Sexuality

the integration of the somatic, emotional, intellectual, and social aspects of sexual being in a positive manner

denotes chromosomal sexual development (XY & XX), external and internal genitalia, secondary characteristics, and hormonal states

the inner sense a person has of being male or female

the behavior a person conveys as being male or female, which may or may not coincide with gender identity

• the preferred gender of the partner of an individual
• (Hetero/homosexual)

a person who finds pleasure with both opposite sex and same sex partners

• a person of certain biologic gender who feels trapped swithing the body of the wrong sex
• many transsexuals utilize surgery to match feelings

• 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

• (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

• 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

• Medication used to treat high blood pressure often causes a change in sexual functioning.
• Modifying the dose or switching meds may relieve sexual dysfunction.

• 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.

• i.e. mastectomy or an ostomy
• can cause anxiety and fear of discomfort or worry about acceptance from a sexual partner

• 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

• persistent pain does not equal sexual contact
• altered or modified positions can be utilized

• 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

• 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

Persists throughout life. The more consistently sexually active, the longer activity continues

Does not decrease after middle age, follows overall pattern of health and performance

Sex does not “weaken” a person

No scientific basis

Normal, common, 85% of men, occur any age after puberty, even some women

Maximum gratification come from each partner being both passive and aggressive in participating mutually and cooperatively

This is a social belief. Women can have a drive as strong, if not stronger, than men.

We don’t know women’s sexual potential, may have greater orgasmic capacity than men with regard to duration and frequency of 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

Unrealistic; not a determinant of sexual achievement or of satisfaction

• Blood flow is from uterus, not vagina, so tissue won’t be damaged
• desire increases during menses
• no evidence for abstinence

No relation to size and ability to satisfy a woman

No normal or single most acceptable position; any variation is best if the partners choose it

• 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)

• 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.

• 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