Linda S. Williams / Paula D. Hopper Copyright © F.A. Davis Company Understanding Medical Surgical Nursing, 4th Edition Chapter 43 Nursing Care of Male Patients with Genitourinary Disorders

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prostate Disorders  Prostatitis  Benign Prostatic Hyperplasia  Prostate Cancer

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prostatitis  Etiology  Acute Bacterial  Chronic Bacterial  Chronic Prostatitis/Chronic Pelvic Pain Syndrome  Asymptomatic Inflammatory Prostatitis  Signs and Symptoms  Pain  Urgency  Frequency  Dysuria  Urine Retention  Fever, Chills

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prostatitis (cont’d)  Diagnosis  Digital Rectal Exam  Urine Culture  EPS  Interventions  Antibiotics  Anti-inflammatory Agents  Interventions (cont’d)  Stool Softeners  Sitz Baths  Prostatic Massage  Avoid Alcohol and Spicy Foods  Surgery

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Prostatitis  Urinary Retention  Risk for Ineffective Self-Health Management  Acute Pain  Anxiety

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Benign Prostatic Hyperplasia (BPH)  Increase in Number of Cells  Signs and Symptoms  Urinary Retention  Dribbling  Nocturia  Dysuria  Urgency  Diagnosis  DRE  BUN, Creatinine  PSA  Urodynamic Flow Studies  Transrectal Ultrasound  Cystoscopy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Symptom Control  Catheterization  Fluids  Antibiotics  Intervention  Watchful Waiting  Alpha-Adrenergic Antagonists  Hormone Blockers  TUMT, TUMA  Surgery

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Transurethral Resection of the Prostate  Resectoscope into Urethra  Overgrown Tissue Chipped Away

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prostatectomy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prostate Surgery  Pre-op Nursing Diagnoses  Impaired Urinary Elimination  Knowledge Deficit

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Postoperative Nursing Diagnoses  Risk Bleeding  Monitor Urine Output and Bleeding  Encourage Fluids  Teach Patient to Avoid  Constipation  Lifting  Aspirin and NSAIDS

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Acute Pain: Bladder Spasm  Monitor Pain  Irrigate Catheter as Ordered  Administer Analgesics, Antispasmodics  Teach Relaxation and Deep Breathing

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Urge Urinary Incontinence  Teach Kegel Exercises  Offer Condom Catheter or Pads  Encourage to Continue Fluids  Discuss Prolonged Incontinence with Physician

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Risk for Ineffective Self-Health Management  Teach to Avoid (About 6 Weeks)  Heavy Lifting  Stairs  Driving  Strenuous Exercise  Straining  Sexual Activity  Aspirin and NSAIDS

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Bladder Irrigation

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Ineffective Therapeutic Regimen Management  Teach Patient  Catheter Care  Report Signs and Symptoms of UTI  Report Increase in Bleeding

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Anxiety: Sexual Function  Explain  Retrograde Ejaculation  Talk with Physician if Erectile Dysfunction Occurs

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Prostate Cancer  Risk Factors  Over 65  High Testosterone  High Fat Diet  Family History  Occupational Exposures

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Rare in Early Stages  Later Stages  Urinary Obstruction  Hematuria  Urinary Retention  Advanced  Bone Pain  Anemia  Weakness  Weight Loss

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  DRE  PSA  PAP  Transurethral Ultrasound with Biopsy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Early  Testosterone-Suppressing Medications  Later Stages  TURP or Open Prostatectomy  Radiation Therapy  Metastatic  Orchiectomy, Estrogen Therapy  Chemotherapy, Radiation  Radical Prostatectomy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Penile Disorders  Peyronie ’ s Disease  Penis Curved – Fibrous Bands  Priapism  Prolonged Painful Erection  Phimosis/Paraphimosis  Foreskin not Retractable

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Cancer of the Penis  Risk Factors  Not Circumcised as Baby  HPV  Therapeutic Interventions  Surgery  Radiation  Chemotherapy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Testicular Disorders  Cryptorchidism  Undescended Testes  Hydrocele  Fluid in Scrotal Sac  Varicocele  Varicose Veins of Scrotum  Epididymitis  Inflammation  Infection  Orchitis  Testicular Inflammation or Infection

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Testicular Cancer  Risk Factors  Cryptorchidism  Family History  DES Use by Mother  Caucasian  High Socioeconomic Status

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Early  Painless Lump  Swelling  Late  Symptoms of Metastasis

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  Ultrasound  Chest X-Ray  Blood for Tumor Markers  Biopsy  Staging

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Surgery  Radiation  Chemotherapy

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Care  Teach Testicular Self-Examination  Provide Emotional Support  Discuss Sperm Bank Deposit  Offer Cancer Support Group

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Vasectomy  Interruption of Vas Deferens  Provides Permanent Birth Control  Effective About 3 Months Following Surgery

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Vasectomy (cont’d)

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Erectile Dysfunction  Problem Obtaining or Maintaining Erection

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Pathophysiology/Etiology  Physical  Circulation  Nerve Supply  Hormone Balance  Limbic System  Psychosocial  Stress  Illness  Fatigue  Alcohol/Drugs

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  History  Blood Tests  Glucose  Testosterone  Evaluation of Circulation  Psychosocial Evaluation

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Medication Changes  Oral Medication  Tadalafil  Sildenafil  Vardenafil  Hormone Therapy  Herbal Remedies  Medication  Injection  Transurethral  Devices  Surgery  Implants  Vascular Surgery

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Penile Implants

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnosis  Risk for Ineffective Self Health Management

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Infertility  Causes  Pretesticular  Endocrine  Testicular  Varicocele  Idiopathic  Post-testicular  Surgery

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  Sexual Practices  Lifestyle Practices  Occupation  Medical-Surgical History  Physical Examination  Semen Analysis

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Changes in Lifestyle Practices  Surgery if Indicated  In Vitro Procedures