Author Question: A male patient tells the nurse he awakens once or twice each night to void and has difficulty ... (Read 21 times)

Anajune7 · **on:** Jul 23, 2018

A male patient tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine.

He describes these symptoms as annoying. The patient's provider examines him and notes that the prostate is moderately enlarged. The patient is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will order:
a. doxazosin (Cardura).
b. finasteride (Proscar).
c. silodosin (Rapaflo).
d. a transurethral prostatectomy.

Question 2

A nurse is obtaining a history from a patient who will receive tadalafil (Cialis) for erectile dysfunction. The patient reports that he expects to have sexual activity three or four times a week. What should the nurse tell the patient?

a. Adverse effects of tadalafil resolve more quickly than those of sildenafil.
b. There is an increased risk of priapism with frequent sexual activity.
c. He should take tadalafil 30 to 60 minutes before sexual activity.
d. He should talk to his provider about daily dosing of tadalafil.

lorealeza · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
Nonselective alpha1-adrenergic antagonists do not commonly affect sexual function and are useful in patients with mild to moderate symptoms, so doxazosin would be a drug of choice for this patient. Finasteride is a 5-alpha-reductase inhibitor and is used for patients with more severe enlargement of the prostate; it also reduces ejaculate volume and libido. Silodosin is a selective alpha1-adrenergic antagonist and can cause abnormal ejaculation. Transurethral prostatectomy is reserved for patients with more severe enlargement of the prostate.

Answer to Question 2

ANS: D
Tadalafil is approved for daily dosing and can be given daily for men who anticipate sexual activity twice a week or more. Tadalafil has longer effectsup to 36 hoursthan sildenafil, and adverse effects take longer to resolve. There is no increased risk of priapism associated with an increase in sexual activity. Because tadalafil has longer effects, dosing and sexual activity do not have to be closely timed.