male reproductive/breast cancer

• bladder cancer risk factors: smoking, aromatic amine exposure (chemicals; factory workers), chronic infection/inflammation from chronic catheter use, incomplete bladder emptying, males
• what is the first sign of bladder cancer?

  hematuria
• medical treatment of bladder cancer: intravesical therapy, topical chemotherapy, precision medicine
• surgical management of bladder cancer: laser ablation, radical cystectomy (removal of whole bladder)
• complications of bladder cancer: bleeding, pain, chemotherapy side effects
• urinary diversion: nephrostomy (tube directly into kidneys to drain; urine should be crystal clear) OR urostomy (psuedo bladder with a piece of the small bladder; urine may be cloudy due to the colon creating mucus)
• physical assessment for bladder cancer: vitals (increased HR & temp with decreased BP = infection; increased HR and decreased BP = blood loss), urine (where is it coming from), bladder
• labs for bladder cancer: urinalysis
• interventions for bladder cancer: continuous bladder irrigation (CBI), I&Os (ACCURATE; tells you if a clot has cut off the flow of urine), medications (-mabs, -libs, intravesical chemo, immunotherapy)
• teaching for bladder cancer: treatment and outcome (risks, plan, treatment outcomes), signs and symptoms to report (blood in urine**), precautions for Calmette-Guerin therapy*
• precautions for Calmette-Guerin therapy: it is a live, weakened bacterium; after voiding pour 2 cups of bleach into the toilet and allow it to sit for 20 minutes before flushing
• continuous bladder irrigation (CBI): mark the irrigate bag with time and line (every time you empty it), empty the catheter bag, and subtract the amount in from the amount out to get total urine
• is the urine turns darker with CBI, what do you do?

  increase irrigation
• breast cancer female risk factors: african american, higher number of ovulatory cycles, late menarche and late menopause, lack of pregnancy and live birth, genetic mutations (HER & BRCA2/BRCA1)
• breast cancer male risk factors: advanced age (60-70), mutation BRCA2 gene or BRCA1 gene, family history, excessive alcohol consumption, testicular disorders, environmental factors, hormonal imbalances
• clinical manifestations of breast cancer: new mass or lump, changes in breast shape or swelling
• medical treatment for breast cancer: surgery (breast conservation therapy (lumpectomy) OR total mastectomy), chemotherapy, radiation
• complications of breast cancer: shoulder immobility, pain, lymphedema
• signs of breast cancer: yellow crusts around nipple, change in dimpling in skin, nipple itself may become retracted in and crusty with discharge, and hardening under nipple (MALES)
• can you take a blood pressure reading on the side of body of the mastectomy?

  NO
• lymphedema: fluid collects in arm due to scar tissue blocking flow of lymph fluid from arm to heart
• physical assessment of breast cancer: vitals (elevated BP with rapid HR = pain/anxiety OR elevated temp and HR = infection), pain, daily weight, I&Os, wound evaluation
• labs for breast cancer: CBC (decrease in WBC and H/H with chemo), liver enzymes (elevated with chemo)
• interventions for breast cancer: post op interventions, emotional support and encouragement
• teaching for breast cancer: explain treatment course, medication and treatment side effects, wound care, nutritional counseling, support groups
• breast reconstruction: tissue expanders will be placed during the mastectomy (filled with saline and stretches the tissues), once healing has occurred the patient will return for breast implants, INFECTION CONTROL
• benign prostatic hyperplasia (BPH) risk factors: males over 40
• clinical manifestations of BPH: difficulty starting the flow of urine (and stopping), weak urine stream, multiple interruptions during urination, dribbling once urination is complete, urgency and frequency, nocturia (3-4 times a night), bladder outlet obstruction
• medical treatment of BPH: watchful waiting/active surveillance, avoid tranquilizers and decongestants/anesthesia
• medications for BPH: 5-alpha reductase inhibitor (FINASTERIDE), alpha-adrenergic blockers (-sins), anticholinergics (decreases muscle spasms for symptom relief)
• surgical treatment of BPH: TURP, transurethral incision of prostate, open prostatectomy, laser surgery
• complications of BPH: depends on treatment; open prostatectomy = ED, incontinence
• TURP: removal of the inner part of the prostate leaving the outer layer; recovery includes the risk for bleeding and infection
• physical assessment of BPH: urinary symptoms (mild symptoms = watchful waiting; severe symptoms = surgery), temperature (increase = UTI secondary to urinary stasis), focused abdominal exam, bladder scan for post void residual (PVR) after they urinate
• labs for BPH: urinalysis, PSA (prostatic antigen; elevated = more prostatic tissue)
• interventions for BPH: catheterization (checking for PVR and relieve distended bladder), CBI if surgery, medications, post surgical care
• teaching for BPH: watchful waiting (recognition of worsening symptoms and when to seek further treatment), decreased liquid intake in the evening (decrease nocturia), brachytherapy precautions
• erectile dysfunction risk factors: DM, cardiovascular disease, low testosterone, smoking, obesity, peyroine's disease, atherosclerosis, CVA/spinal injury, ETOH/substance abuse, performance anxiety
• clinical manifestations of ED: inability to achieve or maintain an erection sufficient for sexual intercourse; diagnosed based on patient history and physical
• medical treatment for ED: treat the secondary cause OR penial vacuum