BACHELOR OF SCIENCE IN NURSING:

CARE OF MOTHER, CHILD AND

ADOLESCENT (Well Clients)
COURSE MODULE COURSE UNIT WEEK

1 2 2a
Human Sexuality

 Discuss the course and unit objectives

 Comprehend study guide prior to class attendance
 Read required learning resources; refer to unit terminologies for jargons
 Actively participate in classroom discussions
 Accomplish and submit assigned course unit tasks on time
 Participate in weekly discussion board (Canvas) Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive
1.Describe composition pertinent to reproductive and sexual health.
2.Assess a couple for anatomic and physiologic health, biologic gender, gender role, gender identity, and
readiness for childbearing.
3.Identify areas of care in relation to reproductive and sexual health that could benefit from additional
nursing research or application of evidence-based practice
Affective
1. Listen attentively during class discussions
2. Demonstrate tact and respect of other students opinions and ideas
3. Accept comments and reactions of classmates openly.
Psychomotor:
1.Participate actively during class discussions
2.Follow Class rule and Apply Netiquettes
3.Integrate knowledge of reproductive health and sexuality with nursing process to achieve quality
maternal and child health nursing care.

Adele Pilliteri, JoAnne Silbert-Flagg. (2018). Maternal and Child Health Nursing: Care of the
Childbearing and Childrearing Family. (8 th Ed.).

Ricci, Susan Scott Essentials of Maternity, Newborn, and Women's Health Nursing (4th Ed.)

Sexuality and Sexual Identity

Sexuality is a multidimensional phenomenon that includes feelings, attitudes, and actions. It has
both biologic and cultural components. It encompasses and gives direction to a person’s physical,
emotional, social, and intellectual responses throughout life.
 Biologic gender is the term used to denote a person’s chromosomal sex: male (XY) or female (XX).
Gender identity or sexual identity is the inner sense a person has of being male or female, which
may be the same as or different from biologic gender. Gender role is the male or female behavior
a person exhibits, which, again, may or may not be the same as biologic gender or gender identity.

Types of Sexual Orientation

Sexual gratification is experienced in several ways. What is
considered normal varies greatly among cultures, although
general components of accepted sexual activity are that it is an
activity of adults and privacy, consent, and lack of force are
included.
1. Heterosexual is a person who finds sexual fulfillment with a
member of the opposite gender.
2. Homosexual is a person who finds sexual fulfillment with a
member of his or her own sex. Many homosexual men
prefer to use the term “gay.” “Lesbian” refers to a
homosexual woman. More recent terms are “men who have
sex with men” (abbreviated as “MWM”) and “women who
have sex with women” (WWW). Many young adults are
worried about the stigma of being labeled homosexual and
therefore keep their identity secret from heterosexual
acquaintances.
3. Bisexuality - people are said to be bisexual if they achieve
sexual satisfaction from both homosexual and heterosexual
relationships. Like men who have sex with men, bisexual
men may be at greater risk for HIV and STIs than are
 others. Female partners of bisexual men need to be aware that they are also at
increased risk for HIV and other STIs.
4. Transsexual or transgender person is an individual who, although of one biologic
gender, feels as if he or she is of the opposite gender (Jain & Bradbeer, 2007). Such
people may have sex change operations so that they appear cosmetically as the
gender they feel that they are.
Types of Sexual Expression
1. Sexual abstinence (celibacy) is separation from sexual activity (Ott, Labbett, &
Gold, 2007). It is the avowed state of certain religious orders. It is also a way of
life for many adults and one that is becoming fashionable among a growing
number of young adults. It is the main point of many high school sex education
classes.
2. Masturbation is self-stimulation for erotic pleasure; it can also be a mutually enjoyable activity for
sexual partners. It offers sexual release, which may be interpreted by the person as overall
tension or anxiety relief. Masters (1998) reported that women may find masturbation to orgasm
the most satisfying sexual expression and use it more commonly than men. Children between 2
and 6 years of age discover masturbation as an enjoyable activity as they explore their bodies.
3. Erotic stimulation is the use of visual materials such as magazines or photographs for sexual
arousal. Although this is thought to be mostly a male phenomenon, there is increasing interest in
centerfold photographs in magazines marketed primarily to women. Some parents of adolescents
may need to be assured that an interest in this type of material is developmental and normal.
4. Fetishism is sexual arousal resulting from the use of certain objects or situations. Leather, rubber,
shoes, and feet are frequently perceived to have erotic qualities. The object of stimulation does
not just enhance the experience; rather, it becomes a focus of arousal and a person may come to
require the object or situation for stimulation.
5. Transvestite is an individual who dresses in the clothes of the opposite sex. Transvestites can be
heterosexual, homosexual, or bisexual. Many are married. Some transvestites, particularly
married heterosexuals, may be under a great deal of strain to keep their lifestyle a secret from
friends and neighbors.
6. Sadomasochism involves inflicting pain (sadism) or receiving pain (masochism) to achieve
sexual satisfaction. It is a practice generally considered to be within the limits of normal sexual
expression as long as the pain involved is minimal and the experience is satisfying to both sexual
partners.
Human Sexual Response
Sexuality has always been a part of human life, but it is only in the past few decades that it has
been studied scientifically. One common finding of researchers has been that feelings and attitudes
about sex vary widely: the sexual experience is unique to each individual, but sexual physiology (i.e.,
how the body responds to sexual arousal) has common features.
1. Excitement
• occurs with physical and psychological stimulation (i.e., sight, sound, emotion, or thought) that
causes parasympathetic nerve stimulation. This leads to arterial dilation and venous constriction
in the genital area. The resulting increased blood supply leads to vasocongestion and
increasing muscular tension.
• In women, this vasocongestion causes the clitoris to increase in size and mucoid fluid to appear
on vaginal walls as lubrication. The vagina widens in diameter and increases in length. The
nipples become erect.
• In men, penile erection occurs, as well as scrotal thickening and elevation of the testes. In both
sexes, there is an increase in heart and respiratory rates and blood pressure.
 2. Plateau
• The plateau stage is reached just before orgasm. In the woman, the clitoris is drawn forward and
retracts under the clitoral prepuce; the lower part of the vagina becomes extremely congested
(formation of the orgasmic platform), and there is increased nipple elevation.
• In men, the vasocongestion leads to distention of the penis. Heart rate increases to 100 to 175
beats per minute and respiratory rate to approximately 40 respirations per minute.
3. Orgasm
• Orgasm occurs when stimulation proceeds through the plateau stage to a point at which the
body suddenly discharges accumulated sexual tension.
• A vigorous contraction of muscles in the pelvic area expels or dissipates blood and fluid from the
area of congestion. The average number of contractions for a woman is 8 to 15 contractions at
intervals of 1 every 0.8 seconds.
• In men, muscle contractions surrounding the seminal vessels and prostate project semen into
the proximal urethra. These contractions are followed immediately by three to seven propulsive
ejaculatory contractions, occurring at the same time interval as in the woman, which force
semen from the penis.
4. Resolution
• Resolution is a 30-minute period during which the external and internal genital organs return to
an unaroused state.
• For the male, a refractory period occurs during which further orgasm is impossible.
• Women do not go through this refractory period, so it is possible for women who are interested
and properly stimulated to have additional orgasms immediately after the first.

Disorders of Sexual Functioning

1. Inhibited Sexual Desire
• Lessened interest in sexual relations is normal in some circumstances, such as after the death
of a family member, a divorce, or a stressful job change. The support of a caring sexual partner
or relief of the tension causing the stress allows a return to sexual interest.
• Decreased sexual desire can also be a side effect of many medicines. Chronic diseases, such
as peptic ulcers or chronic pulmonary disorders, that cause frequent pain or discomfort may
interfere with a man’s or a woman’s overall well-being and interest in sexual activity.
 • Some women experience a decrease in sexual desire during perimenopause. Administration of
androgen (testosterone) to women may be helpful at that time, because it can improve interest
in sexual activity.
2. Failure to Achieve Orgasm
• The failure of a woman to achieve orgasm can be a result of poor sexual technique,
concentrating too hard on achievement, or negative attitudes toward sexual
relationships.Treatment is aimed at relieving the underlying cause. It may include instruction
and counseling for the couple about sexual feelings and needs.
3. Erectile Dysfunction
• Erectile dysfunction (ED), formerly referred to as impotence, is the inability of a man to produce
or maintain an erection long enough for vaginal penetration or partner satisfaction (Wessells et
al., 2007). Most causes of ED are physical, such as aging, atherosclerosis, or diabetes, which
limit blood supply. It may also occur as a side effect of certain drugs.
• Examples of drugs prescribed today for ED are sildenafil (Viagra), tadalafil (Cialis), and
vardenafil (Levitra), which are taken up to once a day to stimulate penile erection.
• a surgical implant to aid erection by the use of vacuum pressure is a possible alternative
(Hossein, 2007). Testosterone injections may be helpful in some men.
4. Premature Ejaculation
• Premature ejaculation is ejaculation before penile–vaginal contact (Docherty, 2007). The term
also is often used to mean ejaculation before the sexual partner’s satisfaction has been
achieved. Premature ejaculation can be unsatisfactory and frustrating for both partners.
• The cause, like that of ED, can be psychological. Masturbating to orgasm (in which orgasm is
achieved quickly because of lack of time) may play a role. Other reasons suggested are doubt
about masculinity and fear of impregnating a partner, which prevent the man from sustaining an
erection. Sexual counseling for both partners to reduce stress, as well as serotonergic
antidepressants such as Mirtazapine, may be helpful in alleviating the problem.
5. Persistent Sexual Arousal Syndrome (PSAS)
• is excessive and unrelenting sexual arousal in the absence of desire (Mahoney & Zarate,
2007). It may be triggered by medications or psychological factors. When assessing someone
with the disorder, be certain to ask if the person is taking any herbal remedies such as Ginkgo
biloba because some of these can have arousal effects.
6. Vaginismus
• is involuntary contraction of the muscles at the outlet of the vagina when coitus is attempted
that prohibits penile penetration (Engman, Wijma, & Wijma, 2007).
• Vaginismus may occur in women who have been raped. Other causes are unknown, but it
could also be the result of early learning patterns in which sexual relations were viewed as bad
or sinful. As with other sexual problems, sexual or psychological counseling to reduce this
response may be necessary.
7. Dyspareunia and Vestibulitis
• Dyspareunia is pain during coitus. This can occur because of endometriosis (abnormal
placement of endometrial tissue), vestibulitis (inflammation of the vestibule), vaginal infection,
or hormonal changes such as those that occur with menopause and cause vaginal drying. A
psychological component may be present.
• Treatment is aimed at the underlying cause. Encouraging open communication between sexual
partners can be instrumental in resolving the problem.

EBSCO HOST http://search.ebscohost.com Usersname: OLFU PW: #fatima2020

http://dbctle.erau.edu/initiatives/seven/ Iowa State Center for Excellence in Learning and Teaching.
 Kumar Kar, S; Understanding normal development of adolescent sexuality: A bumpy ride. 2015 Apr-Jun;
8(2): 70–74

Sexual Orientation: The direction of one’s romantic and sexual attraction—to either the opposite, the
same, or both sexes. Includes heterosexual, homosexual, and bisexual orientations.
Gender identity is one’s internal sense of being either male or female, usually but not always the same
as one’s biological sex.
Sexuality - is about your sexual feelings, thoughts, attractions and behaviors towards other people.
You can find other people physically, sexually or emotionally attractive, and all those things are
a part of your sexuality.

The development of an adolescent occurs not in isolation, rather in the background of the family,
society in a defined culture, which significantly influences the adolescent sexuality. Society's attitude and
cultural perception of sexuality largely have an influence on the families in which an adolescent nurtures and
his or her sexuality cherishes ( Kumar Kar, 2015).

Puberty is an important landmark of sexuality development that occurs in the adolescence. The myriad
of changes that occurs in adolescents puts them under enormous stress, which may have adverse physical, as
well as psychological consequences.

1. Base on the article about understanding normal development of adolescent sexuality, make a reaction
paper about what influences adolescent sexuality.
2. What is the role of your family with regards to your understanding about sexuality, sexual identity and
sexual orientation?

Textbook:

Pilliteri, Silbert-Flagg. (2018). Maternal and Child Health Nursing: Care of the Childbearing and
Childrearing Family. (8 th Ed.) Wolters Kluwer

Devakumar (2019). Oxford Textbook of Global Health of Women, Newborns, Children, and Adolescents.
PB Publishing.

Murray (2019). Foundations of Maternal-Newborn and Women’s Health Nursing, 7th edition. Elsevier.

Flagg (2018). Maternal and Child Health Nursing: Care of the Childbearing and Chilrearing Family.
Wolters Kluwer
Wolters Kluwer. Audrey Berman, Shirlee J. Snyder, Geralyn Frandsen. (n.d.). Fundamentals of Nursing
by Kozier and Erbs (10th ed.).

Pearson. Maternal and Child Health. (n.d.). https://apha.org/topics-and-issues/maternal-and-child-health

Maternal, newborn and adolescent health. (n.d.). https://www.who.int/maternal_child_adolescent/en/

Rosalinda Parado Salustiano. (2009). Dr. RPS Maternal & Newborn Care: A Comprehensive Review
Guide and Source Book for Teaching and Learning. C & E Publishing, Inc.