What Should the Nurse Do?
Paul, a forty-two-year-old male, arrives at the urology clinic with concerns related to sexual dysfunction. He reports symptoms of erectile dysfunction, including difficulty achieving and maintaining an erection, leading to increased stress and strain in his relationship. Paul’s medical history reveals a diagnosis of hypertension for which he is prescribed antihypertensive medication. His vital signs indicate a blood pressure of 140/90 mmHg, heart rate of 78 beats per minute, respiratory rate of 18 breaths per minute, and temperature of 98.5°F. During the assessment, Paul discloses stressors associated with his sexual dysfunction, citing work-related pressures and a recent family loss.
1
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How might Paul’s recent family loss and work-related pressures contribute to his experience of sexual dysfunction, and what implications does this analysis have for developing a holistic care plan?
2
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As a nursing student, what solutions can be generated to address both the physiological and emotional aspects of Paul’s sexual dysfunction, and how might these be integrated into his care plan?
Nick, a thirty-five-year-old male, seeks support at the mental health clinic for distress related to paraphilias. He reports symptoms of recurrent, intense sexual fantasies and urges involving nonconsenting partners, leading to significant personal distress. Nick’s symptoms include persistent, intrusive thoughts about these fantasies that interfere with his daily functioning and interpersonal relationships. His anxiety and depression, managed with medication, have intensified with the distress caused by these symptoms. Vital signs are stable, with a blood pressure of 120/80 mmHg, heart rate of 76 beats per minute, respiratory rate of 16 breaths per minute, and temperature of 98.7°F.
3
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Given Nick’s history of anxiety and depression, what hypothesis should be prioritized in understanding the relationship between his mental health history and the exacerbation of paraphilic symptoms, and how does this guide the selection of interventions?
4
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How will a nursing student determine the effectiveness of interventions in alleviating Nick’s distress and improving his overall well-being, and what adjustments might be necessary based on ongoing assessment?
Alex, a twenty-five-year-old Transgender individual, presents to the LGBTQIA+ health clinic seeking support for gender dysphoria. Alex reports experiencing significant distress due to a misalignment between assigned gender at birth and gender identity. Vital signs are stable, with a blood pressure of 118/76 mmHg, heart rate of 80 beats per minute, respiratory rate of 18 breaths per minute, and temperature of 98.6°F. Alex has a history of anxiety and depression, managed with therapy.
5
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How might societal discrimination and challenges in social relationships contribute to Alex’s experience of gender dysphoria, and what implications does this analysis have for planning nursing care?
6
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Given Alex’s history of anxiety and depression, what hypothesis should be prioritized regarding the impact of mental health on gender dysphoria, and how does this guide the selection of interventions?
7
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What gender-affirming interventions and counseling support can you generate to address Alex’s distress, and how might these be integrated into the nursing care plan?