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NR 509 FINAL EXAM STUDY GUIDE (Summarized) CHAMBERLAIN UNIVERSITY
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NR 509 FINAL EXAM STUDY GUIDE (Summarized) CHAMBERLAIN UNIVERSITY
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NR 509 FINAL EXAM STUDY GUIDE(Summarized) CHAMBERLAIN UNIVERSITY
Prepuce and glans abnormalities
✔✔1. Phimosis is a tight prepuce that cannot be retracted over the glans.
2. Paraphimosis is a tight prepuce that, once retracted, cannot be
returned. Edema ensues.
2. Balanitis is inflammation of the glans
3. balanoposthitis is inflammation of the glans and prepuce.
Check for varicocele
✔✔Patient standing
1. palpate the spermatic cord about 2 cm above the testis.
2. Have the patient hold his breath and "bear down" against a closed
glottis for about 4 seconds (the Valsalva maneuver).
3. During this maneuver, a temporary increase in the diameter of the
spermatic cord indicates filling of abnormally dilated spermatic veins
draining the testis.
Swellings containing serous fluid, such as hydroceles, light up with a red
glow, or transilluminate. Those containing blood or tissue, such as a
normal testis, a tumor, or most hernias, do not. 4. feels like soft bag of
worms. 5. appears to distort contours of scrotal skin.
Vas Deferens abnormalities
✔✔The vas deferens, if chronically infected, may feel thickened or
beaded. A cystic structure in the spermatic cord suggests a hydrocele of
the cord.
,Penis abnormalities
✔✔1. Hypospadis (congenital ventral displacement of the meatus on the
penis)
2. Peyronie Disease
3. Carcinoma of the penis (induration of ventral surface)
4. Pubic/genital excoriations: lice (crabs) or scabies in pubic hair.
Scrotal abnormalities
✔✔1. Scrotal edema
2. Hydrocele
3. Scrotal Hernia
4. Cryptorchidism (poorly developed scrotum)
5. Small Testes
6. Acute Orchitits (Tender painful scrotal swelling)
7. Tumor of the testes
8. Acute Epididymitis (Tender painful scrotal swelling)
9. Torsion of the spermatic cord (Tender painful scrotal swelling)
10. Strangulated inguinal hernia (Tender painful scrotal swelling)
11. scrotal nevi, hemangiomas, or telangiectasias
12. STIs condyloma or ulcers from herpes and chancroid (painful) and
syphilis and lymphogranuloma venereum (painless), with associated
inguinal lymphadenopathy.
13. Erythema and mild excoriation point to fungal infection, not
uncommon in this moist area.
,Prostate cancer
✔✔A distinct hard nodule that alters the contour of the gland may or may
not be palpable.
As the cancer enlarges, it feels irregular and may extend beyond the
confines of the gland.
The median sulcus may be obscured.
Hard areas in the prostate are not always malignant. They may also result
from prostatic stones, chronic inflammation, and other conditions.
benign prostatic hyperplasia (BPH)
✔✔1. Nonmalignant enlargement of prostate gland
2. increases with age, present in more than 50% of men by age 50 yrs.
3. Symptoms d/t smooth-muscle contraction in the prostate and bladder
neck and from compression of the urethra.
4. Symptoms are: urgency, frequency, nocturia, obstructive (decreased
stream, incomplete emptying, straining), or both, and are seen in more
than one third of men by age 65 yrs.
5. May be normal in size, or may feel symmetrically enlarged, smooth,
and firm, though slightly elastic; there may be obliteration of the median
sulcus and more notable protrusion into the rectal lumen.
Prostatitis
✔✔1. presents with fever and urinary tract symptoms such as frequency,
urgency, dysuria, incomplete voiding, and sometimes low back pain.
2. Palpation: tender, swollen, "boggy," and warm.
3. Examine it gently.
, 4. More than 80%: gram-negative aerobes such as Escherichia coli,
Enterococcus, and Proteus.
5. In men < 35 yrs, consider sexual transmission of Neisseria gonorrhea
and Chlamydia trachomatis.
6. Chronic bacterial prostatitis is associated with recurrent urinary tract
infections.
7. Men may be asymptomatic or have symptoms of dysuria or mild pelvic
pain. The prostate gland may feel normal, without tenderness or swelling.
Cultures of prostatic fluid usually show infection with E. coli.
8. Hard to distinguish from the more common chronic pelvic pain
syndrome (80% of symptomatic men who report obstructive or irritative
symptoms on voiding but show no evidence of prostate or urinary tract
infection).
Normal Prostate
✔✔1. Palpated through the anterior rectal wall
2. Rounded, heart-shaped structure approximately 2.5 cm long.
3. The median sulcus can be palpated between the two lateral lobes.
4. Only the posterior surface of the prostate is palpable.
5. Anterior and central lesions, including those that obstruct the urethra,
are not detectable by physical examination.
primary dysmenorrhea
✔✔1. increased prostaglandin production during the luteal phase of the
menstrual cycle, when estrogen and progesterone levels decline.
secondary dysmenorrhea causes
✔✔1. endometriosis
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