Nokea
The client with prostatitis presents with low back pain, dysuria, and unusual sensation following ejaculation. Which treatment(s) does the nurse anticipate being prescribed? Select all that apply.
- A. Analgesics
- B. Sitz bath
- C. Antibiotics
- D. Abstinence
- E. Treatment of sexual partner
Correct Answer: A,B,C,E
Rationale: Prostatitis is an inflammation of the prostate gland that is most often caused by microorganisms. Treatment consists of up to 30 days of antibiotic therapy, mild analgesics, and sitz bath. Sexual partners also need to be treated. Regular drainage of the prostate gland through masturbation or intercourse can be helpful in decreasing the inflammation and discomfort.
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The surgeon has ordered belladonna and opium (B and O) suppositories for the management of a postoperative prostatectomy client who is receiving continuous bladder irrigation. Which symptom(s) would indicate to the nurse the need for administration of this drug? Select all that apply.
- A. Increased blood in the catheter tubing
- B. Slowed or stopped infusion rate
- C. Increased bladder pressure and pain
- D. Increased speed of infusion rate
- E. Signs of urinary retention
- F. Increased force of urinary stream
Correct Answer: B,C
Rationale: Belladonna and opium suppositories are ordered to reduce bladder spasms that cause increased bladder pressure and pain following a prostatectomy. As spasms occur, the infusion of saline will slow or stop. Increased blood in the catheter tubing is a sign of active bleeding. With an indwelling three-way catheter, urinary retention and increased force of urinary stream are not present.
The nurse is reviewing a client's medication and health history. Which assessment finding would cause the nurse to question the client's new prescription for the phosphodiesterase inhibitor sidenafil?
- A. Use of nitrates
- B. History of hypertension
- C. Type 2 diabetes
- D. Use of diuretics
Correct Answer: A
Rationale: PDE5 inhibitors facilitate penile erection by producing smooth muscle relaxation in the corpora cavernosa via vasodilation of the blood vessels. If a client is using nitrates (which also exhibit vasodilation) hypotension is likely to occur. History of hypertension and diabetes does not interfere with the administration of PDE5 inhibitors. Use of diuretics is not significant.
A client comes to the outpatient clinic for information on a vasectomy. Which instruction should be included by the nurse?
- A. Vasectomies should be considered a permanent means of birth control.
- B. Following surgery, sexual intercourse should be avoided for 3 months.
- C. Postoperative discomfort can be relieved with use of warm bath.
- D. Vasectomy can result in permanent impotence.
Correct Answer: A
Rationale: Although attempts to reverse a vasectomy have proven successful, a vasectomy should be considered a permanent means of birth control. Scar formation and/or sperm leakage can interfere with restoration of reproductive effectiveness. Sexual intercourse can be resumed when it is comfortable to do so, usually in about 1 week. Postoperative discomfort should be controlled with application of cold to reduce swelling or use of mild analgesics. On occasion, clients have complained of impotence, but vasectomies have no effect on erection or ejaculation.
Which pharmacologic agent poses the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)?
- A. Muscle relaxers
- B. Antihypertensives
- C. Nitrates
- D. Antihistamines
Correct Answer: D
Rationale: Antihistamines and over-the-counter cold medications should be avoided in clients with BPH due to the increase in urinary retention properties. Muscle relaxers are commonly prescribed for treatment of urinary retention. Nitrates and antihypertensive medications do not cause significant risk in the management of BPH.
Which recommendation would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?
- A. Ensure immunizations against infectious diseases such as mumps.
- B. Engage in activities and exercises that minimize heavy lifting.
- C. Encourage the consumption of foods that are rich in fat and starch.
- D. Urge the limited intake of foods and fluids containing caffeine.
Correct Answer: A
Rationale: Nurses should advocate for infant and childhood immunizations against infectious diseases such as mumps to reduce potential adult complications such as orchitis. Minimizing activities involving heavy lifting or urging limited intake of caffeine have no effect on the potential for adult complications such as orchitis. The nurse should encourage foods that are low in fat and starch; however, this also would have no effect on the potential for orchitis.