1 / 58

THE GENITOURINARY SYSTEM

THE GENITOURINARY SYSTEM. GENITOURINARY SYSTEM Structural Disorders. Objectives: To learn the common structural and functional disorders of the male reproductive system To learn nursing management for these disorders To learn about infertility and impotence

milla
Download Presentation

THE GENITOURINARY SYSTEM

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. THE GENITOURINARY SYSTEM

  2. GENITOURINARY SYSTEMStructural Disorders • Objectives: • To learn the common structural and functional disorders of the male reproductive system • To learn nursing management for these disorders • To learn about infertility and impotence • To describe various forms of contraceptives • To know nursing management, including pharmacology related to disorders.

  3. STRUCTURAL DISORDERS • Hydrocele: benign, non-tender collection of clear, amber fluid within the space of the testes and the tunica vaginalis or along the spermatic cord. • Occurrence is in males > 21 years old • Cause unknown. May develop secondary to • trauma, orchitis or epididymitis

  4. Clinical Manifestation • Scrotal swelling possible: can be painful if it develops suddenly. • Inflammation of the epididymis or testis or a lymphatic or venous obstruction can be the cause.

  5. STRUCTURAL DISORDERS • Congenital hydrocele: occurs in newborn when the canal between the peritoneal cavity and the scrotum does not close completely during fetal development. • Aspiration of fluid is only temporary measure and can lead to secondary infection • Surgery is the treatment

  6. Medical/Surgical Management • -Sometimes aspiration of the fluid is done which • increases the risk for infection. After aspiration, pain • is relieved and scrotum can be examined easier. • -Surgery is usually the treatment. Removal of the sac to • avoid constriction of the circulation of the testes.

  7. Nursing Interventions • Post-op and post aspiration • - Maintain bed rest • - Scrotal support • - Ice to edematous areas • - Frequent dressing changes

  8. STRUCTURAL DISORDERS • Spermatocele: benign nontender cyst of either the epididymis or the rete testis. • Contains milky fluid and sperm • Usually painless and requires no treatment • Varicocele: dilation of the veins of the scrotum; occurs when the venous system that drains the testicle lengthens and enlarges. • Absent or malfunctioning valves in spermatic venous system; permits blood to accumulate resulting in decreased hydrostatic pressure…..

  9. Varicocele: symptoms may include bluish discoloration of the scrotal skin or palpation of a wormlike mass when male bears down…..condition seldom requires treatment. • Torsion of the spermatic cord: vascular pedicle of the testes twists, resulting in partial or complete venous occlusion. • Three types • Sx: abdominal/scrotal pain, scrotal, edema, N/V, fever

  10. MED-SURG MANAGEMENT • Specific to the condition • Hydrocele • Spermatocele • Varicocele • Torsion

  11. NURSING MANAGEMENT • Bed rest with scrotal support • Ice to area • Analgesics prn • Monitor vital signs, incisional drainage and dressing. Use strict asepsis when changing dressings.

  12. STRUCTURAL DISORDERS • Phimosis: when the opening of the foreskin is so small that it cannot be pulled back over the glans; may interfere with urination. • Inguinal Hernia: most common type, occurs in groin area, frequently occur after activities (heavy lifting) that increase intraabdominal pressure; subsides with relaxation. • Pain located lower than abdominal hernia

  13. FUNCTIONAL DISORDERS • Impotence: inability of an adult male to have an erection firm enough or to maintain it long enough to complete sexual intercourse. • Functional: psychological factors, aging, difficulty with relationships or communication • Atonic: result of medications, alcohol, cocaine and nicotine. Or diabetes, vascular and neurological disorders, renal disease.

  14. FUNCTIONAL DISORDERS • Anatomic: Peyronie’s disease- the development of non-elastic, fibrous tissue just beneath the penile skin, leading to anatomic impotence.

  15. MED-SURG MANAGEMENT • Medical • Determine whether lifestyle is a factor • Assessment may include nocturnal penile tumescence monitoring or DICC • Treatment based on assessment and findings: change in lifestyle, manage stress, lose weight, exercise. • External devices can be used (VCD)

  16. MED-SURG MANAGEMENT • Surgical: revascularization and penile implants • Disadvantages: expense, post-op complications, especially post-op infection. • Pharmacological: Medications that produce erections are available: • Viagra (sildenafil citrate) • Oral transmitters or sublingual apomorphine

  17. Nursing Interventions • -Post-op care post penile implant • -Patient/family teaching: • Use and care of the implant • Medication use, effects and side effects • -Nursing Diagnoses: Sexual dysfunction, ineffective • sexuality problems, disturbed body image, deficient • knowledge.

  18. INFERTILITY • Approximately 1 in 6 couples experience infertility, the inability to produce offspring. • Primary infidelity • Secondary infidelity • Etiology: may be related to anatomic or endocrine problems • Detailed history and physical exams needed

  19. 40% of infertility factors are female related • 40% are male related • 20% are a combination of multiple factors involving both partners • Infertility causes in female include: • -Blocked passages through the cervix or fallopian tubes • -Uterine or cervical abnormalities • -Cervix too narrow for sperm navigation • -Development of antibodies by woman’s system to • male’s sperm (kills sperm on contact in cervical • mucousa)

  20. Infertility causes in males include- • -Varicoceles • -Cryptorchism • -Impaired sperm • -Insufficient number of sperm • -Hormonal imbalance • -Use of hot tubs or sauna (may decrease sperm)

  21. INFERTILITY • Basic infertility workup may be started when couple unable to conceive after 6-12 months of unprotected intercourse. • Basal temperature chart • Endometrial biopsy • Semen analysis • Endocrine imbalance testing • Male-female interaction studies • Laparoscopy

  22. MED-SURG MANAGEMENT • No one treatment for infertility problems • -Diagnostic Tests: Testing to rule out systemic disease • ( e. g. DM, neoplasms, hepatic and renal disease, etc.) • -genetic disorders • -Male infertility testing: semen analysis, sperm volume, • sperm motility and density • -Endocrine testing to check pituitary gonadotropins, and • testosterone production

  23. MED-SURG • Pharmacology • Hormone imbalances or deficiencies: clomiphene citrate, menotrins, human chronic growth hormone, progesterone suppositories • -Clomiphene and Chorionic Gonadotropin

  24. Medical: • Artificial insemination Surgical: - In vitro fertilization GIFT - ZIFT -Both procedures are expensive

  25. Pharmacology • -Hormone imbalances or deficiencies: clooiphene • citrate, menotrins, human chronic growth • hormone, progesterone suppositories • -Clomiphen and Chrionic Gonadotropin • Clomid (clomiphene): synthetic nonsteroidal • compound; binds to estrogen receptors and causing • anterior pituitary to increase secretion of FSH and • LH. Used to induce ovulation in anovulatory • women.

  26. MED-SURG • Pharmacology • HCG: extracted from human placentas; actions identical to those of pituitary LH; used to induce ovulation in anovulatory women. Also used to for treatment of prepubertal cryptorchism ( failure of the testes to descend into the scrotum)

  27. MED-SURG • PHARMACOLOGY • Adverse reactions: • Clominophene: vasomotor flushes, abdominal discomfort, ovarian enlargement, blurred vision, N/V, nervousness. • HCG: headache, irritability, restlessness, fatigue, edema, precocious puberty (when given for cryptorchism)

  28. MED-SURG • Pharmacology • Menotropins: purified preparations of the gonadotropins ( FSH and LH) extracted from the urine of postmenopausal women: used to induce ovulation and pregnancy in anovulatory women; also used with HCG to stimulate multiple follicles for in vitro fertilization. In men, use to induce the production of sperm

  29. MED-SURG • Adverse Reactions: ovarian enlargement, hemoperitoneum (Blood in the peritoneum), abdominal discomfort, and febrile reactions. • Patient teaching considerations

  30. Med-Surg • Health Promotion • Seek prompt medical attention for infections affecting the reproductive system • Wise choices for contraception and sexual practices

  31. Family Planning • - A range of options for individuals wanting to • prevent or plan conception • - Birth control planning involves moral, • religious, cultural, and personal values. The • nurse should be sensitive to these factors when • discussing birth control with patients. • - Selection of birth control practices and • procedures should take into account the health • individual, effectiveness of the method, cost, • cost, ease of use, age, and parity (# of • pregnancies), preference of the couple and • willingness to comply with use.

  32. CONTRACEPTION • Contraception: prevention of pregnancy • Natural method: • Rhythm method -Rhythm method is a abstaining from intercourse during woman’s fertile period of the month -Usually lasting 7 days; 3 days before ovulation and 3 days after

  33. -Basal body temperature chart must be maintained • -Spinnbarkeit method monitors stretchiness of • cervical mucous to determine ovulation • -This type of mucous provides favorable • environment for sperm and its’ motility toward • the ova • - Immediately after ovulation, the mucous • becomes hostile to the sperm • - Home kits are available to take this test

  34. Hormonal methods: • Oral contraceptives- works by suppressing • ovulation (“the pill”) • Depo-Provera • Lunelle • Mirena • Transdermal Patch • Vaginal ring -Some contain estrogen and progesterone; others contain only progestins -Clients may experience mild side effects in response to the pseudopregnancy state (nausea, breast tenderness, weight gain)

  35. Nonhormonal methods: • -Intrauterine Device • -Barriers: cervical cap, diaphragm, condoms • -Vaginal ring • -Spermicides • Sterilization method: • -Permanent and very effective • -Tubal ligation • -Vasectomy

  36. PHARMACOLOGY • Objectives: • Discuss medical uses, actions and adverse reactions to male and female hormones • Discuss pre-administration and ongoing assessments the nurse should perform with a person taking male or female hormones • Discuss adverse reactions and/or special considerations

More Related