An older patient reports that sleep was being severely affected ...

[jho37]

An older patient reports that sleep was being severely affected by the need to urinate frequently. The patient states he has begun restricting his fluid intake after 5 PM to help with the problem. The nurse responds
 
  a. Have you seen a decrease in waking up since you cut back on fluids?
  b. You need sufficient fluids, so don't be too restrictive.
  c. You need the same amount over 24 hours, so drink enough by dinnertime.
  d. Have you had your prostate checked by your health care provider?

Question 2

A 70-year-old female patient shares with the nurse her concern that recently it takes more time to achieve an organism. The nurse responds most therapeutically when answering
 
  a. You've described a common result of aging for both men and women.
  b. If you experience difficulty achieving orgasms, you should discuss that with your doctor.
  c. Your body produces fewer sex hormones now, and you need more stimulation to climax.
  d. I understand your concern. Let's talk more about the changes you've noticed.

[Brenm]

Answer to Question 1

C
It is important that older adults, who as a group are at risk for inadequate fluid intake and dehy-dration, not reduce the total amount of liquids drunk in 24 hours. This is a common issue in the older population, so the nurse educates the patient on the amount of fluid he or she needs in a 24-hour period. Telling the patient don't be too restrictive does not give the patient information to make an informed decision on fluids. The other two questions are good assessment questions, but physiologic safety and maintenance are more important.

Answer to Question 2

C
In both genders, the reduced availability of sex hormones in older adults results in less rapid and less extreme vascular responses to sexual arousal. The nurse should first share this information with the patient then offer to talk more about concerns. Although this is a normal finding, simply stating this does not give the woman much information. The nurse should be willing to discuss sexual concerns with the patient and not just pass the patient along to someone else.