Questions Accompany Prostate Cancer

1. Which modifiable risk factor should the nurse identify for the development of cancer of the prostate in a client? (select all that apply) 1. Previous exposure to chemicals. 2. The client has a diet high in red meat. 3. Cigarette smoking. 4. Parasitic infections of the bladder. 5. The client just celebrated his 55th birthday. 1. The client has already been exposed; this cannot be undone. 2. Diet high in red meat, animal fat and consumption of calcium is a Modifiable risk factor for BPH 3. Cigarette smoke contains more than 400 chemicals, 17 of which are known to cause cancer. The risk is directly proportional to the amount of smoking. 4. Clients may be unaware of a parasitic infection of the bladder for some time prior to diagnosis, but it is not a risk factor for cancer of the prostate. 5. Age is not modifiable. 2. The nurse correctly comprehends the pathophysiology of Prostate cancer when the nurse states clinical symptoms of prostate cancer include. (Select all that apply) 1. Difficulty in initiating urination 2. Minimal hematuria with pain 3. Prostate gland appears stony hard 4. The client reports weight loss 1.3.4 are hallmark signs of prostate cancer Gross, painless hematuria is a common sign 3. The nurse instructs the patient that the most definitive way of diagnosing prostate cancer is. 1. Trans rectal Ultrasonography 2. PSA screening greater than 4 ng/mL 3. Prostate gland with palpable irregularities or induration is suspected to be malignant 4. Prostate Biopsy 5. CT scan followed by and MRI for confirmation. 3. All of the techniques are useful in diagnosing however the most definitive way to diagnose all cancer is with a biopsy. CT scan and MRI are useful to determine metastasis 4. A client is brought to the surgical unit after a suprapubic prostatectomy. He has a 3 way Foley catheter. The nurse notices a very dark red output via the catheter. What is the priority nursing intervention? a. report to the physician b. increase the irrigation flow rate c. check the latest hemoglobin and hematocrit d. chart the observation 4. B this is done first prior to checking blood work, next would be notifying the physician, then charting. 5. The nurse is caring for a client who will have a bilateral orchiectomy. The client asks what is involved with this procedure. The nurse’s most appropriate response would be? “The surgery: 1. Removes the entire prostate gland, prostatic capsule, and seminal vesicles.” 2. Tends to cause urinary incontinence and impotence.” 3. Freezes prostate tissue, killing cells.” 4. Results in reduction of the major circulating androgen, testosterone.” 4. Bilateral orchiectomy (removal of testes) results in reduction of the major circulating androgen, testosterone, as a palliative measure to reduce symptoms and progression of prostate cancer. A radical prostatectomy (removal of entire prostate gland, prostatic capsule, and seminal vesicles) may include pelvic lymphadenectomy. Complications include urinary incontinence, impotence, and rectal injury with the radical prostatectomy. Cryosurgery freezes prostate tissue, killing tumor cells without prostatectomy. 6. A client with prostate cancer is having the urinary catheter removed by the nurse. The nurse will evaluate which of the following outcome goals for this client? a Client will verbalize that follow-up care is not needed. b Client will verbalize less pain. c Client will regain urinary continence. d Client will have no bleeding or clots in the urine. c The client who has had a prostatectomy will very likely experience some form of incontinence after the urinary catheter is removed. The outcome goal after removal of the catheter is to regain continence of urine. Pain does not affect incontinence. Bleeding and clots are expected for 2 weeks after surgery. The client should verbalize the need for follow-up care. 7. When a client is receiving hormone replacement for prostate cancer, the nurse should do which of the following? Select all that apply. 1. Inform the client that increased libido is expected with hormone therapy. 2. Reassure the client that erectile dysfunction will not occur as a consequence of hormone therapy. 3. Provide the client the opportunity to communicate concerns and needs. 4. Gynecomastia may occur as a consequence of hormone therapy. 5. Lupron: a gonadotrophic releasing hormone does not decrease testosterone. 3, 4. Hormone manipulation deprives tumor cells of androgens or their byproducts and, thereby, alleviates symptoms and retards disease progression. Complications of hormonal manipulation include hot flashes, nausea and vomiting, gynecomastia, and sexual dysfunction. As part of supportive care, provide explanations of diagnostic tests and treatment options and help the client gain some feeling of control over his disease and decisions related to it. To help achieve optimal sexual function, give the client the opportunity to communicate his concerns and sexual needs. Inform the client that decreased libido is expected after hormonal manipulation therapy, and that impotence may result from some surgical procedures and radiation. A psychiatrist is not needed. 8. The client diagnosed with cancer of the prostate is scheduled to have radiation brachytherapy. Which precautions should the nurse implement? Select all that apply. 1. Place the client in a private room. 2. Wear a dosimeter when entering the room. 3. Encourage visitors to come and stay with the client. 4. Plan to spend extended time with the client. 5. Notify the nuclear medicine technician. 1. Brachytherapy is the direct implantation of radioactive seeds through the vagina into the uterus. The client should be in a private room at the end of the hall to prevent radiation exposure to the rest of the unit. 2. Nurses wear a dosimeter registering the amount of radiation they have been exposed to. When a certain level is reached, the nurse is no longer allowed to care for clients undergoing internal radiation therapy. 3. Visitors are limited while the radiation is in place. 4. In this case, spending extra time with a client is not done. The nurse does only what must be done and leaves the room. 5. The nuclear medicine technician will assist with the placement of the implants and will deliver the implants in a lead-lined container. The technician will also scan any items (linens and wastes) leaving the room for radiation contamination. 9. The client underwent prostate cancer surgery is approaching the time of d/c. What instruction should the nurse provide to this client? select all that apply. a. maintain a high fluid intake after you go home b. call the doc immediately if you notice blood in urine c. you will experience sexual impotency after the surgery d. avoid strenuous activity for 4-8 weeks e. avoid heavy lifting for 2-4 weeks A. fluids D. avoid strenuous activity Lifting should be avoided for 4-6 weeks E. Sexual impotence follows & 5% to 10% of patients have various degrees of urinary incontinence The problem with C is the wording may not will. Would be correct 10. The elderly client recovering from a perineal prostatectomy has been experiencing stress incontinence. Which independent nursing intervention should the nurse discuss with the client? 1. Establish a set voiding frequency of every two (2) hours while awake. 2. Encourage a family member to assist the client to the bathroom to void. 3. Apply a transurethral electrical stimulator to relieve symptoms of urinary urgency. 4. Discuss the use of a “bladder drill,” including a timed voiding schedule. 1. Timed voiding is more helpful with neurogenic disorders, such as those related to diabetes. 2. A prompted voiding is useful with a client who does not have the cognitive ability to recognize the need. 3. The use of transvaginal or transurethral electrical stimulation to stimulate the pelvic floor muscles to contract is a collaborative intervention. 4. Use of the bladder training drill is helpful in stress incontinence. The client is instructed to void at scheduled intervals. After consistently being dry, the interval is increased by 15 minutes until the client reaches an acceptable interval.