Jump to content

Need help with a careplan on sexual dysfunction of the post op patient...

Students   (3,573 Views 5 Comments)

Certifiable has 5 years experience as a BSN, RN and specializes in Oncology/hematology.

5,014 Profile Views; 183 Posts

advertisement

OK, I have to hand in a SOAPIE (care plan) on my patient, A woman of 70 who was sexually active before her spinal surgery (Spondylectomy) but now thinks she won't be. I could pick a really boring diagnosis about her balance or mental state, but I feel that those have been done to death. So I chose this. However, as I'm not really that versed in nursing careplans, having only submitted two previous ones, I feel that i'm in over my head.

Should I opt out for the boring, safe one, or is there anyone here who can help me?

i've got the subjective, objective, diagnosis down... but the planning and implamentation is a bit foggy for me right now... how am I, an inexperienced 24 yr old 2yr nursing student supposed to know how to tackle a sexual intimacy problem?

For those who are interested in helping me, this is my diagnosis (as translated into English... it's not the language I study nursing in, so it may not sound right): "inturruption of sexual practices, brought on by her Spondylectomy surgery that manifests in a cessation of sexual activity". something like that.

the long term goal is that she gets back to a healthy sex life, but the intermeadiate goal is that she have sex within two months, and that it be pain and anxiety free (or at least moderate).... am I mad? is that unrealistic?

HELP!

Share this post


Link to post
Share on other sites

559 Posts; 6,053 Profile Views

If priority nursing diagnoses = boring to you, you're going to have a LOOOOONG career.

Pick a priority diagnosis and do it well. There are plenty of post-op issues that are far more critical than sexual dysfunction. Of course it's important, but first she needs to get healthy.

Share this post


Link to post
Share on other sites

58 Posts; 2,421 Profile Views

I would also pick a priority diagnosis -- I'm surprised you can pick non-priority ones, my program has us identify five and then write up the most important three. Things like risk for infection seem more important than giving her man an old-fashioned, you know?

Share this post


Link to post
Share on other sites

Double-Helix has 6 years experience as a BSN, RN and specializes in PICU, Sedation/Radiology, PACU.

1 Article; 3,375 Posts; 41,280 Profile Views

I personally don't think you have enough evidence for the sexual dysfunction diagnosis. For this diagnosis, there needs to be some evidence of decreased libido, physiologic challenges with sex, etc. There isn't any indication that she has a cessation in sexual activity, as she is a fresh post-op. You may be able to make a better case for Disturbed Body Image, due to their patient's fear and potential inaccuracies about the changes the surgery will have on her life. Of course, choosing a priority diagnosis (infection, fall risk, self-care) would be easier and probably more beneficial for your education at this point, since you will see those diagnoses frequently.

I'm also concerned about your goals. Your long term goal- get back to healthy sex life- is that measureable? Timed? What does a healthy sex life even mean? It doesn't sound very specific to me. How did you choose the short term goal "the patient will have sex within two months."? Did you discuss this with the patient? Sex is a personal decision, no matter what the circumstance and, as a patient, I certainly wouldn't appreciate a nurse setting a goal telling me when I should be having sex again without my input.

If you really wanted to talk with this patient about her concerns about sex after surgery, simply ask her about her fear, assess why she thinks she won't be having sex (Does she think she will be too weak? In too much pain? Will she feel undesirable?), and provide the correct education using information about the surgical procedure and normal sexual functioning of older women.

Share this post


Link to post
Share on other sites

Certifiable has 5 years experience as a BSN, RN and specializes in Oncology/hematology.

183 Posts; 5,014 Profile Views

Let me clarify my intentions:

We need to hand in a hypothetical care plan b/c our neurosurgery rotation finished before the task was set- it's not possible for me to speak with this patient and clarify a care plan.

Secondly, I am fully aware that there are WAY more important care plans for this patient than sexual disfunction, I just thought it would be nice to challenge myself, kind of take me out of my comfort zone.

Third, said patient already had a mastectomy and many other procedures in the past, so I think that the body image issue, as important as it is, is not the source of her anxiety about sex, it's the actual mechanics of it- she's worried about her back ("before this operation I had a sex life, but now, I think that's over"- her words).

Share this post


Link to post
Share on other sites
  • Recently Browsing 0 members

    No registered users viewing this page.

×