An older man who recently had a myocardial infarction is being ...

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An older man who recently had a myocardial infarction is being discharged home from the hos-pital. He tells a nurse, I am really worried about having sex with my wife. I am afraid that I am going to have another heart attack.
 
  The best response by the nurse includes which of the following? (Select all that apply.)
  a. If you are able to engage in mild to mod-erate physical activity without symptoms, you can resume sexual activity.
  b. You really should not engage in sexual activity until 3 months have passed post heart attack.
  c. It is best if you avoid eating a large meal for several hours before you have sexual relations.
  d. If you have chest pain while having sex, stop and rest, and take your nitroglycerin.
  e. You might want to consider some alter-nate positions that avoid strain.

Question 2

Symptoms of HIV are often under-recognized in older adults because:
 
  a. there is a very low incidence of HIV in older adults.
  b. many of the classic symptoms are also common to other conditions common in older adults.
  c. presenting symptoms are markedly dif-ferent from those in younger adults.
  d. AIDS progresses much slower in older adults so symptoms are not recognized easily.

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Answer to Question 1

ANS: A, C, D, E
Individuals who are post MI who are able to engage in mild to moderate physical activity with-out symptoms can generally resume sexual activity; those with a complicated MI may need to resume sexual activity gradually over a longer period of time. Suggestions include avoiding large meals several hours before sex and suggesting alternative positions to avoid strain. If the indi-vidual does experience chest pain, it is important to stop and rest if he or she feels chest pain, take nitroglycerin if prescribed, and seek emergency treatment for sustained chest pain. There is no reason to wait 3 months post MI to resume sexual activity.

Answer to Question 2

ANS: B
The classic symptoms of weakness, anorexia, and fatigue are common to other conditions com-mon in older adults; additionally, they may also be attributed to normal age-related changes. The incidence of AIDS in older adults is increasing, rising faster among older adults than among younger adults. The symptoms are identical in older and younger populations. AIDS progresses more quickly in older adults than it does in younger adults.