Sexual Health Flashcards
1
Q
Gordon’s Functional Health Patterns
A
- One of the 11 patterns is sexual and reproductive pattern. This is an integral component of a person’s health and wellbeing and can be impacted by changes in health, illness and treatments
- Sexual health history: approproate to age and situations: sexul relationships, changes and problems
- When appropriate; e.g. use of contraceptives- identify any problems
- Female→ When menstruation started? Last menstrual period? Menstrual problems?
- Examination: None generally required unless problem identified or symptomatic, or routine pap test
2
Q
Nurse’s role in promoting sexual health in Primary Health Care
A
- General practice is the main provider of sexual health care in NSW
- Practice nurses in primary care settings (GPs) can play a major role in promoting Sexual and reproductive health
- 55% of Australians diagnosed with an STI or blood borne virus (BBV) access treatment through a GP
- 8% access treatment through a public Sexual Health Clinic
- Symptoms is one of the main reasons people seek sexual health services. Many STDs are asymptomatic
- Opportunistic STO screening should be a routine part of any medical consultation in GP, especially in priority populations
- NSW STI program unit
Women present to their Primary health care provider (e.g. GP/practice nurse) for pap smears and contraception or if symptomatic - An opportunity to discuss breast care and other women’s health issues
- Men are less likely to present for preventative care and are often asymptomatic if they have an STI
- PCH is an opportunity for nurses to provide holistic and preventative primary health care
- Focuses on health promotion includes not only STI screening, but focuses on reproductive health as well
3
Q
Breast Care
A
- 1 in 8 women will be diagnosed with breast cancer in their lifetime
- Accounted for 27.2% of all cancers in women- 2nd most common cancer in women after lung
- Early detection saves lives- the earlier a cancer is discovered, the greater the chances of successful treatment
- 9 out of 10 breast changes are not due to cancer, but still need to be referred to a doctor
- Breast cancer is also diagnosed in men (chances are much lower)
4
Q
Risk factors of breast cancer
A
- Being female
- A strong family history of breast cancer
- Family history and genetic susceptibility
- Obesity and inactivity and diet
- Having previously been diagnosed with Breast Cancer
- Other risk factors: Having children after 30, or no children, not breast feeding, early age of first menstruation, increased alcohol intake, aging
5
Q
Breast Check- Education
A
- Encourage people to perform checks themselves
- A lump, lumpiness or thickening in the breast or armpit, especially if only in one breast
- A change in size or shape of breast
- Skin changes, such as dimpling or redness
- A change to the nipple, such as a rash, ulcer or itchiness
- An unusual or persistent pain
50-74, breast screening (Mammography)
6
Q
Cervical cancer and Pap test-screening
A
- In 2010 Cervical cancer was the 3rd most commonly diagnosed gynaecological cancer with 818 cases
- Commence age 25, Exit screen age 70-74
- If symptomatic, test done at any age
- Collects a sample from the cervix that detects early changes in the cells of the cervix
- Without treatment, these changes could lead to cancer
Nurse’s role:
- Last pap test and what was the result
- Any unusual symptoms such as breakthrough bleeding
- Irregular cycle, dyspareunia (pain with sex)
- Perform the test
7
Q
Cervical cancer vaccination- Gardasil
A
- Vaccinated against HPV types 6, 11, 16 and 18
- What is HPV? Human Papilloma Virus (aka wart virus)
- Gardasil prevents against cervical, vulvar, vaginal and anal cancer, precancerous or dysplastic lesions, genital warts and some types of anal cancers
- Vaccination program began in 2007, as of now it is also offered to boys as part of the school vaccination program
8
Q
Cervical cancer vaccination- Gardasil: ROLE FOR THE NURSE
A
- Asking young people that you may see in practice (male and female) if they have been vaccinated
- Educate
- Are there any missed doses
- Parents permission (if under 16 and willing)
- Since its introduction we are seeing declining rates of HPV in both young men and women
- Does not replace pap smear screening for women
9
Q
Contraception- History
A
- The OCP has been in Australia since the early 60’s
Some say it has revolutionised the way women live - Freedom to work- promoted equally
- Less children- better conditions
- Less mortality from ‘backyard abortions’
10
Q
Contraception- Types
A
- The pill (OCP) 2 main types
- The combined pill (COCP)
- Contains 2 hormones and stops the ovaries releasing an egg each month
- The progesterone only pill (POCP- mini pill)
- Changing cervical mucus so that sperm cannot pass through to fertilise the egg
- The pill is about 99.7% effective if taken properly, and only 91% effective with typical used
- The POCP needs to be taken at exactly the same time every day and may cause irregular bleeding patterns
11
Q
Emergency contraception (ECP)
A
- Available “over the counter”
- Delays ovulation
- Does not interrupt an established pregnancy or harm a developing embryo or foetus if taken early in pregnancy
- Continue with other contraception such as condoms for the rest of the cycle
- Take within 5 days
12
Q
CONTRACEPTION: NURSES ROLE
A
- Ask when was LNMP, normal cycle length, when did the intercourse occur
- May need to perform a pregnancy test if possibility of pregnancy
- Educate on outcomes. Discuss longer term contraception options
- Do they need an STI screen?
13
Q
Hormonal IUD
A
- Small T-shaped device that is fitted inside uterus
- Slowly releases a low dose of progesterone over 5 years; periods usually become lighter or may stop
- 99.8% effective
- Copper IUD- affects lining of uterus- 99% efficacy
- Nurse’s role: Assess for suitability
14
Q
What about men? - TSE
A
- Testicular cancer is a rare cancer. About 690 men are diagnosed yearly. This accounts for about 1% of all cancer in Australian men
- Testicular cancer occurs most often in men aged 20-40 years
- The average age at diagnosis is 35
- All men need to regularly perform TSE
15
Q
Testicular Self Examination
A
- All men should check their testicle regularly to become familiar with the usual feel of their testicles so that they know when there is a change
- TSE only takes a few minutes and should be done every 4 weeks
- Testicle→ Small, oval shaped sex gland that produces sex hormones and sperm
- Epididymis→ A series of small tubes attached to the back of the testicle that collect and store sperm. The epididymis connects to a larger tube called the vas deferens
- Scrotum→ A skin sack that houses the testicles
- Sperm production needs a temp around 4℃ lower than the body, which is why the testicles are located outside the body in the scrotum
