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WorksheetsChapter 67- Male Reproductive Problems
Total questions: 33
Worksheet time: 33mins
Which are the pathophysiologies of Benign Prostatic Hyperplasia (BPH)?
bladder obstruction outlet
increased residual urine (stasis)
chronic urinary retention
overflow urinary incontinence
urine back flow into bladder
Select the risk factors for Benign prostatic hyperplasia (BPH).
increased age
black men younger than 65
hx of bladder cancer
obesity
drinking too much soda
Which are the common s/s of Benign Prostatic Hyperplasia (BPH)?
urinary hesitancy
weak stream
sensation of incomplete bladder emptying
post-void dribbling
burning when urinating
A HCP will perform a prostate exam-digital rectal exam to assess for Benign Prostatic Hyperplasia. Which of the following are true?
Feel the urge to urinate as the prostate is palpated
Feel the urge to defecate as the prostate is palpated
BPH will be a uniform, elastic, nontender enlargement
BPH will be an abnormal, hard, tender enlargement
Select the complications of Benign Prostatic Hyperplasia.
urinary tract infections
bladder calculi
acute urinary retention
hydroureter-dilation of the ureters
hydronephrosis-dilation of the kidneys
Which are the non-surgical treatments for Benign Prostatic Hyperplasia (BPH)?
Avoid drinking large amounts in a short time
Avoid alcohol, diuretics and caffeine
Void as soon as you feel the urge
Avoid anticholinergics, antihistamines, and decongestants
Drink plenty of fluids
A Transurethral Resection of the Prostate (TURP) is performed by removing the enlarged portion of the prostate through an endoscopic instrument. For which of the following meet the criteria to have this procedure?
acute urinary retention
chronic UTIs
hematuria
hydronephrosis
reduced semen expulsion
Select the pre-op education/care for a Transurethral Resection of the Prostate (TURP).
educate on anesthesia
indwelling catheter (will have urge to urinate)
traction could be uncomfortable
having blood-tinged urine is normal
do not take anticoagulants beforehand
What is the main disadvantage of a Transurethral Resection of the Prostate (TURP)?
the remaining prostate tissue may grow and cause urinary obstruction
the patient may have excessive blood in their urine following the procedure
the patient will most like be impotent following the procedure
the procedure may cause any remaining BPH tissue to become cancerous
Which are included in the post-op care/teaching for a Transurethral Resection of the Prostate (TURP)?
3-way urinary catheter in place continuous bladder irrigation
traction via taping catheter to the patient's thigh or abdomen- do not bend leg
patient should not have a continuous, uncomfortable urge to void
monitor color, consistency, amount of urine output at least every 2-4 hours.
assess patient for reports of severe bladder spasms with decreased urine output, indicating obstruction
Post-op care for a Transurethral Resection of the Prostate (TURP) includes continuous bladder irrigation. How can you tell if there has been a bladder obstruction?
if there are blood clots
urine looks like ketchup
decreased urine output
Though rare, the Transurethral Resection of the Prostate (TURP) procudure does have a serious and potentially critical complication called TURP syndrome. What are the s/s of TURP syndrome?
Irrigation fluid is over absorbed into the body
shortness of breath, bradycardia, EKG changes
headache, dizziness, altered LOC
tachypnea, tachycardia, tremors
After a patient has had a TURP, which teachings about what may happen after catheter removal should you include?
Urinary frequency, dribbling, and leakage-temporary
Urine progresses: red to amber in 2-3 days
Increase fluid intake to 2000-2500mL/day
Do kegel exercises
Avoid urinary irritants like acidic fruits, carbonated beverages, and chocolate
Select the correct teachings for a patient going home following a TURP.
Avoid heavy lifting, strenuous exercise, straining and sexual intercourse per hcp (usually 2-6 weeks)
Avoid NSAIDS r/t increased risk for bleeding
Avoid caffeine and alcohol
If urine bloody, stop activity, rest, & increase fluid intake
Call HCP if experiencing impotence after 1st week post-op
Which are the risk factors of prostate cancer?
being over 65 years old
African American men
African American men who live in the Caribbean
Family hx of first degree (father, brother, son)
Jewish men
Which foods should men increase to prevent prostate cancer?
milk products
fruits and vegetables
tomatoes
red meat
soy
Which are the early s/s of prostate cancer?
difficulty starting urination
frequent urination
urinary retention
painful intercourse and ejaculation
hematuria
Which are the diagnostic assessments for prostate cancer?
Prostate-specific antigen (PSA)
Early Prostate Cancer Antigen (EPCA-2)
Digital Rectal Exam (DRE)
Transrectal Ultrasound (TRUS)
urinalysis (UA)
Which type of radiation is used to treat prostate cancer where low-dose seeds, needles or wires are imp0lated into/around the prostate gland?
And which stage of prostate cancer is this type of radiation used for?
Internal radiation
External radiation
Early stage
Late stage
An option to treat prostate cancer is external radiation. How often and for how long does this course of radiation take?
5 days a week
For 4-6 weeks
3 days a week
For 8-10 weeks
Radiation can have some complications. Which of the following are those?
Acute Radiation Cystitis
Radiation Proctitis
Bladder carcinomas
Rectal hematomas
Prostate cancer can be treated by androgen deprivation therapy. There are 2 types. What do these types of therapy do?
Block body’s ability to use the available androgens
Stimulates the pituitary gland to release LH to ↓ testosterone production by the testes
Blocks the body from producing androgens
Stimulates the body to increase production of testosterone
In which situations is chemotherapy used for prostate cancer?
Cancer has spread and other therapies were not successful
Small cell prostate cancer is rare and is more responsive to chemotherapy
Cancer is in the early stages, so chemotherapy is the best option
Cancer has not yet metastasized
A Laparoscopic Radical Prostatectomy (LRP) is a surgery to remove the prostate and nearby lymphnodes. Which are the post-op care for this procedure?
Indwelling urinary catheter, removed day 3
Patient Controlled Analgesia (PCA)
Penile, scrotum swelling>elevate, apply ice 24-48 hrs
Shower 1-2 days, remove small bandage but leave wound closure tape
Avoid ambulation until 3 days after surgery
A Open Radical Prostatectomy is removal of the prostate. Select the post-op care for this surgery?
PCA and I & O
OOB night of surgery, Ambulation @ 24 hours
Teach urinary catheter use: keep urinary meatus clean, leg bag
Kegel exercises to prevent incontinence
Avoid straining for a BM
Which are the common complications of a Open Radical Prostatectomy?
Erectile dysfunction
Incontinence
Hemauria
Painful urination
Prostate discharge planning includes which?
restrict lifting
take stool softeners
take showers instead of baths
teach urinary catheter care
cleared to have sex after 3 days
Which are the risk factors for testicular cancer?
undescended testis
family history
Caucasian men
ages 20-35
ages 50-65
Which are the s/s of testicular cancer?
painless, hard swelling or enlargement of the testicle
painful intercourse
heaviness/aching in lower abdomen
painful, hard swelling or enlargement of the testicle
When should a testicular self exam be performed?
monthly
immediately after bath or shower
bi-weekly
in the morning soon after waking up
Chemotherapy and radiation are some non-surgical ways to treat testicular cancer. Which should be known about radiation for TC?
Radiation: external beam radiation therapy (ERBT)
Remaining testicle is shielded
May have ↓sperm count-returns in 24-30 months post radiation
Ejaculate may be radioactive, so do not have sex without a condom until after treatment is complete
What should someone know before taking medications to treat erectile dysfunction?
Abstain from alcohol before intercourse-may impair ability to have an erection
Take 1 hour before intercourse
No grapefruit or grapefruit juice
Men taking nitrates should avoid
No citric fruits or juices
Which are included in the post-op care for a vasectomy?
Leave bandaging in place for 48 hrs
Apply ice pack to scrotum for 24-48 hrs
Heavy lifting, sports and intercourse avoid for 1 week
Report: increased pain, incisional bleeding, increased swelling, fever
3 month f/u-semen analysis
