Lecture 2 - Sexual dysfunction, abuse, and assault

Phases of teh sexual response cycle include:

1. The desire phase which is mainly due to the hormone ______. Estrogen supports by maintaining vaginal _____ and lubrication. the cerebral cortex, ____ system, and endocrine system are also involved.

2. The 2nd phase is called the ___ or arousal in which sexual tension continues to inc. Physiological signs include in men having a penile ____ due to vasocongestion. In women there is vaginal lubricaition and ___ of the clitoris, labia, and breasts. Both will have inc in HR, BP, and muslce _____. There will be a general ____ of teh skin and a nipple erection may occur

3. The 3rd phase is ____ which is attained only at high levels of sexual tension. It is from a combo of mental activity and erotic ____ of erogenous areas. This is the ____ or highest level of sexual tension. There is rhythmic muscular ______ in the genital area. In men _____ of semen occurs and contractions occur in uterine and vaginal. Autonomic responses incle inc in pulse, BP, and respirations

4. Phase 4 is the ____ phase in which sexual tension developed prior in phases has subsided. The body returns to its _____ and muscles begin to ____ and vasocongestion dissipates. There is inc in ______ and feeling of pleasure and emotional vulnerability.

testosterone; elasticity; limbic; excitement; erection; swelling; tension; flushing; orgasm; stimulation; climax; contraction; ejaculation; resolution; baseline; relax; perspiration

Patient cues that indicate sexualit y concerns include:

1. Nonverbal behaviors like ____, blushing, signs of anxiety, and overt ____ sexual behavior

2. Verbal behaviors includes inappropriate sexual comments or ____, open concerns abt partner relationships, expressived convern over diminished sexuality or sexual _____, and expressived concern over sexual impact of ____ and comorbidities.

Perform a self-assessment:

1. Causes of nurse discomfort include fear of causing ____, poor training, inexperience, inadequate time, beliefs that sexual HX is not ____. Concerns related to ____ and gender differences especiallly for the older adults

2. Helpful considerations include remembering that assessing sexuality is a part of ____ nursing care and remember to have a ___ tone and approach.

Assessment guideliines:

1. Do the assessment in a ____ area without disctractions.

2. Keep notetaking to a ____

3. Interview free from bias/judgment

4. Maintain good eye ____, relaxed posture, friendly facial expressions

discomfrot; inappropriate; jokes; performance; meds; embarassment; important; age; holistic; professional; private; minimum; contact

Psychological therapies for sexual dysfunction include:

1. The use of ______ focus in which patients progress from general touching and cuddling without intercourse to more intimate forms of expression.

2. The use of behavioral therapy which is useful for men with ____ ejaculation when psychogenic or when ____ factors are present and are often best ocmbined with meds.

3. The use of systemic _____ which is using relaxation exercises combined with sexual anxiety–producing stimuli.

4. the use of ____ training for women who never had an orgasm as it helps women learn abt their bodies and their sexual responsiveness

Meds binclude ____

sensate; premature; relatonship; desensitization; masturbation; viagara

Nursing DX for gender dysphoria inlcudes gender identity _____ due to incongruent b/w expressed and assigned gender.

The ourcome would be improved gender identity by seeking _____ support, using healthy coping behvaiors, and acknowledging and ____ sexual identity.

TXTs include:

1. Meds in adolescents is used to delay ___ to allow more time for exploration.

2. Meds in adults is used to alter thier ____ toward preferred gender. Men transforming into women will be given _____ but women to men will be given ____ which is a controlled substance.

3. Surgical is used for sex ______ and a pysch eval is required before

4. Psychological therapeis for children is the use of ____ directed therapy and optimizing psychological adjustment and well-being but there is lack of ____ on best approach. For adults/adolscents, this includes inidivual/family therapy and ____ skills to dedal with harassment. ____ term therapy is recommended

disturbance; social; accepting; puberty; chemistry; estrogen; testosterone; reassignment; family; consensus; coping; long

Paraphilic disorders include:

1. Exhibitionistic disorder is intentional display of ___ in public

2. A ______ disorder is sexual focus on objects intimately associated with the human body.

3. A frotteuristic disorder is rubbing or touching on a _____ person.

4. A _____ disorder is predominant/exclusive sexual interest toward prepubescent children.

5. A sexual sadism disorder which is sexual satisfaction from the physical or psychological ______ of the victim.

6. A sexual _____ disorder is sexual satisfaction by being humiliated, beaten, bound, or otherwise made to suffer.

7. A ____ disorder is sexual satisfaction by dressing in the clothing of the opposite gender.

8. A ____ disorder which is seeking sexual arousal through viewing, usually secretly, other people in intimate situations.

genitals; fetishistic; nonconsenting; pedophilic; suffering; masochism; transvestic; voyeuristic

A Situation that puts stress on a family with a violent member is called a ___ situation. The perpetrator is any household member who is ___ toward another.

The vulnerable person is a family member upon whom abuse is ____. A ____ recognizes recovery and healing process.

crisis; violent; perpetrated; survivor

There are two ypes of child abuse:

1. Acts of ____ are deliberate and intention. They include ____, sexual, and emotional abuse.

2. The act of _____ is neglect in which the basic physical, emotional, or education needs are not ____ and the child is not protected from harm

The most common form of child abuse is ____. About 92%, of child abuse perpetractors are the victim’s ____.

For children 5-18, they are more likely to be killed during the ____ and for 5 and under they are more likely to be killed in the ___ due to seasonal depression. ____ is a big safety net.

The occurence of one type of abuse is a strong ____ of the occurence of another type.

Risk factors include

1. The child is seen as ____ or fragile

2. Child reminds parents of someone they ____ or is result of unwanted pregnancy

3. Child does not live up to parent’s ____

4. Child whos emotional bonding was interrupted due to ___ or prolonged illness.

Characteristics of abusive parents include

1. A _____ of childhood abuse/neglect, family authoritarianism or ___ punishments

2. Low self-esteem, social isolation, poor coping skills, and low ____ tolerance

3. Experiencing a ____, severe mental illness, or substance use diorser

4. Unrealistic expectations of child

5. Poor impulse contorl or violent ____

commission; physical; omission; met; neglect; parents; summer; winter; school; predictor; different; dislike; fantasy; prematurity; HX; harsh; frustration; crisis; temper

In intimate partner violence, same-sex relationships have the ____ rates as heterosexual relationships. It is more common in ____ compared to the other gender.

Risk factors include:

1. In male perpetrators, this includes a belief in male _____, or belief that physical aggression lends ____.

2. Patholigical jealousy

3. Substance/alcohol use

4. Resentment toward ___ or baby

5. Violence may escalate when women attempts more _____ ot to leave

The cycles of violence includes:1

1. The ____ building phase in which the abuse is edgy and has minor explosions. The victim may feel ____ and afraid.

2. The serious ____ phase in which the tension becomes unberable. The victim may ____ an incident to get it over with and may cover up the injury or look for _____

3. The ____ phase in which the abuser displays loving bhevaior. The vitcim is trusting, hoping fr _____, and wants to believe partner’s promises.

The cycle repeats and periods of calm/safety will ___ over time and repetition.

same; women; dominance; power; pregnancy; independence; tension; tense; battering; provoke; help; honeymoon; change; decrease