Question

1. What is menopause? Perimenopause?

2. What is erectile dysfunction (ED)?

a. List a medication used in the treatment of ED.

b. Discuss a nursing implication of the medication.

c. Discuss a teaching point of the medication.

3. What causes sexual problems? Name 3 issues.

4. Does sexual drive increase with age? Explain.

Answer 1

1.Menopause is defined as the time of life when ovaries are not producing hormones and mensuration cycle cease due to the permanent decline in the ooctyle without any physiological or biological cause. It occur usually at the age when women reaches 40s and 50s.

Perimenopause is also known as menopausal transition, it occur at the time period in which body natural transition towards permanent fertility. In this phase body is physiological prepares itselft and hormone are fluctuation but mensuration cycle is present.

2.erectile dysfunction- it is defined as the persistent inability to maintain errection that is sufficient for intercourse. It put pressure on the relationship and makes the stressful situation for the men. Occupation impotence is not a concern but consistent is a concern for to seek a physician.

A. The cause of erectile dysfunction may be physical or psychological. Treatment involves drug therapy and support groups to gain self confidence.

There are 2 types of medication used in the treatment of erectile dysfunction

1- phosphodiesterase 5 inhibitors (PDE5) includs cildenafil, tadalafil, vardenafil. These drugs causes the smooth muscle relaxation of the phallus which allow more blood flow to it and causes erection.

2. Alprostradil Is a prostaglandin, it alo dialate the smooth muscle and act on the cavernosal artery of the found in the phallus and dilate the artery to increase flow.

B. NURSING IMPLICATIONS

1.dont use drug in the patteint who is having hypersensitivity to it.

2. Always use a drug in adult men, not in older men it increases the risk of prostate cancer.

3.drug contraindicated in priapism ( pain with erectile dysfunction)

4.use causiouly alprostradil with anticoagulant(cause bleeding), alpha adrenergic blocker and hypertensive medication.

5.drugs are contraindicated to cardiovascular patient who is advisable not do sexual activity.

6.carfully assess phallus for penil fibrosis. And discontinued the treatment. In case of alprostradil.

7. Patient should be assess for drug effectiveness, device malfunctioning, or failure as alprostradil come in the disposable, single dose, dual chamber syring.

8.assess baseline LFT in case of PDE5.

9.dont use PDE5 In hepatic and renal impairment, and use cautiously in patient with left ventricular outflow obstruction, sicke cell anemia, phallus deformities etc.

10. Monitor blood pressure and heart rate and rhythm before and during therapy.

C. TEACHING POINT ON MEDICATION

PDE5

- explain when to use PDE5, 1hour before sexual activity

- tell patient don't use Drug with organic nitrate as it may causes hypotension.

-advice a patient for sexual counselling, it help in enhence the drug effect.

- notify the physician immediately if erection is painful or last longer than 4 hours.

- tell patient to seek medical help if experience headache or sudden loss of vidion in one or both eyes or hearing loss accompanied by tinnitus and dizziness.

- dont take a drug more than once a day.

ALPROSTRADIL

-inform patients to start intial therapy at the office setting to teach the administration.

- advice patient to take injection no more than 3times per week.

- tell patient to inform the physician about hard tissue or nodule in the phallus

- tell patient to sit, stand or walk for 10minutes after suppositories insertion. To enhance blood flow.

- tell patient to expect errection after 5 to 20minutes after injection and 10min after suppositories insertion.

-advice the patient to follow the prescription instructions exactly to prevent needle breakage.

- inform the patient about mild to moderate pain immediately after injection and burning after suppositories insertion.

Q3.sexual problem is a persistent disatisfaction from the sexual life to lack of sexual response, orgasm, desire or pain.

The cause of sexual problems or dysfunction is not due to underlying disease some time it is associated with tobacco, smoking, alochol, stress and relationship factors.

3 issues can causes sexual problems

A. Erectile dysfunction

B. Clinical depression

C. Femal arousal dysfunction

D. Any disease such as heart disease, diabetes, neurological disorders, hormonal imbalance, drug abuse, chronic diseases and alcoholism.

Q4 Does sexual drive increase with age? Explain.

NO, Progressive age may leads to the natural fall in the hormone occur which Mai decrease the sexual derive or libido. In both male and female.

Some emotional changes occur a age progresses which may change interest in intercourse.

And it may causes the long time to achieve erection or delay in the arousal in females. Which may be most of the time distressing for the relationship.

I hope you know the other name of phallus.

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