Nursing Management: Male Reproductive Problems Chapter 55 Nursing Management: Male Reproductive Problems

1. A 62-year-old man is seen at the health clinic because he is concerned about a gradual decrease in sexual performance. After a nursing history obtained from the patient reveals no specific risk factors related to erectile dysfunction, the most appropriate action for the nurse to take first is to 1. explain normal age-related changes in sexual performance to the patient. 2. discuss the variety of aids and devices available to enhance sexual performance. 3. consult with the health care provider about testing the patient for hypogonadism. 4. refer the patient to a qualified therapist to explore possible psychologic causes of decreased function. Answer: 1 Rationale: Normal physiologic age-related changes are associated with changes in erectile function and may be an underlying cause of erectile dysfunction (ED). The nurse should provide an explanation of these age-related changes to reassure an anxious older man regarding normal changes in his sexual abilities.

1. “It is possible that I’ll be sterile following this procedure.” 2. A patient with benign prostatic hyperplasia is scheduled for a transurethral resection of the prostate (TURP). The nurse assesses the patient’s knowledge of the procedure and its effects on reproductive function, and determines a need for further teaching when the patient says, 1. “It is possible that I’ll be sterile following this procedure.” 2. “It is likely that I will become impotent from this procedure.” 3. “I understand that some retrograde ejaculation may occur.” 4. “I will have a catheter for a couple of days to keep my urinary system open.” Answer: 2 Rationale: Retrograde ejaculation is common with a transurethral resection of the prostate because of trauma to the internal urethral sphincter. If retrograde ejaculation occurs, the patient may be sterile after the procedure. The catheter is removed 2 to 4 days after surgery. Erectile dysfunction is unlikely with a transurethral resection of the prostate.

2. risk for situational low self-esteem. 3. sexual dysfunction. 3. After radical perineal prostatectomy for advanced cancer of the prostate, the priority nursing diagnosis for the patient is 1. risk for infection. 2. risk for situational low self-esteem. 3. sexual dysfunction. 4. total urinary incontinence. Answer: 1 Rationale: The perineal approach has a higher risk of postoperative infection (because of the location of the incision in relation to the anus). Careful dressing changes and perineal care are important after each bowel movement to prevent infection.