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
dysfunction
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
tissue
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
advanced
o Syphilis—Four Stages
Primary: chancre at site of inoculation, regional enlargement of lymph
nodes; HIGHLY CONTAGIOUS AT THIS STAGE
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
untreated)
o Chlamydia
Incubation period is 1-3 weeks; can be asymptomatic for months
Target cervix and male urethra
Dysuria, urinary frequency, discharge (like gonorrhea)
Version | 2021 |
Category | Exam (elaborations) |
Pages | 21 |
Language | English |
Comments | 0 |
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