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Flashcards in Chapter 35 Deck (24):
1

Sexuality has many definitions

Expression of an individual's sexuality is influenced by interaction among biological, sociological, psychological, spiritual, economic, political, religious, & cultural factors
-values, attitudes, behaviors, relationships with others, & the need to establish emotional closeness with others influence sexuality

2

Sexuality differs from sexual health

Sexual health: State of physical, emotional, mental, & social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity

3

Sexual development in infancy and early childhood

-first 3 yrs of life crucial in development of gender identity
-child identifies w/parent of same sex & develops complementary relationship w/parent of opposite sex
-children become aware of differences between sexes & begin to perceive that they are either male or female, & interpret the behaviors of others as appropriate for a male or female

4

Sexual development in school-age years

-parents, educators, & peer groups serve as role models & teachers for how men & women act & relate to one another
-need accurate info about changes in their bodies & emotions during this time period & what to expect going into puberty
-knowledge decreases anxiety

5

Sexual development in puberty/adolescence

-emotional changes are dramatic as physical ones
-time when they explore their primary sexual orientation
-may identify w/sexual minority group (lesbian, gay, bi, trans)
-LGBT individuals at higher risk for depression, suicide, abuse of tobacco, alcohol, and drugs than the general public
-risky behavior tends to continue through life

6

Sexual development in young adulthood

-matured physically but continue to explore & mature emotionally in relationships
-at times young adults require support and education or therapy to achieve mutually satisfying sexual relationshiops

7

Sexual development in middle adulthood

-concerns about sexual attractiveness
-physical changes due to aging affect sexual functioning
-decreasing levels of estrogen in perimenopausal women lead to diminished vaginal lubrication & decreased vaginal elasticity. Both of these changes lead to dyspareunia (occurrence of pain during intercourse)
-decreased levels of estrogen may also result in a decreased desire for sexual activity
MEN: increase in the postejaculatory refractory period & delayed ejaculation
-when children leave home intimate relationships changes

8

Sexual development in older adulthood

-Positive correlation between sexual activity and physical health
-many are sexually active in engage in high risk sexual encounters which leads to HIV & STI rates over the past 12 years
-factors that determine sexual activity in older adults include: present health status, medications, past & present life satisfaction, status of marital or intimate relationships
-sexual activity is normal in later years but is not essential to maintain quality of life
-excitement phase prolongs in both men & women & it takes longer for them to reach orgasm.
-the refractory time following orgasm is longer
-both experience a reduce availability of sex hormones
-men often have erection that are less firm and shorter acting
-women usually do not have difficulty maintaining sexual function unless of a medical condition that impairs their sexual activity
-infrequency of sex in older women related to age, health, & sexual function of their partner

9

Sexual orientation

-Describes the predominant pattern of a person's sexual attraction over time
-LGBT experience decreased access to health care & do not readily seek preventive care

10

Contraception

-provide varying levels of protection against unwanted pregnancies
-some require prescription, others do not
-methods that are effective for contraception do not always reduce risk of STIs

11

Nonprescription contraceptive methods

-abstinence
-barrier methods: OTC spericidal products & condoms, diaphragm
-timing of intercourse w/regards to the woman's ovulation cycle: rhythm, basal body temperature, cervical mucous, fertility awareness methods
-

12

Contraceptive methods that require a health care provider's intervention

-hormonal contraception: several forms (pills, rings, injections, subdermal implant, transdermal skin patches, IUDS)
-IUDs: Copper or progesteron; they stop the sperm from fertilizing an egg
-diaphragm: round, rubber dome that has a flexible spring around the edge. Used with contraceptive cream/jelly & inserted into vagina. Woman needs to be refitted after significant change in weight (10lbs gain/loss) or pregnancy
-cervical cap: functions like diaphragm; but covers only cervix. May be left in longer
-sterilization or tubal ligation or vasectomy

13

Sexually transmitted infections: Approximately 20 million people in the united states are diagnosed with an STI each year

-Highest incidence occurring in men who have sex w/men, bisexual men, youths between ages 15-24
-blacks and hispanics are diagnosed w/STIs more frequently than whites
-women have more complications associated with STIs than men

14

Treatment of STIs in America costs about $16 million annually. Commonly diagnosed STIs include

Syphilis, gonorrhea, chlamydia, trichomoniasis, & infection with the human papilloma virus (HPV) & herpes simplex virus (HSV) type II (genital warts, genital herpes)

15

Gonorrhea, chlamydia, syphilis, and pelvic inflammatory disease (PID) are caused by?

Bacteria & are usually curable with antibiotics

16

HIV

-Bloodborne pathogen present in most body fluids
-sometimes spread through sexual contact
-transmission occurs when there is an exchange of body fluid
-primary routes of transmission: contaminated IV needles, anal intercourse, vaginal intercourse, oral-genital sex, transfusion of blood & blood products
Three Steps of progression
1) primary infection stages lasts 1 month after contacting virus. Flu-like symptoms
2) Clinical latency phase: no symptoms of infection. HIV antibodies appear in blood 6 weeks-3 months after infection
3) Acquired immunodeficiency syndrome (AIDS): when person shows symptoms of disease.
-Highly active antiretroviral therapy (HAART) & having an experienced HIV clinician greatly increase survival time
-if left untreated people will live about 10 years

17

Human Papillomavirus Infection (HPV)

-Most common STI in the states; 14 million new infections each year
-most infections asymptomatic & self-limiting
-certain types can cause cervical cancer in women & anogenital cancers & genital warts in both men & women
-spread through direct contact w/warts, semen, & other body fluids from others who have the disease

18

The bacteria Chlamydia trachomatis causes chlamydia

-most commonly reported infectious disease in the US affecting 3 million each year
-spread by contact with fluids from infected site
-can be transmitted during birthing process & cause conjunctivitis & pneumonia in newborns
-frequently infects cervix & if untreated can cause PID, ectopic pregnancy, & infertility from damage to female reproductive organs
-causes few symptoms so some people may not know they have it so the CDC recommends screening for all sexually active women up to age 25
-high risk populations are those with multiple sex partners or infected with other STIs & men who have sex with men

19

Sociocultural dimensions of sexuality

-each culture has own set of rules & norms that guide sexual behavior, sexual health, & willingness to discuss

20

Female sexual interest tends to fluctuate during pregnancy

-Increased interest during second trimester & decreased interest during first and third trimester
-decrease in libido during first trimester because of nausea, fatigue, & breast tenderness
-during second trimester, blood flow to pelvic area increases to supply placenta, resulting in increased sexual enjoyment & libido
-during third trimester the increased abdominal size makes finding a comfortable position diffucult

21

The incidence of erectile dysfunction (ED) increases with age but can occur in men under 40. Risk factors are similar to those for heart disease

-Diabetes mellitus
-hyperlipidemia
-HTN
-hypothydroidism
-chronic renal failure
-smoking
-obesity
-alcohol abuse
-lack of exercise

22

Illnesses that affect sexual functioning

-Diabetes mellitus
-Cancer (prostate, breast, colon, ovarian, testicular, rectal)
-Neuropathy
-Spina bifida
-Spinal cord injury
-Unstable angina
-Uncontrolled HTN
-COPD
-HIV
-Substance abuse
-Depression

23

Medications that affect sexual functioning

-Antihypertensives
-Antipsychotics
-Antidepressants
-Antianxiety
-Diuretics
-Oncological agents
-Recreational or illicit drugs

24

PLISSIT Assessment of Sexuality

Permission to discuss sexuality issues
Limited Information related to sexual health problems being experienced
Specific Suggestions- only when the nurse is clear about the problem
Intensive Therapy-referral to professional with advanced training if necessary