male reproductive system assessment

• Penis


  Used for urination and reproduction
• Internal genitalia


  • Testes
  • Spermatic cord
  • Epididymis
  • Vas deferens

  
• Inguinal area


  • Located between the anterior superior iliac spine laterally and symphysis pubis medially
  • Frequent site of hernia development
• Anus and rectum


  • Anal canal
  • Anal opening
• Prostate


  Prostate gland and nearby structures
• Risk factors for HIV/AIDS include being the fetus of an HIV-positive mother, mother-infant transmission during pregnancy or delivery, exchange of blood or body fluids through blood transfusions, needle sticks, breast-feeding by HIV-infected mother, body piercing with nonsterilized instruments
• Reducing risk for HIV/AIDS


  1. Use precautions to decrease transfer of bodily fluids

  2. Avoid unprotected sex or practice sexual abstinence

  3. Avoid having multiple sex partners

  4. Avoid anal sex

  5. Avoid intravenous drug use

  6. Avoid mixing sex and alcohol or drugs

  7. Use a new, sterile needle each time for medications requiring needle use

  8. Consider circumcision if uncircumcised and lifestyle is risky

  9. Follow guidelines for handling body secretions, objects that touch bodily secretions, or contaminated items

  10. Openly discuss HIV risk behavior history with partner and use above precautions

  11. Avoid other high-risk behaviors such as intravenous drug use (especially sharing needles)
• If you already have AIDS

  1. Eat healthy, well-rounded diet

  2. Avoid food and drink that may easily transmit food-borne illness

  3. Get immunizations against other illnesses if allowed by physician

  4. Be aware that companion animals may harbor parasites that can cause infections

  5. Tell your sex partner right away if you are HIV positive

  6. If pregnant, seek medical care right away

  7. Seek support from support group to deal with your emotions

  8. Obtain and stay on antiretroviral protocol, if available
• Teaching opportunity


  • Trusting relationship is key to interview
  • Demonstrate key self-examination
  • Explain that self-examination helps detect abnormalities early
• Risk factors for prostate cancer


  • Age: rare in men under 40, rises rapidly after age 50
  • Race/ethnicity: highest for African American or Caribbean males of African origin; occurs less often in Asian, Hispanic/Latino men than in whites
  • Geography: most common in North America, northwestern Europe, Australia, and on Caribbean islands; less common in Asia, Africa, Central America, and South America
  • Family history: having a father or brother with prostate cancer
  • Certain gene changes
  • Exposure to agent orange
  • Working on a farm, in a tire plant, with paint, with cadmium or firefighters exposed to toxic chemicals
  • Diet: slightly higher risk for those who eat a diet high in red meat or high fat daily, and fewer vegetables
  • Low melatonin levels (sleeping with even small light source; shift work)
• Symptoms of prostate cancer


  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in the semen
  • Swelling in the legs
  • Bone pain
  • Erectile dysfunction
• Education topics: prostate cancer


  • Don't overeat (consume moderate servings and calories)
  • Eat a diet low in fat and rich in fruits and vegetables, high in fiber, and high in omega-3 fatty acids
  • Soy products and other legumes have phytoestrogens that may have a positive effect
  • Drink green tea daily
  • Drink no more than two alcoholic drinks a day
  • Get moderate exercise daily
  • Sleep in a dark room; avoid bright light at night
• Testicular cancer carries a high mortality rate, especially if not detected early. The American Cancer Society (ACS) recommends a testicular exam as part of a routine cancer-related check-up. Male clients should be aware of the need for a monthly testicular self-examination and its importance in the early diagnosis and treatment of testicular cancer.
• Trusting relationship


  Occurs when the client feels open to sharing information about his genitalia. Nurses should keep in mind the sensitivities of the client, as well as their own feelings regarding body image, fear of cancer, and sexuality.
• Collecting subjective data


  1. Interview approach (COLDSPA) for nursing assessment

  2. History of current health problem

  3. Past and family histories

  4. Lifestyle and health practices
• Collecting subjective and objective data

  • History of present concern: pain, lesions, discharge, lumps or swelling, mass, urination, sexual dysfunction, bowel patterns, stool, itching and pain
  • Past health history
  • Family health history
  • Lifestyles and health practices
• Collecting objective data


  1. Physical examination of client

  2. Preparing the client

  3. Equipment and supplies: stool, gown, disposable gloves, flashlight, and stethoscope

  4. Validating and documenting findings
• Preparation of client


  Explain to the client that he will be asked to stand for most of the examination of the genitalia.
• Physical assessment of penis


  • Inspection and palpation of base of penis and pubic hair, shaft, foreskin, and glans, urethral discharge
• Physical assessment of scrotum


  • Inspection of size, shape, and position, scrotal skin
  • Palpation of scrotal contents
  • Auscultation
  • Transillumination

  
• Physical assessment of inguinal area

  • Inspection for inguinal and femoral hernia
  • Palpate for inguinal hernia and nodes, inguinal nodes, femoral hernia, scrotal hernia
• Physical assessment of anus and rectum

  • Inspect the perianal area for lumps, ulcers, lesions, rashes, redness, fissures, thickening of the epithelium
  • Palpate the anus
• Physical assessment of prostate gland

  • Palpate the prostate gland
• Abnormalities


  • Penis
  • Scrotum
  • Anus
  • Rectum
  • Prostate
• Older client findings


  • Lumps
  • Swelling
  • Masses
  • Sexual dysfunction
• Analysis of data


  • Diagnostic reasoning
  • Selected nursing diagnoses: wellness diagnoses, risk diagnoses, actual diagnoses
  • Selected collaborative problems
  • Medical problems
• Male external genitalia


  Penis and scrotum
• The testes are part of the internal genitalia, not the external genitalia

  
• Penis


  • Used for urination and reproduction
  • Components: shaft and glans
• Testes


  • Ovoid-shaped organs, similar to the ovaries in women
  • Part of the internal genitalia
  • Connected to the trunk via the spermatic cord which houses blood vessels, nerves, and ductus deferens
  • Covered by the tunica albuginea capsule and divided into lobules by septa

  
• Sperm production


  1. Seminiferous tubules in the testes function as sperm-forming factories

  2. Sperm travels from the rete testis to the epididymis

  3. Interstitial cells in the seminiferous tubules produce androgens like testosterone
• Spermatic cord


  • Runs from the epididymis via the inguinal canal and arches over the urinary bladder
• Ductus (vas) deferens


  • Runs from the epididymis, empties into the ejaculatory duct
  • Peristaltic waves squeeze sperm forward during ejaculation
  • Can be cut in a vasectomy to prevent sperm transportation
• Urethra


  • Extends from the bladder to the tip of the penis, carries both urine and sperm
  • Has 3 regions: prostatic, membranous, and spongy (penile)
  • Internal urethral sphincter closes during ejaculation to prevent urine and sperm backflow
• The inguinal area is a frequent site of hernia development
• Disposable gloves are necessary for a male genitalia examination
• Risk factors for HIV/AIDS


  • Being the fetus of an HIV-positive mother
  • Mother-infant transmission during pregnancy or delivery
  • Exchange of blood or body fluids through transfusions, needle sticks, breastfeeding, body piercing
• Ways to reduce risk for HIV/AIDS


  • Use precautions to decrease bodily fluid transfer (avoid unprotected sex, multiple partners, anal sex, IV drug use, mixing sex with alcohol/drugs)
  • Use new, sterile needles if taking medications requiring them
  • Consider circumcision if uncircumcised and lifestyle is risky
  • Follow guidelines for handling contaminated items
  • Discuss HIV risk history openly with partner
  • Avoid other high-risk behaviors like IV drug use
  • Eat healthy, get immunizations, be aware of parasite risks if already have AIDS
  • Tell sex partner if HIV positive, seek medical care if pregnant, obtain antiretroviral protocol
• Introducing discussion of risk reduction during the health history interview is a teaching opportunity
• Risk factors for prostate cancer


  • Age (rare under 40, rises after 50)
  • Race/ethnicity (highest in African American/Caribbean, lower in Asian/Hispanic)
  • Geography (most common in North America, Europe, Australia, Caribbean)
  • Family history (father or brother with prostate cancer)