Grief, Loss, Death; Nutrition & Fluids; Sexuality
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| 3 categories of loss | 1. anticipatory
2. actual
3. perceived
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| Perceived Loss | loss experienced by an individ but cannot be verified by others (loss of job creates feeling of a loss of independence)
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| Anticipatory Loss | grieving b4 loss has occurred
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| Loss | an actual or potential situation in which something that is valued is changed or is no longer available
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| Types of loss | declining health, loss of a body part, terminal illness, impending death of self or another, loss of possessions/beliefs/job, many more
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| What is the total response to the emotional experience related to loss? This is manifested in thoughts, feelings, & behaviors associated w/ sorrow. | Grief
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| What is the outward social expression of loss and what might this be influenced by? | Mourning, influenced by culture, spiritual beliefs, customs
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| What is the response experienced after the death of someone w/ whom a significant relationship was shared? | Bereavement
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| Which type of grief is brief, but genuine and is considered "normal" grief? | Abbreviated Grief
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| Which type of grief occurs when one is unable to acknowledge the loss to others, perhaps b/c it is a taboo? | Disenfranchised Grief
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| Which type of grief is considered maladaptive? | Complicated Grief
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| Name 4 types of complicated grief | 1. chronic/unresolved
2. delayed
3. exaggerated
4. masked/inhibited
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| This type of grief induces somatic symptoms b/c normal symptoms are suppressed. | masked/inhibited grief
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| This type of grief involves the use of dangerous activities to lessen the pain of loss | exaggerated grief
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| This type of grief occurs when a griever purposely or subconsciously holds off grieving for a while. | Delayed grief
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| This type of grief occurs when one has difficulty expressing grief, may deny the loss altogether, or may grieve beyond the expected time | Chronic/unresolved grief
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| What is the difference b/w situational and developmental loss? | Situational: loss of job, child, functional ability
Developmental: departure of grown children, retirement, death of aging parents
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| What are Engle's 6 stages of the grieving process? | 1. Shock & Disbelief (denies emotionally, accepts intellectually)
2. Developing Awareness (anger)
3. Restitution (mourning rituals)
4. Resolving the Loss (reminisces)
5. Idealization (repressed negativity about loss)
6. Outcome (depends on outside fa
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| What are Kubler-Ross's 5 stages of grief? | 1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
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| List 6 factors affecting the grieving process | * personality
* coping skills
* Hx substance abuse
* Hx mental illness
* Relationship to deceased
* Culture
* Gender
* Type of death
* Support system
* Experience & Hx of losses
* Age
* Culture & belief system
* Concurrent stressors
* Quality
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| 3 Components of a Grief Assessment | 1. nursing hx
2. assessment of personal coping resources
3. physical assessment
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| Behavioral patterns, emotional reactions, and coping patterns of grief fall into which of Neuman's variables? | psychological variable
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| What are some things to keep in mind when addressing Neuman's physiological variable in relation ot grief? | * Grief can have somatic effects
* Signs & symptoms, degrees of reaction
* History of significant losses
* Predisposing factors or stressors
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| How can children be negatively affected by loss, in terms of development? | Because parents or others may attempt to shield the child from the pain of loss, emotional development can be damaged; child may feel lonely, afraid, & abandoned
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| What are some common losses experienced in early and middle adulthood? | * loss of older parent
* mid-life crisis
* impaired health
* changing roles
* change in appearance
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| What are some common losses experienced in late adulthood? | * loss of health
* loss of mobility
* retirement
* limited income
* loss of longtime mate
* loss of independence
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| Rituals, bereavement, and mourning are all components of which Neuman variable? | Spiritual variable
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| Family changes relating to loss and cultural influences/rites are characteristic of which Neuman variable? | Sociocultural variable
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| 3 Nursing Dx | * Grieving (normal)
* Complicated (dysfunctional) grieving
* Risk for complicated grieving
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| How can nurses support a grieving client? | * Maintain an accepting, non-judgmental attitude
* Respect cultural practices & grief rxns
* Assist w/ rituals as needed
* Stay present
* Listen
* Identify support systems
* Refer to bereavement specialists
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| True or False: Nurses uncomfortable with death have a positive impact on clients. | False.
* The nurse may focus only on physical care
* The nurse may avoid emotionally sensitive convos that are necessary for client to resolve & communicate
* Limit contact w/ the patient & family: does not facilitate healing
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| What percentage of people die from chronic illness vs sudden death? | 90% chronic illness
10% sudden death
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| What is a major factor in determining where a person dies? | the availability & willingness of able caregivers
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| Who might a patient choose to die with? | family, "chosen" family, pets, or self (alone)
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| What type of care improves one's quality of life (not cure for dz) thru prevention & relief of suffering (doesn't mean ct is dying)? | Palliative care
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| Which type of care focuses on the support & caring of dying person & family with the goal to ease into a peaceful, dignified death & improve quality of life (of ct & family) thru dying process/bereavement | Hospice care
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| List 6 physical signs of decline. | * increased weakness & fatigue
* increased drowsiness, sleepiness
* decreased responsiveness
* confusion, disorientation
* decreased oral intake
* decreased ability to swallow
* restlessness & agitation
* incontinence
* change in bowel elimination
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| Should the nurse hydrate the dying patient? | If the pt is declining, one must keep the mouth moist, but do not attempt to hydrate. The dehydration causes the body to release comforting endorphins.
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| List 6 ways to provide comfort for the dying patient. | * pain management
* nausea meds
* allow adequate air flow
* mouth care
* scopolamine for secretions (do not suction... secretions are normal).. patches behind ear can be used to dry up throat
* turning & positioning
* gentle massage
* talk to patie
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| Signs of imminent death (w/i 6 hrs) | 1. Loss muscle tone
- low urine
- relxtn facial musc
2. Slowing circulation
- chnges in vs, lower BP & pulse
- cold, mottled limbs
3. Sensory imprmnt
- chnges in vision, taste, smell
4. Chnges in resprtions
- death rattle
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| Fears related to death | * being alone with patient
* how death will occur
* what to do with dead
* overmedication
* where does person go?
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| What does the nurse do at the time of death? | * communicate w/ fam
* remove tubes
* bathe/dress deceeased
* allow family time
* assist w/ phone calls
* notify healthcare parties
* assist w/ funeral arrangements
* destroy leftover meds
* initiate grief support
* aware of organ donor/autopsy
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| Good nutrition is necessary for what 3 things? | 1. growth
2. healing
3. maintaining body functioning
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| A poor diet increases the risk of: | * infection
* poor healing
* illness
* decreased mental & physical fxning
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| Some signs of good nutrition + nutrients involved. | * shiny hair (zinc & biotin)
* bright eyes (Vits A, C, E)
* Clear skin
* Appropriate body wt & dvlpmnt
* Regular BM (fiber, H2O)
* Alert
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| 6 Essential nutrients | 1. carbohydrates
2. lipids
3. proteins
4. vitamins
5. minerals
6. water
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| What are simple substances that are ingested, digested, & absorbed by the body cells for nourishment? | nutrients
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| Which nutrient provides the body's major source of energy and describe the types. | Carbohydrates (simple or complex)
1. sugar (mono, disaccharides)
2. starch (polysaccharides)
3. fiber (derived from plants)
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| Which carbohydrates are water-soluble, water-insoluble, or cannot be digested? | sugars are water-soluble, starches are insoluble, and fibers are indigestible
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| How and where are carbohydrates stored? | Carbs are stored as glycogen or fat, mostly in the skeletal muscles or liver
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| Which nutrient is essential for tissue growth & repair & is only nutrient that can make new cells? | Protein
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| The building blocks of proteins are? What are the 2 types and the difference b/w the 2? | amino acids
2 types of AA:
1. essential (must consume these)
2. nonessential (body can make)
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| Describe complete & incomplete proteins & give examples of each. | * Complete proteins: contain all essential AAs; include meat, fish, eggs, poultry
* Incomplete proteins: lack one or more essential AA; include soybeans, nuts, beans & usu derived from veggies (must combine to get all essential AAs)
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| What proportion of body solids are proteins? | 3/4
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| What type of nutrient is an organic substance, greasy & insoluble in water, but soluble in alcohol? | Lipid
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| 2 types of lipids | * fats (solid at room temp)
* oils (liquid at room temp)
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| Types of fatty acids | * unsaturated
* saturated
* simple
* compound
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| What is needed to create bile acids & steroid hormones and can be found in cell membranes? | cholesterol
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| What type of nutrient is organic & needed only in small amts to catalyze & regulate metabolic processes? | vitamins
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| List the fat-soluble & water-soluble vitamins. | Fat-soluble: A,D,E,K (stored in body)
Water-soluble: B,C (must be replaced regularly & are affected by food processing, preparation, & storage)
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| List the top 2 minerals & the percentage of minerals they comprise. | Calcium (most abundant) & Phophorus: 80%
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| List some body processes that minerals are required for: | * bone & teeth formation
* nerve & muscle fxn
* fluid & electrolyte balance
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| List some ways we can preserve the nutrient content of foods. | * Expose food to as little water as possible
* Keep lids on pans
* Avoid high temps
* Keep & use cooking water
* Store fruits & veggies cold
* Keep milk in opaque cartons
* Use foods in whole form
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| List 4 Dietary Guidelines | * maintain a healthy weight
* diet low in fat & cholesterol
* eat a variety of foods
* eat a well-balanced diet
* limit sugar, salt, alcohol
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| List some physiological stressors that impact an individ's normal & flexible lines of defense in maintaining adequate nutrition. | * inability to obtain food (physical, financial..)
* increase in caloric requirements (pregnant, wound healing, exercise increase)
* Difficulty in ingesting food/calories (loss of teeth, dysphagia, digestive dz, absorption probs)
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| List some psychological factors that impact an individ's normal and flexible lines of defense relating to maintenance of adequate nutrition | * Attitude toward food & eating (food preferences, familiarity)
* Food should be presented as a meal, not a treatment (to promote a positive & healthy attitude towards food)
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| List some sociocultural variables that affect nutrition. | * cultural/ethnic attitudes about eating/food
* lifestyle (cooking skills, working people, muscular and mental activities that require more calories
* Socioeconomic status (affects when, how often/much one eats (may not have oven, fridge)
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| Developmental stressors that may impact nutrition: | * Children need adequate nutrients, learn eating habits from guardians
* Females need more calcium, vitamin C, and iron as they age
* Males need increased protein, calories
* Elderly may eat less, need less, and dehydration is common
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| Spiritual variables that affect nutrition: | * Some religious practices have dietary laws & rituals (avoid certain foods (meat, caffeine, alcohol, shellfish)
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| DETERMINE: Factors used to assess nutritional status | D: dz
E: eating poorly
T: tooth loss/ mouth pain, NV
E: economic hardship
R: reduced social contact
M: multiple meds
I: involuntary weight loss
N: needs assistance in self-care
E: elder years (above 80)
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| List 4 nutritional things to assess. | * age, sex, activity
* increase in caloric requirements
* difficulty ingesting sufficient calories
* difficulty eating
* appetite changes, N,V,D
* weight changes
* med hx
* physical disability
* beliefs
* economic status
* health status
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| What is a 24 hour recall? | Nurse asks client to recall foods/fluids consumed over last 24 hours
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| BMI formula | weight in kilograms/height in meters squared
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| normal BMI | 18.5-24.9
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| A BMI over 30 indicates... | obesity
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| What interferes with mobility, breathing, & undernourishment? | morbid obesity
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| What does a BMI of 25.0-29.9 indicate? | overweight
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| What does a BMI below 18.5 indicate? | underweight
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| List 5 signs of inadequate nutrition. | 1. tired, listless appearance
2. abnormal weight
3. dry, scaly, flaky, bruised, pale, or pigmented skin
4. brittle, pale nails
5. dry, dull hair
6. pale, red, dry eyes
7. swollen, red, cracked lips, vertical fissures
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| List 5 signs of inadequate nutrition. | 8. swollen, beefy red, abnormally sized tongue
9. swollen, bloody, spongy gums
10. flaccid, wasted, underdeveloped muscles
11. anorexia, diarrhea, indigestion, constipation, enlarged liver
12. sensory loss, mental confusion, irritability
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| What should one always ask when doing an assessment (GI system)? | When was your last BM?
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| 3 important considerations when assess weight. | 1. Describe any weight loss or gain
2. Duration of change
3. Whether change in weight was intentional or not
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| 2 diseases that would indicate: Imbalanced Nutrition: Less than body requirement | kwashiorkor, marasmus
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| 4 lab tests most frequently used to assess nutritional status | 1. serum proteins
2. urea nitrogen
3. creatinine
4. total lymphocyte count
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| Common Nutritional interventions | * stimulating appetite
* assisting with meals
* dysphagia issues
* optimal assistance in feeding
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| What are the Dysphagia diets (4 consistencies) and who might have dysphagia? | 1. honey
2. nectar
3. thin
4. spoon-thick
* elders, stroke pts, cancer pts (radiation to head/neck), cranial nerve dysfxn
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| 2 Common Diets & description | 1. Regular (standard, hospital balanced diet: 2000 kcal)
2. Light (variation of regular, for post op, etc) less fat, less fiber
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| Who orders a diet usually? | MD
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| NPO means? | nothing by mouth
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| The following foods are okay for what type of diet: broth, tea, cola, plain gelatin, apple/cranberry juices? What might this diet be good for? | Clear liquids; a short-term diet, for preventing dehydration, relieving thirst, minimizing GI stimulation
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| Milk, cream soups, custard, grits, strained cereals, ice cream, pudding, yogurt are found in which diet? | Full liquid (liquid at room temp or melt at body temp... high cholesterol, not easy to take for long)
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| Which diet leaves minimal residue in bowel and is good for a pt who might have an ulcer? This includes no raw fruits, veggies, or fried foods) | Low Fiber or Low Residue diet
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| Which diet stimulates BM and includes fruits, veggies, whole grains? | High Fiber diet
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| Which diet is easy to chew and digest (chopped, pureed, strained, soft foods)? | Soft or Mechanical soft diet
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| Which diet would include no canned foods, low sodium & potassium foods, low protein, phosphorus, & fluids? Principle sources of energy are carbs & fats & must be supplemented w/ vits & electrolytes | Renal diet: indicated for end-stage kidney failure pts
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| Which diet is mechanically & chemically non-irritating & served at moderate temperature? | Bland diet
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| Which diet is indicated for obese, diabetic, cardiac clients & includes baked foods, fruits, veggies, lean meats, lean dairy? | Low Fat diet
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| Which diet is high in fats & protein, low in carbs, and is used for Tx of epilepsy? | ketogenic diet
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| A diet low in sodium, including no cannded foods/soups, no shellfish, no instant food, no sodas, no salt, no baking soda, no cholesterol is... | cardiac/hypertensive diet
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| These are between meal nourishments that prevent hunger, increase calories, increase protein for healing, and prevent hypoglycemia; can be served mid-morning, mid-afternoon, or at bedtime... + examples | Supplements:
* high protein shake: Ensure
* snacks of fruit, crackers, ice cream, milk
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| How can one assist a person who has vision impairment with meals? | * Open drink boxes, cutting food, buttering bread
* Explaining position of food according to the hour of the clock
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| List 3 things the nurse can do to prepare the person and room for a meal? | * provide toileting
* wash clt's hands/face
* sit clt up
* provide oral hygiene to maximize taste
* insert dentures
* remove bedpans & eliminate odors
* ensure diet right for clt
* offer alternate if meal
unappealing
* serve tray warm
* record
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| 3 ways to manage nausea/vomiting | * encourage fluid intake
* promote comfort
* provide oral care (esp after emesis)
* eliminate odors
* rest b4 meals
* encourage smaller meals
* give prescribed meds b4 meals
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| What precautions can be made to prevent aspiration? | * sit up 90 degrees
* dysphagia diet
* tip head forward w/ swallowing
* eat slowly, alternate food/fluids
* place in unaffected side of mouth
* check for pocketing
* keep head of bed elevated after meals
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| How long should one keep the head of bed elevated after meals for a patient on aspiration precautions? | 30-60 minutes
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| What is enteral nutrition and which 2 ways can it be administered? | tube feeding or gavage
* continuous
* intermittent
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| When might enteral nutrition be used? | * when upper GI is impaired
* when transport of food to small intestine is impaired
* anorexia
* severe dysphagia
* to prevent N,V, & gastric distention after surgery: suction
* Remove stomach contents for lab analysis
* Lavage the stomach (poisonin
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| Which type of enteral administration occurs over a 24 hour period, involves an infusion pump, and guarantees a constant rate? | Continuous feeding
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| Which type of enteral nutrition administration delivers 300-500 mL over several times during the day, usu thru the stomach, and over at least 30 minutes at a time? | Intermittent feeding
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| How long must the HOB be elevated after intermittent feeding? | 1-2 hours
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| How long should the HOB be elevated during continuous feeding? | at all times, in Semi-Fowler's position
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| Who might be at risk for aspiration? | Clt w/:
* Decreased LOC
* Poor cough/gag reflex
* Endotrach intubation
* Recent extubation
* Inability to cooperate
* Restlessness/agitation
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| Before feeding each time, it is imperative to do what? | check that the tube is in the stomach!
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| What is a normal stomach pH? | 1-4
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| How much food can one hold in the stomach when eating and how much is in there when it's "empty"? | One can hold 1 Liter when eating, but normally, the stomach holds 50 mL
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| What type of nutrition is used to rest the bowel, when nutrients cannot be absorbed? | hyperalimentation or total parenteral nutrition
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| Who might need hyperalimentation or TPN? | * severely malnourished
* severely burned
* bowel dz
* acute renal failure
* hepatic failure
* mets cancer
* major surgery
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| Which type of technique is used in TPN? medical or surgical? | surgical technique
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| TPN solution includes what ingredients and how is it administered? | * Ingredients: high glucose, calories, vitamins, minerals, electrolytes, proteins, & lipids
* Admin intravenously thru a central venous catheter (superior vena cava, diluted by blood in large veins)
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| How often should the dressing around a central line be changed? | q 72 hrs
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| True or false. Hyperalimentation is administered and removed quickly & abruptly. | False. TPN must be administered gradually to prevent hyperglycemia and must be tapered off to prevent hyperinsulinemia & hypoglycemia
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| A person receiving this type of feeding requires blood glucose monitoring: | TPN
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| What is the most important essential nutrient after O2? | water
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| This occurs when the amount of fluid taken in and lost is equal. | Fluid balance
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| What are charged particles capable of conducting electricity? | electrolytes: Na, K, Cl, Mg, P, etc
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| How does one receive fluids and electrolytes? | thru food, drink, IV therapy
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| How many mL/day does an adult need? | 2000-2500 mL/day
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| An average adult weight is what percentage of water? Is this more or less than an infant's? | Adult is 40-60% water
* Less than an infant, who is 70-80% water
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| When might the water requirement increase? | * hot weather
* fever
* exercise
* illness
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| List 4 normal methods and 4 Abnormal methods of fluid loss. | Normal:
1. Urination
2. Defecation
3. Expiration
4. Perspiration
Abnormal:
1. Emesis
2. Diarrhea
3. Gastric suctioning
4. Bleeding
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| What is insensible water loss and how much is lost/day? | This includes perspiration & expiration... we lose 300-400 mL/day from each
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| Normal Urine Output is how many mL/day? | 1400-1500 mL/day
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| 2 types of Body fluids | Intracellular and Extracellular fluids (ICF & ECF)
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| Where is ICF found and what proportion of body fluid does it comprise? | found w/i cells of the body, makes up 2/3 body fluid
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| Where is ECF found and what proportion of total body fluid does it comprise? | found outside body cells, makes up 1/3 total body fluids
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| CSF, pleural, peritoneal, and synovial fluids are types of what ECF? | transcellular fluids (TCF)
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| Lymph is a type of what ECF? | Interstitial fluid (ISF)
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| Plasma is a type of what ECF? | intravascular fluid (IVF)
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| List 4 things found in ECF and/or ICF. | * O2 from lungs
* Dissolved nutrients from GI tract
* Waste products (CO2)
* Ions (major components)
* Salts
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| What is the major cation and what is the major anion of ECF? | * Na+ is cation
* Cl- is anion
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| What are the major ions in ICF? | KCl
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| Water follows which ion, contributing to fluid balance in the kidneys? | sodium
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| Which mode of transport do fluids and electrolytes move thru cells and over membranes? | osmosis
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| What is the intermingling of molecules in liquid, gases, & solids by random movement? | diffusion
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| 3 ways the rate of diffusion varies: | * concentration of solutes in solution
* temperature of solution
* size of molecules
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| 4 fxns of electrolytes | 1. maintaining fluid balance
2. acid-base regulation
3. enzyme rxn facilitation
4. transmitting neuromuscular rxns
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| A serum sodium of less than 135 mEq/L is called | deficit: hyponatremia
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| A serum sodium of more than 145 mEq/L is | excess: hypernatremia
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| The serum sodium reference range is what and what is its function? | range is 135-145 mEq/L; assists in control & regulation of H2O balance
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| Where is serum sodium found and where is potassium serum found? | serum sodium is in ECF
serum potassium is found in ICF
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| The reference range of potassium serum is what? What are the deficit & excess terms used? | range: 3.5-5.0 mEq/L; a deficit (below 3.5) is called hypokalemia, and an excess (above 5) is called hyperkalemia
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| How often must potassium be ingested and why? | K must be taken daily b/c the body cannot store it
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| Functions of potassium in the body? | * vital for all muscle activity
* acid-base balance
* intracellular enzyme rxns
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| Functions of calcium and percentage of Ca in bones? | * regulating muscle contrxn & relxn
* neuromuscular fxn
* cardiac fxn as pacemaker
* 99% found in bones
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| 3 ways to assess body fluids | 1. V/S
2. I & O
3. Daily weights
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| List 3 labs used to assess fluid & electrolyte balance. | * serum electrolytes
* CBC + Hct: measures RBC volume (high volume = dehydration)
* Osmolality: blood solute cncntrtn
* Urine pH: measures kidney fxn
* Urine specific gravity: low when solutes are low, high = dehydrated
* ABGs: acid-base balance, O2
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| When should we assess fluid balance? | * fluid intake is limited
* fluid lost is greater than intake
* V,D, NG suction, bleeding, diaphoresis, polyuria
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| Dry lips & mucous membranes, dry skin & poor turgor, low urine output, dark & concentrated urine, hypotension, increased pulse, and infants w/ no tears and sunken eyes/fontanels indicates what problem? | dehydration
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| List 3 signs of fluid excess | * Intake exceeds output
* edema/swelling
* lung congestion
* increased V/S
* JVD
* Urine dilute when kidney is fxning properly
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| What is the best way to determine water balance? | * weigh the patient (w/ same clothing and scale)
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| Does a person with kidney, heart, or liver disease commonly have dehydration or overhydration? | overhydration
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| What protocol is followed when limiting a client's fluid intake? | * remove water pitcher
* sign over bed indicated restricted foods
* strict I&O watch
* divide fluid intake of 3 shifts
* provide frequent oral care
* limit diuretics
* encourage likable fluids
* hot fluids hot, cold fluids cold
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| How can one encourage fluids? | * force fluids: offer frequently
* maintain adequate intake by instructing client to drink x much by x time
* provide ice chips
* avoid thirst provoking foods (salt/sugar)
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|
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| When might a patient be NPO? | * Surgery
* Labs
* Illness
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|
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| What should be included when charting fluid input? | * Tube feedings & TPN
* Foods, fluids by mouth
* IV fluids
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|
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| What should be included when charting fluid output? | * urine
* emesis
* wound drainage
* diarrhea (size, consistency, odor)
* NG suction
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|
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| How much urine voided is normal/hour? | 30-50 mL/hr
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|
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| How many mL in an ounce? | 30 mL
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|
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| How many liters in a quart? | 1 L
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|
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| How many oz in a pint? | 16 oz
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|
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| How many mL in a tablespoon? | 15 mL
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|
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| How many mL in a teaspoon? | 5 mL
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|
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| What types of containers are used to measure fluids for intake or output? | * graduate
* urinal
* specimen cup
* pilgrim cap (hat)
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|
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| What should the ct be instructed to not do when using a pilgrim cap or bedpan? | Do not put toilet paper in pan!
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|
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| List 4 things that should be inspected and reported when administering IV therapy. | * redness
* swelling
* pain
* bleeding
* fluid not dripping from bag
* correct fluid
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|
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| List 1st 3 basic skills a nurse needs to address sexuality with a client. | 1. therapeutic communication skills
2. self-knowledge w/ own sexuality
3. knowledge of basic sexuality, how problems & Tx may affect sexuality & sexual fxn & interventions
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| List 2nd 3 basic skills a nurse needs to address sexuality with a client. | 4. knowledge of sexual growth & development thru/o life cycle
5. acceptance of sexuality as important, willing to help clients express their sexuality
6. ability to recognize need of client & family members to talk about sexuality
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|
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| Why do we study sexuality? | * To give clients accurate info about how their illness or meds may affect their sexuality
* Sexuality contributes to overall wellness
* Sexuality includes all 5 Neuman variables
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|
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| List 3 things that might affect our sexual values. | * religious teaching
* environmental influences
* social influences
* beliefs about sexual orientation
* sex roles
* life experiences
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|
||||
| List some cultural differences that affect sexual behaviors | * premarital sex
* incest taboo
* circumcision
* homosexuality
* rites of passage into adulthood
* sexual attractiveness
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|
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| What is most important question when addressing sexuality during physical assessment relating to current admission? | Do you believe this illness will have any effect on your sexual functioning? Describe.
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|
||||
| dyspareunia | painful intercourse
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|
||||
| the state in which an individual experiences a change in sexual fxn during desire, excitation, &/or desire, that is unsatisfying, unrewarding, or inadequate. | sexual dysfunction
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|
||||
| Defining characteristics of sexual dysfunction? | * verbalizing problem
* actual/perceived limitation imposed by dz/therapy
* alteration in relationship w/ SO
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|
||||
| Other related factors of sexual dysfunction? | * no SO
* lack of privacy
* altered body fxn/structure
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|
||||
| Physiological changes or characteristics associated with sexuality & problems. | * circumcision
* decreased lubrication in elderly
* medical illness: diabetes, arthritis
* physical appearance: scars, obesity
* physical trauma: spinal cord injury, surgery, rape
* hermaphrodite: intersexed
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|
||||
| 3 physiological issues related to medication & examples of each. | 1. loss of sexual desire/libido: antihypertensives, antianxiety meds, antidepressants, diuretics, hormones
2. erectile dysfunction: antiarrhythmics, anticholinergics, antipsychotics
3. orgasmic or ejaculatory dysfxn: same as 1 above
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|
||||
| How might Neuman's psychological variable affect sexuality? | * mental status
* self-awareness
* knowledge
* perception of self
* anxiety level related to sex
* emotions/feelings about sex
* self-esteem
* hx of rape/incest
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|
||||
| The family of origin, culture, race, family of choice, group affiliation, national origin, and education affect which of Neuman's variable regarding sexuality? | Sociocultural variable
🗑
|
||||
| Gender identity, age, sexual and basic developmental stage, maturational crises, moral development, and maturity level are characteristic of which Neuman variable in regards to sexuality? | Developmental
🗑
|
||||
| Neuman's spiritual variable affects sexuality how? | * love
* power
* values
* religion
* hope
* beliefs
* connection
* personal meaning
🗑
|
||||
| 3 domains of sexuality (NANDA): | * sexual identity
* sexual fxn
* reproduction
🗑
|
||||
| gender | physical sex of male or female: body parts
🗑
|
||||
| gender identity | the gender that one associates him or herself w/ regardless of physical parts
🗑
|
||||
| gender role | the role that culture defines as male or female... boys wear blue, girls wear pink, men are dominant, women are submissive
🗑
|
||||
| impotence | inability to sustain an erection
🗑
|
||||
| infertility | inability to produce viable eggs or sperm
🗑
|
||||
| climacteric | synonym for menopause
🗑
|
||||
| libido | sexual desire
🗑
|
||||
| retrograde ejaculation | when ejaculate shoots up into bladder instead of out urinary meatus
🗑
|
||||
| sexual deviance | Any deviation from cultural norms: sadism, masochism, voyeurism, exhibitionism, incest, transvestitism, zoophilia, bestiality, necrophilia, fetishism
🗑
|
||||
| Ineffective sexuality pattern | expressions of concern regarding own sexuality
🗑
|
||||
| Ineffective sexuality pattern may be related to... list 3. | * lack of SO
* ineffective or absent role model
* conflicts w/ sexual orientation
🗑
|
||||
| Altered sexuality pattern may include: | * reported difficulty, limitations, or changes in sexual behavior or activities
* alteration in relationship w/ SO or lack of SO
🗑
|
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