Nokea
The nurse is caring for a patient recently diagnosed with benign prostatic hyperplasia (BPH) who tells the nurse that he does not want to have a transurethtral resection of the prostate (TURP) because he is afraid it might affect his ability to have intercourse. Which of the following actions should the nurse take?
- A. Offer reassurance that sperm production is not affected by TURP.
- B. Discuss alternative methods of sexual expression besides intercourse.
- C. Provide education about the use of medications for erectile dysfunction (ED).
- D. Teach that erectile dysfunction (ED) is unlikely following a TURP.
Correct Answer: D
Rationale: ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse should discuss this with the patient. Erectile function is not usually affected by a TURP, so the patient will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the patient has not asked about fertility, reassurance about sperm production does not address his concerns.
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The nurse is assessing a 53-year-old man who has been having increasing problems with erectile dysfunction (ED) for several years and is interested in using sildenafil. Which of the following actions should the nurse take first?
- A. Ask the patient about any prescription drugs he is taking.
- B. Tell the patient that sildenafil does not always work for ED.
- C. Discuss the common adverse effects of erecogenic drugs.
- D. Assure the patient that ED is commonly associated with aging.
Correct Answer: A
Rationale: Because some medications can cause ED and patients using nitrates should not take sildenafil, the nurse should first assess for prescription drug use. The nurse may want to teach the patient about realistic expectations and adverse effects of sildenafil therapy, but this should not be the first action. Although ED does increase with aging, it may be secondary to medication use or cardiovascular disease in a 53-year-old.
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.
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 assessing a patient with benign prostatic hyperplasia (BPH). Which of the following symptoms should the nurse assess to determine the severity of the BPH?
- A. Blood in the urine
- B. Lower back or hip pain
- C. Erectile dysfunction (ED)
- D. Strength of the urinary stream
Correct Answer: D
Rationale: The American Urological Association (AUA) Symptom Index (used in Canada) for a patient with BPH asks questions about the force and frequency of urination, nocturia, etc. Blood in the urine, ED, and back or hip pain are not typical symptoms of BPH.
The nurse is caring for a patient who had a transurethral resection of the prostate (TURP) and has a continuous bladder irrigation with symptoms of painful bladder spasms. The nurse observes a decrease in urine output and clots in the urine. Which of the following actions should the nurse take first?
- A. Increase the flow rate of the bladder irrigation.
- B. Administer the prescribed IV morphine sulphate.
- C. Give the patient the prescribed belladonna and opium suppository.
- D. Manually instill and then withdraw 50 mL of saline into the catheter.
Correct Answer: D
Rationale: The assessment suggests that obstruction by a clot is causing the bladder spasms, and the nurse's first action should be to irrigate the catheter manually and to try to remove the clots. IV morphine will not decrease the spasm, although pain may be reduced. Increasing the flow rate of the irrigation will further distend the bladder and may increase spasms. The belladonna and opium suppository will decrease bladder spasms but will not remove the obstructing blood clot.