Men's health for Test 3
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| What is the focus of Men's health? | Focus is on conditions affecting reproduction, sexuality, and urinary elimination in males
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| What are major issues (2) that deter males from seeking care concerning men's health? | Anxiety and embarrassment
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| Two important nursing considerations when working in men's health: | --Be sensitive to cultural and emotional issues related to sexuality and the genitals
--Provide privacy and education
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| Symptoms related to urinary obstruction (4) | 1-delayed or abrupt stream
2-pain with urination
3-increase of infection
4-frequent urination
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| Nursing assessment for this focus includes gathering information concerning: | Urinary function and symptoms, Sexual function & manifestations of sexual dysfunction, Symptoms related to urinary obstruction, Medications, drug, and alcohol use,Conditions that may affect sexual function
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| Examples of conditions that may affect sexual function (3) | diabetes, cardiac disease, and multiple sclerosis
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| Common Diagnostic Tests include (4) | Prostate specific antigen (PSA), Ultrasonography, Prostate fluid or tissue analysis, Tests of male sexual function
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| Disorders of Male Sexual Function | Ejaculation problems, and Erectile dysfunction
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| Causes of erectile dysfunction | Psychogenic and organic causes, Medications associated with erectile dysfunction
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| Organic causes of erectile dysfunction | vascular, endocrine, hematological, and neurologic disorders, trauma, alcohol, medications, and drug abuse
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| Ejaculation problems | Premature ejaculation, Retrograde ejaculation
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| Medical Management of erectile dysfunction (3) | Pharmacologic therapy (oral, IM, urethral suppositories), Negative pressure devices, and sexual counseling
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| Side effects of oral pharmacologic therapy for erectile dysfunction and contraindications | headache, flushing, dyspepsia, Caution with retinopathy, Contraindicated with nitrate use
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| Side effects of Injected vasoactive agents as therapy for erectile dysfunction | Complications include priapism (persistent abnormal erection)
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| Priapism | persistent, abnormal erection (considered a medical emergency)
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| What is an example of a negative pressure device used to treat erectile dysfunction? | Vacuum constriction devices (erectile pump)
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| Prostatitis | inflammation of the prostate caused by an infectious agent
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| Treatment of prostatitis | Appropriate anti-infective agents and measures to alleviate pain and spasms
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| Most common cancer in men and the second most common cause of cancer death in men | prostate cancer
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| Nursing Diagnoses of the Patient Undergoing Prostatectomy (4) | Anxiety, Acute pain preoperatively, Acute pain postoperatively, Deficient knowledge
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| Major nursing goal for pre-op Prostatectomy patients | Adequate patient preparation and reduction of anxiety and pain
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| Relief of pain for post-op prostatectomy patients | Monitor urinary drainage, keep catheter patent, watch for bladder spasms, warm compresses or sitz baths (spasms), analgesics and antispasmodics as needed, Encourage pt to walk, avoid prolonged sitting, Prevent constipation, Irrigate catheter as prescribed
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| Affects of bladder spasms in post-op prostatectomy patient | pressure and fullness, urgency to void, and bleeding from the urethra around the catheter
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| Regaining bladder control post-op prostatectomy | a gradual process (dribbling may continue for up to one year depending upon the type of surgery), Perineal exercises help
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| Rehabilitation and Home Care-prostatectomy | Avoid straining, heavy lifting, long car trips (for 6 to 8 wks), Diet: encourage fluids and avoid coffee, alcohol, and spicy foods, Assess sexual issues and provide referrals as needed
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| Hypospadias | a birth (congenital) defect in which the opening of the urethra is on the underside, rather than at the end, of the penis
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| epispadias | A congenital defect in which the urethra does not develop into a full tube. The urine exits the body from the wrong place. (upper portion of the penis)
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| Phimosis | the inability to retract the distal foreskin over the glans penis
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| Bowen’s disease | Bowen's disease (also called squamous cell carcinoma in situ) is a slow-growing and red, scaly skin patch (Penile cancer)
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| Peyronie’s disease | A curve in the penis caused by inflammation and scar tissue form along the shaft of the penis
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| Urethral stricture | a narrowing of the urethra caused by injury or disease such as urinary tract infections or other forms of urethritis
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| Circumcision | the surgical removal of the foreskin (prepuce) from the penis (in Latin, circumcision means "to cut around")
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| Inflammatory and Infectious Problems of the scrotum and testes | Skin problems, Epididymitis, Orchitis
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| Epididymitis | swelling (inflammation) of the epididymis, the tube that connects the testicle with the vas deferens Symptoms:may begin with a low-grade fever, chills, heavy sensation in the testicle area, area becomes more sensitive to pressure
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| Orchitis | swelling (inflammation) of one or both of the testicles. Symptoms: Blood in the semen; Discharge from penis; Fever; Groin pain; Pain with intercourse or ejaculation; Pain with urination (dysuria); Scrotal swelling
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| Acquired Problems of the scrotum and testes | Varicocele, Testicular torsion, Hydrocele, Spermatocele
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| Varicocele | widening of the veins along the cord that holds up a man's testicles (spermatic cord). Symptoms: Enlarged, twisted veins in the scrotum; Painless testicle lump, scrotal swelling, or bulge in the scrotum
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| Testicular torsion | the twisting of the spermatic cord, which cuts off the blood supply to the testicle and surrounding structures within the scrotum: symptoms include Sudden onset of severe pain in one testicle, n/v, Swelling within one side of the scrotum
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| Testicular cancer is most often presented in what age group? | age 15 to 40 (it is highly treatable and curable)
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| Treatment of testicular cancer | orchidectomy, retroperitoneal lymph node dissection (open or laparoscopic), radiation therapy, and chemotherapy
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| Nursing management for testicular cancer | Assess physical and psychological status, Support coping ability, Address issues of body image and sexuality, Encourage a positive attitude, Provide patient teaching, Provide TSE and follow-up care
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| Vasectomy | surgery to cut the vas deferens, the tubes that carry a man's sperm from his scrotum to testicles
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| Andropause | usually occurring between the ages of 45 and 55, during which a man's testosterone levels may fall
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| orchidectomy | the surgical removal of one or both testes
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| retroperitoneal lymph node dissection | a procedure to remove abdominal lymph nodes to treat testicular cancer
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| Retrograde ejaculation | when all or part of semen travels backward (retrograde) into the bladder at the time of ejaculation due to the muscle that shuts the bladder functioning abnormally
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| Early diagnosis of testicular cancer can be made if patients regularly perform: | monthly testicular self-exams (TSE) and annual testicular exams
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| When performing Testicular Self-Exams patients look for | swelling, lumps, or changes in the size or color of a testicle, or any pain or achy areas in the groin
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| Testicular self-exam directions (one testicle at a time) | Use both hands to roll testicle (with slight pressure) between fingers. With thumbs over top of testicle, with the index and middle fingers of each hand behind the testicle, and & roll it between fingers. check spermatic cord
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| Signs/symptoms of andropause | decreased libido, erectile dysfunction, fatigue, decreased bone mass
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| Andropause is managed with | hormone replacement therapy, side effects of hrt for andropause include chloresterol issues, mood swings, possible correlation with BPH
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| Manifestations of testicular cancer | painless lump or mass
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| Testicular cancer development risk factors | 1 orchidectomy
2 undescended testes
3 positive family history
4 Caucasian Americans are at higher risk
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| Patient teaching for Post-op prostate surgery patients includes: | 1 catheter care
2 warning signs that need to be reported to physician (bleeding or inability to void bladder)
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| Nursing communication/teaching to help reduce anxiety in patients undergoing prostate surgery includes: | 1 maintain trusting relationship/provide privacy
2 allow pt to verbalize concerns
3 explain post-op tests and procedures
4 explain all diagnostic tests
5 education regarding pain management
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| Potential post-op prostate surgery complications | 1 urinary obstruction
2 infection
3 DVT
4 sexual disfunction
5 ineffective teaching to pt regarding care
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| Prostatectomy postoperative goals (4) | 1 voiding w/continuous flow
2 avoiding or minimizing risk of infection
3 watching for bleeding
4 pain management
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| Treatment of prostate cancer may include | 1 prostatectomy
2 radiation
3 chemotherapy
4 hormone therapy
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| Manifestations of prostate cancer | 1 early-few or no symptoms
2 urinary obstruction, blood in urine, painful ejaculation
3 metastasis (liver, bone marrow, lungs, brain)
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| Increased risk of developing prostate cancer includes (3) | Age, Family history, African Americans are at higher risk of developing
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| Rates of BPH by age | Affects half of men over age 50 (50%), and 80% of 80y/o
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| Manifestations of BPH are similar to | prostate cancer
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| Prostatitis | inflammation of prostate caused by an infectious agent
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| Treatment of BPH | 1-Pharmacologic treatment 2-catheterization 3-surgery
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| Drug therapy for treatment of BPH | Alpha-blockers (Relax muscles near the prostate, 5 alpha-reductase inhibitors (slow or shrink prostate growth), Phosphodiesterase type 5 inhibitors (PDE5 inhibitors)(relax muscles near prostate)
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