Anus, Rectum, and ProstateStructure and Function: Developmental CompetenceStructure and Function: Developmental Competence (cont.)Structure and Function: Cultural CompetenceStructure and Function: Cultural Competence (cont.)Subjective DataSubjective Data (cont.)Slide 8Slide 9Slide 10Objective Data (cont.)Objective Data: Developmental CompetencePromoting A Healthy Lifestyle: Colorectal Cancer ScreeningPromoting A Healthy Lifestyle: Colorectal Cancer Screening (cont.)Sample chartingSample charting (cont.)Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Anus, Rectum, and ProstateAnus, Rectum, and ProstateChapter 25Chapter 25Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 25: Anus, Rectum, and ProstateChapter 25: Anus, Rectum, and ProstateStructure and Function:Structure and Function:Developmental CompetenceDevelopmental CompetenceInfantsInfantsFirst stool passed by newborn is dark green First stool passed by newborn is dark green meconium; occurs within 24 to 48 hours of birth, meconium; occurs within 24 to 48 hours of birth, indicates anal patencyindicates anal patency•From then on, infant usually has stool after each feedingFrom then on, infant usually has stool after each feedingGastrocolic reflex: wave of peristalsis in response Gastrocolic reflex: wave of peristalsis in response to eatingto eating•Infant passes stools by reflexInfant passes stools by reflex•Voluntary control of external anal sphincter cannot occur Voluntary control of external anal sphincter cannot occur until nerves supplying area have become fully until nerves supplying area have become fully myelinated, usually around 1myelinated, usually around 1½½ to 2 years of age to 2 years of age•Toilet training usually starts after age 2 yearsToilet training usually starts after age 2 yearsSlide 25-2Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 25: Anus, Rectum, and ProstateChapter 25: Anus, Rectum, and ProstateStructure and Function:Structure and Function:Developmental CompetenceDevelopmental Competence (cont.)(cont.)Children and adultsChildren and adultsAt male puberty, prostate gland undergoes a very At male puberty, prostate gland undergoes a very rapid increase to more than twice its prepubertal rapid increase to more than twice its prepubertal size; during young adulthood size remains fairly size; during young adulthood size remains fairly constantconstantProstate gland commonly starts to enlarge during Prostate gland commonly starts to enlarge during middle adult years; increases with agemiddle adult years; increases with age•Thought that hypertrophy caused by hormonal imbalance Thought that hypertrophy caused by hormonal imbalance leading to proliferation of benign adenomas which leading to proliferation of benign adenomas which gradually impede urine output because they obstruct gradually impede urine output because they obstruct urethraurethraSlide 25-3Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 25: Anus, Rectum, and ProstateChapter 25: Anus, Rectum, and ProstateStructure and Function:Structure and Function:Cultural CompetenceCultural CompetenceProstate cancerProstate cancerMore common in North America and northwestern More common in North America and northwestern Europe; less common in Central and South Europe; less common in Central and South America, Africa, and AsiaAmerica, Africa, and Asia•Incidence higher for African American men than other Incidence higher for African American men than other racial groups, and more likely to be diagnosed at racial groups, and more likely to be diagnosed at advanced stageadvanced stage•Mortality rates are two times higher for black menMortality rates are two times higher for black men•Diets heavy in red meat or high-fat dairy products may Diets heavy in red meat or high-fat dairy products may be factorbe factor•Some evidence suggests that prostate cancer may Some evidence suggests that prostate cancer may increase with obesityincrease with obesitySlide 25-4Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 25: Anus, Rectum, and ProstateChapter 25: Anus, Rectum, and ProstateStructure and Function:Structure and Function:Cultural CompetenceCultural Competence (cont.)(cont.)Prostate cancer (cont.)Prostate cancer (cont.)Screening recommendations vary for racial groupsScreening recommendations vary for racial groups•Beginning at age 50, men are recommended to have prostate-Beginning at age 50, men are recommended to have prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) specific antigen (PSA) blood test and digital rectal exam (DRE) yearlyyearly•Men at high risk, African American men, and men with first-Men at high risk, African American men, and men with first-degree relative with disease should begin screening at age 45degree relative with disease should begin screening at age 45Colorectal cancer also has racial variationColorectal cancer also has racial variationIncidence in African American women and men is Incidence in African American women and men is almost 20% higher than in whitesalmost 20% higher than in whitesMortality 40% higher in African American men and Mortality 40% higher in African American men and women than in whites women than in whites Slide 25-5Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 25: Anus, Rectum, and ProstateChapter 25: Anus, Rectum, and ProstateSubjective DataSubjective DataUsual bowel routineUsual bowel routineChange in bowel habitsChange in bowel habitsRectal bleeding, blood in stoolRectal bleeding, blood in stoolMedications: laxatives, stool softeners, ironMedications: laxatives, stool softeners, ironRectal conditions: pruritus, hemorrhoids, Rectal conditions: pruritus, hemorrhoids, fissure, fistulafissure, fistulaFamily historyFamily historySelf-care behaviors: diet of high-fiber foods, Self-care behaviors: diet of high-fiber foods, most recent examinationsmost recent examinationsSlide 25-6Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 25: