A 22-year-old man tells the nurse at the health clinic that he ...

[cnetterville]

A 22-year-old man tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction. Which question should the nurse ask first to assess for possible etiologic factors?
 
  a. Do you experience an unusual amount of stress?
  b. Do you use any recreational drugs or drink alcohol?
  c. Do you have chronic cardiovascular or peripheral vascular disease?
  d. Do you have a history of an erection that lasted for 6 hours or more?

Question 2

After a transurethral resection of the prostate (TURP), a 64-year-old patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine. Which action should the nurse take first?
 
  a. Increase the flow rate of the bladder irrigation.
  b. Administer the prescribed IV morphine sulfate.
  c. Give the patient the prescribed belladonna and opium suppository.
  d. Manually instill and then withdraw 50 mL of saline into the catheter.

[whitcassie]

Answer to Question 1

ANS: B
A common etiologic factor for erectile dysfunction (ED) in younger men is use of recreational drugs or alcohol. Stress, priapism, and cardiovascular illness also contribute to ED, but they are not common etiologic factors in younger men.

Answer to Question 2

ANS: D
The assessment suggests that obstruction by a clot is causing the bladder spasms, and the nurse's first action should be to irrigate the catheter manually and to try to remove the clots. IV morphine will not decrease the spasm, although pain may be reduced. Increasing the flow rate of the irrigation will further distend the bladder and may increase spasms. The belladonna and opium suppository will decrease bladder spasms but will not remove the obstructing blood clot.