A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool.

What does this score indicate?

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.

Encourage fluid intake of at least 2 L/day.

This is because adequate hydration can help soften the stool and facilitate its passage through the intestines.Fluid intake should be increased gradually to avoid fluid overload or electrolyte imbalance.

Choice B is wrong because alow-fiber dietcan contribute to constipation by reducing the bulk and water content of the stool.

Fiber helps retain water in the stool and stimulate peristalsis.A high-fiber diet is recommended for clients who have constipation.

Choice C is wrong because astimulant laxativeshould not be used daily or for a long period of time, as it can cause dependence, dehydration, electrolyte imbalance, and damage to the intestinal mucosa.Stimulant laxatives should be used only as a last resort when other measures fail.

Choice D is wrong becausephysical activitycan help prevent constipation by increasing intestinal motility and blood flow.Physical activity should be encouraged for clients who have constipation, unless contraindicated by other conditions.

Normal ranges for fluid intake are about 2 to 3 L/day for adults, depending on age, weight, activity level, and climate.Normal ranges for fiber intake are about 25 to 38 g/day for adults, depending on age and sex.