Chapter 19- Assessing the Male Breasts and Reproductive System (objectives 3,2,6)

What are the four P's?

1.) partners
2.) practices
3.) protection
4.) past STI's

What is the risk factors of testicular cancer?

1.) family history
2.) undescended testicle
3.)men infected with HIV and AIDs
4.) body size

What are the risk factors of penile cancer?

1.) not being circumcised
2.) HPV infection
3.) phimosis
4.)smoking
5.)advancing age
6.)ultraviolet light treatment for psoriasis

What are the risks of prostate cancer?

1.) men older than 50 years
2.) family history

What is the risk factors of male breast cancer?

1.) advancing age
2.) exposure to radiation prior to age 30
3.) high estrogen levels
4.) family history of breast cancer
5.)inherited gene mutation
6.) Klinefelter syndrome
7.) alcohol
4.) testicular conditions

Dysuria

is pain and difficulty with urination; usually described as a "burning" quality; may indicate infection or inflammation of the lower urinary tract

Bladder pain

may indicate cystitis, inflammation of the bladder due to infection

Back pain

elicited by costovertebral tenderness may indicate inflammation of the kidneys or possibly the presence of kidney stones

Testicular pain

may be related to trauma, infection, or cancer; testicular torsion occurs when the testicle twists inside the scrotum, decreasing the blood flow to the testicle and causing severe pain in the scrotum; this is a surgical emergency

inguinal pain

may be related to an inguinal hernia; part of the intestine protrudes through the abdominal wall; more evident if the patient coughs, bends over, or lifts a heavy object exerting intra-abdominal pressure

Benign prostatic hypertrophy (BPH)

is a nonalignment enlargement of the prostate glade as part of the aging process

Hydrocele

is an accumulation of fluid around the testes

Epididymitis

is swelling and inflammation of the epididymis; may be related to STI

What are some cultural considerations?

1.) cultural and racial considerations may place restrictions on discussing sexual issues
2.) certain cultures may only some-gender health care providers

What are the sequence of assessment of assessing the male breasts and reproductive system?

1.) inspecting and palpating the male breasts
2.) inspecting the male genitalia

What is the purpose of inspecting and palpating the male breasts?

To assess for lumps, nipple discharge or abnormalities

What is the assessment steps for inspecting and palpating the male breasts?

1.) explain
2.) with the patient lying in the supine position, inspect the male breasts
3.) inspect the areola
4.) inspect the nipples
5.) as the pt to raise his arms over his head and inspect the lateral aspect of the breasts toward the mid-axillary line for skin changes
6.) gently palpate each breast and axillary area using the finger pads of your second, third, and fourth fingers using the vertical strip pattern assessment technique, assessing for lumps or masses
7.) palpate any lump or masses
8.) put gloves on and palate each areola area
9.) gently palpate and press each side of the nipple at the base noting any discharge
10.) document

When inspecting the male breasts wat are you looking for?

1.)symmetry
2.) color
3.) contour (dimpling or retraction)
4.)edema
5.)lesions
6.)ulcerations
7.) texture of skin

What are you looking for when inspecting the areola?

1.) shape
2.) color

What are you looking for when inspecting the nipples?

1.)size
2.)position
3.)shape
4.)discharge
5.)scaling or crusting

When palpating any lump or mass what would you note?

1.) shape
2.)size
3.) consistency (hard, soft, or rubbery)
4.)mobility (mobile or immobile)
5.) location (document by using the clock method)

What are you looking for in the nipple discharge?

1.) color
2.) consistency
3.) odor

What is the purpose of inspecting the external genitalia?

To assess the external male genitalia for lesions, edema, and masses

What is the assessment steps of inspecting the external genitalia?

1.) explain
2.) ask the patient to lie on the examination table in the supine position
3.) put on gloves
4.)drape the pt so that only the genital area being examined is exposed
5.) inspecting the skin of the male genitalia
6.) assess the structures
7.) gently lift up the scrotum to assess the posterior side
8.) ask the patient to turn on his side with the upper leg slightly bent, and gently spread the buttocks apart to inspect the anus.
9.) Maintaining the pt dignity, ask the patient to stand. Ask the pt to hold his penis up for this next part of the assessment. While sitting on the stool or squatting at eye level, compare right or left scrotal sacs.
10.) assess the groin area for inguinal bulging; if suspected, ask the pt to cough for better visualization of any suspect bulging.
11.) document

What are you assessing for when inspecting the skin of the male genitalia?

1.) color
2.) lesions
3.) drainage
4.) edema
5.)hair distribution

What structures do you asses when inspecting the external genitalia?

1.)penis- assess the ventral, lateral, and dorsal sides
2.) prepuce- note whether the pt is circumcised or not; if uncircumcised ask the patient to retract the foreskin
3.)urethral meatus- note the location of the urethral opening,
4.)pubic hair-assess pattern of hair distribution
5.)skin- assess for irritation, erythema, or pubic lice, more commonly known as crabs, derive their name from the crab-shaped insects that sometimes take up residence in the pubic hair; itching is the most common symptom reported

What is the purpose of obtaining a urethral culture?

To identify the organism causing the infection

What are the assessment steps when obtaining a urethral culture?

1.) gather supplies
2.) explain
3.) put gloves on
4.) open up the culturette tube and remove the swab
5.) maintaining sterility of the swab tip, hold the shaft of the penis and gently insert the tip of the swab about 2 to 4 cm into the urethra
6.) gently turn the swap clockwise for 2 to 3 seconds, maintaining contact with the mucosal surfaces
7.) slowly withdraw the swab and insert into culturette tube and medium
8.) break off the end of the swab at the score line
9.) turn and recap tightly; document or attach preprinted label with the patient's name, date, and source of culture.
10. Document