ch 33 - intimacy and sexuality Flashcards
zone of touch: least sensitive or embarrassing
-includes hands, arms, shoulders, back
social zone
zone of touch: must ask permission to initiate procedures
-includes mouth, wrists, feet
consent zone
zone of touch: highly sexually charged
-includes face, neck, front of body
vulnerable zone
zone of touch: most highly protected
-includes genitalia
intimate zone
5 major relational areas of intimacy
- commitment
- affective intimacy
- cognitive intimacy
- physical intimacy
- interdependence
The sum of cultural factors that influence thoughts and actions related to interpersonal relationships, as well
as sexuality related to ideas and learned behavior
sexuality social sphere
Reflects attitudes, feelings toward self and others, and learning from experiences
psychological domain of sexuality
Reflected in physiological responses to
sexual stimulation, reproduction,
puberty, and growth and development
biological sexuality
most prevalent sexual problem in older men
erectile dysfunction
Inability to achieve or sustain an erection sufficient
for satisfactory sexual intercourse in at least 50%
of attempts
erectile dysfunction
meds for ED (3)
- sildenafil (viagra)
- vardenafil (levitra)
- tadalafil (cialis)
contraindications for ED meds (4)
- nitrate therapy
- HF with low bp
- certain HTN regimens
- CV conditions
2 changes with older women that can affect sexual activity
- postmenopausal changes (lower estrogen)
- UI
problems/effects caused by arthritis on sexual function
- pain, fatigue, limited ROM
- steroid therapy may decrease desire
interventions for improving sexual activity in pts with chronic arthritis
- schedule for time of day when less fatigued
- suggest pain meds
- relaxation techniques before activity
- maintain optimal health (exercise and diet)
problems/effects caused by CV disease
- most men = no changes
- women don’t have changes after MI
- fear of another MI/death
- sob
interventions for improving sexual activity in pts with CV disease
-counseling for realistic restrictions
POST MI:
-avoid large meals several hours before activity
-allow for unrestricted breathing
-stop and rest if having chest pain
POST CABG/PACEMAKER:
-avoid strain/direct pressure on device
-don’t engage in sexual activity if having poorly controlled arrhythmias
-instruct pacemaker could fire during activity
problems/effects caused by CVA
- depression
- erectile disorders
- fatigue
- mobility and sensory deficits
- perceptual and visual deficits
- communication deficits
- fear of relapse or sudden death
interventions for improving sexual activity in pts with CVA
- counseling
- alternate forms sexual expression
problems/effects caused by COPD
- coughing
- exertional dyspnea
- activity tolerance
- meds can cause ED
interventions for improving sexual activity in pts with COPD
- plan activity when energy is highest
- avoid pressure on chest
- plan activity for time when meds are most effective
- use of oxygen before/during/after
- teach partner to observe for difficulty breathing
problems/effects caused by diabetes
- neuropathy can cause ED
- women have decreased desire
- decrease/absence orgasms
- less sexual activity
- local genital infections
interventions for improving sexual activity in pts with diabetes
- possible recommendations for penile prosthesis
- alternative forms sexual expression
- recommend immediate attention genital infections
common S+S HIV/AIDS in older adults (4)
- fatigue
- weakness
- weight loss
- anorexia
PLISSITT (guide for discussion of sexuality)
P: permission from client to initiate discussion
LI: provide limiting info needed to function sexually
SS: specific suggestions for pt to proceed with activity
IT: provide intensive therapy surrounding issues of sexuality
problems/effects caused by breast cancer
- loss of sexual desire
- body image change
problems/effects caused by prostate cancer
- incontinence after surgery
- ED
problems/effects caused by most cancers
- loss of sexual desire
- ED, retrograde ejaculation
- vaginal dryness
- anxiety/depression
- pain
- nausea from Tx
interventions for improving sexual activity of pt with prostate cancer
- use of phosphodiasterase inhibitors
- kegels
- routine toileting
RF AIDS/HIV (3)
- sexually active and not using condoms
- don’t know partner’s drug and sexual history
- blood transfusion between 1978-1985
who should get STD testing (older adult)
- women with new/multiple sex partners
- men who have sex with men screened yearly
- sexually active men who have sex with men should have HIV testing q3-6 months
- anyone who has unsafe sex tested yearly for HIV
- anyone who shares injection drug equipment tested yearly for HIV
meds that may affect sexual health
- antiHTN
- meds for prostate diseases
- cholesterol meds
- antidepressants
- meds that can affect mood
- anticholinergics
- pain meds (narcotics)
- osteoporosis meds
- oral hypoglycemics
- insulin
- chemo
