NSG 170 sexuality

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

bacterial STIs

chlamydia, gonorrhea, syphilis

beta blockers

decrease desire

causes of psychological ED

anxiety, fatigue, depression, negative body image, privacy, trust

other treatment for ED

penile injections, urethral suppositories, penile implants, vacuum constriction devices

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 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

Trisomy

3 copies of a chromosome (down syndrome)

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

populations at greatest risk

adolescents, disabilities (cognitive, developmental, physical), newly unpartnered, sexual orientation/identification (LGBTQ)

Herpes testing

PCR (better then culture), blood

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

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

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

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)

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

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

Chlamydia treatment

azithromycin or doxycycline

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

Allele

dominant (RR or Rr) and recessive (rr)

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

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

Osteoporosis

loss of bone density caused by a state of estrogen deficiency

Monosomy

missing a chromosome (turner syndrome)

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

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

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

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

vaginal ring (NuvaRing)

3 weeks at a time, no fitting needed, regulates menstural cycles, expulsion/discharge/irritation, no protection against STIs

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

alcohol

moderate amounts increase effects; chronic use decreases desire

Herpes treatment

no cure but antiviral drugs like Acyclovir

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

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

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 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

Genital Warts (HPV) testing

PAP smear for cervical cancer (x3 years), exam of present clusters

Syphilis testing

RPR, VDRL, and FTA-ABS. RPR-rapid plasma reagin. VDRL- Venereal Disease Research Laboratory. FTA-ABS-fluorescent treponemal antibody absorption.

Sildenafil (PDE-5 inhibitor) should not be taken with which other medications?

antihypertensives and nitrates

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

Polyploidy

condition in which an organism has extra sets of chromosomes

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

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

Which sexually transmitted infection causes condylomata acuminate (genital warts)?

human papillomavirus (HPV)

high-risk sexual behaviors alcohol use, marijuana, or other illicit substances underlying medical conditions/medications

individual risk factors