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  1. Sexual Health
    the integration of the somatic, emotional, intellectual, and social aspects of sexual being in a positive manner
  2. Biologic Sex
    denotes chromosomal sexual development (XY & XX), external and internal genitalia, secondary characteristics, and hormonal states
  3. Gender Identity
    the inner sense a person has of being male or female
  4. Gender Role Behavior
    the behavior a person conveys as being male or female, which may or may not coincide with gender identity
  5. Sexual Orientation
    • the preferred gender of the partner of an individual
    • (Hetero/homosexual)
  6. Bisexual
    a person who finds pleasure with both opposite sex and same sex partners
  7. Transsexual
    • a person of certain biologic gender who feels trapped swithing the body of the wrong sex
    • many transsexuals utilize surgery to match feelings
  8. Positive Self Care Behaviors:
    • Avoid stereotyping typical gender roles
    • Learn the biologic aspects of sexual functioning
    • Ask questions about sexual needs and sexual activity when neccessary
    • Enjoy close relationships with others who love you
    • Give a hug to someone you love
    • Accept touch from others as a sign of caring and affection
    • Practice safer sex (condoms, contraceptives, partner choice)
    • Recognize how age, illness, or disability influence sexual needs and expression
  9. Diabetes Mellitus
    • (hormonal disease in which an inadequate amount of insulin is secreted by the pancreas)
    • Due to its prevalence and affect on sexuality, it is common for men to experience erectile dysfunction
    • Diabetic women often experience orgasmic dysfunction, frequent Monilia infections, loss of arousal and/or vaginal lubrication
  10. Cardiovascular Disease
    • the sexual response cycle can have a great demand on the heart and other structures
    • may cause patient anxiety and can have a negative effect on sexuality and sexual function
  11. Hypertension
    • Medication used to treat high blood pressure often causes a change in sexual functioning.
    • Modifying the dose or switching meds may relieve sexual dysfunction.
  12. Myocardial Infarction
    • stressors are to be avoided after a heart attack, including over exertion, alcohol, and emotional upheavals.
    • Sex cannot be resumed until ~3 months after a heart attack, with a slow building-up period.
  13. Surgeries
    • i.e. mastectomy or an ostomy
    • can cause anxiety and fear of discomfort or worry about acceptance from a sexual partner
  14. Spinal Cord Injuries
    • sexual function after a spinal cord injury depends on the level and extent of the injury
    • ejaculation and orgasm are most likely to remain w/ low spinal injuries
    • women are more likely to experience orgasms than men but lack physical sensations
  15. Chronic pain
    • persistent pain does not equal sexual contact
    • altered or modified positions can be utilized
  16. Mental illness
    • disruption of the function of the brain can cause disturbance in sexual function, affecting desire and function.
    • Alzheimers disease can cause memory loss of sexual Hx.
    • Inappropriate sexual situations can occur as a result of mental illness
  17. Medications
    • side effects can result in sexual interruptions
    • Amyl nitrate: for angina, inhale at time of orgasm to intensify release
    • Anticonvulsants: sative effect; decrease desire, reduce sexual response
    • Antidepressants: tricyclic compounds, MAO inhibitors, Lithium carbonate; similar to antihypertensives; significant male impotence
    • Antihistamines: sedative effect, decrease desire, decrease vaginal lubrication
    • Anytihypertensives: methyldopa, clonidine, Reserpine
  18. Myth: Born with certain amount of sexual drive, release in youth, little left for later
    Persists throughout life. The more consistently sexually active, the longer activity continues
  19. Myth: Need for expressing sexuality is less important later in life
    Does not decrease after middle age, follows overall pattern of health and performance
  20. Myth: Sexual abstinence is necessary in training for sports
    Sex does not “weaken” a person
  21. Myth: Excessive sexual activity can lead to mental illness
    No scientific basis
  22. Myth: Wet dreams are indicators of sexual disorders
    Normal, common, 85% of men, occur any age after puberty, even some women
  23. Myth: Women are passive and men are aggressive, due to physical anatomy
    Maximum gratification come from each partner being both passive and aggressive in participating mutually and cooperatively
  24. Myth: Women should have less desire for sex than men
    This is a social belief. Women can have a drive as strong, if not stronger, than men.
  25. Myth: Women who have multiple orgasms or who readily climax are nymphomaniacs or promiscuous
    We don’t know women’s sexual potential, may have greater orgasmic capacity than men with regard to duration and frequency of orgasm
  26. Myth: There is a difference between vaginal and clitoral orgasm
    it is a total body response, so there are variations in intensity and timing; no reason to think they are separate, they are interrelated
  27. Myth: A mature sexual relationship requires the man and the woman the achieve orgasm
    Unrealistic; not a determinant of sexual achievement or of satisfaction
  28. Myth: Dangerous to have intercourse during menstruation
    • Blood flow is from uterus, not vagina, so tissue won’t be damaged
    • desire increases during menses
    • no evidence for abstinence
  29. Myth: Larger penis better for producing orgasm in women
    No relation to size and ability to satisfy a woman
  30. Myth: Face-to-Face coital position is the proper, moral, and healthy one
    No normal or single most acceptable position; any variation is best if the partners choose it
  31. Myth: Ability to achieve orgasm is the indicator of a persons sexual responsiveness
    • Sexual response is the result of numerous physical, psychological, and cultural influences
    • orgasm is taken out of context as the symbolic factor of sexual response (it is not)
  32. PLISSIT Model for Counseling Patients with Sexual Problems
    • P = Permission giving
    • --Implies giving the patient the freedom to choose to do something that the nurse deems as a positive
    • LI = Limited information
    • --Specific, factual information is needed by the patient
    • Ss = Specific suggestions
    • --Very specific instructions for technique
    • IT = intensive therapy
    • --Involves issues such as marriage, self-concept, sexual desires, etc.
  33. Responding to Patient's Advances
    • 1. Be self-aware: don’t deny feelings of harassment
    • 2. Confront: provide feedback to patient in a non-threatening way and clearly state unacceptable behaviors
    • 3. Set limits: define clear and reasonable consequences that will be enforced
    • 4. Enforce limits: and maintain boundaries
    • 5. Document: behaviors and file incident reports
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Test 3
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