Nursing 122 - Final, Nursing 122- Exam 3, Nursing 122 - Exam 2, Nursing 122 - Exam 1 Questions and Correct Answers the Latest Update and Recommended Version
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Module
Nursing
Institution
Nursing
Testes - details
→ Involved in the production of hormones, primarily testosterone. Disorders of the these
affect male fertility and interfere with testosterone production. Testis is one testicle,
testes is plural.
Epididymitis: details
→ Average age is 20 years. Acute inflammatory proces...
Nursing 122 - Final, Nursing 122- Exam
3, Nursing 122 - Exam 2, Nursing 122 -
Exam 1 Questions and Correct Answers
the Latest Update and Recommended
Version
Testes - details
→ Involved in the production of hormones, primarily testosterone. Disorders of the these
affect male fertility and interfere with testosterone production. Testis is one testicle,
testes is plural.
Epididymitis: details
→ Average age is 20 years. Acute inflammatory process within the epididymis.
Epididymis acts as a reservoir for sperm, while here the sperm mature and become
fertile and mobile. Most often caused by an ascending infection.
Epididymitis: infections caused by:
→ Surgical procedure: Usually by E. coli. Structural malformations or developmental
insufficiencies in a child-Usually reflux of urine even if sterile causes chemical irritation.
Sexual transmission is the most common cause-Usually in heterosexual men chlamydia
trachomatis or neisseria gonorrhea-Usually in homosexual men E. coli and Haemophilus
influenzae.
→ Tenderness and pain in the scrotal area. Pain is exacerbated by wearing restrictive
clothing. In 50% of cases pain is relieved by elevation of the scrotum. Swelling of one
or both sides of the scrotum. May walk with a "waddle". May have temperature. May
have urethral discharge. Urethritis may be present: Burning on urination, Urgency,
General malaise.
Management of Epididymitis.
→ Assess sexual history. Assess for sexual abuse. Assess for recent surgeries or urinary
obstruction. Urinalysis with increased WBC count and the presence of bacteria. Urine
cultures. Scrotal ultrasound or radionuclide scanning may be performed when diagnosis
is questionable. Assess pain (bilateral or unilateral, sudden). Assess symptoms,
discharge etc.
Treatment of Epididymitis
→ Pain management: NSAIDS to reduce swelling. Narcotics if pain is severe. Nerve
blocks. Antibiotics: Must instruct to take the whole prescription, Sexual partners must
also be treated. Stool softeners. Supportive care: Bedrest, Elevate scrotum or scrotal
support, Ice. Avoid sexual arousal and work that would strain the area. Education
about prevention of STD's, condoms, etc.
Orchitis:
→ Inflammation or infection of the testicle. Caused by bacteria or viruses or follows
septicemia. Often occurs after epididymitis. Occurs as a complication of mumps.
Hydrocele is associated with it.
Clinical Manifestations of Orchitis.
→ Same as epididymitis but since it is caused by a systemic infectious process rather than
a localized infection more systemic symptoms are present. Nausea, vomiting, pain
radiating to the inguinal canal. Atrophy of the testes in some. If severe involvement
sterility.
Management of Orchitis
→ Post pubertal male exposed to mumps may be given gamma globulin. NSAIDS.
Antibiotics. Support scrotum. Warm or cold compresses. Rest and increase fluid intake.
→ Testicular circulation is acutely impaired by the twisting of the spermatic cord. May
follow a sudden pull on the cremasteric muscle, such as blunt trauma, jumping into cold
water, bicycle riding etc. or may occur spontaneously. Congenital defect known as
"bell clapper" is a major risk factor. Occurs at 1 year and 12-18 years most often.
Clinical Manifestations of Torsion:
→ Red, swollen, tender scrotum. Unrelieved pain aggravated by elevation. Ischemia.
Affected side is elevated usually. Urinalysis and blood tests are usually normal.
Absence of pain after a time may indicate infarction and necrosis. Gangrene may
occur. Early recognition and treatment are imperative if the scrotum is to be saved.
Management of Torsion
→ Detorsion can be attempted manually. Surgery may be necessary. Testis may or may
not be removed. After surgery no lifting for 4 weeks. Scrotal elevation. Refrain from
sex 6 weeks. Scrotal support. Sitz baths. Address issues relating to sterility, impotence
and loss of masculinity. The patient is still able to have an erection. Fertility may or
may not be affected.
Testicular Cancer: details.
→ 40% greater risk if had cryptorchidism. 15-35 year age group. Half of cases are
found in the advanced stages. Classified as germinal (90-95%) and nongerminal.
Germinal divided further into:Seminomatous, Nonseminomatous.
Testicular Cancer: diagnoistic testing.
→ Determination of cell type determines treatment. CXR. CT scan. Elevated alkaline
phosphatase. Biopsy. Elevated alpha-fetoprotein, beta-hCG and LDH.
Testicular Cancer: manifestations.
→ Subtle and go unnoticed for a while. Dragging sensation or heaviness in the lower
abdomen and groin area. A lump or swelling may be present. Usually nontender and
painless. Back pain, weight loss, fatigue.
→ Orchiectomy or more extensive surgery if metastasis is present. Seminoma is responsive
to radiation. Chemotherapy.
testicular cancer- staging of neoplasia.
→ Stage I=no metastasis. Stage II=mets to retroperitoneal nodes or other
subdiaphragmatic areas. Stage 3=mets to mediastinal and supraclavicular nodes or
other areas above diaphragm.
Testicular Cancer: care
→ Sperm banking and genetic counseling before treatment may be recommended.
Contralateral testis may be normal and will produce enough testosterone to maintain
sex drive, function and characteristics. Spermatogenesis may be decreased for 7
months to 5 years. Scrotal elevation or support. Pain control. Body image and
sexuality. No lifting or driving for 10 days. Checks on other testis for CA. Refer for
counseling if needed.
Testicular Self Exam
→ Done once a month. After warm bath or shower. Roll the testicle between thumbs and
fingers. Should not cause pain. Look for egg-shaped, somewhat firm to touch, and
smooth and free of lumps. Then each month look for changes.
Hydrocele
→ Collection of fluid or a cystic mass. Acute or chronic. Differentiated from a hernia by
the fact that a hydrocele transmits light. Occurs in association with acute infections.
Usually no treatment. If blood supply is compromised then drainage or surgery may be
necessary.
Varicocele
→ Abnormal dilation of the veins of the scrotum. Most frequently in the upper left testicle
of adults. May be associated with infertility. No treatment unless infertility is a concern.
May be dragging feeling, feels like a bag of worms. Varicocelectomy: Post op report
increased pain, it may indicate decreased circulation to the testis.
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