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90 Cards in this Set
- Front
- Back
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-THE DEGREE TO WHICH A PERSON EXHIBITS AND EXPERIENCE MALENESS AND FEMALESNESS PHYSICALLY, EMOTIONALLY, AND MENTALLY. SEXUALITY IS DEFINED NOT ONLY BY A PERSON'S GENETALIA AND HORMAONES, BUT ALSO BY ATTITUDES AND FEELINGS. IT CAN ALSO BE DEFINED AS LEARNED BEHAVIORS IN HOW A PERSON REACTS TO HIS OR HER OWN SEXUALITY AND BY HOW ONE BEHAVES IN RELATIONSHIP WITH OTHERS.
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SEXUALITY
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THE INTERGRATION OF THE SOMATIC, EMOTIONAL, INTELLECTUAL AND SOCIAL ASPECTS OF SEXUAL BEING, IN WAYS THAT ARE POSITIVELY ENRICHING AND THAT ENHANCE PERSONALITY, COMMUNICATION, AND LOVE.
-NURSES NEEDED TO VALUE SEXUALITY AS A CRITICAL ELEMENT OF HEALTH AND WELL-BEING |
SEXUAL HEALTH
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NAME 6 WAYS OF SEXUAL IDENTITY
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BIOLOGIC SEX
GENDER IDENTITY GENDER ROLE BEHAVIOR ORIENTATION SEXUAL ORIENTATION PREFERENCE |
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BIOLOGIC SEX
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TO DENOTE CHROMOSOMAL SEXUAL DEVELOPMENT: MALE(XY) OR FEMALE (XX, EXTERNAL AND INTERNAL GENITALIA, SECONDARY SEX CHARACTERISTICS, AND HORMONAL STATES
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GENDER IDENTITY
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THE INNER SENSE A PERSON HAS OF BEING MALE OR FEMALE, WHICH MAY BE THE SAME AS OR DIFFERENT FROM HIS/HER BIOLOGIC GENDER
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gender role behavior
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the behavior a person conveys about being male or female, which, again, may or may not be the same as biologic gender or gender identity
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sexual orientation
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the prefeered gender of the partner of an individual
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name the 5 types of sexual orientation
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-heterosexual
-homosexual -bisexual -transexual -transvestite |
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heterosexual
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one who experiences sexual fulfullment with a person of the opposite gender
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homosexual
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one who experiences sexual fulfillment with a person of the same gender.
male-gay;female-lesbian |
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bisexual
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a person who finds pleasure with both opposite-sex and same-sex partners. homo- and hetero- may have bisexual relationships at times
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transsexual
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a person of a certain biologic gender who has the feelings of the opposite sex. the person feels trapped within the body of the wrong sex. the reason behind this is unknown. many change their bodies through surgery and hormaone therapy
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transvestite
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individual who desire to take on the role or wear the clothes of the opposite sex. most trans-are hetreo-, an many keep their lifestyle hidden
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female physiology
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external genitalia-
-mons pubis -labia majora and labia minora -clitoris internal genitalia -ovaries -fallopian tubes -uterus -vagina |
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mons pubis
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a pad of fatty tissue that lies over the part of the body pelvis called the symphysis pubis. mature female-coarse hair. it contains many nerve endings that make it sensitive to touch and pressure
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labia majora
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consists of 2 rounded folds of fatty tissue. the outer lips separate downward from the mons pubis and meet again below the vaginal introitus
- contains a multitude of sebaceous and sweat glands they respond to touch during sexual activity |
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labia minora
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the smaller lips located within the labia majora. they are thin and sensitive structures and are pale pink. when stimulated by touch, may turn a darker pink or even red owing to the presence of many blood vessels. no hair and smooth
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clitoris
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found above the urinary meatus at the joining of the labia minora, called the clitoral hood. it is a small, buttonlike structure similiar to the penis in its reaction to stimuli. it contains erectile tissue, blood vessels, and nerves. it is extremely sensitive
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hymen
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a thick membrane with no apparant function. remanant of "tags" of the hymen may be present at the vaginal intoitus in both sexually active an inactive women
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ovaries
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normal female usually have 2, one on each side. they resemble an almond in size and shape. when a girl is born, each ovary contaions 200,000-400,000 follicle. this number decreases until puberty, when 100,000-200,000 follicle remain, and the number continues to decrease over the reproductive years.
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progesterone and estrogen
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the ovaries secrete these hormones
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fallopian tubes
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slender structure that extend from either side of the uterus and end in a fringed fashion near each ovary. thier function is to transport a mature ovum from an ovary to the uterus. the fertilized ovum then travels the rest of the way to the uterus, where it implants. an unfertilized ovum travels down the same path but does not implant and is eventually explelled from the body during menses. because the lumen of each tude is narrow, it can easily be damaged by the effects of infection and surgery.
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uterus
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pear shaped organ about 3" long, located between the urinary bladder and the rectum. its primary purpose is to house and nurture a pregnancy.
3 layers- 1-the outmost layer, the perimetrium, consists of elastc tissue 2-the middle layer- the myometrium, is muscular 3-the innermost layer- the endometrium, comprises tissue that thickens and sloughs off with menses. |
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cervix
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structure at the lower position of the uterus that connects the uterus and the vagina. it is usually closed, but during the birth process, it dilates and thins out extensively to permit the birth of a baby.
-smooth pink structure that possesses few nerve endings. -when touched, the sensation resemble that of touching the end of the nose |
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vagina
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-tubular, hollow organ that lies betwen the urethra and the rectum
-walls of the vagina are composed of rugae, or ribbed tissue -vagina serves: 1)a receptacle for the penis during sexual intercourse 2)a birth canal for the passage of baby 3)an exit for menstrual flow from the uterus sexual activity-the wall of the vagina secrete "sweat" a thin watery material -lubrication is necessary for the comfortable placement and movement of the penis in the vagina |
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breasts
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-not part of internal/external
-important aspect of female physical sexuality - |
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menstration
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a cycle during which the body prepare for the presence of a fertilized ovum. cycles are about 28 days long but may vary from 21 to 40 days.
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menarche
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1st menstrual period
-experienced at about 12 yrs. but could be 8-17rys |
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menopause
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the cessation of a women's menstrual activity, occurs between 45 and 55yrs
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premenstrual (tension) syndrome
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menstrual cycle-related distress, reportedly occors in 50-90% of female pop.
characterized by irritablilty, emotional tension, anxiety, mood changes, H/A, breast tenderness, and water retention |
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male physiology
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external genitalia
-testes -scrotum -penis internal genitalia testes->tubles->epididymis->vas deferens->ejactulatory ducts |
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testes
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-size of a walnut, feel smooth and are freely movable within the scrotum
-produce sperm and the hormones necessary for the maintenance of male sex characteristics (main hormone-testosterone) |
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scrotum
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-loose, baglike structure that house the testes
-looseness of the scrotum in intential to provide expansion and contraction -sensitive organ and can suffer discomfort if handled too roughly. it can be a source of sexual pleasure when lightly stroked, fondled or caressed during sexual act. |
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penis
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-a tubular structure
funtions-elminates urine,to ejaculate semen, for sexual plessure -normal amount of serum per ejactuation is 2-6ml, which inculdes 120-169million sperm |
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erogenous zones
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areas that when stimulated cause sexual arousal and desire.
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the largest erogenous zone
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the skin
-other areas ears, lips, thighs, and breasts |
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excitment phase
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initiated by erotic stimulation and arousal. physiologic changes include increased heart rate and blood pressure and the appearance of a pink flush to the skin
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plateau phase
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intensity of this is greater than the excitment phase but not enough to begin orgasm. desire and arousal continue to build and intensity. last 15-20 minutes
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orgasm phase
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defines the climax and sexual explosion of the tension that has been building over the previous phases. last only a few seconds, but very intense. consists of contractions that can number between 4 and 20. the male often ejacualtes
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resolution phase
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characterized by a return to normal body functioning present before the excitment phase. relaxation, fatigue, fulfillment, are commom
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what are the 4 phase of sexual response cycle
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-excitment
-plateau -orgasm -resolution |
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forms of sexual expression
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kissing, hugging, stroking, squeezing, breast stimulation, manual stimulation of the genitals,
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mastrubation
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technique of sexual expression in which an individual practices self-stimulation. people masturbate regardless of age, sex, or marital status
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oral-genital stimulation
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stimulation of the genitals by the mouth or tongue
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celibacy
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abstinence from genital sexual activity
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alternative forms of sexual expressions
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-voyeurism
-sadism -masochism -sadomasochism -pedophillia |
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voyeurism
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achievement of sexual arousal by looking at the body of another
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sadism
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the practice of gaining sexual pleasure while inflicting abuse on another person
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masochism
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gaining sexual pleasure from the humiliation of being abused
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sadomasochism
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act of practing saidsm and masochism together
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pedophillia
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practice of adults gaining sexual fulfillment by performing sexual acts with children
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factors affect sexuality
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development consideration- sexuality through the lifespan. from birth until death
culture-how sexaulity is perceived by a society religion- taboos, sin, marriage ethics-guilt, forms of sexual expression lifestyle- life stresses, risky behavoir childbearing consideration |
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sexuality transmitted diseases
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more that 20 have been identifed. it is important to understand at least 5 key points about all STIs in this country today
1. STI's affect men and women of all backgrounds and economic levels 2. the incidence of STI's is rising, in part because in the last few decades, people have been sexuality active earlier, yet are marrying later on 3. most of the time, ST's cause no symptoms, particularly in women 4. health problems caused by STI's tend to be more severe and more frequent for women than for men, in part because the frequency of aymptomatic infection means that many women do not seek care until serious problems have arised 5. when diagnosed and treated dearly, many STI's can be treated effectively |
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assessment of sexual history
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-any inpatient or outpatient receiving care for pregnancy, STI, infertility, or contraction
-any pt. experiencing sexual dysfunction -any pt. whose illness will affect sexual functiong and behavior in any way |
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4 levels of sexual history are:
(Watts General Levels) |
1. sexual history as part of a comprehensive health history-obtained by a nurse
2. sexual history-obtained by a nurse with education and training in sexuality 3. sexual problem history- obtained by a sex therapist 4. psychiatric/psychosocial history-obtained by a psychiatric nurse clinician |
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nursing diagnosis written to address problems of sexuality belong to one of 2 categories
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1. ineffective sexuality patterns- the state in which an individual experiences or is at risk for a change in sexual health, which results in concern regarding own sexuality. sexual health is the integration of somatic, emotional, intellectual, and social aspects of sexual being in ways that are enriching and that enhace personality, communication, and love
2. sexual dysfunction- the state in which an individual experiences or is at risk for change in sexual function that is viewed as unsatisfying, unrewarding, or inadequate |
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sexual dysfunction
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a problem that prevents an individual or couple from engaging in or enjoying sexual entercourse and orgasm. dysfunctions might occur as a result of physiologic malfunctions, conflicts with cultural norms, interpersonal problems, or any combination of these. anxieties and fears concerning the sexual act are almost always present
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male primary sexual dysfunction- impotence
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the inability of a man to attain or maintain an erection to such an extent that he cannot have satisfactory intercourse. common causes include various illness, treatment for these illnesses, and personal anxieties
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premature ejaculation
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condition in which a man consistently reached ejaculation or orgasm before or soon after entering the vagina. causes are rarely physical
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retarded ejaculation
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man's inability to ejaculate into the vagina, or delayed intravaginal ejaculation. causes are similar to impotence
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4 types of female primary sexual dysfunction
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-inhibited sexual desire
-dyspareunia -vaginismus -vulvodynia |
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male primary sexual dysfunction
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-retarded ejaculation
-premature ejaculation -impotence |
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inhibited sexual desire
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congestion and vaginal lubrication are absent or minimal. caused by anxiety, negative emotions, fear, interpersonal problems, or physical factors. it is defined as the inability of a woman to reach orgasm
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dyspareunia
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painful intercourse. causes are usually physical
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vaginismus
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rare conditions in which the vaginal opening closes tightly and prevents penile penetration. due to involuntary spastic contractions of the muscle at and around the vaginal opening and the levator ani muscles. causes may be physical, psychological, or both
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vulvodynia
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chronic vulvur discomfort or pain categorized by burning, stinging, irritation or rawness of the female genitalia that interferes with sexual activity. little is known about cause or treatment
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diabetes vs. sex
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erectile dysfuntion is a great concern. if severe, possible penile implant or pharmocologic treatment. for women, orgasmic dysfuntion, loss of vaginal lub
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cardiovascular vs. sex
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sexual response cycle can greatly increase the demands on the heart and other structures. might experience anxiety over the effect the illness will have on sexuality and sexual functioning
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HTN VS. SEX
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biggest issue is the meds used to control HPT frequently causes changes in sexual functioning. may be relieved by changing meds or doses
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MI VS. SEX
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heart needs amle time to heal. sex hould be resumed gradually, about 3 wks. into recovery, beginning with masturbation to partial erection in the male. can try sexual intercourse 3 months after recovery.
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diseases of the joints/mobility vs. sex
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pain, fatigue,stiffness, and loss of ROM can go along with many joint diseases. the disease itself does not cause the sexual dysfunction, although the manifestation of it can cause discomfort and anxiety
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surgery/body image vs. sex
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scars, changes in body image affect a person's self-perception as a sexual being
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spinal cord imjuries vs. sex
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the extent of sexual response that remains after a spinal cord injury depends primarily on the level and extent of the injury. ejaculation and orgasm are most likely to remain with low spinal injuries
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chronic pain vs. sex
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someone in constant pain might not desire any sexual contact. altered or modified positions for sex are sometimes necessary. desire for human warmth and contact does not cease because of pain
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mental illness vs. sex
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disruption in the mind functioning will no doubt play a role in sexual dysfunction
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meds vs. sex
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amyl nitrite, anticonvulsants, antidepressants, antihistamines, antihypertensives,antipsychotics, antispasmodics, barbituates, cocaine, ethyl alcohol, marijuana, narcotics
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4 questions to obtain sexual information
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1) description of the problem
2)onset and cause of the problem 3)past attempts at resolution 4)goals of the patient |
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nic/noc for ineffective sexuality patterns
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noc
role performance self esteem body image nic sexual counseling |
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nic/noc for sexual dysfuntion
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noc
abuse recovery:sexual risk control: sexuality transmitted infection physical aging status sexual identity nic sexual counseling |
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outcome identification
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-define individual sexuality
-establish open patterns of communication with significant others -deveolp self-awareness and body awareness -describe responible sexual health self-care practices -practice responsible sexual expression -adapt sexual technique as needed -identify stressors that contribute to dysfuntion |
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"plissit" model for sexual discussion
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for counseling to be used by therapists and nontherapists for patients with sexual problems
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p-permission giving
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the nurse may make a suggstion that the patient can use. permission giving is not the same as advice. permission giving is not the same as advice. permission giving implies giving the patient freedom to choose to do something that the authority figue deems to be a positive alternative. it may be something the pationt wanted to do all along
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LI-limited information
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specific factual information is required by the patient. it often invovles some aspect of anatomy and physiology or the specifics of certain sexual expressions
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ss-specific suggestions
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pt. need very specific instructions regarding a useful technigue. may pts. have a sexual dysfunction for which they are seeking intervention and correction
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it-intensive therapy
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used primarily by therapists, it involves issues such as marriage, self-concept, and sexual desire, to name a few. if the 1st 3 levels of counseling presented were unsuccessful, intensive therapy in indicated
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4 types of female primary sexual dysfunction
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-inhibited sexual desire
-dyspareunia -vaginismus -vulvodynia |
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male primary sexual dysfunction
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-retarded ejaculation
-premature ejaculation -impotence |
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inhibited sexual desire
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congestion and vaginal lubrication are absent or minimal. caused by anxiety, negative emotions, fear, interpersonal problems, or physical factors. it is defined as the inability of a woman to reach orgasm
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dyspareunia
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painful intercourse. causes are usually physical
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vaginismus
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rare conditions in which the vaginal opening closes tightly and prevents penile penetration. due to involuntary spastic contractions of the muscle at and around the vaginal opening and the levator ani muscles. causes may be physical, psychological, or both
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