20ym with MR and CP with "other" needs

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Specializes in Med/Surge, Private Duty Peds.

i need some help with how to handle this. i have a 20ym pt with mr and cp, is wheel chair bound and the iq of about a 10-12 yo. while preparing to give him a bath the other day he says " my pee-pee hurts" he is known to have frequent uti's and had just finished a round of antibiotics for one. well is wasn't from the uti, he had an erection!

i have brought the subject up to mom who replied " i never thought about him and that, his 25 year old brother was very private in his teen years"

i have no idea how to handle this, any advice? i have tried to ignore it, mentioned it to mom again, no luck in having her talk to pt.

i am lost as to what to do. i work private duty nursing and this is a first. sure i seen men with erections when working the floor but not this. i take of this pt 3 days a week for 12hr a day. i have tried telling him not to think about his pee-pee hurting, to relax . let him listen to music, taking him for a stroll outside,and other deverations but no luck! he still complains about it hurting.

any help would be greatly appreciated!!

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Specializes in Correctional, QA, Geriatrics.

First thing I want to say is I totally understand. I have worked a fair number of years with clients with MR and they do have a way of presenting nurses with some unique challenges.

You wrote you are doing private duty care for him. Are you working through an agency? If so then he has a case manager I am sure. You need to consult with the case manager and the agency team needs to meet with the mother about some kind of sex ed for her son. Being MR does not eliminate the sex drive. This needs to be dealt with so he can learn a more appropriate way of indicating he is in need of some "private time". He most likely also needs some education about how he can deal with his sexual needs.

It seems you have tried various methods of distracting or redirecting his attention without success. Please don't be discouraged about the lack of progress with those methods. Sometimes we have to just grit our teeth and keep redirecting inappropriate behavior to other avenues of expression. Is he displaying the same behavior with his other nurses? If he is maybe they have found an effective way to redirect him.

I wish you luck and success in helping your patient learn how to cope more appropriately with his needs.

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Specializes in ICU/ER.

If he truley has the IQ of a 10-12 year old just tell him that is normal and sometimes "your member does grow and feel tight" and leave it at that.

As the mother of boys I know they get erections way before age 20, so I am sure this is not totally new to him.

I remember the funny story of my 5 year old telling my 10 year old "when I wake up in the morning my member is huge"and the 10 year old saying ya you should see mine in the morning and he held his hand out as far as it could possibly go in front of his pants showing the length. Even at 10 they exagerate!!

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i don't know...

do erections hurt?:confused:

just because he has an erection doesn't mean he still doesn't have a uti.

try to catch him the next time he pees and ask him if it hurts.

i'd probably do a u/a, c&s.

leslie

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Specializes in ICU.

i'd talk to him as i would a "normal" boy. as a caregiver, this lies within the 'education' perameter. unless his erection continues for hours there is no medical emergency here. this too will pass :lol2:

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