A nurse is planning care for an older adult client who has constipation due to decreased intestinal motility.

Which of the following interventions should the nurse include in the plan?

The correct answer is A.“Do you drive your own car or use public transportation?.” This question is appropriate for the domain ofmode of transportation, which is one of the eight areas of occupational performance assessed by the Lawton Instrumental Activities of Daily Living (IADLs) Scale.The scale evaluates a person’s ability to engage in more complex activities thought necessary for functioning in community settings.

Choice B is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofability to use a telephone.The scale asks about the person’s ability to operate a telephone, dial numbers, and answer calls.

Choice C is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofshopping.The scale asks about the person’s ability to take care of all shopping needs independently, shop for small purchases, or need assistance with shopping.

Choice D is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofmobility.The scale does not assess mobility directly, but it may be inferred from the person’s ability to travel by public transportation or car.

The Lawton IADLs Scale has a summary score that ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 to 5 for men.The score identifies areas of need in regard to care and support.

You can do any of the above options, depending on your preference and medical condition.

Erectile dysfunction (ED) is the inability to get and maintain an erection for sexual activity.

It can be caused by physical or psychological factors, or both.

ED can affect your self-esteem, stress level and relationship quality.

There are different treatment options for ED, and they work in different ways.

Some of the most common ones are:.

• Oral medicationssuch as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Stendra).

These drugs enhance the effects of nitric oxide, a chemical that relaxes the muscles in the penis and increases blood flow.

You need to take them before sexual activity, and they only work if you are sexually stimulated.

They are not safe for everyone, especially if you have heart problems, low blood pressure, liver disease or certain eye conditions.They can also cause side effects such as headache, flushing, nasal congestion or indigestion.

• Penile self-injectionssuch as alprostadil (Caverject, Edex) or papaverine (OraVerse).

These are shots of medicine that you inject into the base or side of your penis with a fine needle.

They cause an erection by dilating the blood vessels in the penis.

The erection lasts about 20 to 30 minutes, and you need to use them only when needed.They can cause side effects such as bleeding, pain, priapism (a prolonged and painful erection) or fibrous tissue formation.

• Alprostadil urethral suppository(Muse).

This is a tiny pellet of medicine that you insert into your urethra (the tube that carries urine out of the body) with a special device.

It works by expanding the blood vessels in the penis and causing an erection.

The erection lasts about 30 to 60 minutes, and you need to use it only when needed.It can cause side effects such as burning, pain, bleeding or infection.

• Vacuum erection device(VED).

This is a plastic tube that you place over your penis and pump out the air to create a vacuum.

This draws blood into the penis and causes an erection.

You then slide a rubber ring around the base of your penis to keep the blood in place.

The erection lasts as long as the ring is on, up to 30 minutes.

You need to use it only when needed.It can cause side effects such as bruising, numbness, pain or difficulty ejaculating.

• Penile implant surgery.

This is a procedure where inflatable or bendable devices are surgically placed on both sides of your penis.

You can control when and how long you have an erection by inflating or deflating the devices with a pump or a switch.This is a permanent solution for ED, but it requires surgery and has risks of infection, mechanical failure or erosion.

Other treatment options for ED include hormone therapy, psychotherapy, lifestyle changes and natural remedies.

However, these may not be as effective or safe as the ones mentioned above.

The best treatment option for you depends on your personal preference, medical condition, cost and availability.

You should talk to your doctor about the benefits and risks of each option and choose the one that suits you best.