NURS 3512 - Complex Concepts Exam 2 Study guide 2021

Complex Concepts Exam 2 Review

Erectile Dysfunction (1-3 questions)

 Management of Care

o Medical management of ED begins with a medical and sexual history to

determine the degree of the problem and to reveal disease, lifestyle habits, or

med use that may be contributing to ED

o Nocturnal penile tumescence and rigidity monitoring helps differentiate

between psychogenic and organic causes

 Physically healthy men have involuntary erections in sleep

o Mechanical Device—Vacuum Constriction Device

 Draws blood into the penis w/ a vacuum and traps it there with a

constricting band at the base of the penis

o Surgery involves either revascularization procedures or implantation of

prosthetic devices

o Nurses should:

 Maintain a professional affect when discussing ED

 Promote self-esteem

 Provide info about treatment options

 Teach patient and partner how to use penile implant

 Health Promotion

o Treatment of ED usually starts with lifestyle changes: quitting smoking,

reducing alcohol intake, losing weight, increasing exercise

 Pharmacological Interventions

o Oral Meds: -FIL (sildenafil, vardenafil, etc.)

 Enhance erections only when sexual stimulation is present

 Acts within 30-60min

 Facilitate relaxation of smooth muscle in penis to increase blood flow

 Don't take more than once a day

 Don't take with nitrate-based drugs or alpha-blockers

 Complications

o Can cause relationship issues with significant other

o Priapism—erection lasting longer than 4hrs

 May be a side effect of ED medications

BPH (1-3 questions)

 BPH is when the enlargement of the prostate gland starts to cause urinary


o Can impair the outflow of urine from bladder, causing retention and infection

(of urinary tract or kidneys)

 Management of Care

o Typical S/S: urinary frequency/urgency/hesitance/incontinence, dribbling

post-voiding, diminished force of urinary stream, straining with urination

o Nursing Care (Education):

 Frequent ejaculation helps decrease size of prostate

 Avoid drinking large amounts of fluids at one time

 Urinate when urge is first felt

 Avoid bladder stimulants (alcohol, caffeine)

 Avoid meds that cause decreased bladder tone (anticholinergics,

decongestants, antihistamines)

o Transurethral Resection of the Prostate (TURP)

 Most common surgical procedure

 Resectoscope inserted through urethra trims away excess prostatic


 Post-op: placement of indwelling 3-way catheter

 Drains urine and allows continuous irrigation

o Keep irrigation return pink or lighter by adjusting rate

 Avoid heavy lifting, strenuous exercise, straining, sexual intercourse

for 2-6 weeks

 Drink lots of fluids (12+ 8oz glasses)

 Pharmacological Interventions

o Goal is to re-establish uninhibited urine flow

o Finasteride—decreases production of testosterone in prostate, causing a

decrease in size

 Can take 6-12mos for therapeutic effects

 Impotence and decreased libido are possible

 Teratogenic to male fetus!! Preggo women should avoid contact with

broken tablets/semen of client on this med

o Tamsulosin (alpha blocker—no –FIL!!!!)

 Causes relaxation of bladder and prostate and decrease pressure on

urethra, re-establishing a stronger flow

 Ortho hypo can occur

Menopause (1-3 questions)

 Menopause is the cessation of menses. Complete when no menses have occurred for

12 months.

 Health Promotion

o This is a normal process!!

o Weight-bearing exercises reduce chance of osteoporosis

 Clinical Manifestations

o Hot flashes

o Decreased vaginal secretions/vaginal dryness

o Mood swings/changes in sleep patterns

o Decreased bone density

o Decreased HDL/Increased LDL

o Decreased skin elasticity

o Breast tissue changes

 Complications

o Embolic complications—risk increased by concurrent smoking

 MI, stroke, thrombophlebitis

o Cancer—long term use of HT can increase risk for breast cancer

 Teaching

o American Cancer Society recommends periodic cancer-related checkups

o Increase Ca intake and do weight-bearing exercises

o Yearly mammograms, clinical breast exams, and pap tests until age 65

 Management of Care

o Increased FSH level is considered menopausal

o HRT was common until the AHA advised against it to protect heart

o Promote effective sexuality pattern—vaginal dryness can interfere with

sexual expression/satisfaction

o Promote self-esteem

o Promote a healthy body image

Sexually Transmitted Infections (4-6 questions)

 Gonorrhea, Syphilis, Chlamydia, Genital Herpes, HPV

 Prevention

o Most effective way to prevent STIs is to avoid sexual intercourse with an

infected partner

o Use latex condoms

o Don’t exchange sex for money or drugs

 Clinical Manifestations

o Gonorrhea

 Men: dysuria; serous, milky, purulent penile discharge

 Women: dysuria, urinary frequency, abnormal menses, increased

vaginal discharge, dyspareunia

 20% of men and 80% of women are asymptomatic until disease is


o Syphilis—Four Stages

 Primary: chancre at site of inoculation, regional enlargement of lymph


 Secondary—systemic; 6 weeks later; skin rash (on palms of hands or

soles of feet), mucous patches in oral cavity, sore throat, condyloma

lata (flat, broad based papules)

 Latent—no symptoms; may last 1yr to a lifetime

 Tertiary—infiltrating tumors in skin/bones/liver; inflammatory

response involving nervous and cardiovascular system—RARE (only if


o Chlamydia

 Incubation period is 1-3 weeks; can be asymptomatic for months

 Target cervix and male urethra

 Dysuria, urinary frequency, discharge (like gonorrhea)

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Version 2021
Category Exam (elaborations)
Pages 21
Language English
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