Page 1274 - Saunders Comprehensive Review For NCLEX-RN

12. Prepare the client for local radiation therapy if
prescribed.
13. Instruct the client in home care measures and the signs
and symptoms of infection.
14. Administer bisphosphonate medications as prescribed
to slow bone damage and reduce pain and risk of
fractures.
XII. Testicular Cancer
A. Description
1. Testicular cancer arises from germinal epithelium
from the sperm-producing germ cells or from
nongerminal epithelium from other structures in the
testicles.
2. Testicular cancer most often occurs between the ages
of 15 and 40 years.
3. The cause of testicular cancer is unknown, but a
history of undescended testicle (cryptorchidism) and
genetic predisposition have been associated with
testicular tumor development.
4. Metastasis occurs to the lung, liver, bone, and adrenal
glands via the blood and to the retroperitoneal lymph
nodes via lymphatic channels.

B. Early detection: Perform monthly testicular self-

examination (Fig. 44-1).
1. Performing testicular self-examination: Perform
monthly; a day of the month is selected and the
examination is performed on the same day each
month.
2. Client instructions (see Fig. 44-1)

C. Assessment

1. Painless testicular swelling occurs.
2. “Dragging” or “pulling” sensation is experienced in
the scrotum.
3. Palpable lymphadenopathy, abdominal masses, and
gynecomastia may indicate metastasis.
4. Late signs include back or bone pain and respiratory
symptoms.
D. Interventions
1. Administer chemotherapy as prescribed.
2. Prepare the client for radiation therapy as prescribed.
3. Prepare the client for unilateral orchiectomy, if
prescribed, for diagnosis and primary surgical
management or radical orchiectomy (surgical removal
of the affected testis, spermatic cord, and regional
lymph nodes).

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