporting evidence - non-invasive therapies – don’t need to know about
- invasive therapies/surgeries
___________
BPH treatment: based on symptoms
- mild
- Watchful waiting
- Avoid decongestant – pseudoephedrine (tighten muscles in prostate = makes its harder for urine to leave bladder)
- Avoid antihistamines – diphenhydramine (tighten muscles in prostate = makes its harder for urine to leave bladder)
- Restrict evening fluids – r/t nocturia
- Double void – after voiding, wait a moment, and try and void again
2 . drug therapy
- 5 alpha reductase inhibitors – finasteride
- Alpha blockers – tamsulosin
- Combination therapy - herbal therapy
- Saw palmetto – no supporting evidence - non-invasive therapies – don’t need to know about
- invasive therapies/surgery
- TURP – transurethral resection of the prostate
(2) STD dx =
nucleic acid amplification test (NAAT)
which STD is NAAT the gold standard dx?
trichomoniasis
chlamydia
trichomoniasis
__________ STD
- Bacterial infections
- caused by Treponema pallidum
- transmission – direct contact with ulcer “chancre” can be external or internal in genital area
- Can be transmitted to baby during pregnancy – high risk
- incubation period – 10-90 days
syphillis
Slit lamp test
Magnifies the anterior or posterior eye structures with low powered microscope?
Who gets this test:
- routine testing
- cataracts
- retinal detachment
- glaucoma
- macular degeneration
Slit lamp test
Magnifies the anterior eye structures with low powered microscope
Who gets this test:
X - routine testing
- cataracts – can see white/opaque lens
- retinal detachment
- distinguish between open-angle and closed-angle glaucoma
- macular degeneration
tests for each disease:
1. glaucoma
(4)
- cataracts
(3) - retinal detachment
(2) - macular degeneration
(1)
- gonioscopy
- IOP testing
- slit lamp test
- ophthalmoscopy
- glare testing
- Miniature eye chart/pocket chart
- glaucoma
- gonioscopy
- IOP testing
- slit lamp test
- ophthalmoscopy - cataracts
- slit lamp test
- glare testing
- Miniature eye chart/pocket chart - retinal detachment
- slit lamp test
- Miniature eye chart/pocket chart - macular degeneration
- slit lamp test
Benign prostate hyperplasia
T/F
- Associated with aging
- BPH does predispose person to prostate cancer
- digital rectal exam (DRE) purpose – estimate the prostate ___, _____, and ______
- prostate with BPH is symmetrical/asymetrical? enlarged/small? soft/firm? rough/smooth?
- indicated labs are urinalysis, C&S, and serum creatinine
- TRUS (trans-rectal ultrasound) Helps differentiate BPH from cancer
- if DRE and PSA are abnormal, next test?
- Only way to definitively dx prostate cancer is a biopsy via ____
T - Associated with aging
F - BPH doesn’t predispose person to prostate cancer
- digital rectal exam (DRE) purpose – estimate the prostate size, symmetry, and consistency
- prostate with BPH is symmetrically enlarged, firm, smooth
- indicated labs are urinalysis, C&S, and serum creatinine
T - TRUS (trans-rectal ultrasound) Helps differentiate BPH from cancer
- if DRE and PSA are abnormal, next test? TRUS
- Only way to definitively dx prostate cancer is a biopsy via TRUS
s/s
- men
- within a few days
- pain with urination
- purulent urethral discharge
- epididymitis – inflammation of the epididymis (tube at back of testicles that carry sperm)
- women
- asymptomatic or minor overlooked symptoms
- increased vaginal discharge
- dysuria
- frequency of urination
- bleeding after intercourse
- rectal
- mucopurulent rectal discharge
- anorectal pain
- bleeding
- pruritis
- painful bowel movement
gonorrhea
Imaging assessments for the eye are
Painless and require no special follow up:
- CT
- MRI
- radioisotope scanning
- ultrasonography
- gonioscopy
- CT
- MRI
- radioisotope scanning
- ultrasonography
X - gonioscopy
s/s BPH
lower urinary tract symptoms (LUTS) =
- inflammation or infection causing _________ symptoms
- Nocturia
- Frequency
- Urgency
- Dysuria
- Bladder pain
- Incontinence
whats usually 1st symptom?
- narrowing of urethra causing ________ symptoms
- __creased effort required as the bladder tries to empty through decreased urethra diameter
- __crease in caliber and force of urine stream
- Difficulty initiating a stream
- Intermittency – starting and stopping stream several times while voiding
- Dribbling at end of urination
-1. inflammation or infection causing irritative symptoms
- Nocturia – 1st symptom
- Frequency
- Urgency
- Dysuria
- Bladder pain
- Incontinence
- narrowing of urethra causing obstructive symptoms
- Increased effort required as the bladder tries to empty through decreased urethra diameter
- Decrease in caliber and force of urine stream
- Difficulty initiating a stream
- Intermittency – starting and stopping stream several times while voiding
- Dribbling at end of urination
BPH treatment: surgery
TURP (transurethral resection of the prostate)
T/F
- 2nd line surgical treatment for BPH
- Resectoscope inserted into urethra
- prostate tissue is removed/excised
- anesthesia – _____ or ______
- outpatient procedure
- post procedure – large 3-way indwelling catheter w/ 30 mL balloon, continuous bladder irrigation
F - Gold standard surgical treatment
T - Resectoscope inserted into urethra
T - prostate tissue is removed/excised
- anesthesia – spinal or general
F - inpatient procedure
T - post procedure – large 3-way indwelling catheter w/ 30 mL balloon, continuous bladder irrigation
retinal detachment treatments
- which 2 are the Main methods used to seal retinal breaks
Both work by creating inflammatory reaction that causes adhesion/scar to seal the retinal break - _________
- Extraocular procedure
- Silicone patch wrapped around eye
- Indents the globe so that the eye ball moves toward the retina
- Usually under local anesthesia
- Outpatient procedure - ________-
- Intraocular procedure
- Gas bubble is injected into the vitreous cavity
- Patient needs to be positioned so that the bubble can apply max pressure on the retina by gravity (Often head down and to one side for several days to several weeks)
- Position depends on where bubble is
- Visual prognosis varies – based on extent, length, and area of detachment
- laser photocoagulation
- scleral buckle procedure
- cryopexy
- pneumatic retinopexy
- laser photocoagulation and cryopexy
- scleral buckle procedure
- pneumatic retinopexy
syphilis
- Bacterial or viral infection?
- caused by _____ _____
- transmission – direct contact with “______” can be external or internal in genital area
- Can be transmitted to baby during pregnancy?
- incubation period – ___ - ____ days
complications
- chancre (early) increase risk of ___ transmission
- high risk of ___ involvement (if syphilis and HIV positive)
- _____ syphilis – permanent damage with CNS, vision, dementia
- _____ syphilis – chest pain, dyspnea, murmur, cardiomegaly
- ______ syphilis – scarring on skin, changes in nasal septum and palate
- Bacterial infections
- caused by Treponema pallidum
- transmission – direct contact with syphilitic ulcer “chancre” can be external or internal in genital area
- Can be transmitted to baby during pregnancy – high risk
- incubation period – 10-90 days
complications
- chancre (early) increase risk of HIV transmission
- high risk of CNS involvement (if syphilis and HIV positive)
- neurosyphilis – permanent damage with CNS, vision, dementia
- CV syphilis – chest pain, dyspnea, murmur, cardiomegaly
- gummatous syphilis – scarring on skin, changes in nasal septum and palate
Prostate cancer treatment
- early stage
-Watchful waiting
-Repeated ___ and ____ - surgical therapy
–radical prostatectomy
-s/e – _________ (temporary ~24 months) and __________ (temporary ~ few months) - radiation therapy
- alone or with surgery and hormone therapy
- external (____therapy)
- internal (____therapy) - drug therapy
- ________ deprivation therapy
- _______therapy for metastasis
- early stage
- Watchful waiting
- Repeated DRE and PSA - surgical therapy – radical prostatectomy
- s/e – erectile dysfunction (temporary ~24 months) and urinary incontinence (temporary ~ few months) - radiation therapy
- alone or with surgery and hormone therapy
- external (teletherapy)
- internal (brachytherapy) - drug therapy
- androgen deprivation therapy
- chemotherapy for metastasis
glare testing
quantifies vision loss associated with ________
who gets this test:
- cataracts
- glaucoma
- retinal detachment
glare testing
quantifies vision loss associated with light scatters
who gets this test:
- cataracts (can also get Miniature eye chart/pocket chart)
X - glaucoma - ophthalmoscopy
X - retinal detachment - Miniature eye chart/pocket chart
eye disorders that are major causes of blindness
1st ______
2nd ______
1st cataracts,
2nd glaucoma
s/s
- Benign growths on anogenital skin or mucosa
- most people don’t know they are infected
- discrete warts – white, grey, flesh colored, hyperpigmented
- 1-10 warts, can coalesce together to make larger mass
- early lesions not detectable
- men – warts on penis or scrotum
- women – inner thighs, vulva, vagina, intra-anally
genital warts
genital warts treatment
- can be confused with other STI lesions, r/o other STI
- HPV _______ – cover genital warts and many strains that cause cervical cancer
- treatment goal = remove symptomatic _____
- Chemical or ablative methods in office
- Petroleum jelly on site, keep clean
- Patient applied treatment available
- Does removing warts decrease spread of HPV?
- _____ warts more difficult to treat
- long term follow up
- can be confused with other STI lesions, r/o other STI
- HPV vaccines – cover genital warts and many strains that cause cervical cancer
- treatment goal = remove symptomatic warts
- Chemical or ablative methods in office
- Petroleum jelly on site, keep clean
- Patient applied treatment available
- Removing warts doesn’t decrease spread of HPV
- Anal warts more difficult to treat
- long term follow up
STD transmission
T/F
- mucosal tissues in genitals, rectum, mouth
- skin to skin through casual contact
- skin to skin through sexual contact
- blood – birth
- blood - needles
- autoinoculation
T - mucosal tissues in genitals, rectum, mouth
F- skin to skin (not spread through casual contact)
T - skin to skin through sexual contact
T- blood - birth
T- blood - needles
T - autoinoculation – touching/scratching infected area and transferring to another part of same person’s body
PSA Nursing implication
- pt should be informed about _____ and _____ of PSA screening
-_______ – evaluation and treatment may be unnecessary
-________ – early detection of prostate cancer
PSA Nursing implication
- pt should be informed about risk and benefits of PSA screening
- Risks – evaluation and treatment may be unnecessary
- Benefits – early detection of prostate cancer
vision disorders
1.
Issue with the lens
- Etiology
- DM
- HTN - Eye disorder that increases IOP
- r/t retinal aging
- retinal break
Urgent situation
- cataracts
- retinopathy
- glaucoma
- macular degeneration
- retinal detachment
treatment for what vision disorder?
- laser photocoagulation
- cryopexy
- scleral buckle procedure
- pneumatic retinopexy
Repair of retinal detachment