NSG 170 sexuality
cervical cap
a rubber cap that fits over the cervix, used with spermicide to prevent conception. must be fitted. increased risk for TSS. must remain in place for 6 hours after sex
hormone injections
a three-month injectable shot, regulates menstrual cycles, no protection against STIs
Menopause symptoms
*HAVOCS* *Hot flashes *Atrophy of the *Vagina *Osteoporosis *Coronary artery disease *Sleep disturbances
Which statement indicates a client understands transmission of the human immunodeficiency virus (HIV)? - I can contract HIV by participating in oral sex - I can contract HIV by eating from used utensils - HIV is contracted by using contaminated needles - I can contract HIV by using the bathroom of a person who is HIV positive - babies can contract HIV because of contact with maternal blood during birth
- I can contract HIV by participating in oral sex - HIV is contracted by using contaminated needles - babies can contract HIV because of contact with maternal blood during birth
Which response would the nurse provide to the mother questioning why her teenage daughter was foolish and became pregnant despite several discussions with the mother about birth control? - apparently your daughter wasn't listening to you - you should have made sure that her boyfriend understood birth control too - teenagers often fail to use birth control because they forget to discuss it with their sexual partners - although teenagers can intellectually discuss birth control, they often don't believe that they become pregnant
- although teenagers can intellectually discuss birth control, they often don't believe that they become pregnant
Organic Erectile Dysfunction
- failure to achieve a spontaneous erection (*NEUROGENIC*) gradual deterioration of function
Which guideline is useful for reducing disparity when caring for transgender clients? - learning about health care needs of homosexual clients - always referring to transgender clients using pronouns of the sex with which they were born - always referring to transgender clients using pronouns of the sex with which they transition - learning about the treatment options for transgender clients and requirements of follow-up care
- learning about the treatment options for transgender clients and requirements of follow-up care
Which initial response would the nurse make during a routine yearly physical to an older adult who says "I haven't had sex lately because I can't get an erection anymore"? - let's discuss this concern a little more - be sure to tell your primary healthcare provider about this problem - there is medication available for ED - this is an expected physiological response to getting older
- let's discuss this concern a little more
The Joint Commission recommendations for creating safe and welcoming environment for LGBTQ?
- posting a client's bill of rights and nondiscrimination policies visibly - providing information on special health care concerns for LGBTQ clients - avoiding assumptions about any client's sexual orientation and gender identity - arrange an all inclusive waiting room
Which disadvantage of the diaphragm for birth control would be emphasized to the client receiving instruction from the nurse regarding family planning methods? - its failure rate is 50% when it is used alone - it is physically uncomfortable when in place - thrombus formation and pulmonary emboli may occur - some women find its insertion and removal inconvenient
- some women find its insertion and removal inconvenient
Which should be included in a teaching plan about condom use?
- the condom must be positioned after an erection has occurred - the condom should be checked
Osteoporosis treatment
-Calcium/vitamin D supplementation (prophylaxis) -Increased weight-bearing exercise -bisphosphonates, calcitonin, denosumab (treatment) -Hormone (estrogen) replacement therapy (HRT) slows bone loss
Which information would the nurse include as part of the teaching plan for the client requesting information on different methods of contraception?
-Withdrawal methods does not work -IDU are left in place for 3-10 years -natural family planning relies on temp - hormonal/non hormonal
sex-linked dominant
-father carries the abnormal X gene: daughters will inherit the disease and none of his sons will have it -mother carries the abnormal X gene, half of all their children (daughters and sons) will inherit the disease tendency
Which risk factors associated with IUD use would the nurse include in the discussion of an IUD with a client? expulsion of the device risk for infection during insertion delay of return to fertility risk for perforation of the uterus increased incidents of vaginal yeast infections
-risk for perforation of the uterus -expulsion of the device -risk for infection during insertion
Trisomy
3 copies of a chromosome (down syndrome)
vaginal ring (NuvaRing)
3 weeks at a time, no fitting needed, regulates menstural cycles, expulsion/discharge/irritation, no protection against STIs
average age for menopause
45-50 years old
Pedigree
A diagram that shows the occurrence of a genetic trait in several generations of a family.
sex-linked recessive
A male will be affected, because he carries only one X chromosome. A female carrying a mutation in one gene, with a normal gene on the other X chromosome, is generally unaffected Ex: hemophilia and color blindness
Genotype
An organism's genetic makeup, or allele combinations.
Acyclovir (Zovirax)
Antiviral; 7-day course for genital herpes outbreak
Reportable STIs
HIV/AIDS, gonorrhea, syphilis, chlamydia, pediatric STIs
assessment for ED
Hx (sexual/medical), symptoms, physical exam, neuro exam, assess medications/drugs/alcohol, doppler probe, nerve conduction tests, psychosocial evaluation
Chlamydia testing
NAAT - preferred swab, urine, tissue culture
Gonorrhea testing
NAAT swab
Genital Warts (HPV) testing
PAP smear for cervical cancer (x3 years), exam of present clusters
Herpes testing
PCR (better then culture), blood
Chlamydia symptoms
Painful urination, discharge, pelvic pain, irregular bleeding
Sexual History: The 5 P's
Partners, Prevention of pregnancy, Protection of STDs, Practices, Past history of STDs
Syphilis testing
RPR, VDRL, and FTA-ABS. RPR-rapid plasma reagin. VDRL- Venereal Disease Research Laboratory. FTA-ABS-fluorescent treponemal antibody absorption.
hormone implant
Timed-release medication placed under the skin of the upper arm, providing long-term protection. regulates menstural cycles. no protection against STIs.
What is the causative organism for syphilis?
Treponema pallium (spirochete bacteria)
primary and secondary sex characteristics develop menarche develop relationships, masterbation common, maybe sexually active, may experiment with homosexuality, risk for pregnancy/STIs parents influence values and beliefs regarding behaviors
adolescence sexual development
populations at greatest risk
adolescents, disabilities (cognitive, developmental, physical), newly unpartnered, sexual orientation/identification (LGBTQ)
sexual activity is common establish own lifestyle and values form a long term intimate relationships encourage communication among partners STI risk
adult sexual development
genital warts
an STD caused by the human papilloma virus (HPV); highly contagious; asymptomatic; cauliflower clusters
treatment for gonorrhea
antibiotics; one intramuscular injection of ceftriaxone
Sildenafil (PDE-5 inhibitor) should not be taken with which other medications?
antihypertensives and nitrates
causes of psychological ED
anxiety, fatigue, depression, negative body image, privacy, trust
Chlamydia treatment
azithromycin or doxycycline
intrauterine device (IUD)
hormonal/non-hormonal; decreased menstural symptom; stay in place for 3-10 years; insertion is painful and can cause infection; no protection against STIs
emergency contraception
hormone pills or an IUD that can be used after unprotected intercourse to prevent pregnancy; OTC; no protection against STIs
male and female condoms
barrier method, STI protection, no Rx, inexpensive, interferes with spontaneity, expiration date, break/slip off
physiological menopausal changes
breasts become smaller, uterus and ovaries atrophy, decreased bladder and urethral tone, LDL increases, HDL decreases, hot flashes/flushes
Which sexually transmitted infection causes condylomata acuminate (genital warts)?
human papillomavirus (HPV)
Allele
dominant (RR or Rr) and recessive (rr)
Herpes treatment
no cure but antiviral drugs like Acyclovir
in addition to being highly infectious, which additional fact would the nurse teach the client with gonorrhea? easily cured occurs very rarely can produce sterility limited to the external genitalia
can produce sterility
caution when using oral contraceptives
cardiovascular disorders, estrogen-dependent cancers/breast cancer, hypertension, liver tumors, diabetes (>20 year hx), >35 years old and. smoking, prolonged immobilization
Which sexually transmitted infection is most commonly reported?
chlamydia
bacterial STIs
chlamydia, gonorrhea, syphilis
Polyploidy
condition in which an organism has extra sets of chromosomes
Osteoporosis risk factors
family hx, late menarche, early menopause, smoking, alcohol use, excessive caffeine, inadequate calcium/vitamin D earlier in life
Sildenafil is prescribed for a man with ED. Which side effects of this medication would the nurse mention in teaching? flushing headache dyspepsia constipation hypertension
flushing headache dyspepsia
viral STIs
genital warts (HPV) and herpes
there is no cure for which STIs?
genital warts (caused by hpv) and herpes
nitroglycerine
given with erectile dysfunction can cause severe hypotension and cardiac events
silent infection
gonorrhea
Which STIs should the partner also be treated?
gonorrhea and chlamydia
beta blockers
decrease desire
antidepressants
decrease sexual desire, orgasmic delay/dysfunction, delayed/failed ejaculation, painful erection
Anticonvulsants
decrease sexual desire, reduce response
Antihistamines
decrease vaginal lubrication, decrease desire
diuretics
decrease vaginal lubrication, decrease desire, erectile dysfunction
multiple/casual partners failure to practice safe-sex measures
high-risk sexual behaviors
high-risk sexual behaviors alcohol use, marijuana, or other illicit substances underlying medical conditions/medications
individual risk factors
sexual response is present before birth self manipulation is normal and common
infancy sexual development
autosomal dominant
inheritance pattern of a dominant allele on an autosome; huntington's disease
narcotics
inhibit sexual desire/response, erectile and ejaculatory dysfunction
Diaphragm (birth control)
inserted into vagina and placed against cervix prior to sex. the sponge contains a spermicide. remain in place for 8 hours after sex. some protection against STIs. increased risk for TSS. must be fitted
Osteoporosis
loss of bone density caused by a state of estrogen deficiency
Monosomy
missing a chromosome (turner syndrome)
alcohol
moderate amounts increase effects; chronic use decreases desire
interest in sexual activity continues sexual activity may be less frequent vaginal secretions diminish, breast atrophy more time needed to achieve erection, fewer sperm produced privacy may be of concern, educate about enhancement products
older adults sexual development
What is another treatment for gonorrhea co-infection with chlamydia?
oral doxycycline
pharmacologic treatment for ED
oral phosphodiesterase-5 inhibitor (PDE5) or sildenafil
Syphilis symptoms
painless genital ulceration-chancre; flu-like symptoms; body system problems
Gonorrhea has become more resistant to
penicillin antibiotics
other treatment for ED
penile injections, urethral suppositories, penile implants, vacuum constriction devices
menopause treatment
pharmacologic hormone replacement (estrogen/progesterone; selective estrogen receptor modulators (SERMs) raloxifene (to prevent osteoporosis) nonpharmacologic dietary changes (avoid spicy foods, caffeine, alcohol) relaxation techniques and exercise
explore own and others body parts learn correct names focus love for parent of opposite gender answer questions honestly and simply
preschool sexual development
Which is the priority intervention for a 13 year old girl who reports that she has been sexually abused by her grandfather for almost 2 years? keeping the extended family unit intact validating the truth of the child's accusations providing a safe and nonjudgmental environment securing psychiatric treatment for the grandfather
providing a safe and nonjudgmental environment
abstinence
refraining from sexual intercourse (all kinds); full protection from STIs; does not regulate menstural cycle
psychological menopausal changes
relief, grief, loss, mood swings, irritability, depression
ectopic pregnancy, infertility, eye infection
result of gonorrhea or chlamydia infection
Hepatomegaly or Splenomegaly of infant
result of syphilis infection from mother
identify with parent of same gender increased modesty advise parents to discuss basic info at 10 years old
school age sexual development
secondary prevention
screening for STIs, screening for intimate partner violence, cervical cytologic screening (PAP), HIV screening, screening for other STIs
herpes simplex virus type 2
sexually transmitted, ulcer-like lesions of the genital and anorectal skin and mucosa; after initial infection, the virus lies dormant in the nerve cell root and may recur at times of stress
Why is an infection caused by Neisseria gonorrhoeae particularly troublesome for a female client? medication is expensive infection is difficult to treat with antibiotics symptoms are often overlooked treatment has many adverse effects
symptoms are often overlooked
oral contraceptives
synthetic hormones used to prevent pregnancy and treat menstrual disorders; decrease acne/PMS/endometriosis Sx; contraindicated: HTN, smoker, cancer; takes longer for fertility to return
Natural Family Planning (NFP)
taking basal temp, charting, avoiding sex when temp is high, not very effective, must be consistent, no protection against STIs
Phenotype
the set of observable characteristics of an individual that can also be determined by lab tests
menopause
the time of natural cessation of menstruation; also refers to the biological changes a woman experiences as her ability to reproduce declines
continue to develop gender identity exploration is normal encourage contact with opposite gender if single parent
toddler sexual development
Benzathine penicillin G
treatment for primary, secondary, and early latent syphilis
autosomal recessive
two copies of an abnormal gene must be present in order for the disease or trait to develop; cystic fibrosis
causes of organic ED
vascular disease, endocrine disease, neurological disease, chronic disease, penile disease/trauma, surgery medications, obesity
Sterilization
vasectomy and tubal ligation; permanent; no protection against STIs
laproscopy
visual examination of the abdominal cavity
colposcopy
visual examination of the vagina
Which intervention would the nurse implement to prevent cross-contamination of herpes genitalis from one client to another?
wear a gown and gloves when providing direct care
transdermal patch birth control
weekly patch, regulates menstural cycle, increased clot risk, no protection against STIs
Gonorrhea symptoms
women-greenish-yellow discharge, discomfort while urinating, fever, abdominal cramping, pain, vaginal bleeding men- inflammation of the urethra, yellowish-white or yellowish-green discharge, burning while urination