Psych-Summative Exam

• Four aspects of sexuality


  • Sexual identity
  • Sexual orientation
  • Sexual behavior
  • Gender identity
• Sexual identity


  The pattern of a person's biologic sexual characteristics
• Sexual orientation


  One's attractions, desires, and arousals towards others based on their sex and gender
• Sexual behavior


  How one responds to sexual impulses and desires
• Gender identity


  A person's sense of maleness or femaleness
• Sexuality orientations


  • Bisexuality (both sexes)
  • Transexual/transgender (individuals whose sexual identities are entirely with the opposite sex)
  • Heterosexuality (opposite sex)
  • Homosexuality (same sex)
  • Transvestism ("cross-dresser")
• Sexual response cycle


  1. Desire - ability, interest, and willingness to receive sexual stimulation

  2. Excitement - psychological stimulation, foreplay, physiological changes

  3. Orgasm - strong, rhythmic contractions, emission and ejaculation

  4. Resolution - organs and body systems return to unaroused state, satisfaction
• When is a sexual behavior abnormal?
• Types of sexual disorders


  • Alteration in gender identity
  • Alteration in sexual orientation
  • Alteration in sexual behavior
  • Alteration in sexual functioning
  • Painful sexual disorders
• Gender identity disorder


  A condition in which there is a discrepancy between an individual's gender identity and assigned (biological) sex
• Child behaviors signifying cross gender identity


  • Stated desire to be other sex
  • Cross-dressing
  • Cross-sex role play
  • Cross-sex toy and activity preference
  • Cross-sex peer affiliation
• Theories of gender identity disorder


  • Biological - pre- and post-natal hormone levels, genetic makeup
  • Psychological - how sex-linked characteristics are maintained and transmitted
  • Social - gender roles conveyed by family, authority figures, media
• Treatment for gender identity disorder


  1. Very young child - parents set limits on cross-gender behaviors

  2. Older child/Early Adolescent - puberty blocker, hormones

  3. Adults - individual and couples therapy
• Alteration in gender identity

  • Transsexualism - persistent discomfort about sex assignment, intense feelings about transsexual surgery, feeling trapped in wrong body
  • Gender identity disorder of childhood - persistent and intense distress at one's sexual identity
• Alteration in sexual orientation


  • Ego-dystonic homosexuality - client experiences inappropriate homosexual arousal pattern
• Alteration in sexual behavior


  • Sexual acting out - extramarital affairs, promiscuity
  • Paraphilia - sexual urges/fantasies directed toward nonhuman objects, pain, or non-consenting individuals
• Sexual dysfunction


  Individual is unsatisfied in their sexual function
• Types of sexual dysfunctions


  • Hypoactive sexual desire - absence of sexual fantasies and desires
  • Sexual aversion - avoidance of genital sexual contact
  • Sexual arousal disorder - persistent/recurrent lack of sexual excitement and pleasure
• Painful sexual disorders


  • Vaginismus - involuntary vaginal spasm at penetration
  • Dyspareunia - painful sexual intercourse
• Nursing diagnoses for sexual disorders


  • Altered sexuality patterns
  • Ineffective individual coping
  • Altered family process
  • Anxiety
  • Potential for violence: self-induced or to others
• Nursing interventions for sexual disorders


  1. Sexuality belief and values discussion

  2. Encourage discussion of feelings

  3. Explain suicidal precautions
• Substance abuse


  Overindulgence in or dependence on an addictive substance, especially alcohol or drugs
• Types of substances abused


  • Downers - depressants of the SNS
  • Uppers - stimulants of the SNS
  • Alcohol
  • Opiates
  • Narcotics
  • Hallucinogens
  • Stimulants
  • Inhalants
  • Cigarettes
• Intoxication


  A condition when physical or mental control is markedly diminished by the effects of alcohol or drugs
• Detoxification


  The process of removing toxic substances from the body
• Withdrawal


  When a person stops using drugs or alcohol and the brain produces a surge of adrenaline causing withdrawal symptoms
• Effects of alcohol intake


  • Aggression
  • Blackouts
  • Coordination problems
  • Difficulty walking
  • Slurred speech
  • Polyuria
  • Impaired attention, concentration, memory and judgment
• An overdose or excessive alcohol intake in a short period of time can result in altered level of consciousness, breathing depression and vomiting, coma, and death
• Wernicke-Korsakoff's syndrome


  Characterized by amnesia, clouding of consciousness, confabulation, and peripheral neuropathy
• Common behavioral problems of alcoholics


  • Denial
  • Dependency
  • Demanding
  • Destructive
  • Domineering
• Alcohol withdrawal syndrome


  1. Stage 1 (6-8 hrs after last intake) - anxiety, anorexia, insomnia, tremors, nausea/vomiting, hyperactivity, increased pulse and BP, depression

  2. Stage 2 (8-12 hrs after last intake) - confusion, gross tremors, nervousness, disorientation, auditory and visual hallucinations, illusions, nightmares
• Symptoms of alcohol overdose or excessive intake


  • Altered level of consciousness
  • Breathing is depressed and vomiting
  • Coma
  • Death
• Wernicke-Korsakoff's Syndrome


  Characterized by amnesia, clouding of consciousness, confabulation (falsification of memory) and peripheral neuropathy
• Common behavioral problems of alcoholics


  • Denial
  • Dependency
  • Demanding
  • Destructive
  • Domineering
• Alcohol withdrawal syndrome


  1. Stage I (6-8 hrs after last intake): Anxiety, anorexia, insomnia, tremors, N/V, hyperactivity, increased pulse and BP, depression

  2. Stage 2 (8-12 hrs after last intake): Confusion, gross tremors, nervousness, disorientation, auditory and visual hallucinations, illusions, nightmares

  3. Stage 3 (12-48 hrs after last intake): Severe hallucinations, seizures

  4. Stage 4 (3-5 days after last intake): Confusion, delirium, clouding of consciousness, disorientation, visual and tactile hallucinations, fever, increased BP, tremors, tachycardia
• Benzodiazepines


  Drugs used to reduce alcohol withdrawal symptoms, e.g. Lorazepam (Ativan), Diazepam (Valium)
• Disulfiram (Antabuse)


  Used to treat chronic alcoholism, an alcohol antagonist that inhibits the enzyme acetaldehyde dehydrogenase
• Fetal Alcohol Syndrome (FAS)


  Result of alcohol's inhibiting effects on fetal development during the first trimester of pregnancy, characterized by microcephaly, severe mental retardation, stillbirth
• Symptoms of sedative, hypnotic, and anxiolytic intoxication


  • Slurred speech and stupor
  • Impaired verbal communication
  • Coma
  • Lack of coordination
  • Unsteady gait
  • Labile mood
  • Impaired attention or memory
• Symptoms of barbiturate and hypnotic overdose


  • Respiratory arrest
  • Cardiac failure
  • Coma
  • Death