A 25-year-old client is about to undergo a unilateral orchiectomy for treatment of testicular cancer. The client says to the nurse, "I'm so worried that my future spouse is going to call off our engagement." What is the best response by the nurse? A)"Are you concerned about how the surgery will affect your sexuality?" B)"If you are concerned about infertility, you could always bank your sperm." C)"The cancer is at an early stage. You are going to be fine." D)"What have you and your future spouse discussed about your condition?"

Question

Quizplus · Accepted Answer

A diagnosis of testicular cancer is very often a source of anxiety for a client and can cause concern about sexual performance and fertility. How a client's sexuality is affected by this diagnosis depends on how advanced the cancer is and the course of prescribed treatment. Decisions about sperm banking and/or whether the client wants to procreate in the future are best made prior to surgery, radiation, and/or chemotherapy. The client and significant others need to be given counseling and the opportunity to discuss the potential effects of treatment and the options for preserving sperm. In this scenario, the client's stated concern about the future with the partner may be the way of voicing concern about how the surgery will affect sexuality. In order to determine what counseling or information this client needs, it is most important for the nurse to first assess the client's knowledge of the condition and what the client and the future spouse have already discussed. In addition, by using the therapeutic communication techniques of presenting a general lead and exploration, the nurse can facilitate the conversation and the nurse-client relationship. (Option A) This is not the best response as it requires a short, single answer from the client and does not provide the opportunity for exploration or elaboration. "Yes" or "no" questions are useful and necessary in some client-nurse interactions. However, generally they are considered to be nontherapeutic as they are not conversation enhancers. (Option B) Banking sperm is an option for clients with testicular cancer. However, it is more important for the nurse to first explore the client's concerns and knowledge about the condition. (Option C) This statement by the nurse may be giving false reassurance to the client. In addition, it blocks further discussion or exploration of the client's knowledge about the condition and related concerns. Educational objective: A diagnosis of cancer is a cause of anxiety for any client due to concerns about prognosis. A client with a diagnosis of testicular cancer will have additional concerns about sexual performance and fertility. Using therapeutic communication techniques, such as a broad opening and a general lead and exploration, will facilitate the nurse-client relationship and a meaningful discussion about the condition and concerns.

A 25-Year-Old Client Is About to Undergo a Unilateral Orchiectomy