Imagine yourself working in a program with teenage individua…

Nursing questions:Discusion1. Imagine yourself working in a program with teenage individuals. What are some ways to discuss healthy relationships while being aware of the risks of sexually transmitted diseases, pregnancy, and rape?
references:1 :–i13o&t=8s2: Reproductive HealthBirth Control vs. ContraceptionPercentage of U.S. Women Ages 15-44Using Contraception and ReasonsFigure 5-1 Percentage distribution of women aged 15 to 49 years, by currentcontraceptive status: United States, 2015-2017.Data from Daniels, K., Abma, J.C. (2018). Current contraceptive status among women aged 15-49: United States, 2015-2017. NCHS Data Brief, no 327.Hyattsville, MD: National Center for Health Statistics. Available at: Perspectives of BirthControl Griswold v. Connecticut (1965)Mandated coverage for contraception forfederal employees via an act of Congress(1998)All new health insurance plans must cover allFDA-approved methods of birth control,sterilization, and related education andcounseling without cost sharing (2010).Race and Religion Also InfluenceContraception UseFigure 5-3 Percentage of all womenaged 15-49 who were currently usingfemale sterilization, oral contraceptivepill, male condom, or LARCs, byHispanic origin and race: UnitedStates, 2015-2017.Data from National Health Statistics Reports. National Survey of FamilyGrowth, 2015-2017. Available at: Awareness Methods“Free, no equipment necessary, but notreliable”Calendar methodAvoidance of intercourse during fertile time of month bycalculating time of ovulationBasal body temperatureFertility cycle related to changes in basal bodytemperatureCervical mucus or ovulation methodFertility cycle related to variations in type of cervicalmucusPros vs. Cons of FertilityAwareness MethodsPros Cons❑ No side effects❑ Used by anyone❑ Cost-effective❑ Limited effectiveness❑ Need to abstain fromsexual intercoursecertain days/month❑ No protection fromSTIsBirth Control PillsMost commonly usedform of contraceptive99% effectiveSuppresses awoman’sreproductivehormone cycleOne type of birth control pills.© Christy Thompson/ShutterstockOral ContraceptivesUsed by 16% of women aged 15-44 yearsPros Cons❑ Lighter and less painfulperiods❑ Reduced PMSsymptoms❑ Improved skin❑ Protection againstovarian and endometrialcancers, ovarian cysts,benign breast disease,and PID❑ Mood changes❑ Spotting❑ Weight changes❑ Drug interactions❑ Decreased libido❑ Headaches❑ Fluid retention❑ Health risks for somewomenHormone Delivery MethodsDepo-ProveraInjectable progestin every 3 monthsContraceptive patch (Xulane)Patch worn on skin for 1-week intervals; fourth week ispatch-freeNuvaRingFlexible, plastic ring inserted into the upper vagina andworn for 3 weeks; removed during week ofmenstruationBarrier Methods (1 of 5)SpermicidesFigure 5-4 Spermicidal agents.Barrier Methods (2 of 5)Diaphragm, cervical capDome-shaped latex cup sealing cervixFigure 5-5 Diaphragm Figure 5-6 Cervical cap.Barrier Methods (3 of 5)CondomsFigure 5-7 Condom useBarrier Methods (4 of 5)Female condomsPolyurethane sheath lining entire vagina and externalgenitalsFigure 5-8 The internal condom.Barrier Methods (5 of 5)Pros ConsCondoms offer protectionfrom STIs.Can be used as backupfor pill users (or with othermethods)Can be used for the shortor long termSmall risk of bacterialinfection or toxic shocksyndrome for diaphragm,sponge, and cervical capMust be used properlyMay have higher long-term costsIntrauterine Device (IUD)Small object insertedby clinician into awoman’s uterusEffectiveness issuperior to that of pills,patch, or ringAn IUD is a small object placed in theuterus through the cervix by aclinician.© Spike Mafford/Photodisc/ThinkstockPermanent MethodsFemale sterilizationTubal ligation = fallopian tubes cut and tied– Laparoscopic sterilization– Minilaparotomy– EssureMale sterilizationVasectomy = vas deferens cut and tiedOther Forms of ContraceptionAbstinenceNo penis-in-vagina intercourseWithdrawalCoitus interruptusBreastfeedingLactational amenorrhea method (LAM)Emergency Contraception (EC)NOT the same as RU-486, otherwise known as“the abortion pill”Use of high-dose birth control pills taken within72 hours of unprotected sexPlan B = progestin-only form of emergencycontraceptionella = another form of emergency contraceptionavailable by prescriptionFailure RatesA failure rate is the chance that the averagecouple using a given birth control method willbecome pregnant in a given year.Failure rates can be either for “perfect use” (idealconditions) or “actual use” (failure rate in the real world)Failure rates range from less than 1% to 30%.Condoms, sponges, and diaphragms have the largestdifference between these rates.Contraceptive FailureHigh rates of effectiveness—oralcontraceptives, hormone injectables andimplants, IUDs, condoms, vaginal hormonalring, hormone patch, sterilizationLower rates of effectiveness—diaphragms,cervical caps, sponges, spermicidal agents,fertility awareness methods, rhythm method,withdrawalHandling an UnplannedPregnancyAdoption—can be “open” or “closed”; privateor publicAbortionAbortionA controversial issue of debate or a very commonmedical procedure?…both, actuallyAbortion continues to be one of the greatestdebates in American society.© Rena Schild/ShutterstockPerspectives on Abortion (1 of 2)Why do women choose abortions?Pregnancy would reduce a woman’s ability to work,finish school, or care for others.Cannot afford a(nother) babyRelationship issues or not wanting to be a singlemotherCompleted childbearingNot ready for a(nother) childDid not want people to know she was pregnant or hadsexPerspectives on Abortion (2 of 2)Characteristics of U.S. abortion patientsMore than half are in their 20s; women ages 20 to 24have the highest rates.36% are non-Hispanic White, 30% are non-HispanicBlack, 25% are Hispanic, and 9% are other races.Six in ten already have one child.Three in ten have two or more children.Women in poverty have more abortions than wealthywomen.Abortion ProceduresSurgical abortionVacuum curettageDilation and curettage (D&C)Dilation and evacuation (D&E)Medical abortion (“abortion with pills”)Mifepristone, misoprostol (RU-486)Global PerspectivesMotherhood continues to be a major risk to life andhealth in the developing world (most of Asia, Africa,and Latin America)Informed Decision MakingIf you want to prevent pregnancyReview your and your partner’s needsPersonal medical historyReview failure ratesRisks and benefits of methodReevaluate periodically6: Sexual HealthSexual Health Defined:“A state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence ofdisease, dysfunction or infirmity. Sexual health requires apositive and respectful approach to sexuality and sexualelationships, as well as the possibility of havingpleasurable and safe sexual experiences, free ofcoercion, discrimination, and violence. For sexual healthto be attained and maintained, the sexual rights of allpersons must be respected, protected, and fulfilled.”World Health Organization [WHO]. (2006). Defining Sexual Health. Report of a technical consultation on sexual health 28-31 January2002, Geneva, Switzerland: WHO. Available at: on Sexual Healthand Sexuality (1 of 4)Cultural and religious dimensions“Marriage” is universal theme in all culturessanctioning sexual privileges and obligations.Sexual behavior is often defined by cultural values.– Normative sex roles– Acceptable types of sexual activity– Sanctions/prohibitions on sexual behavior– Premarital sex– Sexual restraint for females– Same-sex relationships– Contraception decision makingPerspectives on Sexual Healthand Sexuality (2 of 4)Economic dimensionsDaughter in marriage = dowryValue of bride = virginitySexual aggression = power and economicdynamicsCommercial sex industry/prostitutionPerspectives on Sexual Healthand Sexuality (3 of 4)Legal dimensionsLaws prohibiting certain types of sexualbehavior/intimacy—cohabitation, fornication,sodomySame-sex partnersMarriage, annulment, separation, divorce, childcustody, child supportPerspectives on Sexual Healthand Sexuality (4 of 4)Political dimensionsSex education in schools– Abstinence-only until marriage programs– Comprehensive or abstinence-plus programsClass DiscussionWhat are some current national or internationalnews items related to:The commercial sex industry or prostitution?Marriages between same-sex partners?Sex education curricula in schools?Sexual Behavior amongYouth in the United StatesFigure 4-1 Sexual behaviors among U.S. youth, 2017.Data from Centers for Disease Control and Prevention. (2018). Youth risk behavior surveillance—United States 2017. Surveillance Summaries. Morbidity and MortalityWeekly Report 67(SS-8):1-114Sex, Gender, and Gender IdentitySex: An individual’s biological status (male, female,intersex): anatomy, chromosomes, and biologicalcharacteristicsGender: The economic, social, and cultural attributesand opportunities associated with being masculine,feminine, or a combination of bothGender identity: An individual’s personal subjectivesense of being male, female, or somewhere in betweenHomologous Sex StructuresFigure 4-3 External genital differentiation-male and female.Definitions (1 of 2)IntersexA person who is born with sex chromosomes, externalgenitalia, or internal reproductive organs notconsidered “standard” as male or femaleGender expressionThe way a person acts to communicate gender withina given culture, such as clothing and interestsAndrogynyHaving characteristics of both sexes, but appearinggender neutralDefinitions (2 of 2)TransgenderUmbrella term for anyone whose biological sex is notaligned with the person’s sense of self or genderidentityGender dysphoriaPsychological term used to describe a strong andpersistent cross-gender identificationTransitioningProcess in which transgender people work to changetheir appearance and societal identity to match theirgender identityClass Discussion (1)What are some of the challenges faced bytransgender people? As individuals? Inschool? In social situations? In various publicplaces?What are some possible solutions to thesechallenges?Sexual Stereotypes: DiscussionWomen are undersexed and men are oversexed.Women are inexperienced and men are experts.Women are recipients and men are initiators.Women are controllers and men are movers.Women are nurturing and supportive, and men arestrong and unemotional.Women are sensitive and men are insensitive.Women are dependent and men are independent.Women are passive and men are aggressive.Sexual OrientationSexual orientation refers to one’s sexual andromantic attraction to other people, whether theattraction is to members of the opposite sex, thesame sex, or both sexes.Opposite sex = heterosexualSame sex = gay, lesbian, homosexualBoth sexes = bisexualIssuesHomophobiaProfilingDiscrimination in medical careExternal Female Sexual AnatomyFigure 4-4 External female sexual anatomy.Internal Female Sexual AnatomyFigure 4-6 Internal female sexual anatomy.Common Problems Related withMenstruationDysmenorrhea– Painful menstrual flowPremenstrual syndrome (PMS)– Group of symptoms linked to menstrual cyclePremenstrual dysphoric disorder (PMDD)– Severe form of PMSAmenorrhea– Lack of menstrual flowPhysical Health and the Well-Woman ExamExam stepsMedical historyGeneral physical examination– Breast examination and pelvic examinationPelvic examination– Phase I = external examination– Phase II = use of speculum; collection ofspecimens– Phase III = bimanual examinationSexual Arousaland Sexual ResponseMasters and Johnson: Female SexualResponse CycleFour Phases1. Excitement2. Plateau3. Orgasm4. ResolutionFigure 4-7 Masters and Johnson’s model lists threevariations among women in the sexual response cycle.Forms of Sexual ExpressionTraditional heterosexual positionsMasturbationPettingOral-genital stimulation (cunnilingus, fellatio)Anal intercourseUse of sex toys and accessoriesSexuality Through the Life Span (1 of 4)ChildhoodSelf-genitalstimulationEngage in play thatmay be viewed assexual in natureCurious aboutsecondary sexcharacteristicsChildren are innately interested in their bodies.© Asiaselects/Getty ImagesSexuality Through the Life Span (2 of 4)AdolescencePuberty– Secondary sex characteristicso Hair growth, breast budding, vaginal wallsthicken, uterus enlarges, vaginal pHincreases in acidity– Menarcheo About 2 years after breasts start to developand by the age of 15Sexuality Through the Life Span (3 of 4)Young to middle adulthoodIncreasing number of single, sexually active adultsMarriage at later ageIncrease in the number of women who never marryPlacing career goals and advanced educationbefore marriageIncreased divorce rateIncrease in cohabitating adultsIncrease in the number of women who no longerdepend on marriage to ensure economic stabilitySexuality Through the Life Span(4 of 4)Older adulthoodClimacteric—physiological changes that occurduring period from female fertility to infertilityMenopause—cessation of menstruation– Vaginal dryness and thinning, delayedlubrication, hot flashesDecline in frequency and intensity of sexualactivityQuality vs. quantity of sexual expressionSexual DysfunctionPrevalence– About 44% of U.S. women report sexual problems,with low desire being the most commons sexualproblem (38.7%).Historically called “frigidity”Areas of dysfunction– Sexual desire disorders– Sexual arousal disorders– Orgasmic disorders– Sexual pain disordersSex ResearchWell-known studiesKinsey Report (1948 and 1953)– Factors affecting sexual behavior in males/femalesMasters and Johnson (1966)– Sexual response cycle phasesRedbook Survey (1977)– Sexual behavior and attitudes of American womenHite Report (1976)– Sexual practices of American womenBlumstein and Schwartz (1983)– Sexual and nonsexual components of relationshipsABC Primetime Poll (2004)– Found most Americans were monogamous and happy about itClass Discussion (2)How do definitions of terms like “virginity” or “premarital”complicate sexual health research?Communication contributesgreatly to the satisfaction ofan intimate relationship.© Iofoto/Dreamstime.comSexual Violence as aPublic Health ProblemTypes of sexual violence Sexual assault and rapeFemale genital mutilation (FGM)Forced sterilizationInformed Decision MakingGynecological checkupUnderstanding personal feelings, thoughtsabout sexual well-beingUnderstanding the medical languageassociated with sexual healthUnderstanding responsible sexual behaviorUnderstanding myth vs. factCommunication between parents and childrenKnowledge of healthcare resources Plagiarism Free Papers
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