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N.314 chapter 19 Male Genitalia Assessment

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Answer
Key goals of the male genitalia assessment   detect serious life threatening problem and patient education & health promo  
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The physical exam   examine to detect abnormalatie,life threating disease, painful conditions interfere w/ normal function, allows u to watch client demo proper technique 4 testicular self exam & provide teaching  
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penis   reproductive orgtan freely moveable  
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scrotum   thin walled sac; suspended below pubic bone; posterior to penis  
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scrotum contains   sweat & sebaceous glands  
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scrotum also provides   covering 4 testes, epidydimis Vas Deferens ,  
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Internal genitalia   testes, epidydimis Vas Deferens ,  
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epididymis   A long, narrow, convoluted tube, part of the spermatic duct system, that lies on the posterior aspect of each testicle, connecting it to the vas deferens.  
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Vas Deferens   The main duct through which semen is carried from the epididymis to the ejaculatory duct.  
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testes   The two organs in the male reproductive system that produce sperm and testosterone. The testes are housed in the scrotum.  
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Physical assessment Penis!st step =   inspect the base and pubic hair  
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how is the inspect the base and pubic hair of the penis inspected?   client -stand in front of u note pubic hair growthpattern any excoration erthyema @ base &w/in the hair  
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erthyema   Redness of the skin caused by dilatation and congestion of the capillaries, often a sign of inflammation or infection.  
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Inspect the skin of the shaft Note any   rashes lesions bumps  
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palpate the shaft   palpate any abnormalaties noted during inspection also note any hardened or tender areas  
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Inspect foreskin ?   observe color, location & integrity in uncircumsized men  
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why is client asked to retract the foreskin?   to allow observation of glans  
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Inspect the glans   Observe 4 size shape lesions or redness note the location of the urinary meatus on the glans  
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Palpate 4 urethral discharge   gently squeeze the glans between index & thumb  
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Scrotum inspect size shape and position   have client hold penis out of way Observe 4 swelling lumps or bulges  
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Inspect scrotal skin 4   observe color integrity lesions rashes spread out sctotal folds, lift sac 2 inspect posterior skin.  
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How are scrotal contents palpated?   Palpate each testis and epidymis between thumb & 1st. 2 fingers note sixe, sdhape, consistancy, nodules and tenderness***do not apply to much preassure  
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What is palpated in the scrotum from where 2 where?   Palpate each spermatic cord & vas deferens from the epidymis to the inguinal ring  
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How & why is the scrotal Contents   if abnormal mASS or swealling noted, darken the room and shine a light from the back of the scrotum through the mass. Look 4 red glow  
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Inguinal Area   Of or located in the groin.Relating to the left or right inguinal region of the abdomen.  
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Inguinal Area inspect for inguinal & femoral hernia   look 4 bulges ask client to bear down continue to inspect the area  
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Palpate 4 Inguinal Hernia and inguinal nodes   client = shift weight to L for palpation of Ringuinal canal and vice vesa  
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how will you know u have palpated the external inguinal ring   it is triangular shapped slitlike opening  
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while Palpateing 4 Inguinal Hernia and inguinal nodes AFTER the the external inguinal ring has been found what is the next step?   try to push your finger through the opening of the external inguinal ring . If possible keep palpating up the  
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when your finger is IN THE INGUINAL CANAL or @ the external inguinal ring what is the client asked to do and why?   Bear down or cough feel for any bulges against your finger repeat procedure on other side  
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next step?   palpate inguinal lymph nodes  
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Inguinal lymph nodes Area   Inguinal lymph nodes are lymph nodes found in the upper thigh near the groin. The presence of swollen inguinal lymph nodes are an important clinical sign because swelling may indicate an infection in the lower extremities or spread from cancers, such as a  
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palpate 4 femoral hernia by   located front of thigh femoral canal area ask client 2 bear down or cough feel 4 bulges  
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Inspect & palpate 4 scrotal Hernia when why if   if a mass was discovered during inspection and palpation of the scrotum and hernia is suspected  
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Inspect & palpate 4 scrotal Hernia by asking client to ? and note what   lie down, note whether the bulge disappeares  
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If mass does not disappear when client lies down what is the next assessment step   auscultate for bowl sounds, Then gently palpate mass and try to push upward into the abdoman* if client complains of extreme tenderness or nauseado not try to push the mass up into the abdoman [ya]  
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risk factors Adults Hiv/aids   (blank)  
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The highest incidence of HIV occurs in   men who have sex with men MSM  
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Next highest group of HIV infected are   intravenous drug users, {more so in Northeast} ??  
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risk factors 4 HIV/AIDS   *anal intercourse MSM *intravenous drug use needle sharers higher*  
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risk factors 4 HIV/AIDS heterosexual transmissions   having multiple sexual partners, bisexual partners, or partner w/ uses intravenous drugs (sex with any infected partner)  
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Risk reduction teaching tips   *Use precautions to decrease transfer of bodily fluids *Avoid other high risk behaviors* Openly discuss HIV risk behavior history with partner and use precautions  
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*Use precautions to decrease transfer of bodily fluids   abstinence * condom use* double glove sharps*single glove w/ handeling bodily secreations or objects that touch bodily secreations* follow guidelines for safe handeling of contaminated items  
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*Avoid other high risk behaviors*, such as   intravenous drug use* sex w/ X partners*Mixing Sex w alcohol and or drugs* Anal intercourse Openly discuss HIV risk behavior history with partner and use precautions  
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cultural considerations HIV?AIDS what population is the predominant mode of transmission Of HIV and increasing steadly in The united states & developing world   heterosexual  
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__________continues to have highest levels of HIV/AIDs casesw/ 24.5 million persons living w/ the disease @ end of 1999   Sub-Saharan Africa  
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define a high HIV prevalence rate   more than 1% of population betwn ages 15 and 49  
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Majority of AIDs cases in the united States were in?   Caucasians  
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Majority of AIDs cases in the united States were in,Caucasians*EXCEPT   Northeast and mid alantic where largest percentage =African Americans  
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hispanic cases accounted for over ___ of the aids cases In the northeast and South   one fifth  
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In the united states the highest over all rates of HIV/AIDS are in the ______followed by the _______, _______ and ____   1= South 2= Northeast 3= Midwest and west  
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The highest rates are in _____ betweenj the ages of __ and __   males between the ages of 25 and 44 years of age  
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Why is the rate of HIV/AIDS increasing in African American Males?   decrease in the rate for Caucasian gay males  
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what year did the rate increase of HIV/AIDS rate increase level off t   1996  
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In 1996 the rate increase of HIV/AIDS rate increase leveled off to 0% rate of increase in which community?   0% rate of increaseAfrican American  
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In 1996 the rate increase of HIV/AIDS rate increase leveled off to5 % decline in which community?   5% decline in Hispanics  
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In 1996 the rate increase of HIV/AIDS rate increase leveled off to4% decline in which community?   4% declineAsians and Native Americans  
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elderly male clienttells nurse he has had a problem urinating for past few weeks nurse should refer client to physician for possible   prostrate enlargement  
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25 yr old client is determined to understand the Guidelines from the Americian Cancer Society when he says he should have a testicular exam every   a testicular exam every three years  
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45 year old male had problems having an erection for the last couple of weeks but is doing better now The nurse should explain that?   Transient periods of erectile dysfunction are common  
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male client = job heavy lifting* strenous activity* nurse should asssess the client for?   inguinal hernia  
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inguinal hernia   A hernia into the inguinal canal  
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assessment of genitalia male clienthas an erection the3 nurse should ?   continue the exam in an unhurried manner  
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b-4 begining the genitalia exam of an adult maleclient the nurse should ?   Ask client to empty his bladder  
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adult male client = nurse detects pimple-like lesions on the clients gland. Nurse explaines the need 4 a referral* Client demostrates he understood instructions when tthe client says he may have a   herpes infection  
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chancre lesion found under foreskin chancre lesions are associated with?   syphilis  
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white discharge from penis =   urethritis  
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absent testes =   cryptorchidism  
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cryptorchidism   —Occurs when a boy is born with one or both testicles in the lower abdomen rather than the scrotum. Known also as undescended testicles, it is the primary risk factor for testicular cancer.  
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testes swollen and painful refer for possible   epididymitis  
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epididymitis   Inflammation of the epididymis, one of the common results of gonorrhea.  
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transilluminating scrotal contents does not detect ared glow client should b refered for a possible?   varicocele  
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varicocele   A varicose condition of veins of the spermatic cord or the ovaries, forming a soft tumor.  
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suspect male client = hernia further assess 4   bowel sounds @ the bulge  
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history diagonosis =hernia reason 4 visiting clinic tody =nauseated and has extreme tenderness on left side what should the nurse do?   refer client to an emergency room  
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corona   base of the gland  
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Hernia   Protrusion of bowel through weakened muscles  
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chancres   red oval ulcerations caused by syphilis  
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Phimosis   tight foreskin that cannot be retracted *An abnormal constriction of the foreskin that prevents it from being drawn back to uncover the glans penis.  
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ParaPhimosis   retracted foreskin that cannot b returned to cover the glans  
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Hypospadias   displacement of the urinary meatus to the ventral surface of the penis*A deformity of the penis, in which the urethra opens upon its under surface.  
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ventral   Relating to or situated on or close to the abdomen; abdominal.  
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epispadias   displacement of the urinary meatus to the dorsal surface of the penis (de)*A deformity in which the urethra opens upon the top of the penis, instead of at its extremity.  
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dorsal   Of, toward, on, in, or near the back or upper surface of an organ, part, or organism.  
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cryptorchidism   undecended testicle  
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ventral   Relating to or situated on or close to the abdomen; abdominal.*Relating to or situated on or close to the anterior aspect of the human body or the lower surface  
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anterior aspect*   anterior*=Located on or near the front of an organ or on the ventral surface of the body in humans.*aspect = A side or surface facing in a particular direction: the ventral aspect of the body  
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