Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

BSN 4

Pre-Test

Instructions: Below are statements that are answerable by True or False. This mental exercise pertain to
the topics that you will be learning as presented in the following topics. Read and analyze each
statement and write TRUE if the statement is correct and FALSE if the statement is incorrect. Do not
attempt to look for the answers in the topics presented below. Let us see how many points you will get.
After reading the lessons, you may try answering the same questions again and check whether you
scored better for the second time.

FALSE 1. Absence of one testicle affects longevity of an individual.

TRUE 2.Cryptorchidism is congenital malposition of the testis.
TRUE 3.The cause of testicular cancer is undescended testis.
TRUE 4.An undescended testicle manifests as enlarged scrotum and sensation
of heaviness in the scrotum that usually affects urination.
TRUE 5.Testicular cancer affects men of all ages but peaks at the age of 50-55.
TRUE 6.A monthly self- testicular examination is one method of screening in
testicular cancer.
TRUE 7.Testosterone is responsible for the development male characteristics in
an individual.
TRUE 8.Surgical removal of the testicle is the best option of testicular cancer.
TRUE 9.Sperm banking prior to surgery in testicular cancer would answer the
problem of infertility.
TRUE 10.Untreated hernia is a risk factor of testicular cancer.
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Assessment Task: Testicular Cancer

Benhur, 20 years old, single is an emancipated minor. When he reached the age of 19,
he decided to live with her childhood friend Vannah. They both are working in a textile factory;
Benhur being a supervisor. They both are enjoying each other’s company. Benhur had once told
her partner, Vannah that he is very ready to have a child with her.
Lately, Benhur had been experiencing discomfort and painless testicular enlargement
for the past 15 days. He noticed this after a long bike riding but he never told her partner about
it. It was only a day prior to consultation to his doctor that he became more suspicious about
what he was experiencing.

The following PE and Laboratory Exams were done:

● On physical (Testicular) exam: enlarged, painless scrotum and with feeling of heaviness
when standing; absent left testicle
● Smokes 3- 5 sticks of cigarette pr day for the 10 months
● On transillumination: dark shadow was seen
● Routine Urinalysis: findings not significant
● CBC: RBC findings – within normal limits
WBC findings - within normal findings
● CXR: heart is not enlarged, no lesions seen but with consolidation on the right lower lung
field
● CT scan reveals only one testicle found on its proper location; one testis not descended,
found on the inguinal ring. A small suspicious nodule is seen on the scrotum.

To confirm a diagnosis of TCa, Benhur sought second opinion to other oncologists – he has
cancer, stage 1. He was advised to undergo radical orchiectomy.
Questions:
1. If you were the client, how will you overcome the anxiety related to your present situation?

First I will empower myself with knowledge, especially this days that just a click away and you
can find some answer. I will also seek answer or advise from a specialist where they can explain
about my situation. In this case I will be able to know how to combat my foe. Then I will seek
support from my family and friends.

2. If you were Vannah, how will accept the situation, knowing that he wants a child with you?

Radical orchiectomy can be either unilateral or bilateral. Unilateral orchiectomy results in

decreased sperm count but does not reduce testosterone levels. Bilateral orchiectomy causes
infertility and greatly reduced testosterone levels leading to loss of sexual interest, erectile
dysfunction, hot flashes, breast enlargement (gynecomastia), weight gain, loss of muscle mass
and osteoporosis. The administration of hormone replacement therapy after orchiectomy can
help to mitigate the negative side effects

If bilateral will be done, then, I would convince him that he can put his sperm on the sperm bank
before the procedure, to preserve and in due time when he is healed we can still have our baby.

3. When Benhur comes back to the hospital and tells you he is decided to undergo surgery, what
preparations should you advice to him to prevent complications intraoperatively (during the
operative phase) and postoperatively? Enumerate your nursing actions and give the rationale of
each intervention.

I’ll make myself available on surgery day, to take him home. Anesthesia and pain medicine will
make it unsafe for him to drive or get home on his own.
Understand exactly what surgery is planned, along with the risks, benefits, and other options.
If you take aspirin or some other blood thinner, ask the doctor if you should stop taking it before
your surgery. Make sure that you understand exactly what your doctor wants you to do. These
medicines increase the risk of bleeding.
Tell the doctor ALL the medicines and natural health products you take. Some may increase the
risk of problems during your surgery. Your doctor will tell you if you should stop taking any of
them before the surgery and how soon to do it.

On the day of surgery

Follow the instructions exactly about when to stop eating and drinking. If you don't, your
surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery,
take them with only a sip of water.
 Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes,
deodorants, or nail polish.
Do not shave the surgical site yourself.
Take off all jewellery and piercings. And take out contact lenses, if you wear them.

Nursing Intervention:
* Advise patient to Take medicine as directed
- Contact your healthcare provider if you think your medicine is not helping or if you
have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines,
vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the
list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an
emergency.
* Use of bandage over your surgery site
- Do not take the bandage off until your healthcare provider says it is okay.
* Instruct patient to apply ice over your incisions to decrease your pain and swelling
- Put some crushed ice in a plastic bag and cover it with a thin towel. Place this over
your incision or between your legs for 15 to 20 minutes every hour. Do not leave the ice on for
too long as this may damage your skin.

4. On the day of discharge, what instructions should you give to your client on the following:

Activities Allowed: may walk and start to gradually add activity as your body
tolerates it, bath for 48 hrs post op but avoid soaking with water of any
kind like pool, sauna, lake, hot ant bath. Tub.

Complications to watch: pain or redness around the incision

pus or bleeding from the incision
fever over 100°F (37.8°C)
inability to urinate
 hematoma, which is blood in the scrotum and usually looks like
a large purple spot
loss of feeling around your scrotum

Diet: After surgery you will be given clear liquids such as broth, juices, or
Jello. As you are able to tolerate it ,you will return to a regular diet.

Follow-up visit/consultation: Ask your caregiver when you need to return for
a follow-up visit. You may need to see your caregiver for
tests to check how your body is doing. You may need to
have follow-up x-ray scans and blood tests after your
surgery. Make sure to keep all your planned visits with
your caregiver. Write down any questions you may have.
This way you will remember to ask these questions
during your next visit

Post Test

FALSE 1. Absence of one testicle affects longevity of an individual.

TRUE 2.Cryptorchidism is congenital malposition of the testis.
TRUE 3.The cause of testicular cancer is undescended testis.
TRUE 4.An undescended testicle manifests as enlarged scrotum and sensation
of heaviness in the scrotum that usually affects urination.
FALSE 5.Testicular cancer affects men of all ages but peaks at the age of 50-55.
TRUE 6.A monthly self- testicular examination is one method of screening in
testicular cancer.
TRUE 7.Testosterone is responsible for the development male characteristics in
an individual.
TRUE 8.Surgical removal of the testicle is the best option of testicular cancer.
TRUE 9.Sperm banking prior to surgery in testicular cancer would answer the
problem of infertility.
TRUE 10.Untreated hernia is a risk factor of testicular cancer.
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Reflection:

Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin
underneath the penis. The testicles produce male sex hormones and sperm for reproduction.

Young men around the ages of 15 to 40 are most at risk of developing testicular cancer.
Common symptoms of testicular cancer includes a lump in the testis, the feeling of heaviness in
the scrotum and the change in the size and shape of the testicles.

With the module presented, there are ways to prevent testicular cancer, risk factors and
treatments and managements that are very new to me. Upon assessment to a patients with
testicular cancer, the patient would complain of painless enlargement of the scrotum, and a
positive nodule. There are some diagnostics procedure to determine the diagnosis one of which
is CT Scans to detect metastasis , intravenous pyelogram to detect urinary involvement, chest
Xray to check for lesions and Blood exams to check for tumor makers, it also includes and
elevated AFP and beta-HCG and LAD.
Factors that may increase your risk of testicular cancer include:
An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal
development and usually descend into the scrotum before birth. Men who have a testicle that
never descended are at greater risk of testicular cancer than are men whose testicles descended
normally. The risk remains elevated even if the testicle has been surgically relocated to the
scrotum.
Abnormal testicle development. Conditions that cause testicles to develop abnormally, such as
Klinefelter syndrome, may increase your risk of testicular cancer.
Family history. If family members have had testicular cancer, you may have an increased risk.
Age. Testicular cancer affects teens and younger men, particularly those between ages 15 and
35. However, it can occur at any age.
Race. Testicular cancer is more common in white men than in black men.

Testicular cancer is highly treatable, even when cancer has spread beyond the testicle.
Depending on the type and stage of testicular cancer, you may receive one of several treatments,
or a combination.
Being a woman, I will not undergo with this predicament but being a soon to be nurse where our
priority is to promote wellness and health to our patient, we must do everything to perform our
duties and responsibilities.