45.13: Chapter 33

Unfolding Case Study

1. First, the nurse must recognize the patient’s report about being unable to achieve or maintain an erection is significant because sexual dysfunction can negatively impact overall health. The nurse should also recognize the patient is actively being treated for depression and hypertension based on the current medications listed.

2. The nurse should recognize that both antidepressant and antihypertensive medications can contribute to the development of ED and this patient is on both types of medications. The patient also has a history of diabetes, which has been linked to ED. Additionally, the patient is experiencing depression, which may impact his sexual health and well-being.

3. The nurse should gather information about potential psychological and psychosocial factors that may be causing the ED symptoms. The nurse should first ask more about the patient’s depression and if he feels that it is being treated effectively. The nurse should also gather information about the patient’s body image, stress level, culture, religion, and lifestyle to gain a better understanding of any risk factors that may be present and contributing to his ED symptoms.

4. The nurse should anticipate the provider will want to obtain a more thorough history of the symptoms. Additionally, the nurse should anticipate the provider may suggest a combination of medications and counseling to treat the ED symptoms. The provider may also suggest counseling or support groups for spouses of cancer patients.

5. Because providing education about sexual health topics can be sensitive and difficult, the nurse should first create a safe and supportive environment for the patient to openly discuss his concerns. As an educator, the nurse should provide the patient with factual and easy-to-understand information about the potential causes of ED and what treatments are available. The nurse must employ good communication skills during this discussion, such as by using active listening and nonjudgmental language to create a safe place for the dialogue to occur. The nurse should focus on the facts, ensure that the patient understands that his symptoms are not his fault, and provide him with the education and resources that he needs to make informed decisions about his sexual health.

6. First and foremost, the patient should express an understanding of the provided information. The patient should also feel empowered to take control of his sexual health decisions versus feeling bad that he needs pharmacologic assistance to maintain an erection. Long-term positive outcomes after treatment initiation would include improvement in ED symptoms and less sexual frustration reported by both the patient and his wife.