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Mens & Womens health
alterations
| Question | Answer |
|---|---|
| Describe the treatment management of epididymitis | Bedrest with scrotum elevated, antibiotics, ice packs, avoid lifting, straining, sexual excitement for 3-4 weeks |
| Describe the difference in prostate assessment between prostatitis, BPH and prostate CA | Prostatitis - boggy, swollen, tender ; BPH - smooth and symmetrical ; Prostate CA - nodular and asymmetrical |
| Describe post-op care for TURP patient | Bladder irrigating for 24 hrs |
| Name two teaching points to included when explaining Proscar | Cannot be handled by pregnant women and decreases libido |
| Clinical manifestations of Testicular Cancer | Mass in testicle, heaviness in scrotum, backache, scrotum does not transilluminate |
| Name two important teaching points with testicular cancer | Self testicular exams-monthly in a warm area. Consider sperm banking |
| Phosphodiesterase Type 5 inhibitors (PHE5) MOA | Inhibit enzyme 》 smooth muscle relaxation and increase blood flow, promoting penile erections |
| Describe what a vasectomy | Bilateral surgical ligation or resection of the ductus deferens performed for the purpose of sterilization |
| Give an example of the following paraphilic disorders (exhibitionistic, fetishistic, frotteuristic, pedophilic, voyeurism) | Exhibitionistic- display genitals in public Fetishistic- sexual focus on objects Frotteuristic- rubbing/touching Pedophilic- interest in younger children Voyeurism- secretly viewing other people in intimate situations |
| Describe the difference in symptoms between candidiasis vaginitis and bacterial vaginosis | Candidiasis vaginitis-thick, white. itching, burning, soreness, erythema, dyspareunia, dysuria. Bacterial vaginosis: grayish-white, fishy smell, itching, burning during urination |
| Name STI prevention recommendations | Abstain from sex Condoms; STI treatment Notify all sexual partners Any genital discharge should be checked by healthcare provider |
| Describe what Pelvic inflammatory disease | Widespread inflammation of the fallopian tubes, ovaries, pelvic peritoneum, pelvic veins, and connective tissue. Presents as lower abdominal pain, |
| Describe clinical manifestations of TSS | High fever, flu-like symptoms, hypotension, rash |
| Describe 5 teaching points for PMS symptoms | Keep a diary of symptoms, vitamin supplements, reduce stress, exercise 3-5 days a week, eat a balanced diet, Increase water intake, avoid simple sugars, avoid salt foods, decrease caffeine intake, stop smoking, limit alcohol, attend PMS support group |
| Name 5 physical symptoms that occur during the perimenopausal period | Hot flashes, night sweats, fatigue, heart palp, loss of bone density, vaginal dryness (recommend lubricant), flushing, more abdominal fat, loss of libido |
| List & describe use of a bisphosphate? | Reduce bone turnover Alendronate (fosamax), risedronate (actonel), ibandronate (boniva). May be contraindicated in women with ulcer of GI dz |
| Describe the presentation of breast CA | Mass, serous/serosanguinous nipple drainage, nipple ulceration, skin edema or erythema, suspicious mammogram findings, genetic link |
| Describe post op care of a mastectomy patient | No BP or venipunctures in affected arm Affected arm elevated above heart Early movement of affected arm Assist with coping Teach self care (drain care, exercises, prevention of lymphedema) |
| Describe 5 teaching points to discuss with a newly diagnosed osteoporosis patient | Weight-bearing and resistance exercise, swimming, stop smoking, decrease alcohol and caffeine, fall prevention |
| Define HRT and the risks | Hormone replacement therapy to tx the discomforts of menopause. Increase risk for breast CA Increase risk of blood clots |
| Exercise involves conscious contracting and relaxing of the pelvic muscle | Kegel |
| Name method of contraceptive uses the calendar to predict ovulation | Rhythm method |
| Name form of contraceptive used within 72 hours of intercourse | morning after pill Plan B |
| List the danger signs of IUD | P - period (late, spotting, bleeding) A - abdominal pain (dyspareunia-painful intercourse) I - infection (abnormal discharge) N - not feeling well, fever/chills |
| What are the danger signs of the pill | A-abdominal pain C- chest pain H- headache E- eye problem S- severe leg pain |
| Identify peak times that intimate partner violence occurs | pregnancy, postpartum, during the cycle of "tension building phase" |
| List some female treatment options for infertility | Clomid, HRT, tx of STD, in vitro, intrauterine insemination |
| List 5 fertility tips for women | avoid douching, promote retention, avoid leaking of sperm, have intercourse 1-3 times per week, decrease anxiety, maintain nutrition |
| Three categories of fibrocystic breast disease | non proliferative lesions, hyperplasia without atypical cells, and atypical hyperplasia. |
| Fibrocystic breast disease manifestations | Complains of lump or thickening, breast pain, breast changes. |
| Fibrocystic disease Nurse Teaching | Avoid caffeine, wear a supportive bra. |
| Classic symptom of Secondary dysmenorrhea | Constant pain & cramping in lower abdomen beginning before & lasting several days after menstruation Infertility |
| Endometriosis: symptoms | chronic pelvic pain, infertility, and adhesions r/t abnormal growth of endometrial tissue outside the uterus → cause inflammation, scarring, & blockages in reproductive organs. |
| Endometriosis associated three main problems | Cyclic pain: deep, unilateral/bilateral and sharp/dull pain. Infertility: (adhesions) endometrial tissue outside the uterus and ovaries. Tissue grows and proliferates during follicular and luteal phase of the cycle. Dyspareunia: painful intercourse. |
| Phimosis drug and treatment | Antibiotics - systemic, local ; circumcision Early management with topical steroids and/or antifungals. |
| Phimosis Teaching | Proper cleaning and pros/cons of circumcision. |
| Epididymitis Pathology | The causative organism passes upward thru the urethra & the ejaculatory duct, then along the vas deferens to the epididymis |
| Epididymitis Causes | Chlamydia & Gonorrhea – most common cystoscopic examination trauma urinary tract infection long term catheter use |
| Epididymitis Clinical Manifestations/Assessment/DX | Urethritis; Painful scrotal swelling; Test. pain (unilateral); Red scrotum; Fever, chills; Pyuria, bacteriuria; abscess; “Duck waddle” walk Dx: + leukocyte esterase- test 1st urine; ↑ serum WBC ; Nuclear med scan w/ injection of radioactive dye |
| Varicocele Diagnostic and Tx | Physical exam of scrotum and palpitation. Ultrasound can visualize the veins Digital Rectal exam: "bag of worms" upon scrotal palpation. |
| Varicocele Nursing management | Ice pack 12-24 hours postoperatively and scrotal support. |
| Hydrocele Diagnosis & Treatment Management | Painless collection of clear to amber fluid in scrotum dx : can be transilluminated, excluding mass. tx associated with infections, trauma, systemic infections. |
| 5α-Reductase inhibitors | -rides ↓ Size of prostate gland & Takes 3 to 6 months for improvement Example: finasteride (Proscar), dutasteride (Avodart), Jalyn (finasteride + tamsulosin) Side effects: decreased libido, decreased volume of ejaculation, erectile dysfunction |
| BPH Alpha blockers | -sin blood pressure medication that can also be used to treat benign prostatic hyperplasia (BPH). They work by relaxing the bladder neck and prostate muscles, making urination easier. tamsulosin, doxazosin, terazosin, alfuzosin, silodosin |
| BPH Antibiotics indications | tx UTI, other infections |
| Erectogenic Drugs | Tadalifil (Cialis) effectively reduces symptoms of both BPH and ED. |
| Medications that make BPH worse | All men with BPH should avoid medicines that can worsen symptoms or cause urinary retention. These include certain antihistamines (such as diphenhydramine [Benadryl]) and decongestants (eg, pseudoephedrine, found in some cold medicines). |
| Hormones that shrink the prostate | Luteinizing hormone–releasing hormone (LHRH) agonists |
| Common LHRH agonists | The most used to treat prostate cancer are: leuprolide (Lupron, Lupron depot, Eligard) goserelin (Zoladex) triptorelin (Trelstar) |
| Androgen deprivation : Estrogen | Estrogens play a role in proliferation in the prostate, but interestingly are capable of stimulating as well as inhibiting growth. |
| Testicular Cancer Diagnostic Studies | Made through hx symptoms Scrotum does not transilluminate ^ alpha-fetoprotein (AFP) ^ human chorionic gonadotropin (hcg) Orchiectomy to remove the tumor & make positive dx (bx not suggested) CT abd, chest (r/o mets) |
| Prostate Cancer Diagnostic Studies | Two primary screening tools: PSA and blood test. Elevated PSA levels indicate prostatic pathology, not necessarily cancer. Biox of prostate tissue necessary to confirm. Bone scan, CT, MRI, and TRUS determine location and spread |
| Pt w/ fever, perineal pain, and urinary urgency, frequency, & dysuria. To assess if pt's problem is r/t bacterial prostatitis, the nurse reviews the results of the prostate exam for which characteristic of this disorder? | Soft and swollen prostate Tender, indurated prostate gland that is warm to the touch |
| Bacterial prostatitis symptoms | swollen and tender prostate gland & also warm to the touch, firm, and indurated. Systemic symptoms include fever with chills, perineal and low back pain, and signs of UTI, often accompany the disorder. |
| Early symptom of BPH | ↓ force in stream of urine is early symptom of benign prostatic hyperplasia → leading to dribbling. Later signs: hematuria, frequency, urgency, urge incontinence, & nocturia. Untreated, complete obstruction & urinary retention can occur. |
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