Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 9 Genitourinary System^391


poorer prognosis. The diagnosis will also have varied degrees of psychological
impact on the patient.


HALLMARK SIGNS AND SYMPTOMS



  • Painless enlargement of the testis

  • Palpable mass on surface of testis

  • Unilateral feeling of heaviness in the scrotum

  • Testicular pain due to bleeding within the testis in a small percentage of patients

  • Back pain due to metastasis

  • Cough or shortness of breath due to pulmonary metastasis


INTERPRETING TEST RESULTS



  • Scrotal ultrasound shows mass on testis.

  • CT scan of pelvis, abdomen, and chest may be needed to check for metastasis.

  • Human chorionic gonadotropin (hCG) elevated.

  • Fetoprotein (AFP) elevated.

  • Lactate dehydrogenase (LDH) elevated.

  • CBC shows anemia later in disease.


TREATMENT



  • Orchiectomy.

  • Chemotherapy, combination medications.

  • Radiation therapy to reduce chance of recurrence.

  • Monitor tumor markers periodically.

  • Monitor follow-up CT scans periodically.

  • Depending on treatments planned, some patients may want to bank sperm, if
    fertility will be a concern after treatment.


NURSING DIAGNOSIS



  • Fear

  • Anxiety

  • Disturbed body image

Free download pdf