Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to:
A. Encourage the client to ask questions about personal sexuality.
B. Provide time for privacy.
C. Provide support for the spouse or significant other.
D. Suggest referral to a sex counselor or other appropriate professional.
Correct Answer: D. Suggest referral to a sex counselor or other appropriate professional.
The nurse should refer this client to a sex counselor or other professional. Making appropriate referrals is a valid part of planning the client’s care. Erectile Dysfunction (ED) is common in men with diabetes; these men tend to present with more severe and refractory ED compared to non-diabetic peers. While ED is the best established diabetes-related sexual dysfunction, ejaculatory and sexual desires issues may also occur in men.
Option A: The nurse doesn’t normally provide sex counseling. Diabetic neuropathy may impair autonomic and somatic nerve processes essential to erections. Diabetes is also associated with impaired relaxation of cavernosal smooth muscle due to endothelial-derived nitric oxide, which may be a side effect of glycosylation products.
Option B: It is recommended that diabetic men be screened for the presence of low testosterone by checking serum total testosterone; sex hormone binding globulin and albumin should also be tested to assess for free and bioavailable testosterone.
Option C: As with most aspects of diabetes care, routine exercise, careful monitoring of glucose levels, and usage of appropriate therapies to prevent hyperglycemia are key to preventing progression of diabetes-induced sexual problems. Weight management and dietary prudence are also critical in the management of diabetes.
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