Chapter 34: Sexual Health

Sexuality

central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction

Sexual ientity

a person's perception of his or her gender, gender identity, gender role and sexual orientation.

gender

biological sex status

Gender roles

the societal norms for appropriate behavior.

androgyny

blending of traditional masculine and feminine roles

gender identity

the image we have about ourselves as a man or women. An internal experience.

transgender

differently gendered, when a person forms a gender identity that is not the same as their biological gender.

preoperative transsexuals

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

after sex reassignment surgery, person legally changes gender.

Intersexed

people who are born with ambiguous sexual organs.

cross-dresser

a person who occasionally or frequently wears the clothing characteristic of the opposite sex, particularly the undergarments, as a form of sexual expression.

sexual orientation

the general tendency of a person to feel sexually attracted to people of a certain gender.

heterosexual

attracted to the opposite sex

homosexual

attracted to the same sex

bisexual

attracted to both sexes

serial monogamy

partners are mutually faithful but make no lifelong commitment.

ethnocentric

people who see their own culture and sexual behaviors as the norm for all.

Sexual Health

a state of physical, emotional, mental, and social well-being in relation to sexuality

sexual response cycle

the sequence of physiological events that occur when a person becomes sexually aroused.
4 stages: excitement, plateau, orgasm, resolution

An 18-year-old comes to the clinic requesting birth control pills. When discussing sexual health, what action should the nurse take first?
Urge the teen to practice healthy sexual behaviors.
Inform her about the risk of pregnancy and STIs.
Assess the teen

Assess the teen's knowledge of sexuality and reproduction.

The nurse needs to open a dialogue about a client's sexual health. What should be the nurse's first action?
Recognize personal biases or experiences related to the client's sexuality.
Perform a comprehensive physical assessment.
Collect a comprehensive se

...

The nurse is conducting a sexual history with a client scheduled for cardiac surgery who has voiced concern about resuming sexual activities after surgery. Which statement by the nurse is best?
"You can have sexual intercourse after your surgery, but ther

You are expressing a very normal concern; perhaps we could discuss your feelings further.

Nathan and Monica are teens who are in love. Their relationship is becoming more physical, and they tell the nurse they like to lie next to each other while undressed.
What is the priority teaching need?
Self-examination
Premenstrual Syndrome
Douching
Con

Contraception
(The nurse cannot assume that everyone has the same level of sexual knowledge, despite age and educational background. Before beginning the teaching session, determine what Nathan and Monica do know about their bodies and reproduction. The n

Shari comes to the clinic and says she feels "unclean down there" and that over-the-counter products are not helping the odor.
What is the priority teaching need?
Make the Connection. Drag and drop proper term that is best exemplified by each case scenari

Douching

A nurse has agreed to speak to her daughter's Girl Scout troop about their changing bodies. The girls are all 10 years old.
What is the priority teaching need?
Self-examination
Premenstrual Syndrome
Douching
Contraception
Menopause
Preventing Sexually Tra

Menstruation

Susan commonly misses a day or two of work each month because of severe headaches and cramping prior to her menstrual cycle.
What is the priority teaching need?
Self-examination
Premenstrual Syndrome
Douching
Contraception
Menopause
Preventing Sexually Tr

Premenstrual Syndrome

Miranda, a woman in her late 40s, comes to the clinic saying she is having difficulty sleeping and is experiencing night sweats.
What is the priority teaching need?
Self-examination
Premenstrual Syndrome
Douching
Contraception
Menopause
Preventing Sexuall

Menopause

Hector is a 14-year-old at the clinic for his annual exam and discussion of preventive health measures.
What is the priority teaching need?
Self-examination
Premenstrual Syndrome
Douching
Contraception
Menopause
Preventing Sexually Transmitted Infections

Self-examination

Walter, a 72-year-old widower, is enjoying meeting new women in his senior community. He shares with the nurse that he hasn't had this type of sex life since before he was married.
What is the priority teaching need?
Self-examination
Premenstrual Syndrome

Preventing STI's

The nurse is educating a client about the douching. What should be included in the conversation? Select all that apply.
Works well for vaginal odor
Must be at room temperature
Increases risk of infection
Does not prevent pregnancy
Washes away the normal f

Increases risk of infection
Does not prevent pregnancy
Washes away the normal flora

A client tells the nurse she is frustrated with how she feels before each menstrual cycle. What suggestions could the nurse make to improve the symptoms? Select all that apply.
Three balanced meals a day
Regular exercise
Increase caffeine intake
Avoid alc

Regular exercise, avoid alcohol, avoid salt.

The nurse is educating a group of teens about contraception. What options are available? Select all that apply.
Birth control pills
Spermicides
Depo-Provera injections
Diaphragm
Intrauterine device

Birth control pills
Spermicides
Depo-Provera injections
Diaphragm
Intrauterine device

Shoshana, a sexually active young woman, has a difficult time discussing her sexuality with the nurse. What could be some reasons for this? Select all that apply.
Her culture considers sex outside of marriage wrong.
She's never had an open discussion abou

Her culture considers sex outside of marriage wrong.
She's never had an open discussion about sex.
She is embarrassed about her sexually activity.

Which statement by the nurse would be supportive in opening a dialogue about sex?
"It's common for people to feel sexually frustrated after this type of illness."
"You can expect changes in your libido from this medicine."
"Next, I have to ask you about y

You can expect changes in your libido from this medicine.

Menstrual phase

the phase of the menstrual cycle during which menstruation occurs, the uterus sheds the endometrial lining and several ovarian follicles develop.

follicular phase

phase of menstruation that begins on first day of menstrual bleeding, ends with ovulation, associated with growth of ovarian follicles and regrowth of the endometrium.

ovulatory phase

menstruation phase where a surge in LH and FSH occurs, follicle ruptures and egg is released for fertilization

luteal phase

phase of menstruation that if fertilization occurs, the endometrium thickens to support an embryo
If fertilization does not occur, progesterone levels drop, and menses begins.

Desire

stage of sexual response cycle characterized by an interest in sexual intimacy. occurs in the mind and is communicated verbally or through body language.

libido

an individual's typical level of desire.

sexual arousal

occurs with erotic stimuli such as sights, sounds and fantasies.

Excitement

the body's physical response to desire. increased heart rate, blood pressure, and respiratory rate increase

myotonia

muscle tension

Vasocongestion

genital and pelvic blood supply increase

Plateau phase

phase in human sexual response in which stimulation continues, The person may achieve, lose, and regain this phase several times without experiencing orgasm.

paraphilias

sexual deviations

dysmenorrhea

Physical symptoms: Cramping, lower abdominal pain, back and upper thigh pain, headache, vomiting, and diarrhea.
Treatments: Bedrest, application of heat to the back and abdomen, and analgesics such as aspirin and other NSAIDs, for example, ibuprofen or na

premenstrual syndrome (PMS)

Physical symptoms: Headaches, constipation, breast tenderness, and weight gain; associated with bloating, abdominal swelling, or swelling of the hands and feet.
Emotional and social symptoms: Some women feel as though they are on an emotional roller coast

premenstrual dysphoric disorder (PMDD)

a more severe form of menstrual cycle dysfunction in which women may become seriously depressed for a week or more before their periods.

Rape

nonconsensual vaginal, anal, or oral penetration. It occurs through force, by the threat of bodily harm, or when the victim is incapable of giving consent.

Dyspareunia

painful intercourse

vaginismus

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.

Erectile dysfunction (ED)

sexual arousal disorder in men. Formerly known as impotence, is the persistent or recurring inability to achieve or to maintain an erection sufficient for satisfactory sexual performance.

hormone replacement therapy (HRT)

remains the most effective treatment to relieve symptoms of menopause, such as itching, dryness, discomfort with intercourse, hot flashes, sleep disturbances, and other symptoms.

Human Papillomavirus (HPV)

sexually transmitted disease that is often asymptomatic and found on routine pap smears.

abstinence

no sexual intercourse. Only method of contraception considered 100% effective.

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.

Condoms

relatively inexpensive form of contraception and protects against STIs

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

Type of contraceptive that is 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.