Question

Mr. J, age 23, comes to the clinic today with vague complaints of “just not feeling good”. While going through the review of systems, he offhandedly mentions that he “can’t get it up like I did in the past, but no big deal”.

1. How will the nurse respond to this comment?

He reports that it is difficult to have an erection, and when he does, it only lasts a few seconds.

1. What is he most likely describing?

2. What questions would be appropriate to help identify the etiology? Give the rationale for each question.

3. Mr. J wants to know why the nurse is asking him so many questions. How would you explain this line of questioning to him?

4. Why would the nurse consider recommending a cardiovascular evaluation for someone with this condition?

Answer 1

1. Mr. J, 23 years came to the clinic with only by saying " just not feeling good and cant get it up like I did in the past". From these, it is difficult for the nurse to jump into a conclusion. So she can act by saying " Let me check" or by " Let me ask more questions about this". Such questions make the patients to tell more about other signs or symptoms and the nurse can also easily drawn into a conclusion to plan a treatment for the diagnosis.

Questions: a) Do you have any other symptoms related to erection? To understand more about the reason for the pain.

b) Can you bale to walk to a short distance? To know the intensity of pain.

c) What activities results in more pain or what causing untolerable pain? To find out the reason for the pain.

d) Do you ever experience such pain before or how many times in a day you experience such pain? To know about the frequency of pain.

Mr. J came to the hospital with a clinical symptom that he is having pain. As I said earlier, by saying pain while erection cannot able to diagnose find out what causing the pain or any association with other medical conditions. So,the nurse have to ask in detail more about the pain to finally diagnose the disease and to start treatment to reduce the pain.

Erectile dysfunction is always associated with other conditions commonly with cardiovascular diseases (CVD). It is a warning sign that the symptoms of erectile dysfunction often develops before any cardiovascular dysfunction occurs. So, the nurse should also check the cardiovascular health status of Mr. J to find out any associated relationship with them.