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68wm6 p2 Dis Mal Rep
Disorders of the Male Reproductive System
Question | Answer |
---|---|
What is Phimosis? | Condition in which the prepuce is too small to allow retraction of the foreskin over the glans |
What is Hydrocele? | Accumulation of fluid between the membranes covering the testicle and the membrane enclosing the testicle |
When does pain from hydrocele occur? | If hydrocele occurs suddenly |
Who do most hydroceles occur in? | Most hydroceles occur in males over 21 years old |
What causes hydrocele? | Actual cause unknown; may develop as a result of trauma, orchitis(inflammation of the testes), or epididymitis |
Medical management of hydrocele | *Aspiration of fluid from the sac; relieves pain and allows scrotum to be examined more easily *Surgical removal of the sac to avoid constriction of circulation of testes |
Nursing interventions for hydrocele | *Bed rest *Scrotal support with elevation *Ice to edematous areas *Frequent dressing changes to avoid skin impairment |
What is vaicocele? | Veins within the scrotum become dilated. Obstruction and malfunctioning of the veins cause engorgement and elongation, therefore blood cannot drain adequately |
Who is varicocele often seen in? | Often seen in men with low fertility |
S/Sx of varicocele | *Pulling sensation *Pain *Edema |
Medical management of varicocele | *Surgical removal of the obstruction *Ligation of the spermatic vein has been shown to improve semen quality |
Nursing interventions for varicocele | *Bed rest *Scrotal support *Ice on the incision site *Medication for discomfort as ordered |
What is testicular torsion? | A twisting of the spermatic cord resulting in a kinking of the artery, thereby compromising blood flow to the testicle |
Who does testicular torsion occur in? | Occurs in pre-pubescent boys and in men whose spermatic cords are congenitally unsupported in the tunica vaginalis (the membrane surrounding the testes). |
Risk factors for testicular torsion | *May follow severe exercise *May occur during sleep *May occur after a simple maneuver such as crossing the legs |
S/Sx of testicular torsion | *A sudden, sharp testicular pain *Nausea, vomiting, chills, and fever *Extremely tender testis with swelling *Pain intensifies with elevation of the scrotum |
Medical management of testicular torsion | immediate surgery |
Nursing interventions for testicular torsion | *Preoperatively, administer prescribed analgesia to relieve pain *Post-operatively, apply scrotal support *Inspect dressing for signs of drainage *Administer antibiotics if ordered *Report any sudden onset of pain to the physician |
Prior to surgical intervention for testicular torsion, what occurs if the scrotum is elevated? | Increased pain |
What are the causes of impotence? | *Functional impotence (psychological) *Anatomical impotence (physical defect) *Neurological abnormalities affect erectile function *Radical prostatectomy *Medications *Abused substances *Disease (DM, COPD) |
Medical management of impotence | *Assessment of the causative factors *Sildenafil citrate (Viagra) *Hormonal replacement (testosterone) *Mechanical devices |
What is the medicinal use of androgens? | *Hypogonadism in androgen-deficient men. *Delayed puberty in men (enanthate and pellets) *Androgen-responsive breast cancer in post-menopausal women (palliative) (enanthate) |
What is androgen responsible for? | *Normal growth, development, and maintenance of male sex organs (Primary and secondary) *Male hair distribution *Vocal chord thickening *Alterations in muscle and fat distribution |
What route of administration of testosterone/androgen that bypasses initial liver metabolism? | Buccal mucosa |
Contraindications of androgen | *Pregnancy and lactation. *Male patients with breast or prostate cancer. *Severe liver, renal, or cardiac disease (propionate) |
Androgens in geriatrics increases the risk of what? | risk of prostatic hyperplasia/carcinoma |
What is virulism? | deepening of voice, unusual hair growth or loss, clitoral enlargement, acne, menstrual irregularity |
For the PT on androgens, how often should bone age determination be conducted? | Bone age determinations should be measured every 6 months to determine rate of bone maturation and effects on epiphyseal closure |
What are the adverse effects of androgen? | *Virulism *Edema *Erectile dysfunction (too often, difficulty) *Cramps *Anxiety, headache, depression *Buccal: bitter taste, gingivitis, gum edema, gum tenderness. |
For a PT on buccal androgen, when should serum testosterone concentrations be monitered? | 4-12 wk after starting therapy |
For a PT on transdermal androgen, when should serum testosterone concentrations be monitered? | 3-4 wk after starting therapy. these concentrations should be obtained in the morning (following application of patch during previous evening) |
What is Virilon (testosterone) often confused with? | Verelan (verapamil) |
What should be done with all bedridden patients on androgens to prevent mobilization of calcium from the bone. | RoM exercises |
How should buccal androgens be applied? | Apply 2x daily, rotate sides with each dose |
What adverse effects of androgens should be reported immediately? | *Priapism (sustained and often painful erections). *Difficulty urinating. *Gynecomastia. *Edema (unexpected weight gain, swelling of feet). *Hepatitis (yellowing of skin or eyes and abdominal pain). *Unusual bleeding or bruising |
What is androgen therapy limited to? | 3 - 6 months |
What are Phosphodiesterase Type-5 Inhibitors used for? | *Erectile dysfunction. *sildenafil (Revatio): pulmonary hypertension |
What drugs should be avoided with Phosphodiesterase Type-5 Inhibitors (Such as viagra/levitra/cialis)? | Nitrates |
List 5 side effects of Phosphodiesterase Type-5 Inhibitors | *Headache, dizziness, insomnia *Abnormal vision (color tinge to vision, increased sensitivity to light, blurred vision) *Epistaxis *MI, SUDDEN DEATH, CARDIOVASCULAR COLLAPSE. *Priapism *UTI *Flushing, rash *Mylagia. *Paresthesias. |
Why should Phosphodiesterase Type-5 Inhibitors not be taken with nitrates or anti-HTNs? | Vastly increased risk of hypotension |
True or False: Phosphodiesterase Type-5 Inhibitors are a great choice for PTs with the absence of sexual stimulation. | False. No effect in the absence of sexual stimulation |
When should sildenafil (Revatio, Viagra) be administered? | 1 hr before sex |
When should tadalafil (Cialis) be administered? | at least 30 min prior to sex |
When should Revatio be administered? | Dose for pulmonary hypertension is administered 3 times daily without regard to food, Doses should be spaced 4-6 hr apart |