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NURSING 701 FINAL STUDY GUIDE Chapter 59: Assessment and Management of Problems Related to Male Reproductive Processes

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NURSING 701

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NURSING 701

 Male Reproductive System:  Assessment: • Symptoms related to urinary obstruction: o Increased urinary frequency o Decreased force of stream o “Double or triple” voiding  2-3x voiding over a few minutes. o Nocturia (at night), dysuria, (painful urination) hematuria (blood in ur...

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NURSING 701 FINAL STUDY GUIDE
Chapter 59: Assessment and Management of
Problems Related to Male Reproductive Processes
 Male Reproductive System:
 Assessment:
• Symptoms related to urinary obstruction:
o Increased urinary frequency
o Decreased force of stream
o “Double or triple” voiding  2-3x voiding over a few minutes.
o Nocturia (at night), dysuria, (painful urination) hematuria (blood in urine), and hematospermia (blood in
semen).
• Conditions that may affect sexual function:
o Diabetes  affects circulation
o Cardiac disease
o MS
o Stroke (CVA)
 Diagnostic Tests:
• PSA (Prostate specific antigen)
o Elevated w/ Prostate Cancer
o BPH, acute urinary retention, acute prostatitis may elevate.
o Less than 4 ng/mL = normal.
• Ultrasounds  TRUS
• Prostate fluid analysis
• Tests of Male sexual function
 Erectile Dysfunction: (ED) Release of nitric oxide into the corpus cavernosum during sexual stimulation.
• Impotence
• Psychogenic cause  Due to mental situation; stress, depression
• Organic Cause  Physiologic cause; cardiovascular disease, diabetes, tumors, hematologic causes, neuro.
 Medical Management:
• Oral Medications: Sildenafil (Viagra)

, o Side Effects:
▪ Vasculature of eyes
▪ C/I w/ nitrates due to sudden drop in BP (hypotension).
▪ HA, flushing, dyspepsia
• Injected vasoactive agents
o Priaprism – persistent erection over 4 hours.
• Urethral suppositories
• (-) pressure devices – Penis pumps (pulls blood into penis)
 Prostatitis- Inflammation of the prostate gland that is often associated with lower urinary tract symptoms and symptoms
of sexual discomfort and dysfunction.
• Due to infection or blockage.
 S/S:
• Perineal discomfort
• Burning
• Urgency
• Frequency
• Pain w/ voiding
 Medical Management:
• Antibiotics
• Ejaculation  decreases prostate fluid.
 Nursing Management:
• Promote adherence
• Patient teaching
• DO NOT push fluids  dilutes medication.
• Avoid catheters
 Benign Prostatic Hyperplasia: noncancerous enlargement or hypertrophy of the prostate.
• Obstructs bladder from being able to empty.
 S/S:

, • Increased frequency
• Nocturia
• Urgency
• Difficulty in starting urination
• Decrease in volume or force
• Dribbling
• Sensation that the bladder has not emptied
 Medical Management:
• Medications – Flomax (maximizes flow of urine)
o Hytrin – Relaxes prostate muscle
• TUIP  decreases swelling
• Transurethral needle ablation  destroys the prostate.
• Microwave thermotherapy  heat w/ probe through the urethra that destroys the prostate.
• Saw palmetto  OTC medication
 Prostate Cancer: Testosterone dependent
• DRE (digital rectal exam) over age 50 screenings.
• Over 40 if considered at risk
 Risk factors:
• Increasing age
• Family predisposition
• AA race
 Manifestations:
• Barely any s/s
• Urinary obstruction
• Blood in urine or semen.
• Painful ejaculation
• Symptoms of metastasis (pain, anemia, fatigue)

,  Medical Management:
• Prostatectomy  Primary treatment; removal of prostate
• Radiation therapy
• Hormonal therapy  ADT (androgen deprivation therapy)
• Chemotherapy
• Cryosurgery  freezing tissue via a probe (destroys urethra)
o Only if prostatectomy is not tolerated.
 Complications w/ surgery:
• Hemorrhage and shock:
o Highest priority!!
• Infection
• DVT  due to immobility
• Catheter obstruction  continuous bladder irrigation
• Sexual dysfunction
 Nursing Management:
• Maintain fluid balance
• Pain relief
o Bladder spasms
• Patient teaching:
o Drainage devices  catheter
o Incontinence
o Avoid straining and heavy lifting
o Avoid long car trips  avoid sitting for 2 months.
o Diet = increase fluids, avoid coffee, ETOH
 Continuous Bladder Irrigation: 3 way foley
• Fluid swishes in bladder and drains out into foley.
• Purpose = prevent blood clots.

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Exam (elaborations)

NURSING 701 FINAL STUDY GUIDE Chapter 59: Assessment and Management of Problems Related to Male Reproductive Processes

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