Sexuality and reproduction

Definition, attributes, and scope of sexuality

Def: human life encompassing sex, gender identities, roles, sexual orientation, intimacy, reproduction

attributes: sexual orientation, gender identity, social constructs of gender

scope: sexual well-being, sexual function and sexual ill-being, sexual dysfunction

Defintion, attributes, and scope of reproduction

def: organisms produce offspring

attributes: non-pregnant state, pregnant state, fertility vs. infertility

scope: infertility, not producing by choice, not pregnant ←→ fertility, pregnant

Populations at risk for sexuality

-infants/children: sexual abuse → STIs, trauma, inability to establish healthy relationships, unhealthy coping strategies, sex traffic

-adolescent: risk HIV, STI, unintended pregnancy, sexual violence, sex traffic, Inc suicide rate for LGBTQ

-disabilities: cog, develop, physical disability overlooked as asexual and risk for sexual abuse

-LGBTQ- HIV n STIS

individual risk factors for sexuality

-High risk behavior: multiple sex partners, sex, not using barriers, intoxication

-underlying med condition, meds → sexual dysfunction: chronic pain, chronic fatigue, anxiety, depression, Cardvasc disease, diabetes, chronic respiratory conditions

lifespan considerations from sexuality

-Childhood: Attitudes & behaviors are child’s family = key to shaping gender identity

-Preadolescent: 8-12 division of boys and girls, sexual curiosity & learning, masturbation

-adolescence: 13-19 physical change, manage emotion and emotional aspects of sexuality = intimate relationship, gender identity

-adulthood: sexual maturation continues, effectively communicate intimate relationship & make decisions about sexual health, family planning, prevent STIs

culutural considerations for sexuality

cultural norms, values, beliefs influence sexual behavior

Populations at risk for reproduction

Adolescent pregnancy

BIPOC preg

Geriatric preg

women n men with comorbidities/chronic illnesses

individual risk factors for reproduction

biophysical factors( genetics, nutrition, age)

psychosocial factors ( smoking, caffiene, alc)

sociodemographic ( access to care, financial, marital status)

environmental factors ( air pollution, chemical exposure, stress)

lifespan considerations from reproduction

individuals who have not reached sexual maturity

ind who have reached sexual maturity, infertile, menopause

cultural considerations for reproduction

family planning

unplanned preg

roles of assigned women and men

rights of men and women

Factors that contribute to infertility

Primary and secondary prevention of healthy reproduction

Prim:

Safe sex, STI prevention, contraceptions

diet n nutrition

preconception counseling

carcinogen avoidance -smoking dec sperm count, women restrict b. flow

Secondary:

prenatal care

screen for domestic violence and abuse

anticipate postpartum resources

Presumptive signs of pregnancy

missing period, N, cravings, Inc appetite, mood changes, tender breasts, quickening, inc urine

Probable signs of pregnancy

+ test, enlargement of abd, braxton hicks(starter contractions), hegar(softening lower uterine segment) Goodwell(softening of tip of cervix)

positive signs of pregnancy

fetal heart beat doppler, doctor palpate, ultrasound

Why are presumptive and probably signs of pregnancy not reliable or diagnostic?

What are cardiovascular changes in a pregnant women

Inc b. vol

Inc plasma vol

Inc cardiac output

Dec vascular resistance

Dec BP

vasodilation

varicose veins

What are blood changes for a women pregnant

20-30% RBC prod

Inc 40-50% plasma

Inc WBC

Dec Platelets

Dec hematocrit

Inc clotting factors- fibrinogen

Dec albumin - when shifts out bc osmotic P = edema

anemia Dec hematocrit from disproportion of plasma n RBCs

clot prone = DVT, pulmonary embolism

What are key milestones for fetal development?

week 5 - fetus heartbeat

week 6- fetal circulation established

week 7- fetal heartbeat can be auscultated on doppler

week 8- all major organ systems in development (stay away from carcinogens)

week 9-12 - digestive system starts to work

week 17-20 - quickening felt

week 22- fetus is viable

week 21-24 - surfactant starts to be produced

What does the milestones mean for the care of your pt? How might you provide education to a family?

Key diagnostics tests - when done, why, what an abnormal result means, key nursing management, and key patient education points

1st-

urine/serum pregnancy

CBC w. differential

Blood type & Rh factor

Rubella titer

Hep B titer

pap test

gonorrhea n chlamydia

amniocentesis

2nd

CBC 24-26 wks

1 hr glucose

MSAFP

1. Identify and describe key nursing actions (including assessments, interventions, education, etc.) related to amniocentesis. 

1. Describe key patient education regarding nutrition in pregnancy → focus on folic acid, iron, and foods to avoid. 

1. Identify and describe subjective and objective assessments for prenatal clients → why are these assessments done? What do the findings mean?

1. Identify and describe danger signs in pregnancy → What should the nurse assess? What do these mean for the client? What education should the nurse provide to the client?