Sexuality Education for Young Women

Chapter 35
Sexuality
Copyright © 2017, Elsevier Inc. All Rights
Reserved.

 Sexual development
 Sexuality changes with
each stage of
development.
 Infancy and early
childhood
 School-age years
 Puberty/adolescence
 Young adulthood
 Middle adulthood
 Older adulthood
 Sexual orientation
2
Reserved.

 Nikki is a nursing student who volunteers at a
free health clinic in a medium-size college
town. Nikki enjoys volunteering at the clinic
because the nurses allow her to provide health
care education to the young women who
frequent the clinic. Much of Nikki’s teaching
involves education about sexually transmitted
infections (STIs) and reliable birth control
methods.
Reserved. 3

 Nonprescription contraceptive methods:
 Abstinence, barrier methods, spermicide, rhythm
 Methods that require a health care provider’s
intervention:
 Hormonal contraception, intrauterine device (IUD),
diaphragm, cervical cap, sterilization (tubal ligation
or vasectomy)
Reserved. 4

 Nikki is educating Ms. Tamika Jones, a 16-year-
old mother of three, regarding the benefits of
practicing safe sex and using effective
contraception. Nikki explains to Ms. Jones that
sterilization is the most effective birth control
measure aside from abstinence.
Reserved. 5

 About 20 million people in the United States are
diagnosed each year with an STI each year; almost half
of them are 15 to 24 years of age.
 STIs are transmitted from infected individuals to
partners during intimate sexual contact.
 Usually curable STIs: syphilis, gonorrhea, chlamydia,
trichomoniasis.
 Viral STIs: human papillomavirus (HPV) and herpes
simplex virus (HSV) type II, human immunodeficiency
virus (HIV)/acquired immunodeficiency syndrome
(AIDS).
Reserved. 6

 Locating and treating people with STIs
 Some people do not know that they are infected
because symptoms may be absent or may go
unnoticed.
 Common symptoms include discharge from the
vagina, penis, or anus; pain during sex or when
urinating; blisters or sores in the genital area; fever.
 Any contact with another person’s body fluids
around the head or an open lesion on the skin, anus,
or genitalia can transmit an STI.
 Embarrassment
Reserved. 7

 Human immunodeficiency virus (HIV):
 Primary routes of transmission include
contaminated IV needles, anal intercourse, vaginal
intercourse, oral-genital sex, and transfusion of
blood, blood products
 Human papillomavirus infection (HPV):
 Most common STI in United States; spread through
direct contact with warts, semen, or other fluids
 Chlamydia (bacterial)
 Causes infertility, pelvic inflammatory disease (PID),
and neonatal complications
Reserved. 8

 Factors influencing sexuality
 Sociocultural dimension of sexuality
 Impact of pregnancy and menstruation on sexuality
 Discussing sexual issues
 Sexual assessment and interventions need to be
included in health care.
 Nurses who have difficulty discussing topics related to
sexuality need to explore their discomfort and develop
a plan to address it.
Reserved. 9

 Contraception
 Factors that influence effectiveness: method of
contraception, understanding of the method,
consistency of use, compliance with requirements.
 Abortion
 It is essential to choose specialties or places of
employment where personal values are not
compromised and the care of a patient in need of
health care is not jeopardized.
 STI prevention
 Only abstinence is 100% effective.
Reserved. 10

1. Which of the following populations have the
highest incidence of STI? (Select all that apply.)
A. Hispanic women age 15 to 24 years
B. African-American men age 15 to 24 years
C. Caucasian men age 50 to 58 years
D. Caucasian women age 42 to 53 years
Reserved. 11

 Infertility
 Inability to conceive after 1 year of unprotected
intercourse
 Sexual abuse
 Nurses must report suspected abuse to the proper
authorities
 Personal and emotional conflicts
 Sexual dysfunction
 Absence of complete sexual functioning
 Affected by illnesses and medications
Reserved. 12

2. Upon admission, when gathering a patient’s
sexual history, nurses should:
A. focus only on physical factors that affect
sexual functioning.
B. discuss sexual concerns only if the patient
raises questions or concerns.
C. use emotionally laden terms when discussing
sexual concepts.
D. include questions related to sexual function.
Reserved. 13

 Nikki informs Ms. Jones that she has tested
positive for Chlamydia.
 Nikki explains that Chlamydia is the most
commonly reported infectious disease in the
United States, but most people never know
they have it. If it is left untreated, it can cause
PID, ectopic pregnancy, and infertility from
damage to the female reproductive organs, but
it can easily be treated with antibiotics.
Reserved. 14

 Integrate knowledge from nursing and other
disciplines.
 Have understanding of sex practices and risks
associated with sexual problems.
Reserved. 15

 Apply the nursing process and use a critical
thinking approach in your care of patients.
 Provides a clinical decision-making approach to help
you develop and implement an individualized plan
of care.
 Assess all relevant factors, including physical,
psychological, social, and cultural, to determine a
patient’s sexual well-being.
Reserved. 16

 Through the patient’s eyes
 Know patient’s expectations
 Set aside personal views
 Factors affecting sexuality
 Physical, functional, relationship, lifestyle,
developmental, and self-esteem
Reserved. 17

 Sexual health history
 PLISSIT Assessment of Sexuality:
 Permission to discuss sexuality issues
 Limited Information related to sexual health
problems being experienced
 Specific Suggestions—only when the nurse is clear
about the problem
 Intensive Therapy—referral to professional with
advanced training if necessary
Reserved. 18

 Sexual dysfunction
 Many illnesses, injuries, medications, and aging
changes have a negative effect on sexual health.
 Physical assessment
 Teach breast and testicular self-examination.
Reserved. 19

Anxiety Ineffective coping Social isolation
Interrupted
family
processes
Deficient knowledge
(contraception/STIs)
Sexual
dysfunction
Ineffective sexuality pattern
Reserved. 20

 Goals and outcomes
 Maintain the patient’s dignity and identity at all
times
 Develop an individualized plan of care
 Set measurable goals and outcomes
 Setting priorities
 Establish therapeutic relationship
 Often include resuming sexual activities
 Teamwork and collaboration
 Understand your knowledge base limits
Reserved. 21

 Health promotion
 Educate patients about sexual health.
 Have regular health and screening examinations.
 Acute care
 Illness and surgery create situational stressors that
often affect a person’s sexuality.
 Restorative and continuing care
 In the home environment, it is important to provide
information on how an illness limits sexual activity
and to give ideas for adapting or facilitating sexual
activity.
Reserved. 22

 Ask questions about risk factors, sexual
concerns, level of satisfaction
 When outcomes are not met, ask questions to
determine appropriate changes in interventions
Reserved. 23

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