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Attitudes towards the self associated with personal satisfaction and effective functioning?
Client is interdependent, insight,eval:attributes & limits, defines needs, has trust, feels has impact on life experiences, willing to experiment and risk change?
High Self-Esteem
Client overly dependent(pseudoindependent),min insight, devalues self:weak,worthless,cant define needs, doubts motivation of others, powerless, anticipates rejection and failure does not accept change?
Low Self-Esteem
Fostered by our culture and society, Threatened by unemployment, failure in school, often decreases with illness and hospitalization?
Doing Self esteem
Internal sense of being worthwhile, lack of toxic shame, received through unconditional positive regard, reinforced in healthy relationships?
Being Self esteem
Explain how self esteem effects our relationships?
"I want to be close"
"moves closer"
Anxiety felt
Increased anxiety and fear of abandonment
Reacts by pulling away or rejecting other
Name what can lower a persons self esteem?
1.Neg labeling in fm origin
2.lack of pos reinforcement from environment
3.alcohol or substance abuse
5.Body Image
Nursing Diagnosis and self-esteem?
Self-esteem, chronic low
Self-esteem, situational low
Social isolation
coping: ineffective
coping:family compromised
Risk for violence,self directed
Social aspects of human sexuality?
Social class/culture
Educational background
family of origin
childhood/adolescent sexual experiences
Biological aspects of human sexuality?
Meds:TCAs & SSRIs, antipsychotics, BDZs, CV agents, H2blockers, age
Psychological aspects of Human sexuality?
1.Self concept:
1.self-esteem,body image,gender identity,sexual orientation
Aspects of human sexuality:
Psychiatric disorders:
1.mood d/o(bipolar/depression
2.Anxiety d/o
3.Personality d/o
5.substance use d/o
6.Sexual addiction
Aspects of human sexuality:
1.Belief systems
2.connectedness with self &others
3.permission for personal pleasure
4.moral/ethical concerns
5.religious affiliation affirming beliefs
Sexual dysfunction:
Desire phase d/o:
Sexual phase d/o?
distaste for sex,
result of sexual abuse
past neg.experiences c sex
overly rigid religious beliefs
Sexual dysfunction:
Desire phase d/o:
Hypoactive sexual desire?
Absence of fantasies,
substance abuse
low hormone levels
relationship problems
Sexual arousal disorder:
Erectile d/o and female arousal d/o?
lack of vasocongestion
many causes(psychogenic/organic/combination)
Orgasm phase d/o:
Name the phases?
1.orgasmic d/o:spectatoring
2.premature ejaculation:due to age and lack of exp.
3.retarded ejaculation:taking too long
Sexual pain d/o:
1.Dyspareunia:painful intercourse

2.Vaginismus:involuntary muscle contraction
Factors contributing to sexual dysfunction:
Name psychological factors?
-taught that sex is dirty
-hx of childhood sexual abuse
-boundary dysfunction
-Past sexual trauma
-performance anxiety
-fear of failure
-guilt,anxiety or anger
-fear of intimacy
-fear of loss of control
Factors contributing to sexual dysfunction:
-sex in sinful
-overly rigid religious training in childhood
-sexual abuse
Factors contributing to sexual dysfunction:
-Punish as child for normal sex play
-lack of sex education
-lack of rltnshp and comm skills
-cultural beliefs
Factors contributing to sexual dysfunction:
-illness/injuries, medication
-Hormones,endocrine functioning
-failure to engage in effective sexual behavior
Nursing responsibilities:
Human sexuality?
-Self awareness
-comfort c own sexuality
-use sexual terminology
-non-judgemental attitude
-belief that sexual experiences is natural
-sexual expression many forms
-illness disrupts sex expression and practices
-Professional nurse/client
-assessment and Nsg DX
-referral and education
-knowledge of S.T.Ds
When can a nurse initiate a sexual assessment?
-discussing menstruation
-teaching of meds/SE
-medical or surgical problem
-assessng support system
-open ended ques about h/practices
What is needed when taking a sexual history?
-current problem
-onset and course of problem
-clients concept of cause or possible reasons not resolve
-past tx and outcome
-current expectations & goals of tx
Name two nursing diagnosis for sexual dysfunction?
-altered sexual patterns
-sexual dysfunction
Name sexual health interventions?Pliss model
Permission is given for?
- sex fantasies
- sex feelings
- masturbation
- personal techniques used that give pleasure
it's ok to continue what is pleasurable as long as you are coming from a position of informed choice and understand legal considerations. Reassurance is offered.
Limited information?
provide client with specific factual information directly relevant to a particular sexual concern.
with limited informatino what should you teach client about?
intercourse and other sexual practices
What specific information can you teach about sexuality?
-sexual response cycle
-meds effects
-dispel sexual myths
-help client id what is pleasurable
-educate on A&P
-teach relaxation techniques
-sexual positions
-refer to P.E & therapist
Specific suggestions?depends on>
-level of expertise
-advance training in sexuality
specific suggestions offers what to client> Why is this level effective?
-practical guidance for concerns
-effective for problems with arousal, erection, ejaculation, orgasm, dyspareunia
Name some examples of specific suggestions?
-assess dyspareunia and possible reasons and potential remedies
-teach premature ejaculation
-tech to increase sex.desire
-guidance of Ocp
-aging and sexuality
Intensive therapy:when is it used?
-when specific suggestions not successful
Intensive therapy is performed by? Name ex. that may require I.T?
professional c advance training in human sexuality

-Fetishistic behavior
-Transvestite behavior
-Transexual d/o
-pedophilic behavior
-exhitionist, masochistic(receive),sadistic(give,voyeuristic(watch)
-sexual addiction
E.D is due to?
-performance anxiety
-medical condition
E.D can be referred to?
Possible meds needed?
Need CPE
refer to urologist
-testosteron therapy
Alprostadil(prostaglandin E1)intravernous injections or papaverine intracavernous injections
-devices to increase vasocongestion
the person spends hours thinking or obsession about sex. gives a sexual high, time consuming person cannot fulfill work, school, or fam responsibilities?
Sexual addiction: Preoccupation
The individual engages in specific behaviors done just the 'right" way and in the same sequence each time. Ritual behaviors include wearing certain clothing, taking certain steps to get ready, driving certain routes, or looking for patterns only in
Sexual addiction:
The person cannot control sexual behavior, and this behavior becomes the most important aspect of life. Some demonstrate sexually compulsive behavior in a regular pattern, others resist for a time and then have a binge cycle?
Sexual addiction:
At the end of the cycle, the person experiences guilt and shame at the loss of control. The pain of despair creates the need to begin the cycle all over again, addict seeks to relieve pain by getting high. Unable to stop without treatment. breaking of de
Sexual addiction:
Shame and despair
Name 3 phases of Kaplan: for the sexual response cycle?
1.Desire phase
2.Excitement phase
3.Orgasm phase
Name 4 phases by masters and johnson: for the sexual response cycle?
1.Excitement phase
2.plateau phase
3.orgasm phase
4.resolution phase
Sexual aversion disorder
hypoactive sexual desire, this is what type of anxiety?
severe anxiety
during exitement phase
erectile disorder
sexual arousal disorder
premature ejaculation, will cause what type of anxiety?
moderate anxiety
during plateau phase
orgasmic disorder
retarded ejaculation will cause what type of anxiety?
mild anxiety
during orgasm phase
immediate short-term response to crisis?
Alarm phase"fight or flight"
Long-term metabolic adjustments occur?
Resistance phase
collapse of vital signs
Exhaustion phase
-due to exhaustion of lipid reserves
-inability to produce glucocorticoids
Name recovery groups for sexual addicts?
Sex addicts anonymous
Sex and love addicts anonymous
sexaholics anonymous
sexual compulsives anonymous
founded in 1982 with a desire to stop compulsive sex and develop own sexual recovery plan on how to express sex that will not endanger us or others?
Sexual compulsive anonymous
founded in 1978 with the goal to stay sexually sober and the desire to not lust. Any form of sex with one's self or with partners other than the spouse is progressively addictive and destructive?
Sexaholics anonymous
founded in 1976 with the goal of developing the real capacity for partnership based on authentic love and intimacy and the desire to stop living out a pattern of sex and love addiction. Sobriety is individually defined and involves andy sexual or emotion
Sex and love addicts anonymous

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