Treas chapter 34- sexual health Flashcards
Sexuality
central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction
Sexual identity
is a person’s perception of his or her gender, gender identity, gender role, and sexual orientation. All of these are also a part of the person’s overall self-concept
gender
is determined at the moment of conception, when a sperm fertilizes an ovum. The ovum always provides an X chromosome.
Gender roles
are the societal norms for gender-appropriate behavior.
androgyny
refers to a blending of traditional masculine and feminine roles.
Gender identity
one component of sexual identity, is the image we have about ourselves as a man or woman. It is an internal experience: whether we “feel like” a woman or a man.
Transgender people
identify with the opposite gender from their biology
Intersexed
are born with ambiguous sexual organs. For example, the person may have female internal organs (ovaries, a uterus) but also enlarged clitoral tissue resembling a penis.
Preoperative transsexuals
are adults who alter their physical appearance through dress, makeup, and/or the use of hormones so that their external appearance corresponds to their gender identity
postoperative transsexual individual
legally changes gender. During the perioperative period in an inpatient facility, assignment to a single room is preferable.
undifferentiated sexual state
neither male nor female—until about the seventh week of pregnancy when the gonads form into either testes or ovaries.
cross-dresser
person (man or woman) who occasionally or frequently wears the clothing characteristic of the opposite sex, particularly the undergarments, as a form of sexual expression.
Sexual orientation
refers to the general tendency of a person to feel sexually attracted to people of a certain gender.
Masturbation
safe and comforting sexual activity that has neither interpersonal nor disease risks
may encounter parental, cultural, or religious disapproval of masturbation.
stats
decrease pregnancy
increase oral
increase sexual intercourse
condoms
needed for all sexual intercourse
ethnocentric—
that is, to see their own culture and sexual behaviors as the norm for all.
culture influence
gender role, gender identity, marriage, sexual expression, and social responsibilities.
infibulation
vagina sutured shut
FGM
is illegal in most countries but is still performed among certain tribes.
Religion
a powerful influence on sexuality.
lifestyle
Life experiences encompass our interactions with others and the environment. who we are raised around alters our views
abusive relationship
affect your self-concept and might cause you to avoid intimacy in the future.
Sexual Knowledge
Do not let your clients’ age, level of education, or life experiences lead you to make assumptions about their knowledge of sexuality.
assess knowledge
Heart disease or respiratory disease
may cause people to restrict sexual activity because of fatigue, dyspnea, or fear of overstressing the heart.
Diabetes mellitus
leads to neurological changes that may cause male erectile dysfunction; women may experience vaginal dryness and loss of orgasmic ability.
Mastectomy (surgical removal of a breast)
can have a significant influence on a woman’s self-esteem and negatively impact sexuality
disability
If a person becomes disabled while in a marriage or other committed relationship, the strain can threaten the partnership. In contrast, a person who is single or has a lifelong disability may experience difficulty establishing an intimate relationship because of physical limitations, social isolation, poor self-image, or discrimination.
Health and Illness
Sexuality involves body, mind, and spirit so it is not surprising that health status affects sexuality.
Mental Health Disorders
Psychiatric disorders can lead to interpersonal disruptions and difficulty with sexual expression.
psychosis,
interpersonal relationships and sexual patterns are disrupted by lack of contact with reality or frank delusions.
Depression
may avoid interpersonal activities
Mania
may be preoccupied with pleasurable activities and increased sexual activity, as well as verbalization and acting out.
Medication
Many medications used to treat health problems have unwelcome sexual side effects.
Sildenafil (Viagra)
should be used with caution in patients with cardiovascular disease
sexual health
as a state of physical, emotional, mental, and social well-being related to sexuality; it is not merely the absence of disease, dysfunction, or infirmity.
sexual health includes:
A positive and respectful approach to sexuality and sexual relationships
An openness and opportunity to have pleasurable and safe sexual experiences, free of coercion, discrimination, and violence
The respected, protected, and fulfilled sexual rights of all persons
sexual response cycle
sequence of physiological events that occur when a person becomes sexually aroused.
sexual response
total body response, involving many physiological changes (e.g., increased heart rate, flushing). The emotional and mental aspects of sexual activity are equally important to the person’s satisfaction.
erogenous zones
areas that cause sexual arousal when stimulated
Meds that decrease libido
alcohol antianxiety agents anticonvulsants antidepressants antihistamines antihypertensives chemotherapy opioids stimulants
Desire
is a stage of varying length characterized by an interest in sexual intimacy.
Libido
is an individual’s typical level of desire.
Sexual arousal
is desire that occurs with erotic stimuli such as sights, sounds, and fantasies. Desire can occur in anticipation of sexual activity or with physical stimulation.
Excitement
is the body’s physical response to desire. During excitement the following bodily changes occur: heart rate, blood pressure, and respiratory rate increase; muscles tense (myotonia)
Cunnilingus
is the oral stimulation of a woman’s genitals
Fellatio
is stimulation of the male genitals by a partner’s mouth.
Orgasm
plateau
orgasm (ejaculation)
resolution (men may experience refractory period where they cannot achieve an erection again)
paraphilias, or sexual deviation:
exhibitionism disorder, fetishism disorder, frotteurism disorder, pedophilia disorder, sexual masochism disorder, sexual sadism disorder, transvestic disorder, and voyeurism disorder.
Chlamydia Trachomatis
is the most commonly transmitted infection in the United States and is also known as the “silent infection” because the infected person may not have symptoms. Chlamydia can cause serious damage to a female’s reproductive system if untreated.
Gonorrhea
is caused by a bacterium and is common among sexually active teenagers and young adults.
Syphilis
is caused by a bacterium that is transmitted from person to person by direct contact with the syphilis sore that can occur on the external genitalia, vagina, lips, mouth, anus, and in the rectum.
Genital Human Papillomavirus, also called HPV,
is the most common STI.
Many people with HPV do not know they are infected, and in many instances the STI will go away without intervention.
There are more than 40 types of HPV and it is possible for a person to contract more than one type.
Dysmenorrhea
is painful menstruation caused by strong uterine contractions that lead to ischemia of the uterus.
Physical symptoms: Cramping, lower abdominal pain, back and upper thigh pain, headache, vomiting, and diarrhea.
Premenstrual syndrome (PMS)
is characterized by physical and emotional changes occurring 3 to 14 days before the onset of the woman’s menstrual period.
physical symptoms: Headaches, constipation, breast tenderness, and weight gain; associated with bloating, abdominal swelling, or swelling of the hands and feet.
Premenstrual dysphoric disorder (PMDD)
is a more severe form of menstrual cycle dysfunction in which women may become seriously depressed for a week or more before their periods.
Effects of Rape
In addition to psychological and physiological trauma, the rape victim is at risk for STIs and pregnancy.
Three-quarters or more of sexually assaulted teens experience post-traumatic stress disorder.
Low Libido .
(hypoactive sexual desire) manifests as a significant decrease in or absence of sexual fantasies and sexual activity
Arousal Disorders
are experienced by both men and women. In women, arousal disorders manifest as minimal or absent pelvic congestion and vaginal lubrication, even though desire may be present.
Dyspareunia
painful intercourse,
Dyspareunia women
vaginal or urinary tract infections, pelvic inflammatory disease, and endometriosis. vaginal dryness
Dyspareunia men
urinary tract infection or phimosis, a condition in which the foreskin of the penis is too tight. Balanitis, inflammation of the penis, is another cause of dyspareunia in men.
Vaginismus
is a rare female disorder affecting desire and arousal. It is characterized by intense involuntary contractions of the perineal muscles, which close the vaginal opening and prevent penile penetration.
Premature ejaculation
occurs when the male reaches orgasm and ejaculates before, at the time of, or shortly after penetration.
Retrograde ejaculation
occurs when the semen empties into the bladder instead of being ejaculated through the urethra.
Orgasmic Disorders
onditions with a delay in or absence of orgasm after a normal sexual excitement phase.
Causes for erectile dysfunction
disease of blood vessels neurological problems endocrine problems testosterone psychological problems medication
Sexual history
Reproductive history
Sexual self-concept
History of sexually transmitted infections
History of sexual dysfunction
Present sexual functioning
Other factors that affect sexuality, such as medications and diseases
Signs or symptoms of sexual abuse
Knowledge level about sex, reproduction, and contraception
teaching about body function and reproduction
A person’s age, experience, and educational level do not ensure knowledge of sexual functioning. Before you begin any teaching, explore your client’s knowledge base by asking open-ended questions
douching
Teach women that douching is unnecessary and is associated with significant risks. It can wash away the lactobacilli that clean the vagina and protect it from infection.
Odor.
To prevent odor, women should use good perineal hygiene, bathe or shower every day, and change pads or tampons frequently.
Sexual activity during menstruation.
it is not dangerous to engage in sexual activity during menstruation.
Cramping.
For mild cramping occurring before or during menses, aspirin and NSAIDs, such as ibuprofen or naproxen, are effective and can be taken unless contraindicated for other reasons.
PSM treatment
Nonpharmacological treatments. You might suggest a variety of treatments, such as: getting adequate sleep; eating small, frequent meals; reducing dietary intake of sugar, caffeine, alcohol, and salt; taking vitamin and mineral supplements; and exercising.
Medications. Selective serotonin reuptake-inhibiting drugs
breast exam
Any change in how the breasts normally look and feel should be immediately reported to the healthcare provider.
Testicular Exam
The American Cancer Society (2015) advises men that screening for testicular cancer should be a part of the annual cancer screening examination, unless certain risk factors are present
Preventing Sexually Transmitted Infections
abstinence monogamy condoms limit partners honest with sexual health history avoid exchange bodily fluids Avoid contact with genital sores or growths.
Have routine checkups for infection.
Consult a healthcare provider for diagnosis and treatment of symptoms’
Accept responsibility for your actions.
douching
Teach women that douching is unnecessary and is associated with significant risks. It can wash away the lactobacilli that clean the vagina and protect it from infection.
Odor.
To prevent odor, women should use good perineal hygiene, bathe or shower every day, and change pads or tampons frequently.
Sexual activity during menstruation.
it is not dangerous to engage in sexual activity during menstruation.
Cramping.
For mild cramping occurring before or during menses, aspirin and NSAIDs, such as ibuprofen or naproxen, are effective and can be taken unless contraindicated for other reasons.
PSM treatment
Nonpharmacological treatments. You might suggest a variety of treatments, such as: getting adequate sleep; eating small, frequent meals; reducing dietary intake of sugar, caffeine, alcohol, and salt; taking vitamin and mineral supplements; and exercising.
Medications. Selective serotonin reuptake-inhibiting drugs
breast exam
Any change in how the breasts normally look and feel should be immediately reported to the healthcare provider.
Testicular Exam
The American Cancer Society (2015) advises men that screening for testicular cancer should be a part of the annual cancer screening examination, unless certain risk factors are present
Preventing Sexually Transmitted Infections
abstinence monogamy condoms limit partners honest with sexual health history avoid exchange bodily fluids Avoid contact with genital sores or growths.
Have routine checkups for infection.
Consult a healthcare provider for diagnosis and treatment of symptoms’
Accept responsibility for your actions.
Counseling for Sexual Problems tool
PLISSIT model permission limited information specific suggesions intensive therapy
Fertility awareness (natural family planning, rhythm method)
: Intercourse only when a woman is thought to be in the infertile phase of her menstrual cycle. Has a relatively high failure rate.
Withdrawal (coitus interruptus):
Removal of the penis from the vagina before ejaculation; relatively high failure rate in preventing pregnancy.
Spermicides:
Jelly, creams, or foams placed in the vagina. Should be used with a barrier (condom) to effectively prevent pregnancy.
Contraceptive sponge:
Inexpensive; can be inserted into the vagina up to 24 hours before intercourse.
Vaginal ring
: Highly effective for preventing pregnancy; can be left in place for weeks to months (depending on type).
Oral contraceptives (birth control pills):
Highly effective for preventing pregnancy; do not interfere with intercourse; regulate menstrual flow.
Depo-Provera injections:
Highly effective for preventing pregnancy; lasts for 3 months.
Intrauterine device (IUD):
A small piece of plastic that also may contain metal or a hormone: placed through the cervix into the uterus by a healthcare provider; highly effective for preventing pregnancy.
Diaphragm:
Latex dome-shaped cup with a flexible rim that is inserted in the vagina and fits over the cervix; quite effective in preventing pregnancy if used properly with spermicide.
Cervical cup:
Silicone cup shaped like a sailor’s hat that is inserted into the vagina and fits over the cervix. Better fit in women who have not been pregnant or had vaginal deliveries. Quite effective in preventing pregnancy if used properly with spermicide
Hormonal implant:
Small rod(s) containing hormones that are inserted under the skin, usually in the back of upper arm. Safe, effective method; lasts for 3 years; can be removed at any time.
Female sterilization (tubal ligation):
Effective for preventing pregnancy; may be reversible.
Male sterilization (vasectomy):
Effective for preventing pregnancy; may be reversible in some cases.
common reasons for sexually inappropriate behaviors:
Confusion
Neurological disorders, especially those involving the frontal lobe
Mental illness
Poor impulse control
Misinterpretation of nursing care
Need to have power or control over others, especially when the client feels powerless in other aspects of his life
Worries about sexual functioning
Unrealistic view of nursing based on sexual stereotypes
