Unit-6 Clinical practice: Sexuality

1. You are assessing Mr. Clements during his 4-week follow-up appointment after discharge from the hospital. You need to include a sexual health history as a routine part of the nursing history. Give examples of nonjudgmental questions you will ask to determine his sexual function.

2. After determining Mr. Clements sexual orientation, how would you establish a therapeutic relationship to put him at ease discussing the intimate aspects of his life?

3. Mr. and Mrs. Clements both vocalize concern about initiating sexual activity since his MI, saying they are concerned that it might cause another MI. Mrs. Clements states that he seems less interested in intimacy than before the MI and tires easily. Provide at least three strategies that they could use to enhance their sexual functioning.

Stress and Coping

. You are meeting with Sandra and John during their second visit to the Cancer Center. You notice that Sandra is well groomed and not disheveled as she was during the last visit. John and Sandra were able to sit down and talk to one another about various treatment options. They are here today to finalize their decision. Although Sandra appears calm today, John is worried about her emotional status and the impact caring for him during treatments will have. Discuss the various stressors that need to be considered when evaluating their situation.

2. John is now in the Cancer Center for his third dose of the first round of chemotherapy. He had a strong reaction to the medications, and his white count dropped so low that he was unable to take the next dose of chemotherapy. Although John feels good physically and understands the reasons for holding the next round, Sandra is convinced that the treatment is not working. When you meet with Sandra you notice that she is talking fast, can’t concentrate, and is crying. She has a friend with her, and the friend tells you that Sandra did not understand what the oncologist said. When he said that we need to skip this week’s dose, Sandra interpreted it as we have to skip the chemotherapy. Which nursing diagnoses might apply to this situation?

3. John has completed his first round of chemotherapy. His blood chemistries look good, and on scan the tumor is decreased. He is now resting and will begin the second round of chemotherapy. Sandra is still fearful, but she is sleeping and eating well. She still has difficulty meeting with the doctors and understanding the treatments and impact they have on John’s level of health. She says that, when she listens to the doctor, “I feel like I’m watching someone else and really don’t hear or remember many details.” Which approach would be the best to take in planning for Sandra?