| A | B |
|---|
| Adrenarche | (1) increase in adrenal gland activity that occurs just before puberty (2) lasts 1.5 to 5 years |
| After 8 weeks | (1) a period of rapid growth (physical & psychological) & differentiation occurs as the reproductive systems differentiate into recognizable structures (2) males & females have the same external genitalia until the end of the 9th week (3) by the 12th week, differentiation of the external organs is complete (4) at end of this period, person is ready to enter adulthood & assume responsibilities associated |
| Adolescent Spurt | accelerated growth that puberty |
| At Risk For Rape | (1) young unmarried women (2) women who are unemployed or have low family income (3) students all have the highest incidence of rape or attempted rape |
| Acute Phase of Rape Trauma Syndrome (desorientation) | characterized by fear, disbelief, guilt, denial & embarrassment |
| Alprostadil Injection | (1) used to tx erectile dysfunction (2) injection at base of penis twenty minutes before intercourse achieves firm erection in more than 50% of cases (3) erection lasts up to 1 hr |
| Alternative Complementary Therapies (CAMs) | (1) massage for sexual stimulation (2) meditation to help clear the mind of distractions & increase focus (3) yoga might increase flexibility & revitalize energy |
| ANS Parasympathetic & Sympathetic | are involved in the sexual response cycle |
| Characteristics of Reproductive System | are biologically determined |
| Clitoris | (1) located between the labia minora (2) about 5 to 6 millimeters long and 6 to 8 milimeters across (3) its tissue is essentially erectile (4) looks like an opening to an orifice & can be confused w/the urethral meatus (5) has a very rich blood supply & is a primary source of female sexual response |
| Climacteric | (1) 3 phases (a) premenopausal (b) menopausal (c) postmenopausal (2) period of time that marks the cessation of a woman’s reproductive function |
| CNS Plateau Phase | causes (1) contractions of perineum, uterus & fallopian tubes w/heightened pleasure (penile friction stimulates receptors in vaginal walls triggering orgasm) (2) muscle spasms to allow some trapped blood to be drained by venous system (3) rhythmic pulsation are thought to aid sperms entering cervix |
| Culture | defines, evaluates & regulates a person's sexuality |
| Dyspareunia | (1) female pain experienced during intercourse d/t inadequate lubrication, scarring, vaginal infection, or hormonal imbalance (2) application of lubrication before/during intercourse may relieve problem |
| Developmental Task During Adolescence | (1) developing an adult identity (2) gaining autonomy & independence (3) developing intimacy in a relationship (4) developing comfort w/one’s own sexuality (5) developing a sense of achievement |
| Excision | a form of female genital mutilation that involves removal of the clitoris to reduce sexual desire and temptation |
| External Female Reproductive Organs | (1) mons pubis (2) labia majora (3) labia minora (4) clitoris (5) urethral meatus & paraurethral glands (skene's gland) (6) vaginal vestibule (7) hymen (8) introitus (9) perineal body |
| Gametes | (1) name for sex cells (2) are produced by a series of specialized organs called gonads |
| Genital Mutilation (Female Circumcision) | involves excision of the clitoris, the labia majora & the labia minora or other closure of the vagina |
| Genetic Sex of an Embryo | (1) is determined at fertilization (2) the male & female reproductive systems are undifferentiated for about the first eight weeks of gestation |
| Gender Identity | (1) part of the ongoing process of self identity (2) view of self as male or female is formed by age three (3) determined by how child is treated & by sex role models |
| Goal of Nursing | (1) to provide quality care no matter what the person's sexual orientation (2) an accepting nonjudgmental attitude is important to all clients who do not fit the social norms of the dominant culture (3) judgmental attitudes can result in avoidance of care (behavior) |
| Early Adolescence (11 to 14) | period characterized by changes of puberty and the physical & emotional responses to those changes |
| Elder Organs | (1) woman: experiences same vaginal contractions as younger woman (2) male: experiences muscular contractions similar to those of younger man |
| Erectile Dysfunction Tx (Nonsurgical) | (1) tx associated symptoms (alcoholism) (2) readjusting HTN meds or altering other drugs (3) tx insuff blood flow w/vascular surgery (4) erectile dysfunction r/t (a) psychological reasons refer to sexual dysfunction therapist (b) organic causes maybe tx w/penile implants (4) negative pressure devices (erection is induced w/vacuum & maintained w/constriction band around base of penis) (5) alprostadil injection also used (6) Viagra |
| Erogenous Zones | (1) lips (2) ears (3) skin (4) thighs (5) breasts (6) genitals |
| Excitement Phase of Sexual Response Cycle | characterized by increased heart rate & blood pressure & flushed skin & increased blood flow to the genitals |
| Excitement Phase of Female Sexual Response Cycle | (1) older women have less muscle tension than younger women but experience the same clitoral response and nipple erection as younger women (2) blood flow to the vagina, vulva, and clitoris are increased by parasympathetic innervations |
| Excitement Phase of Male Sexual Response | (1) results in triggering of CNS (2) parasympathetic vasodilation increased blood flow into the penis causing engorgement & compressing veins, which prevents venous drainage (3) older men (a) erection takes 2 to 3 times longer to achieve (b) once achieved, erection can be maintained for longer periods before ejaculation |
| Factors Affecting Learning of Gender Roles | (1) family structure (2) employment trends (3) media & advertising (4) head of family |
| Factor Affecting Sexual functioning | (1) developmental age/factors incl (a) andrenarche—increase in adrenal gland activity occurring just before puberty (b) menarche (c) climacteric (2) physical changes that can limit sexual activity or alter self-esteem (3) physical changes r/t age |
| Factors Defining Gender Behavior | (1) family (2) culture (3) religion (4) society (5) family structure |
| Family Planning | a process that involves fertility awareness and considers timing of ovulation and temperature during given days of the female cycle to enable couples to determine when sexual activity may or may not result in pregnancy (2) the couple must be in tune w/female’s cycle for this method to be effective |
| Female Genital Mutilation (FGM) | (1) a practice involving either excision of the clitoris, the labia majora, and the labia minora or the closure of the vagina (2) puberty rites in some culture permits FGM |
| Female & Male Sexual Response To Sexual Cycle includes | (1) excitement (2) plateau (3) orgasm (4) resolution (5) vasoconstriction & myotonia (6) physical & emotional factors |
| Female Sexual Dysfunctions 4 three main dysfunctions | (1) orgasmic dysfunction: inability to achieve orgasm (2) vaginismus: irregular & involuntary contraction of muscles around the outer third of vagina when coitus is attempted (3) dyspareunia pain experienced during intercourse d/t inadequate lubrication, scarring, vaginal infection, or hormonal imbalance (4) vulvodynia: chronic vulvar discomfort/pain characterized by c/o burning, stinging, irritation, or rawness of genitalia (5) frigidity |
| Fertility Awareness | (1) position of cervix (2) cervical mucous changes (3) basal body temperature (4) fertile phase is calculated by determining the shortest & longest menstrual cycle (5) ovulation usually occurs 14 days plus or minus days before start of next menstrual cycle |
| Frigidity | (1) failure of sexual arousal (2) equivalent to impotence in men (3) does not make intercourse impossible but does not create pleasure for both partners (4) may be caused by traumatic sexual experience & abnormal fear (but the degree to which physical factors (testosterone deficiencies) contribute is unknown (5) impaired sexual response is poorly understood (6) has not been as researched as male sexual dysfunction |
| Gender Identity (view of self as male or female is formed by age three &) | view det by how the child is txed by their sex role models |
| Homologous | the female and male reproductive systems are homologous (i.e., fundamentally similar in structure & function) |
| Hormones | testosterone & serotonin or dopamine release influences the sexual response cycle |
| Hymen | the collar or semicollar of tissue that surrounds the vaginal opening |
| Infibulation | (1) stitching the labia majora together to prevent intercourse assuring the bride's virginity |
| Internal Female Reproductive Organs | (1) vagina (2) rugae (3) uterus (4) cervix (5) endometrium (6) myometrium (7) parietal peritoneum (8) ovaries (9) fallopian tubes (10) zygote (11) pelvic floor |
| Integration & Recovery Phase of Rape Trauma Syndrome | client recognize that blame for assault lies not with her but w/assailant; a level of trust w/others returns & she begins to feel safe in her day-to-day activities |
| Introitus | (1) border between external & internal genitals (2) entrance that goes into a canal or hollow organ; another name for the vaginal orifice (3) used for classifying uterine prolapse (a) 1st degree prolapse: cervix is in the vagina (b) 2nd degree: cervix at the level of the introitus (c) 3rd degree: cervix comes out of the introitus (d) procidentia: the uterus also comes out of the introitus |
| Ischemia Phase Menstrual Cycle (days 27 & 28) | (1) causes tissue breakdown (2) both estrogen & progesterone levels drop (3) endometrial tissue sloughs off & capillaries break & blood begins to escape w/tissue & mucus as the menstrual cycle begins again |
| Labia Majora | (1) longitudinal, raised folds of pigmented skin, one on either side of the vulvar cleft (2) chief function is to protect the structures lying between them |
| Labia Minora | (1) soft folds of skin within the labia majora that converge near the anus and form the fourchette (2) they look like shiny mucous membranes and are devoid of hair follicles (3) they are rich in sebaceous glands, which lubricate and waterproof the vulvar skin & provide bacterial secretions |
| Late Adolescence (18 to 20) | involves transition to adulthood, including taking on adult work roles |
| Libido | (1) sexual desire & ability to enjoy intercourse (2) can be affected by drug therapy that alters sex centers of the brain function or that act on the peripheral nerves or blood vessels of genitalia |
| Major Targets for Female Hormones organs | (1) ovaries (produce estrogen, progesterone, testosterone & are sensitive to follicle-stimulating hormone (FSH) & luteinizing hormone (LH)) (2) uterus (sensitive to estrogen & progesterone)(3) fallopian tubes |
| Male & Sexual Dysfunctions: 3 three main dysfunctions | (1) erectile dysfunction (2) premature ejaculation (3) retarded ejaculation |
| Male Climacteric or Male Menopause | (1) testosterone levels may decrease leading to climacteric (2) do not experience as dramatic a reduction in hormone production as women (3) occurs gradually & over a longer period of time (4) is more difficult to dx & is based on symptoms of blood levels of testosterone (5) changes are more psychological (6) no change in reproductive anatomy, sperm production or fertility unless a pathological change occurs in reproductive system |
| Menopausal Phase of Climacteric | (1) defined by a woman’s last menses |
| Menarche | (1) the average time between breast dev & menarche is 2.3 years |
| Menstrual Cycle | (1) refers to the cyclical, physiological uterine bleeding that normally recurs at 4-week intervals in absence of pregnancy during the reproductive period of the female (2) menstruation usually begins fourteen (plus or minus 2 days) after ovulation (3) relative proportion of FSH/LH controls cycle(4) consists of 4 phases (a) menstrual phase (b) proliferation phase (c) secretory phase (d) ischemia phase |
| Menstrual Phase of Menstrual Cycle | (1) first day of menstrual flow (days 1 thru 6) (2) ends with thinning of (a) endometrium lining (b) low estrogen levels (c) dormant uterus |
| Methods of Contraception & Fertility Control | (1) Hormonal: oral contraceptives (“the pill”); postcoital; norplant (2) injectables (Depo-Provera) (3) barrier methods (diaphragm; cervical sponge, cervical cap, condom) (4) IUD (intrauterine device copper T380A (ParaGard), Progesterone T (Progestasert), which prevents implantation (5) abstinence (lack of sexual intercourse) is 100% effective (6) sterilization (tubal ligation for women & vasectomy for men) (7) abortion |
| Middle Adolescence (15 to 17) | is characterized by a transition to a dominant peer orientation |
| Medications that Affect Sexuality | (1) opioids (CNS depressants) (2) barbiturates & benzodiazepines (antianxiety) (3) atropine (anticholinergic agents), (4) cardiovascular agents (antiarrhythmics, antihypertensives, diuretics & beta blocking agents) (5) antidepressants & antipsychotics (6) Social drugs (alcohol, marijuana & cocaine) |
| Mons Pubis | the anterior portion of the symphysis pubis. It is covered with short pubic hair. the amount and texture of hair varies widely among women |
| Myotonia Sexual Response Cycle | characterized by tension and increased contractility |
| Orgasmic Dysfunction | (1) the inability of to achieve orgasm (2) can be caused by (a) drugs (b) alcohol (c) aging (d) anatomic abnormalities of genitals (3) physiological basis (a) hostility toward partners (b) guilt about enjoying sexual act |
| Orgasm Sexual Response Cycle | (1) characterized by genital involuntary spasmodic contractions, decreased muscular control of arms & legs, altered levels of consciousness (2) female: engorgement of erectile tissue w/residual blood from first orgasm, makes multiple orgasm possible w/n short time period (3) males: impulses sent via sympathetic fibers to testes, epididymis & ductal system result in release & sperm transport by peristaltic waves & secretions |
| Outward Adjustment Phase of Rape Trauma Syndrome | (denial); survivor appears to be adjusted but is coping by denial & suppression; a method of regaining control of her life; may buy a weapon, refuse to discuss the assault and refuse counseling |
| Ovarian Cycle | relative proportion of FSH/LH controls cycle |
| Paraurethral Glands (Skene's Gland) | opens into the posterior wall of the urethra close to its opening. The secretions help lubricate the vaginal vestibule, facilitating sexual intercourse |
| Pattern of Ovulation | (1) a woman has a 20 to 40 year period of cyclical ovulation & menstruation (2) pattern begins at menarche & continues thru menopause (3) each month one ovum matures, ruptures from the ovary & enters the fallopian tube |
| Penile Implants | (1) may be used to tx erectile dysfunction 2dry to organic causes (2) may be semirigid rod (permanent semi-erection results) or inflatable prosthesis (stimulates natural erections & flaccidity) |
| Penile Implants Complications | (1) infection (2) erosion of the prosthesis thru the skin (3) persistent pain, which may be severe enough to require removal of prosthesis |
| Perineal Body | (1) wedge-shaped mass of fibromuscular tissue measuring about 4 centimeters by 4 centimeters by 4 centimeters (2) found between the lower part of the vagina & the anal canal (3) during the last part of labor, the perineal body thins out to just a few centimeters in thickness (5) site of episiotomies during childbirth |
| Plateau Sexual Response Cycle | (1) characterized by sex flush (2) pelvic & vaginal vasocongestion decrease vaginal diameter & penile friction stimulates receptors in the walls of vagina triggering orgasm (3) secretion from Cowper’s gland (male) & increase in length & diameter of the penis (4) clitoris is most sensitive |
| Plateau Phase of Male Sexual Response | (1) penis becomes erect & increases in length & diameter & testes are drawn up into toward the abdomen (2) involves secretion from the bulbourethral glands/cowper’s gland |
| Premenopausal Phase of Climacteric | (1) symptoms may start with abnormal hormone functions as early as 36 to 2, despite cessation of menstruation around age 50 (2) number of healthy ovarian follicle declines & sensitivity to certain hormones decrease, estrogen levels fluctuate d/t changes in menstrual cycle |
| Premature Ejaculation | (1) occurs when a man is unable to delay ejaculation long enough to satisfy his partner (2) ejaculation occurs after limited stimulation (3) sensate exercises encouraged by sexual dysfunction therapists to decreased number of incidences |
| Priority Care for Rape Victim | (1) include both psychological support & physical care (2) education regarding methods for preventing rape & sexual assault is critical |
| Primary Function of Reproductive System | to produce sex cells and transport sex cells to locations where their union can occur |
| Postmenopausal Phase of Climacteric | (1) years after cessation of menstruation (2) preventative interventions during this phase are important (3)involve (a) prevention of coronary artery disease (b) prevention of osteoporosis (c) decisions about hormone replacement therapy |
| Proliferative Phase of Menstrual Cycle (days 7 to 14) | (1) time from cessation of menses to beginning of ovulation (2) marked by enlargement of endometrial glands in response to new estrogen stimulation (3) estrogen peaks just before ovulation (4) endometrial layer becomes very thick & filled w/blood |
| Puberty | refers to the fundamental biological changes of adolescence (ages 11 to 14; middle adolescence ages 15 to 17; late adol ages 18 to 20) |
| Rape | is viewed as a situational crisis involving a very traumatic event for which the client is not prepared |
| Rape Trauma Syndrome | (1) cluster of symptoms experienced following rape: (a) acute phase (b) outward adjustment phase (denial) (c) reorganization phase (d) integration & recovery phase |
| Reidentification of Sex Roles Factors | (1) increased emphasis on equality & rights & abilities of individuals (2) personal choice (3) economic needs of families (4) sex-role related advertising & the media |
| Reorganization Phase of Rape Trauma Syndrome: | denial & suppression finally break down; woman depressed w/strong urge to talk about rape; attempts to alter self-concept and resolve feelings about the rape; problems arising incl: gynecological, phobias, lifestyle alterations due to phobias & sexual dysfunction, sleep disorders persist (nightmares in which the rape is relived or escape from the rapist) |
| Resolution Sexual Response Cycle | (1) characterized by relaxation, fatigue, fulfillment (2) not as complete for females as blood remains trapped in woman’s erectile tissue & blood, engorged tissue makes possible females achieving multiple orgasms within a short period of time |
| Retard Ejaculation or Ejaculatory Incompetence | (1) delayed ejaculation or the inability to ejaculate into the vagina, respectively (2) like erectile dysfunction origins may be physical or psychological |
| Risk Factors Assoc W/STDs | (1) sexual partner already infected with an STI (2) more than one sexual partner (3) sexual activity during adolescence (4) illicit drug use and homelessness, which can lead to prostitution, which in turn influences a wide transmission of STIs (5) oral and anal sexual practices, which expose one to a potentially greater bacterial and viral load of organisms |
| Risk Factor for High Teen Birth Rate | (1) poverty (2) low educational achievement (3) poor self-esteem (4) family dysfunction (5) high risk behaviors |
| Secretory Phase of Menstrual Cycle (days 15 to 26) | (1) estrogen drops sharply & progesterone dominates (2) d/t progesterone, the endometrial cells swell & dilate increasing vascular reserves in preparation for the fertilized ovum (3) if fertilization & implantation do not occur, the levels of progesterone & estrogen fall & vasoconstriction occurs, causing decrease in blood supply to large areas of the endometrium |
| Sensate Exercises | (1) activities in which a couple learns to enjoy the sensation of touch without sexual intercourse, such as with massage (2) encouraged by sexual dysfunction therapists to decreased incidences of premature ejaculation |
| Sexual Activity | (1) reflects the preference of the involved couple & can include (a) sexual intercourse (b) masturbation (c) oral-genital stimulation (d) necking (e) petting (f) touching (g) fondling (h) fantasy (i) stimulation of erogenous zones (1i) sexual orientation including heterosexual, homosexual, bisexual and transsexual (2) freedom to engage or restriction against is established by culture & regulated by religion |
| Sex Behavior | is often regulated by social norms |
| Sexual Dysfunction | (1) females (a) orgasmic dysfunction (b) dyspareunia (c) vaginismus (d) physiological age related changes: dryness & decreased elasticity of tissue w/menopause (2) males (a) erectile dysfunction or impotence (b) slower arousal (c) fewer spontaneous erections (d) premature ejaculation (e) lessened orgasmic intensity (f) prostate problems (g) ejaculatory failure (3) general (a) altered body image d/t injury or disease (b) normal aging (c) ability to respond to sexual stimulation (4) drug therapy or damage to ANS (5) tx for prostate cancer further incrs incidence of sexual problems |
| Sexual Orientation | (1) refers to a person’s gender preference in sexual partners (3) three types: (a) heterosexuality (b) homosexuality (c) bisexuality |
| Sexuality | (1) is intrinsic & influences every aspect of a person’s life (2) begins at conception, when fetal gender is determined (3) develops thru childhood as person learns to relate to world; and continues until death (4) sexuality influences a person’s choice of partners, careers, friends, interests, self-perception & perception of the person by others |
| Sex Roles | (1) identifies how a person’s gender is expressed (2) part of this ongoing process of gender identity |
| Sexually Transmitted Infections (STIs/STDs) | (1) specific infections or symptoms transmitted primarily through sexual intercourse (2) may be caused by bacteria, viruses, fungal agents or ectoparasites |
| STD Portals of Entry | (1) skin & mucosal linings of the urethra, cervix, vagina, rectum & pharynx |
| STI Risk Factors | (1) Erectile dysfunction (impotence): inability to achieve or maintain an erection sufficient to accomplish intercourse (2) Premature ejaculation: inability to delay ejaculation long enough to satisfy partner (3) Retarded ejaculation (ejaculatory incompetence) delayed ejaculation or inability to ejaculate into the vagina, respectively |
| Smooth Muscle Relaxants | (1) medication to achieve erection (a) viagra (oral) (2) alprostadil (Injection) (2) medication causes increased blood flow to the penis |
| Types of Family Structure | (1) nuclear family (parents & their children) (2) extended family (nuclear family w/relatives like grandparents, aunts/uncles) (3) blended family (two families joined together) (4) foster families (child from another family placed in an existing family) (5) single-parent family (one parent lives w/children) (6) binuclear or postdivorce family (intragenerational families in which more than two generations live in one household) |
| Urethral Meatus | located 1 to 2.5 centimeters below the clitoris in the midline of the vestibule & often appears like a puckered, slitlike opening |
| Vaginitis | (1) inflammation of the vagina (2) diabetes predisposes women to infection particularly monilial vaginitis caused by the fungas Candida Albicans (3) untreated can cause preterm labor |
| Vaginitis & STDs | (1) most common reasons women seek outpatient, community-based treatment |
| Vaginismus | (1) irregular & involuntary contraction of muscles around outer 3rd of vagina (2) when coitus is attempted vagina close before penetration (3) caused by severe sexual inhibitions often associated w/early learning (4) tx involves sensate exercises & therapy to bring about physiological changes |
| Vaginal Vestibule | (1) boat-shaped depression is enclosed by the labia majora & is visible when they are separated (2) the vestibule contains the vaginal opening or introitus |
| Viagra | (1) oral medication to tx erectile dysfunction (2) smooth muscle relaxant that increased blood flow to penis (3) contraindicated: clients w(a) severe cardiac conditions (b) retinopathy (esp. diabetic retinopathy) |
| Vulva | (1) external genitals of female reproductive organs (2) accessory structures of the female repro system |
| Vulvodynia | (1) chronic vulvar discomfort characterized by c/o burning, stinging, irritation or rawness of female genitalia (2) neither the cause nor cure is known |
| Assessment Facts | (1) begin w/client’s development stage & the presence or absence of intimate relationships (2) finding out whether a person is sexually active sh/precede any attempt to explore issues r/t sexuality & sexual functioning |
| Need for Physical Exam | (1) request for birth control (2) need for a papanicolaou (pap) test (3) suspicions of (a) infertility (b) pregnancy (c) STI (4) reports of (a) discharge (b) lumps or change in color, size or shape of genital organs |
| Health Promotion & Protection Sexuality Issues | (1) frequency of breast self-examination (2) pap smear (3) mammograms (4) testicular self-exams & anal prostate exams w/PSA |
| Dx of Sexual Assessment | (1) prioritization of interventions is based on acuity of presenting problems (2) priorities are based on most important need given the facts presented during assessment (3) priorities are based on the client’s developmental level and socioeconomic factors r/t accessibility to community resources |
| Planning | (1) based on expected outcomes r/t (a) health promotion (b) health protection (c) health restoration (2) look at rationales (a) access to birth control for adolescents (b) sexual education in schools (c) access to rape counseling (d) reportable incidents (e) pregnancy termination rights |
| Interventions | (1) are geared toward positive patient outcomes (2) based on assessment data (3) based on client’s willingness to work w/the hct to implement planned strategies (4) look at appropriateness of intervention based on (a) religious & cultural background or issues (b) lifestyle (c) sexual behaviors |
| Factor affecting a client’s willingness to work w/hcp | (1) religious background (2) cultural issues (3) lifestyle |
| At Risk clients R/T Sexual Problems | (1) include (a) victims of sexual, physical or psychological abuse (2) persons who have been disfigured (3) persons taking medications that decrease sexual drive (4) persons w/altered body image (5) persons w/temporary or long-term physical disability |
| Dx: Altered Sexual Pattern | (1) expresses concern regarding sexuality |
| Dx: Sexual Dysfunction | (1) expresses change in sexual functioning |
