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The nurse has completed discharge teaching for a patient who had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). Which of the following patient statements indicate that additional instruction is required?
- A. I will avoid driving until I get approval from my doctor.
- B. I should call the doctor if I have any incontinence at home.
- C. I will increase fibre and fluids in my diet to prevent constipation.
- D. I should continue to schedule yearly appointments for prostate exams.
Correct Answer: B
Rationale: Since urinary incontinence is common for several weeks after a TURP the patient does not need to call the health care provider if this occurs. The other patient statements indicate that the patient has a good understanding of post-TURP instructions.
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The nurse is preparing a teaching plan for a patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level. Which of the following procedures should the nurse include in the teaching plan?
- A. Cystourethroscopy
- B. Uroflowmetry studies
- C. Magnetic resonance imaging (MRI)
- D. Transrectal ultrasonography (TRUS)
Correct Answer: D
Rationale: In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize the prostate for biopsy. Uroflowmetry studies help determine the extent of urine blockage and treatment, but there is no indication that this is a problem for this patient. Cystoscopy may be used before prostatectomy, but will not be done until after the TRUS and biopsy. MRI is used to determine whether prostatic cancer has metastasized but would not be ordered at this stage of the diagnostic process.
The health care provider prescribes finasteride for a patient who has benign prostatic hyperplasia (BPH). Which of the following information should the nurse include when teaching the patient about the drug?
- A. Change position from lying to standing slowly.
- B. Sexual activity interest may decrease while he is taking the medication.
- C. Improvement in the obstructive symptoms should occur within about 2 weeks.
- D. Required to monitor blood pressure frequently to assess for hypertension.
Correct Answer: B
Rationale: A decrease in libido is an adverse effect of finasteride because of the androgen suppression that occurs with the drug. Although orthostatic hypotension may occur if the patient also is taking a medication for erectile dysfunction (ED), it should not occur with finasteride alone. Improvement in symptoms of obstruction takes about 6 months. The medication does not cause hypertension.
The nurse is admitting a patient scheduled for a unilateral orchiectomy for testicular cancer. The nurse notes that the patient does not talk to his partner and speaks to the nurse only to answer the admission questions. Which of the following actions is best for the nurse to take?
- A. Ask the patient if he has any questions or concerns about the diagnosis and treatment.
- B. Document the patient's lack of communication on the chart and continue preoperative care.
- C. Assure the patient's partner that concerns about sexual function are common with this diagnosis.
- D. Teach the patient and the partner that impotence is rarely a problem after unilateral orchiectomy.
Correct Answer: A
Rationale: The initial action by the nurse should be assessment for any anxiety or questions about the surgery or postoperative care. The nurse should address the patient, not the spouse, when discussing the diagnosis and any possible concerns. Without further assessment of patient concerns, the nurse should not offer education about complications after orchiectomy. Documentation of the patient's lack of interaction is not an adequate nursing action in this situation.
The nurse is conducting discharge teaching with a patient who has undergone a vasectomy in the health care provider's office. Which of the following information should the nurse include in the discharge instructions?
- A. May have temporary erectile dyfunction (ED) because of postoperative swelling.
- B. Should continue to use other methods of birth control for 6 weeks.
- C. Should not have sexual intercourse until his 6-week follow-up visit.
- D. Will notice a decrease in the appearance and volume of his ejaculate.
Correct Answer: B
Rationale: Because it takes about 6 weeks to evacuate sperm that are distal to the vasectomy site, the patient should use contraception for 6 weeks. ED that occurs after vasectomy is psychological in origin and not related to postoperative swelling. The patient does not need to abstain from intercourse. The appearance and volume of the ejaculate are not changed because sperm are a minor component of the ejaculate.
Which of the following information should the nurse include when teaching a patient who has a diagnosis of persistent prostatitis?
- A. Buproofen should provide good pain control.
- B. Prescribed antibiotics should be taken for 7-10 days.
- C. Sexual intercourse and masturbation will help relieve symptoms.
- D. Cold packs should be used every 4 hours to reduce inflammation.
Correct Answer: C
Rationale: Ejaculation helps drain the prostate and relieve pain. Warm baths are recommended to reduce pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed but usually do not offer adequate pain relief. Antibiotics for persistent prostatitis are taken for 4-12 weeks.