1.Which strategies should the nurse recommend to improve the clients sexual health? (Select all that apply).

Question Answered step-by-step 1.Which strategies should the nurse recommend to improve the clients sexual health? (Select all that apply). Ms. Booth, 68 years old, comes to the senior health clinic to establish care and is accompanied by Ms. Singh, her partner of 20 years. Ms. Booth has a history of osteoarthritis in her hips and knees, coronary artery disease, chronic obstructive pulmonary disease with a 53-pack/year history of smoking, and Type 2 diabetes with mild peripheral neuropathy. Her medications include meloxicam 15 mg daily, aspirin 81 mg daily, valsartan/hydrochlorothiazide 160 mg/25 mg daily, nitroglycerin SL 0.5 mg every 5 minutes × 3 as needed for chest pain, fluticasone/salmeterol 250 µg/50 µg inhaled twice a day, glipizide/metformin 5 mg/500 mg twice a day, and pregabalin 50 mg three times per day. Vital signs include a blood pressure of 145/88 mmHg, pulse of 92 beats per minute, respiration rate of 18 breaths per minute, temperature 97.9°F, and oxygen saturation on room air of 96%.The nurse asks Ms. Singh to leave the room during Ms. Booth’s physical examination; however, Ms. Booth asks for her partner to stay, saying they have some sensitive questions to ask and want to ask them together. Both women appear uncomfortable. The nurse sits down, leans forward, smiles, and asks how they can help. Ms. Singh looks at Ms. Booth, then says they are afraid to have intercourse since Ms. Booth’s chest pain began 6 months ago. The nurse nods, then discusses with them ways to adapt to Ms. Booth’s chronic illnesses.1. Engage in sexual activity at a time of day when most relaxed and less fatigued.2. Use analgesics or other pain-relief methods, such as hot packs to affected joints, prior to sexual activity.3. Experiment with different positions to avoid strain and allow for unrestricted breathing.4. Use vaginal lubrication containing glycerin.5. Treat genital infections immediately.6. If chest pain is experienced, take a nitroglycerin then resume activities.7. Consider alternative forms of sexual expression acceptable to both individuals.8. Wear oxygen during sexual activity. 2. Ms. Carlyle, 73 years old, cares for her 105-year-old mother, Mrs. Stanton, who has end-stage Alzheimer’s disease (AD). Ms. Carlyle has been her mother’s caregiver for the past 15 years. In addition to AD, Mrs. Stanton has hypokalemia and constipation. She makes nonverbal vocalizations but no speech and has few voluntary movements of her extremities, except for banging her right wrist on her upper bedrails. She has been bedridden for the past 2 years and is incontinent of bowel and bladder. A percutaneous endoscopic gastrostomy tube was inserted 2 years ago, when dysphagia led to repeated episodes of pneumonia. She has tube feedings every four hours. Mrs. Stanton is 5′8″ tall and weighs 125 pounds (BMI 19 kg/m2). Ms. Carlyle takes meticulous care of her mother and aside from perineal maceration and occasional yeast infections, there have been no pressure injuries.The nurse conducts a home visit and completes a Modified Caregiver Strain Index. Ms. Carlyle scores 12 on the index, indicating her sleep is disturbed, it is physically stressful for her to provide care for her mother, and it is distressing to her to see her mother in this state. She has also had to make adjustments with family and her personal life in order to care for her mother. The nurse sits with Ms. Carlyle and discusses the situation and provides her with community resources to support her as a caregiver and educate her about self-care.Which of the following indicate the caregiver has taken steps to reduce their stress? (Select all that apply).1. “I joined an online Alzheimer’s support group.”2. “I go for a short walk each afternoon while my mother sleeps.”3. “I arranged for respite care so that I can plan a weekend getaway.”4. “I spend time weeding my garden each day.”5. “My blood pressure is under control, so I cancelled my last two appointments.”6. “I withdrew money from my life insurance policy to care for Mom.”7. “I stopped going to my book club so that I wouldn’t be away from Mom so long.”8. “I don’t go to church anymore; it’s too hard to go.” 3. Mrs. Arroyo, 78 years old, is in a hospice for end-stage dementia. She lies in bed curled in the fetal position. She is on a pureed diet with nectar thick liquids. Over the last year, she has been treated for aspiration pneumonia four times. Her weight is steadily declining. Six months ago, she weighed 115 pounds (BMI 18.56 kg/m2) and yesterday she weighed 103.5 pounds (BMI 16.70 kg/m2). Her vital signs are 88/44 mmHg, heart rate of 60 beats per minute, respiration rate of 10 breaths per minute and irregular, and her temperature is 94.2°F. Her albumin level is 2.2 g/L. Over the last day, the nurse has documented the presence of a stage 2 pressure injury measuring 5 mm × 2.5 mm × 2 mm on Mrs. Arroyo’s coccyx; the wound base is pale. Her skin is cool to touch and purplish on hands and feet. She had one wet under pad in the last 24 hours. She is occasionally restlessness but is not responding to stimuli and is no longer eating or drinking. The nurse has called the family to come to the bedside, telling them death is approaching.To facilitate a good death, which nursing actions should be implemented? (Select all that apply).1. Offer small, spicy snacks to stimulate the client’s appetite.2. Provide a warm cotton blanket.3. Start an IV of normal saline to prevent dehydration.4. Identify self and speak softly when providing care.5. Reduce environmental stimuli.6. Encourage the family to talk to the client and give them permission to die.7. Insert a foley catheter to control incontinence.8. Use an electric blanket to keep the client warm. Health Science Science Nursing PRN 1032LL Share QuestionEmailCopy link Comments (0)