The primary care provider's office nurse must return telephone calls concerning 4 clients. Which client has the most emergent situation and requires an immediate call back?

Question

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Priapism is a prolonged, painful erection (>2 hours) caused by trapping of blood in the penile vasculature that can lead to erectile tissue hypoxia and necrosis. The condition is usually idiopathic, secondary to prescription medications (eg, sildenafil, trazodone) or a preexisting medical condition (eg, sickle cell disease, cocaine use). The nurse should return this call first as the condition is a medical emergency that can result in permanent erectile dysfunction; it requires urgent treatment in the emergency department. (Option A) Urinary tract infections can recur in sexually active women. This client needs antibiotics but is not a priority. (Option C) This client may have some degree of prostatic hyperplasia given his age. Decongestants (eg, pseudoephedrine) or antihistamines (eg, diphenhydramine) should be used with caution as they can lead to difficulty voiding and acute urinary retention. The client needs to be assessed, but this is not the most emergent call. (Option D) The client with prostate cancer may need increasing pain medication as clients develop tolerance to opioids. However, this is not a priority. Educational objective: Priapism is a prolonged, painful erection not necessarily related to sexual arousal. It requires urgent treatment in the emergency department as it can lead to erectile tissue ischemia and necrosis.

The Primary Care Provider's Office Nurse Must Return Telephone Calls