Term
| Male Genitourinary Problems |
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Definition
1. Benign prostatic Hyperplasia
2. Cancer of the Prostate
3. Testicular Cancer |
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Term
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Definition
| Increase in the number of cells |
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Term
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Definition
| Increase in the size of the cells |
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Term
| Benign Prostatic Hypertrophy |
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Definition
Enlargement of the prostate gland
**Can result in bladder obstruction |
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Term
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Definition
Related to endocrine changes
Endocrine accumulation of DHT |
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Term
| Clinical Manifestations of BPH |
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Definition
Large, rubbery nontender prostate
Frequent urination and hematuria
Urinary hesitancy
Reduction in size and force of stream
Overflow incontinence
Bladder Distention |
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Term
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Definition
UTIs
Kidney Stones
Hematuria r/t overstretched vessels in bladder
Inflammation of the prostate |
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Term
| Serious Complications of BPH |
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Definition
Hydroureters
Hydronephrosis
Pyelonephritis
Renal Failure |
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Term
| Diagnostic Studies for BPH |
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Definition
Digital Rectum Exam
Urinalysis Culture and Sensitivity
BUN and Creatinine
Prostate Specific Antigen (PSA)
Ultrasound, KUB, cytoscopy
CBC |
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Term
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Definition
Urinary Retention r/t blockage from enlarged prostate
Urinary Incontinence, Overflow r/t overdistention of bladder
Disturbed Sleep Pattern r/t nocturia
Risk for Infection r/t residual urine |
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Term
| Mechanical Management of BPH |
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Definition
Temporary catheter; abx tx
Reduce prostatic fluid
Avoid alcohol, caffeine, and diuretics
Void as soon as urge is felt |
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Term
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Definition
5-Alpha Reductase Inhibitor
Alpha-adrenergic blockers |
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Term
| 5-Alpha Reductase Inhibitor |
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Definition
Proscar
-shrinks prostate by decreasing DTH
SE: ED, decreased libido, erythema
**May take at least 6 months to see effect |
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Term
| Alpha-adrenergic blockers |
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Definition
tamsulosin (Flomax); Uroxatral
-blocks alpha receptors causing constriction of prostate
SE: Dizziness, orthostatic hypotension |
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Term
| Nonsurgical Invasive Management for BPH |
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Definition
Thermotherapy
Prostatic Balloon Device
Stents or Coils |
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Term
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Definition
Electrovaporization
TUNA-shrinks prostate
TUMT-hi temps destroy extra tissue
ILC-laser energy coagulates excess tissue |
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Term
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Definition
| Used to improve symptoms of bladder neck obstruction and improve quality of life |
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Term
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Definition
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Term
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Definition
| Does not remove all of the prostate |
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Term
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Definition
Retention cath
Continuous bladder irrigation |
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Term
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Definition
Adjust rate to keep output pink/clear and free of clots
Monitor color, consistency, and amount of urine
Check tubing for kinks, clots, and decreased output
Monitor I&O and vital signs |
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Term
| TURP--Post-op complications |
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Definition
Infection
Incontinence
Retrograde Ejaculation
Bleeding
**Pt. should be voiding 150-200 mLs/4h |
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Term
| Bleeding associated with TURP |
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Definition
Arterial-bright red with small clots
*call Dr., increase CBI
Venous- burgundy
*call dr., increase tension on catheter |
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Term
| Surgical Invasive Management for BPH |
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Definition
TURP
Suprapubic Prostatectomy
Retropubic Prostatectomy
Perineal Prostatectomy
TULIP
HOLEP |
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Term
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Definition
Remove prostate through bladder
Post-op: Foley and suprapubic cath |
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Term
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Definition
Check residual urine
If <75 mL, remove suprapubic cath
If >75 mL, leave suprapubic cath |
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Term
| Retropubic Prostatectomy for BPH |
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Definition
incision is between pelvis and bladder
-Used when there is a large mass on prostate
**Infection risk is increased, erectile problems, and bleeding and bladder spasms |
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Term
| Perineal Prostatectomy for BPH |
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Definition
incision is made through perineum
-Used for large mass in lower abdomen
-On low-res and abx prior
**Most likely to cause impotence and urinary incontinence |
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Term
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Definition
| Guided laser incision of prostate |
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Term
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Definition
| Holmium laser Enucleation of the prostate |
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Term
| ACS Guidelines for DRE and PSA Screenings |
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Definition
Men beginning at age 50
men with life expectancy of at least 10 years
If African American or 1st degree relative, start at 45
If two 1st degree relatives, start at 40 |
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Term
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Definition
Rarely occurs before 45
highest incidence in Blacks
More than 2 million men living with disease
181,000 new cases in 2008 |
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Term
| 2 major androgens in males |
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Definition
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Term
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Definition
| It is slow-growing with a predictable pattern |
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Term
| Possible risk factors for prostate CA |
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Definition
| age, race, high fat diet, family hx, environmental factors, viruses, vitamins D&E deficiency |
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Term
| Prostate Assessment for CA |
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Definition
man may be asymptomatic OR
obstructive symptoms
Positive DRE |
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Term
| Obstructive symptoms of Prostate CA |
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Definition
Difficulty starting urination
Decreased size and force of stream
Urinary retention
frequency of bladder infection
Painful ejaculation |
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Term
| DRE findings with prostate CA |
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Definition
| Stony hard fixed lesion that may be tender |
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Term
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Definition
| gross, painless hematuria |
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Term
| Tumor spread with Prostate CA |
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Definition
Direct extension, then to lymphatic and blood stream
Common sites: lung, liver, and kidney |
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Term
| S/S of metastasis with prostate CA |
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Definition
| backache, hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, and hematuria |
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Term
| Diagnostic Studies for Prostate CA |
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Definition
DRE
PSA
TRUS
Biopsy
Serum alkaline phosphatase
Bone scan, CT, US, and MRI |
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Term
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Definition
| Glycoprotein produced by prostate |
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Term
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Definition
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Term
| What causes elevated PSA? |
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Definition
BPH, prostatitis, and prostate CA
**CA values usually run very high |
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Term
| Nursing Dx for Prostate CA |
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Definition
Anxiety r/t change in health status and tx options
Acute/Chronic pain r/t effects of metastasis and bone pain
Risk for Sexual Dysfunc. r/t altered body function |
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Term
| Therapeutic Management of PC |
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Definition
Observation
Surgery
Radiation
Drug Therapy |
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Term
| Observation for Prostate CA |
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Definition
"Watchful waiting"
Do routine DRE and PSA; check urinary symp. |
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Term
| Why observation for prostate CA |
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Definition
Potential side effects of treatment
estimated life expectancy
risk for increased mortality if no tx |
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Term
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Definition
TURP
Radical Prostatectomy
Cryosurgical Ablation
Bilateral Ochiectomy |
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Term
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Definition
Removal of entire prostate
LRP (laparoscopic) is latest development
*PSA must be <10, with no prior ab surgery |
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Term
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Definition
Freezes prostate for removal
no help if CA has metastasized |
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Term
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Definition
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Term
| Non-surgical tx for prostate CA |
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Definition
Radiation
Drug Therapy
Chemotherapy |
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Term
| Radiation for Prostate CA |
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Definition
Usually late in tx
External beam or implant
Used with other tx
*30% of prostate CA are resistant |
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Term
| Drug Therapy for prostate CA |
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Definition
androgen deprivation (Eulexin)
LH-RH agonist (Lupron)
Estrogen (DES) |
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Term
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Definition
| not been proven effective for prostate CA |
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Term
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Definition
| Most common in white males, age 15-34 |
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Term
| Major risk factor for Testicular CA |
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Definition
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Term
| Common metastasis for testicular CA |
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Definition
| Retroperitoneum and lungs |
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Term
| Genesis of testicular tumors |
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Definition
Most tumors are germinal
*rising from sperm producing cells |
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Term
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Definition
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Term
| Seminoma tumors in testicular CA |
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Definition
These tumors have best prognosis
*Metastasize late |
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Term
| Nonseminoma tumors in testicular CA |
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Definition
| nonsensitive to radiation |
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Term
| Nongerminal tumors in testicular CA |
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Definition
| arise from stoma, interstitial, or Leydig cells that produce testosterone |
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Term
| Manifestations of testicular CA |
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Definition
gradual onset with mass in testicle
painless enlargement of testis
heaviness in scrotum, inguinal area, or lower ab |
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Term
| S/S Mestastasis in testicular CA |
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Definition
Lymph node swelling
abdominal mass
gynecomastia
sudden hydrocele
testicular pain |
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Term
| Dx evaluation for testicular CA |
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Definition
Tumor Markers
Ultrasound, CT, and MRI
Biopsy |
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Term
| 2 Common Tumor Markers in testicular CA |
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Definition
alpha-fetoprotein
Human chorionic gonadotropin
*used for dx, staging, and monitoring
**levels are elevated with nonseminoma tumors |
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Term
| Ultrasound purpose for testicular CA |
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Definition
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Term
| CT purpose in testicular CA |
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Definition
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Term
| MRI purpose with testicular CA |
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Definition
| check for enlarged lymphnodes |
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Term
| Medical Management of Testicular CA |
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Definition
Surgery
Radiation and chemo
Sperm banking |
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Term
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Definition
Radical orchiectomy
Retroperitoneal lymph node dissection |
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Term
| Nursing dx for testicular CA |
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Definition
Body image disturbance r/t CA treatment
Sexual dysfunction r/t CA or treatment
Acute or chronic pain r/t tumor compression
Anxiety r/t cancer diagnosis |
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