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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.
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The nurse is caring for client who has had a vasectomy. Which would be most important to include in a teaching plan for this client?
- A. Using a reliable method of contraception for several weeks.
- B. Applying warm compresses to the scrotum for the first 24 hours
- C. Taking a prescribed opioid analgesic for pain relief
- D. Resuming sexual activity in 24 to 48 hours
Correct Answer: A
Rationale: It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed is use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week.
A clinic nurse is scheduled to see four male clients. Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer?
- A. Previous sexually transmitted infection (STI)
- B. Low sperm count
- C. Cryptorchidism as an infant
- D. Family history of cancer
Correct Answer: C
Rationale: Caucasian men who have had cryptorchidism as an infant, regardless of whether an orchiopexy was performed, are at higher risk, for incidence of testicular cancer. STIs, low sperm count, and family history of general cancer are not indicative of testicular cancer risk.
A client is diagnosed with prostatitis. Which is the most important teaching point for the management of this disorder?
- A. Avoid tub baths.
- B. Avoid sexual activity.
- C. Limit fluid intake.
- D. Avoid prolonged sitting.
Correct Answer: D
Rationale: Prolonged sitting can aggravate the condition of prostatitis and should be avoided. Warm tub baths and/or sitz baths can provide comfort. Increasing fluid intake can also flush the urethra of microorganisms and decrease risk of bacterial infection. Regularly draining the prostate gland through masturbation or intercourse can be helpful.
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.
The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. The nurse explains that which drug reduces the size of the prostate without lowering circulating levels of testosterone?
- A. Finasteride (Proscar)
- B. Tamsulosin (Flomax)
- C. Terazosin (Hytrin)
- D. Oxybutynin chloride (Ditropan)
Correct Answer: A
Rationale: Finasteride (Proscar) inhibits the conversion of testosterone, depriving the gland of dihydrotestosterone (more potent type of testosterone), which stimulates prostatic growth. Tamsulosin (Flomax) and terazosin (Hytrin) work by reducing the tone of smooth muscle in the bladder neck and prostate gland but have little effect on reducing prostate size. Oxybutynin chloride (Ditropan) is an antimuscarinic, antispasmodic drug used for treatment of overactive bladder.