MAMC exam 8 disorders of male reproductive system
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| etiology & pathophysiology of phimosis | condition in which the prepuce is too small to allow retraction of the foreskin over the glans penis often congenital may be result of local inflammation rarely severe enough to obstruct uring flow does not permit adequate cleansing
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| assessment/diagnosis of phimosis | inability to retract the foreskin
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| medical management of phimosis | circumcision
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| nursing interventions for phimosis | dressing changes bleeding urine flow
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| etiology & pathophysiology of hydrocele | accumulation of fluid between the membranes covering the testicle & the membrane enclosing the testicle scrotum slowly enlarges pain occurs most occur in males over 21 actual cause unknown
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| assessment/diagnosis of hydrocele | based on physical exam
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| medical management for hydrocele | aspiration surgical removal
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| nursing interventions for hydrocele | bed rest scrotal support with elevation ice to edematous areas frequent dressing changes to avoid skin impairment
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| etiology/pathophysiology of varicocele | veins within scrotum become dilated obstruction & malfunction of the veins often seen in men with low fertility
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| assessment/diagnosis of varicocele | pulling sensation pain edema
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| medical management for varicocele | surgical removal of obstruction ligation of the spermatic cord
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| nursing interventions for varicocele | bed rest scrotal support ice on incision site medication for discomfort as ordered
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| etiology/pathophysiology of testicular torsion | twisting of the spermatic cord resultingin a kinking of the artery, thereby compromising blood flow to the testicle spermatic cords are congenitally unsupported may follow severe exercise may occur duing string may occur after simple maneuver
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| assessment of testicular torsion | sudden, sharp testicular pain n/v chills/fever extremely tender testis with swelling pain intensifies with elevation of scrotum
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| medical management for testicular torsion | immediate surgery
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| nursing interventions for testicular torsion | preop, administer analgesia postop, apply scrotal support inspect dressing administer antiobiotics if ordered report any sudden onset of pain to the physician
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| prior to surgery for testicular torsion, what occurs if the scrotum is elevated? | increased pain
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| etiology/pathophysiology of erectile dysfunction (ED) | functional anatomical neurological abnormalities radical prostatectomy medications illicit/abused substances disease
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| diagnosis of ED | based on client history & physical exam
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| medical management for ED | assessment of causative factors sildenafil citrate (Viagra) hormonal replacement mechanical devices
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| nursing interventions for ED | patient education - meds, implant, infection
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| androgens | group of male sex hormones that mediate the normal development & maitenance of male characteristics through androgenic activity
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| action of androgens | responsible for the normal growth & development of male sex organs mainenance of male secondary sex characteristics
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| indications for androgen use | hypogonadism in androgen-deficient men delayed puberty i nmen inoperable breast cancer androgen-responsive breast cancer in post-menopausal women (palliative)
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| contraindications for androgens | hypersenitivity pregnancy & lactation male patients with breast or prostate cancer severe liver, renal, or cardiac disease
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| precautions of androgen use | DM CAD BPH hypercalcemia sleep apnea chronic lung disease geriatric patients prepubertal males
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| adverse effects of androgen | anxiety confusion depression fatigue headache vertigo deeping of voice fluid retention edema peliosis of the liver ABD cramps changes in appetite drug-induced hepatitis N/V gingivitis gum edema/tenderness bitter taste change in libido
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| interactions of androgens & other medications | may increase action of warfarin, oral hypoglycemic agents, & insulin concurrent use of corticosteriods may increase risk of edema formation
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| nursing implications of androgens | I&O bone age determination assess women for virilism
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| lab test considerations of androgens | monitor H&H, LFTs, PSA, & serum cholesterol monitor electrolyte balance
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| action of phosphodiesterase type-5 inhibitors | inhibits the enzyme phosphodiesterase type 5 (PDE5), PDE5 inactivates cGMP enhances effects of nitric oxide released during sexual stimulation nitic oxide activates guanylate cyclase cGMP produces smooth muscle relaxation & eventual erection
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| use of phosphodiesterase type 5 inhibitors | erectile dysfunction sildenafil (Revatio): pulmonary hypertension
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| contraindications of phosphodiesterase type 5 inhibitors | hypersensitivity concurrent organic nitrate therapy, ritonavir, ketoconazole, & itraconazole pulmonary veno-occlusive diseae newborns, women, children
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| adverse effects of phosphodiesterase type 5 inhibitors | headache, dyspepsia, flushing dizziness, insomnia, abnormal vision, chest pain, hypotension/hypertension, MI, N/V/D, dry mouth, abnormal LFT, priapism, UTI, rash, dermatitis, mylagia
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| interactions of phosphodiesterase type 5 inhibitors & other medications | increased risk of severe hypotension with nitrates increased risk of hypotension with antihypertensives or substantial alcohol
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