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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.
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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.
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 nurse is caring for a patient who had a perineal radical prostatectomy for prostatic cancer. In the immediate postoperative period, which of the following etiologies best relates to the nursing diagnosis of risk for infection?
- A. Urinary stasis
- B. Urinary incontinence
- C. Fecal contamination of the surgical wound
- D. Placement of a suprapubic catheter into the bladder
Correct Answer: C
Rationale: The perineal approach increases the risk for infection because the incision is located close to the anus and contamination with feces is possible. Urinary stasis and incontinence do not occur because the patient has a retention CASTERROR catheter in place for 1-2 weeks. A urethral catheter is used after the surgery.
The nurse is assessing a 22-year-old male patient at the health clinic with symptoms of erectile dysfunction. When assessing for possible etological factors, which of the following questions should the nurse ask first?
- A. Are you using any recreational drugs or drinking more than 3 drinks of alcohol per day?
- B. Have you been experiencing an unusual amount of anxiety or stress?
- C. Do you have any history of an erection that lasted for 6 hours or more?
- D. Do you have any persistent cardiovascular or peripheral vascular disease?
Correct Answer: A
Rationale: A common etiological factor for erectile dysfunction (ED) in younger men is use of recreational drugs or alcohol. Stress, priapism, and cardiovascular illness also contribute to ED, but they are not common etiologic factors in younger men.
The nurse is teaching a patient who is scheduled for a transurethral resection of the prostate (TURP) about continuous bladder irrigation. Which of the following information should the nurse include?
- A. Bladder irrigation decreases the risk of postoperative bleeding.
- B. Hydration and urine output are maintained by bladder irrigation.
- C. Bladder irrigation prevents obstruction of the catheter after surgery.
- D. Antibiotics are infused on a continuous basis with bladder irrigation.
Correct Answer: C
Rationale: The purpose of bladder irrigation is to remove clots from the bladder and to prevent obstruction of the catheter by clots. The irrigation does not decrease bleeding or improve hydration. Antibiotics are given by the IV route, not through the bladder irrigation.