NUR 810 Exam 2 NURS 810 Actual Exam

NUR 810 Exam 2 NURS 810 Actual Exam Newest Latest Update Questions and Correct Answers Rated A+

What is balantitis and at what age does it peak? -ANSWER- Inflammation of the glans penis or foreskin

Peaks: 2-5

Why does balantitis occur? -ANSWER-Irritants (soaps, detergents, bubble baths) Trauma Poor hygiene

What is the most common cause of balantitis? -ANSWER-Patients who are uncircumsised and due to inattention to hygiene

Balantitis: Presentation -ANSWER--Irritability in younger pts

-Dysuria -Itching -Pain -Swelling -Erythema

Balantitis: DX -ANSWER--Culture of any discharge

-Test for STIs in older pts -Test for strep

Balantitis: TX (suspected irritant cause or suspected STI cause) -

ANSWER--Sitz baths -Proper hygiene and cleaning of the foreskin and glans

-+/- hydrocortisone cream (more inclined to order if it is a suspected irritant etiology; would then order 0.5% or 1% hydrocortisone crema) -If suspected STI, treat with one time dose of IM ceftriaxone until test comes back -Refer to urology with recurrent episodes

How do you treat if your culture comes back positive for strep? - ANSWER-Treat with 10 days of PO abx with 1st generation cephalosporin Ex. Duricef (Cefadroxil) or Keflex

What is epididymitis? -ANSWER-Inflammation or infection of the epididymis (tube at the back of the testicle that stores and carries sperm) Common in sexually active adolescents

What causes epididymitis? -ANSWER--UTI or STI -Can be seen with urinary tract malformations, neurogenic bladder, or pts who perform frequent caths

What common STIs lead to epididymitis? -ANSWER-Gonorrhea and chlamydia

How does epididymitis present? -ANSWER-Acute scrotal pain Unilateral scrotal pain over 1-2 days Cremasteric reflex is preserved

What is an important task that you must do when a pt presents with testicular pain? -ANSWER-Differentiate from testicular torsion bc torsion is a medical emergency

Epididymitis: DX -ANSWER-Doppler US

UA and culture

STI testing

Common characteristic of epididymitis that can help differentiate it

from testicular torsion? -ANSWER--Prehn's sign: If you elevate the

scrotum, the pain will go away with epididymitis but with torsion, the pain is not relieved with elevation -This is an unreliable practice in younger children

Epididymitis: TX -ANSWER-Rest

Scrotal support (elevation) NSAIDs Should resolve in 2-3 days and if it doesn't, pt should seek further evaluation

When do you treat epididymitis with abx? -ANSWER-Only if pt has suspected UTI or STI

What is phimosis? -ANSWER-Foreskin is too tight Leads to an inability to retract it over the glans penis Can be congenital or r/t poor hygiene

What is a common cause of phimosis? -ANSWER--Recurrent balanitis -Poor hygiene

Phimosis: Presentation -ANSWER--Hx of infection or inflammation

-Pain -Dysuria -Tight, pinpoint opening fo the foreskin and inability to retract the foreskin -Foreskin is flat and effaced -Urinary obstruction can occur

Phimosis: TX -ANSWER--Normal cleansing with gentle stretching of

the foreskin until resistance is felt -Never forcefully retract -Circ if urinary obstruction or infection is present -Good hygiene -Topical hydrocortisone cream to foreskin for 4-8 weeks -If steroids don't work, circ is typically delayed until age 3

What is paraphimosis? -ANSWER-Retracted foreskin that cannot be reduced to the normal position

Is paraphimosis or phimosis a medical emergency? -ANSWER- Paraphimosis - venous congestion and edema of the retracted foreskin can be restrictive to blood flow

Paraphimosis: Presentation -ANSWER-o Constriction of penis

• Pain
• Edema of glans
• Can lead to necrosis
• Dysuria
• Bluish discoloration of the glans and foreskin

Paraphimosis: TX -ANSWER-Surgical release is necessary

What is testicular torsion? -ANSWER-Twisting of the spermatic cord which obstructs testicular blood flow and results in ischemia of the testes

Is testicular torsion a medical emergency? -ANSWER-Yes Irreversible injury to the testes can occur 4-8 hrs after injury

Cause of testicular torsion? -ANSWER-Trauma