Nurs 114 Sexuality Week 4
A client informs the nurse that he has been having difficulty sustaining an erection. Which statement made by the client demonstrates to the nurse that the client understands what a contributing factor to his erectile dysfunction is?
"I should stop smoking cigarettes. I have been smoking for 20 years."
The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching?
"I will need to find an appropriate punishment for him if this continues."
Gynecologic health is an important part of a woman's health history. Which statement best illustrates the way to begin a menstrual history?
"I'd like to ask you some questions about your menstrual periods."
The mother of a 4-year-old child is concerned that she caught him masturbating in the bath tub. Which is the most appropriate response by the nurse?
"Masturbation is a normal part of preschool development."
A 16-year-old has come to the clinic and asks to talk to a nurse. The teen states that she has become sexually active and is concerned about getting HIV. The teen asks the nurse what she can do to keep from getting HIV. What would be the nurse's best response?
"Other than abstinence, only the consistent and correct use of condoms is effective in preventing HIV."
A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurse's best response?
"Tampons need to be changed every 4 to 6 hours."
A nurse is assessing a 10-year-old girl. The girl's parent informs the nurse that the parent is concerned about the daughter's breasts. The nurse assesses the breasts and notes the areola and nipple protrude slightly. Which statement by the nurse is an appropriate response?
"The changes in your daughter's breasts are the first signs of puberty
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why do my hands get puffy and I gain weight right before my periods?" Which statement is an appropriate response by the nurse?
"The level of estrogen increases in your body before your period, and this causes fluid retention."
The staff at a long-term care facility have made minimal effort to secure a shared room for a couple in their late 80s, who have been married for several decades. The manager states, "I'm sure that bedroom activity is the last thing on their mind these days." How should the nurse best respond to the manager's characterization of sexuality in older adults?
"They might not be as active as in years past, but sexuality is still important for older people."
An older adult female comes in to the clinic for her yearly gynecologic appointment and informs the nurse that she is having pain when having intercourse with her spouse. The client has been postmenopausal for at least 5 years. What is the nurse's best response?
"This is caused by a decrease in estrogen levels, but there are things that you may be able to use to help."
The nurse is teaching a group of fifth-grade girls about menstruation. One of the students asks, "Will I have periods the rest of my life?" Which statement is an appropriate response by the nurse?
"You will have periods until you are about 48 to 55 years of age."
Sexuality Birth to 7
-Baby b get erections & g have vaginal lubrication -Discovery of genitals-not a sexual arousal. -learns their gender and they begin to have awareness between girls and boys. -Often engages in curiosity play. -Attitudes and behaviors of family members are vital in shaping sexuality as each child begins to form a gender identity. -Positive physical contact facilitates the quality of relationships during early childhood and is instrumental in shaping sexual and emotional relationships later in life.
A nurse is planning strategies to address factors that affect sexual dysfunction in older adults. Which interventions would be appropriate? Select all that apply.
-Educate older adult clients, intimate partners, and family about the sexual side effects of specific medications. -Assist in attitude and value clarification about substance use, sexuality, and sexual behavior. -Encourage older adult clients to have a thorough physical evaluation by a health care provider. -Provide an open, nonjudgmental response when older clients display a need for warmth, close contact, and companionship.
Hormone Replacement Therapy (HRT)
-Medication that contains estrogen or estrogen and progestin combined. •Treatment should be individualized. •Low doses are most effective with hot flashes and vaginal dryness. •Risk of blood clots increase. •Increased risk of breast cancer •Contraindicated in women with a history of breast cancer, vascular thrombosis, impaired liver function, uterine cancer, and undiagnosed abnormal vaginal bleeding.
Infertility Male
-Motility, density, number, and other characteristics of sperm. -Varicose veins around the testicle. -Retrograde ejaculation or ejaculation into the bladder.
Menopause 45-55 years of age
-Ovaries and uterus become smaller. -Vagina decreases in size and becomes drier. -Dry skin -Periods become irregular. -Moodiness -Nervousness -Insomnia -Headaches -Irritability -Anxiety -Poor concentration -Depression -Hot flashes
9-10 Years of Age
-Physical changes/Puberty begins around age 10 -Girls start developing breast buds -Both boys and girls start developing pubic hair -Increase testosterone in boys and estrogen in girls as their adrenal glands start to mature.
Pre Adolescence 8-12
-Social division of boys and girls into separate groups. -Sexual curiosity and learning occurs between children of the same sex. -First menstrual period starts around age 12 on average.
SOAR
-Stop-Increase awareness -Observe-Recognize and non verbal na dveryal of trafficking -Ask -Respond
sex trafficking, can occur in their own home <boys and girls>
-the recruitment and control of persons for sexual exploitation -not answering -bruises on their body
A nurse suspects that a client may be experiencing post-traumatic stress disorder (PTSD). Which assessment finding would help support the nurse's suspicion?
. . Client was a victim of a rape and beating
5 P's
1.Partners 2.Practices 3.Protection from STIs 4.Past history of STIs 5.Prevention/pregnancy
When a woman asks the nurse at what age menopause usually occurs, what should the nurse respond?
48 to 55 years of age
The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by John, a 22-year-old male, who eventually discloses to the nurse that, while he enjoys having sex with his girlfriend, he also has experienced pleasurable sex with males. The term for this behavior is which of the following?
Bisexual
Adolescence (13-19 Years)
Boys:Nocturnal emissions (spontaneous orgasm), or "wet dreams", Changes in voice, Testes and scrotum increase in size; covering skin becomes darker, Continued hair growth, sweating. Girls: Menses begins usually within 2 years of breast development, Periods may be irregular,Embarrassing moments related to unexpected bleeding. -All teens want to know about sex but often feel uneasy talking to their parents. -vIn the last decade teens at younger ages have started sexual experiments more frequently.
ED Treatmeants
Can be medical, surgical, or both depending on the cause. --Treatment of associated disorders. --Adjustment of medications. -Medications such as Viagra, Levitra, or Cialis. -Penile Implants -Lifestyle changes.
A female client is infected with human papillomavirus (HPV) following unprotected sexual intercourse. The nurse prepares to teach the client about the risk of developing which cancer?
Cervical
A 50-year-old man has a long history of type 1 diabetes, which is poorly controlled. What does diabetes greatly increase the man's risk of experiencing?
ED
A nurse is taking care of a teenager who reports involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client?
Educate the client about the changes that occur during adolescence
polycystic ovary syndrome (PCOS)
Endocrine disorder; infrequent menses; higher then normal androgen levels; insulin resistant; obese or overweight
urse is working with a young woman who has been diagnosed with premenstrual syndrome (PMS) to develop a plan to alleviate her symptoms. Which of the following would be most appropriate to include in this plan?
Engaging in a regular exercise program
If a male has a history of impaired blood flow in his vascular system, he may be prone to developing:
Erectile dysfunction
A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patient's health history is HRT contraindicated?
History of vascular thrombosis
A nurse is reviewing the history of a client who is experiencing difficulty sustaining an erection. Which of the following might the nurse suspect as a possible contributing factor?
Hypertension
he nurse is caring for a client who has been told that he is HIV infected. The client asks the nurse, "Can my partner and I ever have sex again?" What is an appropriate response by the nurse?
If you use latex condoms with water-soluble lubricant consistently, sex is safer, but not completely risk-free."
Sex History
Just use the time you are already doing a health history to add that info -Pt interview -Physical Exam -Diagnostic Tests -Awareness of vulnerable at risk groups
How to take take history
Listen Remain non judgemental maintain respect
Infertility Women
Often associated with a complex physical problem with causes related to endometriosis, uterine factors, anovulation, tubal obstruction.
A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks the nurse about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. What reminders should the nurse give to the mother for when she discusses sex?
Promote open lines of communication; listen instead of lecture; and share family values.
Which dinner selection demonstrates an understanding of nutritional therapy used by women to decrease the signs and symptoms of menopause?
Wheat toast, apple slices, broiled chicken breast, and steamed carrots
Young and Middle Adulthood
Young Adulthood -Starting to have intimate relationships with long-term implications. -Concerned about normal sexual responses regarding themselves and their partners. -Sexual needs and preferences may change. -Couples should develop positive communication skills about each other's desires. Middle Adulthood -Decreased hormone production that causes the transitional phase of their productive lives. -Sexual self-concept, body image, and sexual identity often happen due to the hormone changes. -Women begin perimenopause stage which leads to menopause. -May experience "empty nest syndrome".
Endometriosis
a condition in which patches of endometrial tissue escape the uterus and become attached to other structures in the pelvic cavity
Amenorrhea
absence of menstruation
Best way to not have sex or get an STI
abstinence
Alteration of sexual function
age, disabilities, abuse
A woman tells the nurse she has difficulty achieving orgasm. Orgasm in females results mainly from which stimulus?
clitoral stimulation
AIDS (acquired immune deficiency syndrome)
didn't know what it was or is being afraid to take care of a eperson
Conception to life span
family and environment Sexual wellbeing to dysfunction
Perimenopause
he period around menopause that lasts between 3 and 6 years before the last menstrual period. Around the age of 35.
A client, age 42, visits the gynecologist. After examining the client, the healthcare provider suspects cervical cancer. What will be most important for the nurse to include in assessing the client's health history?
history of human papillomavirus infection
erectile dysfunction (ED)
impotence; the inability of the male to achieve or maintain a penile erection*medication Anxiety Fatigue Depression Pressure to perform sexually Negative body image Absence of desire Privacy Trust and relationship issues Cardiovascular disease Endocrine disease Obesity Hyper/Hypothyroidism Pelvic or genital area trauma Alcohol Smoking Drug abuse Medications
Infertility
is the inability to achieve pregnancy after 1 year of unprotected intercourse. Treatment depends on the cause of the problem
Sexuality
legal sexuality goes along with hunger and thirst how we express ourselves ** Body, mine and spirit emoitnal
gynecomastia
mens breast tissue/breast enlargement in the male
Dysmenorrhea
pain caused by uterine cramps during a menstrual period
Sex in elders is normal
respect and expect that they still have sex Allow Them to have their needs and intimacy is sexuality
Perimenopause
the term used to designate the transition phase between regular menstrual periods and no periods at all
HPV Vaccine
up to age 26, 3 vaccines *preventative*
A nurse is caring for a male client with gonorrhea. The client asks how he can reduce his risk of contracting another sexually transmitted disease (STD). The nurse should instruct the client to:
wear a condom every time he has intercourse
A male client with gonorrhea asks the nurse how he can reduce his risk of contracting another sexually transmitted infection. The client is not in a monogamous relationship. The nurse should instruct the client to do what action?
wear a condom every time he has intercourse.
Cultural consideration
what does the culture say i.e. Hasidic Jews use a sheet fo interocurse
Personal
you have to be able to look at what someone elses stye is subjective
