Sexuality Flashcards
sexuality should be included in what type of assessment?
quality of life
what should be included in sexuality education?
possible changes in sexual function because of treatment, anticipatory guidance and suggestions for adapting to the changes expected
integrating the somatic, emotional, intellectual and social aspects of a sexual being is the definition of what?
sexual health
what are the components of the PLISSIT model for sexuality counseling?
P: permission
LI: limited information
SS: specific suggestions
IT: intensive therapy
one way for a nurse to give permission to the patient to discuss sexuality is by doing what?
initiate the discussion of sexuality and how the treatment may affect sexuality
what patient believes must be taken into account when giving specific suggestions about sexuality?
cultural and religious beliefs, value systems
what trimester of pregnancy is generally the safest to give chemotherapy?
2nd or 3rd
what country septums have a potential for infection in the neutropenic patient?
intrauterine devices IUDs, diaphragm
which contraceptive is not recommended in patients that have hormone dependent cancers?
hormonal birth control pills
which types of chemotherapy must be avoided during the first trimester of pregnancy?
antimetabolites, alkylating agents, folic acid antagonists, radio labeled monoclonal antibodies
can radiation therapy be given to pregnant women?
radiation therapy is usually delayed until after delivery, but can be given if fetus can be shielded
besides treatment for cancer, what other considerations must be made in the pregnant patient?
the type of diagnostic workup and follow-up tests that need to be done
is a CT scan or MRI more desirable in the pregnant patient?
MRI, because there is not radiation exposure
what types of blood tests may not be accurate in the pregnant patient?
serum tumor markers
what risks are increased in the fetus when chemotherapy is given?
low birth rate, mutagenesis, teratogenic effects
what risks should be assessed for the patient receiving active treatment?
thrombocytopenia, disseminated intravascular coagulation, premature delivery
what risks need to be addressed if a mother wants to breastfeed while receiving chemotherapy?
potential for immunosuppression, neutropenia to the baby, unknown effect on growth, possible risk of carcinogenesis
breast radiation may cause what problem to the breastfeeding mother?
decreased or no breast milk
what chemotherapy drugs suppress good gonadal function?
lomustine, doxorubicin, melphalan
men receiving treatment for Hodgkin’s disease with Adriamycin, Bleomycin, vinblastine, and dacarbazine usually recover fertility true or false
true
how long may it take for reversal of fertility after receiving chemotherapy?
as long as four years
high-dose chemotherapy has a low rate of permanent sterility true or false
false there is a high rate of permanent sterility
does tamoxifen use decrease pregnancy risk?
no, and effective birth control needs to be taken during and two months after tamoxifen therapy
what dose of radiation therapy to the pelvis leads to permanent sterility in males?
> 500 cGy
what dose of radiation therapy to the pelvis leads to permanent sterility in females under the age of 40?
20 gy fractionated
what surgical procedures may lead to changes in sexuality?
orchiectomy, penectomy, prostate surgery affecting the prostatic nerve plexus, prostatectomy, hysterectomy
what is oophoropexy and how may it help prevent infertility?
it is the surgical fixation or suspension of an ovary and it may make it possible to avoid radiation to an ovary
what may be done to help preserve male fertility?
freezing stem cells from testicular tissue of pre-pubertal males, sperm banking, shielding of gonads during radiation
what type of counseling may be necessary for someone that loses fertility
grief
what effects on sexuality May Androgen suppressive therapy have in males?
gynecomastia, feminization, erectile dysfunction, decreased fertility, penile atrophy, decreased libido
what are the effects of hormonal therapy of women?
decreased vaginal lubrication, change in libido, masculinization, amenorrhea, menopausal symptoms
what is the etiology of radiation induced sexual dysfunction?
fibrosis to the blood vessels and tissues
how do neuropathies affect sexuality?
is the ability to touch and feel partner
a prostate ectomy may lead to what problems in sexuality?
retrograde ejaculation, erectile dysfunction, diminished orgasm intensity, incontinence
an orchiectomy may lead to what problems associated with the male genitalia?
trophy of the penis, they also decreased libido because of decreased testosterone
a cystectomy may cause sexual dysfunction in men or women. What are the potential problems?
loss of vaginal lubrication or erectile dysfunction because of nerve damage, change in vaginal diameter and length
mastectomy / lumpectomy may lead to sexual dysfunction because of what Associated changes?
numbness and affected breast, phantom pain in mastectomy patients, changes in body image
how does head and neck surgery affect sexuality?
body image changes, changes in speech and communication, may not be able to move head, change and smell / taste, drooling
what issues related to sexuality need to be discussed prior to or following ostomy surgery?
body image, decreased lubrication and blood flow due to vascular changes, odor
a hysterectomy may cause what sexual changes in a woman?
Phantom uterine contractions, decreased libido and lubrication, Scar Tissue may cause discomfort with intercourse, body image
what are the psychological factors that affect sexuality?
anxiety, fear, depression, change in affect / personality, grief, guilt, body image changes
what are some physiological factors that may affect sexuality?
fatigue, pain, sleep deprivation, constipation / diarrhea, alopecia, fistulas, neuropathy, lymphedema, decreased vaginal lubrication, menopausal symptoms ECT.
besides medications that manipulate hormones, what other medications may affect sexuality?
narcotics, sedatives, anticholinergic, benzodiazepine, antidepressants
what medical interventions are available to help improve sexual functioning?
pelvic floor muscle exercise biofeedback, penile implants, penile injections, vacuum devices, vaginal reconstruction
