A nurse is contributing to the plan of care for a client who has erectile dysfunction. Which of the following should be included in the plan of care? (Select All that Apply.)

Brief Introduction: Erectile dysfunction involves the persistent inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance. The physiology of an erection requires parasympathetic stimulation to induce nitric oxide release, causing smooth muscle relaxation and vasodilation of the corpora cavernosa. Dysgenesis often results from underlying vascular insufficiency, neurogenic impairment, or psychological stressors. Rationale: A. Numerous pharmacological agents, including antihypertensives and antidepressants, interfere with the hemodynamic response required for an erection. Beta-blockers and selective serotonin reuptake inhibitors are frequent culprits of iatrogenic dysfunction. Evaluating the medication profile is a priority to identify potentially reversible causes of the condition. B. Tobacco use is a significant risk factor for atherosclerotic disease, which restricts arterial inflow to the pelvic vasculature. Nicotine induces vasoconstriction and long-term endothelial damage, compromising the ability of the cavernous arteries to dilate. Cessation is a critical component of restoring vascular health and erectile capacity. C. Psychological factors play a major role in the neurological signaling required to initiate the erectile response. Depression and performance anxiety can inhibit the brain's ability to process arousal stimuli, leading to psychogenic dysfunction. Screening allows for a holistic approach that may include counseling or psychiatric intervention. D. Post-coital voiding is a behavioral recommendation primarily utilized for the prevention of urinary tract infections, particularly in female patients. It has no clinical relevance to the physiological management or treatment of erectile impairment. This instruction would not be included in a plan focused on improving sexual function. E. Regular physical activity improves cardiovascular endurance and endothelial function, which are essential for maintaining adequate genital perfusion. Sedentary lifestyles are strongly correlated with obesity and metabolic syndrome, both of which exacerbate erectile problems. Assessing activity levels helps in formulating a lifestyle modification plan.