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Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
Slide 33
Erectile Dysfunction (Impotence) (cont.)
• Vacuum constriction devices
• A vacuum draws blood into the penis
• Revascularization
6
Slide 34
Erectile Dysfunction (Impotence) (cont.)
• Assessment
• Patient’s health/family history of diabetes
Slide 35
Erectile Dysfunction (Impotence) (cont.)
• Interventions
• Sexual dysfunction
4
Slide 36
Peyronie Disease
• A hard, nonelastic, fibrous tissue (plaque) just under the skin of the penis of men between
45 and 70 years of age
• Plaque develops as a result of an injury that causes inflammation and scarring of the
tunica surrounding the corpora cavernosa
TALKING POINTS:
• Where is the plaque usually located?
Slide 37
Peyronie Disease (cont.)
• Medical treatment
• Topical or oral medications with vitamin E, oral para-aminobenzoic acid, tamoxifen,
colchicine
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LESSON 50.1
Slide 38
Priapism
• Prolonged erection not related to sexual desire
• Causes
• Injury to the penis, sickle cell crisis, and neoplasms of the brain or spinal cord
• Drugs that may be responsible include phenothiazines, alpha-adrenergic blockers,
anticoagulants, alcohol, cocaine, marijuana, vardenafil (Levitra), and intracavernosal
injections
TALKING POINTS:
• What urinary problems may be caused by priapism?
Slide 39
Priapism (cont.)
• Medical treatment
• Aspirating blood from erectile chambers or injecting drugs that cause contraction of
smooth muscle, inhibiting inflow of blood and allowing outflow
Slide 40
Phimosis
• Edema that may prevent retraction of the foreskin caused by inflammation under the
foreskin
• Often associated with poor hygiene
Infertility
• Couples who have had unprotected intercourse over a 12-month period and have been
Slide 42
Infertility (cont.)
• Cause and risk factors
• Male infertility: endocrine disorders, testicular problems, or abnormalities of the
TALKING POINTS:
• What structural factors may affect testicular function?
Slide 43
Infertility: Cause and Risk Factors
• Infections
• Mumps, tuberculosis, pneumonia, and syphilis
• Chlamydia trachomatis and Neisseria gonorrhoeae
______________________________________________________ Chapter 50Male Reproductive Disorders 17
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
Slide 44
Infertility: Cause and Risk Factors (cont.)
• Cryptorchidism
• Testis in other than a dependent scrotal position
• Because the abdominal cavity is warmer than the scrotum, excessive warmth can
TALKING POINTS:
• It is a common congenital condition, being found in approximately 30% of preterm male
infants and in 1.0% to 3.4% of full-term male infants.
• What is the cause of cryptorchidism?
• Cryptorchidism must be corrected within the first 18 months of life to give the best chance
for fertility.
• Men with undescended testes have a 10 to 30 times higher incidence of testicular cancer
than men whose testes descended normally.
Slide 45
Infertility: Cause and Risk Factors (cont.)
• Testicular torsion
• Occurs unilaterally when testicle is mobile and the spermatic cord twists, cutting off
blood supply to testicle
• Acute surgical emergency requiring immediate release of the torsion or removal of the
testicle
Slide 46
Infertility: Cause and Risk Factors (cont.)
• Varicocele
• A lengthening and enlargement of the scrotal portion of the venous system that drains
the testicle
• Caused by incompetent or absent valves in the spermatic venous system; allows
TALKING POINTS:
• Which testicle is most often affected?
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LESSON 50.1
Slide 47
Infertility: Cause and Risk Factors (cont.)
• Vasectomy
• Surgical removal of a portion of the vasa
• Erection, ejaculation, and intercourse are unaffected
• Postoperative pain/swelling managed with application of an ice bag, mild analgesics,
and scrotal support
• Patient can resume intercourse as soon as he feels comfortable; important to use
TALKING POINTS:
Penile Cancer
• Relatively rare; almost exclusively in uncircumcised men
• Risk factors: chronic irritation, poor hygiene, a history of multiple sexual partners, sexually
Testicular Cancer
• Testicular germ cell carcinoma occurs most often in men between ages of 18 and 34
• Three established risk factors: cryptorchidism, white race, and previous testicular cancer
Slide 50
Testicular Cancer (cont.)
• Early detection
• Education about the need for self-examination
• Monthly examination of the penis, scrotum, and perineal area
• Medical diagnosis
• Ultrasound and blood studies to measure tumor markers: alpha-fetoprotein and
TALKING POINTS:
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Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
6
Slide 51
Testicular Cancer (cont.)
• Assessment
• Fears or concerns related to the effects of surgery and other treatment
• Interventions
• Anxiety
• Acute pain
• Impaired urinary elimination
• Risk for injury
• Constipation
Slide 52
Question 1
• The primary storage site for sperm is _________.
A. epididymis
B. prostate gland
C. seminal vesicles
D. vas deferens
TALKING POINTS:
Slide 53
Question 2
• Sperm are produced in the __________.
A. Cowper’s glands
B. prostate gland
C. seminal vesicles
D. seminiferous tubules
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LESSON 50.1
Activities
Classroom Choose from below to make 30 minutes
1
ASSESS BASELINE
• Have the class complete the Pretest. Collect
their work and use the results to guide how
you teach the class.
DISCUSS
• Discuss in which organ sperm are produced
and trace the path that they follow out of the
body, naming each structure along the way.
PRACTICE
• Using Figure 50–1 (p. 1137) without the
labels on an overhead projector, have
2
DISCUSS
• Discuss the significance of spinal cord injury
to sexual dysfunction.
• Discuss what samples might be taken for
culture and sensitivity testing during the
health assessment and physical examination
of a man’s reproductive system. What items
should be readily available in case samples
are needed?
PRACTICE
• Divide the class into small groups. Have
students identify and list the essential
______________________________________________________ Chapter 50Male Reproductive Disorders 21
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
3
DISCUSS
• Discuss why semen analysis is performed
and how the sample should be collected.
• Discuss the hormones of the male
reproductive system and how they affect
PRACTICE
• Divide the class into small groups. Assign
each group one of the diagnostic tests or
22 Chapter 50Male Reproductive Disorders _______________________________________________________
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LESSON 50.1
4
DISCUSS
• Discuss the treatment of acute and chronic
bacterial prostatitis and nonbacterial
prostatitis.
• Discuss patient preparation and
postprocedure nursing care for the patient
undergoing cystoscopy.
• Discuss patient preparation and
PRACTICE
• Divide the class into three groups: group 1–
epididymitis; group 2–prostatitis; and group
3–orchitis. Have each group discuss its topic
for 5 minutes and then present its disorder
(including signs and symptoms, diagnosis,
treatment, and complications) to the class.
• Lead a class discussion with the following
questions:
• What are some of the medical conditions
______________________________________________________ Chapter 50Male Reproductive Disorders 23
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
• Present a scenario of a 54-year-old man
diagnosed with Peyronie disease. Ask the
class what the patient’s signs and symptoms
would be, what could have caused this, how
it can be treated, and what complications
could occur.
• Divide the class into three groups. Group 1
will explain the pathophysiology and signs
5
DISCUSS
• Discuss the conditions that might be treated
with hormones, such as testosterone and
estrogen products, and testosterone-ablating
agents.
• Discuss the mechanism of action of
sildenafil (Viagra). How does it differ from
alprostadil (Caverject)?
PRACTICE
• Before class, ask students to research on
the Internet various drugs used to treat
erectile dysfunction and print out any
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Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
6
DISCUSS
• Discuss what should be done during the
immediate postoperative nursing
assessment of the patient who has
undergone a prostatectomy.
• Discuss why fluid volume monitoring is so
important in the care of the patient who has
undergone a prostatectomy.
• Discuss psychological considerations when
PRACTICE
• Divide the class into small groups, and
present the following scenario:
• An 83-year-old man had a suprapubic
• Lead a class discussion and provide
students with appropriate nursing diagnoses
______________________________________________________ Chapter 50Male Reproductive Disorders 25
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 50.1
Critical Thinking Question
The nurse practitioner asks a male LPN to collect health history data from a new patient. The
patient is a 64-year-old man who is experiencing dysuria, frequency, warmth, and
tenderness in the groin, and has foul-smelling urine. What information should the LPN
collect from this patient? What condition might the patient have? How will it be diagnosed
and treated? What instructions should the nurse then provide to this patient?
Discussion Guidelines: Initial data collection should include information about the patient’s health
history, including a focused review of the male reproductive system and sexual activity, and a
Instructor Notes/Student Feedback
26 Chapter 50Male Reproductive Disorders _______________________________________________________
50
Assessments for
Male Reproductive Disorders
CHAPTER OBJECTIVES
Lesson 50.1:
2. Identify data to be collected when assessing a male patient with a reproductive system disorder.
4. For selected disorders of the male reproductive system, explain the pathophysiology, signs and
symptoms, complications, medical diagnosis, and medical treatment.
6. Assist in developing a nursing care plan for a male patient with a reproductive system disorder.
Assessments by Lesson & Objective
Lesson 50.1
1
Study Guide
• Part IA: 1-6 (p. 339)
Evolve Instructor Resources
• Test Bank: 1
• Open Book Quiz: 1
2
Study Guide
• Part IIE: 4, 6-8, 12 (pp. 341-342)
Evolve Instructor Resources
• Test Bank: 10, 20, 24, 25, 27, 28
• Open Book Quiz: 2
Evolve Student Resources
• Prioritization: 4, 5
3
Study Guide
• Part IIE: 5, 24 (pp. 341-342)
Evolve Instructor Resources
Evolve Instructor Resources
• Test Bank: 1-3, 5, 11, 14, 15, 17-19
• Open Book Quiz: 5-10
Evolve Student Resources
• NCLEX Review: 2-5, 8, 9
______________________________________________________ Chapter 50Male Reproductive Disorders 27
Introduction to Medical-Surgical Nursing, 6th ed.
Assessments by Lesson & Objective
5
Study Guide
• Part IIE: 9, 23, 27 (pp. 341-343)
• Part IIF: 1-6 (p. 643)
Evolve Instructor Resources
Evolve Student Resources
• Prioritization: 1-3
6
Study Guide
• Part IIE: 15, 20 (p. 342)
• Part IIIH: 1-3 (p. 344)
Evolve Instructor Resources
• Test Bank: 5, 8, 9, 16-18, 26
Instructor’s Notes/Student Feedback