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68wm6 p2 Dis Mal Rep

Disorders of the Male Reproductive System

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
Created by: Shanejqb
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