“Family is defined as a group of people related by blood, marriage, or adoption living together.
” by US Census Bureau “Two or more people who live in the same household, share common emotional bond, and perform certain interrelated social tasks” Types of Family 1. Dyad Family – Refers to two people living together, usually a woman and a man, without children.
Nuclear Family – Composed of a husband, wife and children. Cohabitation – Composed of heterosexual couples who live together like a nuclear family but remain unmarried. Extended Family - Includes not only the nuclear family but also other family members such as grandmothers, grandfathers, aunts, uncles, cousins and grandchildren. 4. Single-parent family – only one parent lives in the home. 5. Blended family (remarriage or reconstituted family) – a divorced or widowed person with children marries someone who has children. 6. Communal Family – comprise groups of people who have chosen to live together as an extended family. Their relationship to each other is motivated by social or religious values rather than kinship. 7. Gay or Lesbian Family – Individuals of the same sex live together as partners for companionship, financial security and sexual fulfillment. 8. Foster Family – Children whose parents can no longer care for them may be placed in a foster or substitute home. Foster parents may or may not have children of their own. 9. Adoptive Family – Families of a great many types (nuclear, extended, single-parent, gay and lesbian adopt children. Stages of Family Development Stage 1: Marriage and the Family During this first stage of family development, members work to achieve three tasks: a. establish a mutually satisfying relationship b. learn to relate well to their families of orientation c. If applicable, engage in reproductive life planning Stage 2: The Early Child-Bearing Family The birth or adoption of a first baby is usually an exciting yet stressful event that requires economic and social role changes. Stage 3: The family with Preschool children A family with preschool children is a busy family because children at this age demand a great deal of time related to their growth and developmental needs and safety considerations as unintentional injuries become a major health concern. Stage 4: The family with School-Age Children Parents of school-age children have the important responsibility of preparing their children to be able to function in a complex world while at the same time maintaining their own satisfying marriage relationship. Stage 5: The family with Adolescent Children The primary goal for a family with teenagers differs considerably from the goal of the family in previous stages, which was strengthen family ties and maintain family unity. Stage 6: The Launching Center Family The stage at which children leave to establish their own households is the most difficult stage because it appears to represent the breaking up of the family. Stage 7: The family of middle years A stage which may view as the prime time of their lives ( an opportunity to travel, economic independence, and time to spend on hobbies or as a period of gradual decline (lacking the constant activity and stimulation of children in the home, finding life boring without them, or experiencing “empty nest” syndrome. Stage 8: The family in Retirement or Older Age These individuals are more apt to suffer from chronic and disabling conditions than younger persons. Although families at this stage are not having children, they remain important because they can offer a great deal of support and advice to young adults who are just beginning their families Trends in Maternal and Child Health Care Implications for Nursing 1. Families are smaller than in previous decades Fewer family members are present as support in a time of crisis. Nurses must fulfill this role more than ever before.
2. Single Parents are increasing in number A single parent may have fewer financial resources; this is more likely if the parent is a woman. Nurses need to inform parents of care options and to serve as a back up opinion when needed. Health care must be scheduled at times a working parent can bring a child for care. Problems of latch-key children and the selection of child care centers need to be discussed. Good interviewing is necessary with mobile families so a health data base can be established; education for health monitoring is important. Screening for child or intimate partner abuse should be included in family contacts. Families are ripe for health education; providing this can be a major nursing role. Comprehensive care is necessary in primary care settings because referral to specialists may no longer be an option. Fewer family members are present as support in a time of crisis. Nurses must fulfill this role more than ever before. A single parent may have fewer financial resources; this is more likely if the parent is a woman. Nurses need to inform parents of care options and to serve as a back up opinion when needed.
1. 2. 3.
3. An increasing number of mothers work outside the home. 4. Families are more mobile than previously; there is an increase in the number of homeless women and children. 5. Abuse is more common than before. 6. Families are more health-conscious than previously. 7. Health care must respect cost-containment 1. Families are smaller than in previous decades 2. Single Parents are increasing in number
eclampsia. severe infection and abortion. prenatal care(International conference on Population and Development ICPD) Reduce maternal mortality rate by three quarters by 2015. Families are more mobile than previously.32 million women undergo induced abortion each year Young mothers account for 17% of induced abortions and 6% of spontaneous abortion. based on the concept of informed choices. postpartum care c. Expand the provision of maternal health services in the context of primary health care.000 to 1. Secretion helps lubricate the external genitalia. o Nurses should be conscientious about obtaining informed consent for invasive procedures o Nurses are legally responsible for reporting inappropriate or insufficient care provided by another practitioner. Families are ripe for health education. Dark and curly pubic hair growth in typical triangular shape that begins one or two years before the onset of menstruations. should include education on safe motherhood. Labia Minora Thinner. Abuse is more common than before.e. fatty. during coitus. smooth surface inside the labia. Families are more health-conscious than previously. a.
. Glands in the labia minora lubricate the vulva ii. Space between the labia is called the vestibule Clitoris Small erectile organ located beneath the arch of the pubis. FEMALE REPRODUCTIVE SYSTEM Mons Veneries Rounded.3. and secretes of fatty substance called smegma. soft. Skene’s glands (Paraurethral Glands) Located lateral to the vaginal opening on the both sides. Increase access to reproductive health services to 60% by 2005. prenatal care b. contains more nerve endings sensitive to temperature and touch. because care is often given to an “unseen client” – the fetus or to clients who are not of legal age for giving consent medical procedures. extending from clitoris to fourchette i. It lubricates the external vulva during coitus and alkaline ph of their secretions helps to improve sperm survival in the vagina. Labia Majora Lengthwise fatty folds and skin extending from mons to the perineum that protect the labia minora. Health care must respect cost-containment.Slow decrease in maternal death Increasing number of pregnant women in high risk category Major causes of maternal deaths are postpartum hemorrhage. It is easily stretched during childbirth to allow enlargement of vagina and passage of fetal head. The lack of access to quality health care is a major determinant in maternal and child mortality. 6. providing this can be a major nursing role. skilled delivery attendants during delivery d. urinary meatus. 7. skin-covered area between vaginal opening and anus. Comprehensive care is necessary in primary care settings because referral to specialists may no longer be an option. Bartholin’s Gland (Vulvovaginal Glands) Located lateral to the vaginal opening on the both sides. and vaginal introitus. and 100% by 2015. lengthwise folds of hairless skin. The leading causes of infant mortality are respiratory conditions of fetus. Good interviewing is necessary with mobile families so a health data base can be established. lose connective tissue over symphysis pubis. immunization Abortion: UP Population Institute Study: 403. Screening for child or intimate partner abuse should be included in family contacts. It also enclose the openings to the endings and vagina. congenital anomalies. o Documentation is essential in protecting the nurse and justifying his or her actions. Very sensitive because of rich nerve supply iii. 5. Maternal and Child health nursing carries some legal concerns that extend above and beyond other areas of nursing. education for health monitoring is important. diarrhea. Key points: Informing clients about their rights and responsibilities is helpful in protecting them. Perineum Muscular.
Health care must be scheduled at times a working parent can bring a child for care. i. Problems of latch-key children and the selection of child care centers need to be discussed. 4.
TRENDS IN THE STATUS OF REPRODUCTIVE HEALTH IN THE PHILIPPINES Maternal and Child Health Reduction in maternal mortality by one half of the 1990 levels by 2000 and a further one half by 2015. Vestibule The flattened. Understanding the scope of practice and standards of care can help nurses practice within appropriate legal parameters. 36% of women who are treated for abortion complications in various hospitals are young women. measles and nutritional deficiencies. 12% of all maternal deaths are due to abortion. 80% by 2010. An increasing number of mothers work outside the home. Hymen A tough but elastic semicircle of tissue that covers the opening to the vagina Fourchette Thin fold of tissue formed by merging of the labia major and labia minora below the vaginal orifice. there is an increase in the number of homeless women and children. ETHICOLEGAL ASPECT OF MATERNAL AND CHILD HEALTH CARE Legal concerns arise in all areas of health care.
Ovaries Oval. It secretes a thin alkaline fluid that when added to the secretion from the seminal vesicles that already accompanying sperm from epididymis further protects sperm from being immobilized by natural low pH level of the urethra due to passage of urine through the same lumen Urethra 3
.EXTERNAL STRUCTURE PENIS Comprises three cylindrical masses of erectile tissue. It contains the testes. Pelvis Serves to both support and protect the reproductive and other pelvic organs. Each innominate bone is divided into three parts namely the ilium. highly vascular. Prostate Gland Lies just below the bladder. it permits the coccyx to be pressed backwards. Infundibular – rim of the funnel is covered by fimbriated (hair covered) cells that help guide the ova into the fallopian tube. The urethra passes through the layers of erectile tissue that serves as both urinary and reproductive tract. Uterus Hallow. allowing more room for the fetal head as it passes through the bony pelvic ring during delivery. 2. each lobule containing interstitial cell. 3. two innominate bones that form the anterior and lateral portion of the ring and the coccyx and sacrum which compose the posterior aspects. The cavity of it is termed cervical canal. It carries sperm from epididymis through the inguinal canal into abdominal cavity. The sacrum forms the upper posterior portion of the pelvic ring. Seminal Vesicle Two convoluted pouches that lie along lower portion of posterior surface of bladder and empty into urethra by way of ejaculatory ducts. It conveys the one from the ovaries to the uterus and to provide a place for fetilization of vary by the sperm Parts: 1. This landmark is identified when securing pelvic measurements. maturation and discharge of ova and secretions of estrogen and progesterone. epididymis and lower portion of the spermatic cord Testes Each testes is encased by a protective white birous capsule and comprises a number of lobules. There is a degree of movement in the joints between the sacrum and coccyx. It acts the organ of intercourse and to convey sperm to the cervix so sperm can meet with the ovum in the fallopian tube. it offers added strength and support to the structure. furnish protection to a growing fetus and expels it from the woman’s body 3 Division of the Uterus 1. Vagina Hollow muscular membranes canal located posterior to the bladder and anterior to the rectum. The portion that can be palpated to determine uterine growth and during pregnancy and force of contraction and for he assessment that the uterus is returning to its nonpregnant state following childbirth. The coccyx comprises five very small bones fused together. It is a bony ring formed by four united bones. It is responsible for the production. thick. ischium and the pubis. INTERNAL STRUCTURES Epididymis A tightly coiled tube that totals approximately 20 feet. expels fetus during birth process then contracts around blood vessels to prevent hemorrhage outermost layer of uterus comprises connective tissue. Scrotum Rugated skin –covered muscular pouch suspended from the perineum. The function of the uterus is to receive the ova from the fallopian tube. Half of it lies above the vagina and half extends into the vagina. It enlarge greatly to aid in accommodating the fetus.5 cm.INTERNAL STRUCTURES Fallopian Tube Arises from each of the upper corner of the uterine body and extend outward and backward. two termed corpus cavernosa and a third the corpus spongiosum. detrimental to the growth of pathologic bacteria. it expands to serve as the birth canal. muscular pear-shaped located in he lower pelvis posterior to the bladder and anterior to the rectum. Isthmus – the short segment between body and cervix. It secrete a viscous portion of semen. is alkaline in pH. Ampulla – the longest portion and it is where fertilization usually occurs 4. It is where some sperm are stored and a part of the fluid that surrounds sperm (semen or seminal fluid) is produced by cells lining the epididymis Vas Defense (Ductus Deferens) Hallow tube surrounded by the arteries and veins and protected by a thick fibrous coating. MALE REPRODUCTIVE SYSTEM . which has a high content of basic sugar & protein. Fundus – upper segment and the most vascular. It is responsible for the conduction of sperm from testes to vas. (Leydig’s Cell) and seminiferous tuble. Isthmus – the portion that is cut or sealed in a tubal ligation 3. With childbirth. almonds –sized organs on either side of uterus that measures 4 by 2 cm. There is a marked anterior projection of this bone at the point where it touches the lower lumber vertebrae. comprised of smooth muscle fibers running in three direction. Seminiferous tubules produce spermatozoa while the Leydig are responsible for production of testosterone. Interstitial – lies within uterine wall 2. Because of this. The prepuce is retractable easing of the skin that protects the nerve – sensitive at birth. in diameter and 1. The function of the canal at the isthmus is the internal cervical as and the distal opening to vagina is called external cervical os. The blood vessels and vas deferens together are referred to as the spermatic cord. shed during menstruation and following delivery middle layer. The portion that is cut when a fetus is delivered by a cesarean birth. The glans is the distal end of the organ which is the bulging sensitive ridge of the tissue. a line that separates the uppers and lower segment Layers: inner layer. Doderlein’s bacillus is the normal flora of the vagina which makes the ph of vagina acidic. provide a place for implantation and nourishment during fetal growth.
• BANDL’S RING – pathologic retraction ring.Cervix – lowest portion and represent one third of the total uterus.
a combination of blood. average range of age 9-17 years Average 28 days: cycles of 23 to 35 days not unsual Average flow: 2-7 days. Ovaries . Prostaglandins fatty acids categorized as hormone produced by many organs of the body.Hollow tube leading from the base of bladder that. follicular. Estrogen secreted primarily by the ovaries. estrogenic.releases FSH and LH FSH. first 4-5 days of a cycle . 2. average 30-80 mL per menstrual period.contain 2 million immature ova (oocytes) at birth. formed during the first 5 months of intrauterine life . or postmenstrual phase
. Follicle – stimulating hormone (FSH) Secreted by anterior pituitary gland during the first half of menstrual cycle Stimulates development of graafian follicle Thins the endoemetrium 2. including the endometrium affects menstrual cycle influences the onset and maintenance of labor 4 Body structures are involved in the physiology of the menstrual cycle:
1. continues to the outside through the shaft and glands of penis. causes suppression of FSH secretions assists in maturation of ovarian follicles responsible for the development of secondary sex characteristics stimulates uterine contraction mildly accelerate sodium and water reabsorption by kidney tubules.Estrogen.releases LHRH or GnRH . It is alkaline in nature and contains a basic sugar and mucin (protein) PHYSIOLOGY OF MENSTRUATION Menstruation is the periodic discharges of blood. stimulates secretion of prolactin accelerate protein anabolism 4.occurs immediately after menstruation. Luteinizing hormone (LH) secreted by pituitary gland stimulates ovulation and development of corpus luteum thicknes the endometrium 3.a hormone that becomes most active at the midpoint of the cycle and is responsible for ovulation or release of the mature egg cell from the ovary and growth of the uterine lining during the second half of the menstrual cycle. by the adrenal cortex and by placenta in pregnancy stimulates thickening of the endometrium. 4.hormone that is active early in the cycle and is responsible for the maturation of the ovum LH.day 14. ranges of 1-9 days not abnormal Difficult to estimate.also termed as proliferative.or female reproductive cycle is defined as periodic uterine bleeding in response to cyclic hormonal changes Menarche – first menstrual period that occurs typically at age 12 but many occurs as early as 9 or as late 17 Menopause – the cessation of menstrual cycles that occurs between 40 and 55 years Term Beginning (Menarche) Interval between cycles Duration of menstrual flow Amount of menstrual flow Color of menstrual flow Characteristics of Normal Menstrual Cycle: Description Average age of onset: 12 or 13 years.deficiency results in delayed puberty and diseases causing early activation lead to abnormally early sexual development or precocious puberty Pituitary gland. LH. mucus and endometrial cells
REPRODUCTIVE HORMONES 1. saturating a pad or tampon in less than an hour is heavy bleeding Dark red. after passing through the prostate gland. Bulbourethral Glands (Cowper's Gland) Lie beside the prostate gland and by short ducts empty into the urethra.Progesterone Uterus Phases of the Menstrual Cycle Proliferative Phase (first phase of Menstrual Cycle) .
3.FSH. Progesterone secreted by corpus luteum and placenta during pregnancy inhibits secretions of LH has thermogenic effect (increase temparature) relaxes cervical secretion of thick mucous maintain thickness of endometrium allows pregnancy to be maintained 5.
Hypothalamus. . increase water content of uterus high estrogen concentration-inhibits secretion of FSH and prolactin but simulates secretion of LH low estrogen concentration after pregnancy. mucus and epithelial cells from the uterus Menstrual cycle .endometrial lining is very thin -FSH stimulates the release of Estrogen which cause a very rapid increase in the thickness of the endometrium (“Proliferate”) from approximately day 5. They secrete an alkaline fluid that helps counteract the acid secretion of urethra and ensures safe passage of spermatozoa Semen The content of semen or fluid that accompanies spermatozoa is derived from the prostate gland (60%) seminal vesicles (30%) epididymis (5%) and bulbourethral (5%).
luteal. sex later -not aroused by nature -does not need necessarily orgasm for procreation
. day 24 or day 25 of the cycle wherein the capillaries rupture. Sexuality influenced by life experiences. Public expression of gender identity. LH stimulates the formation of progesterone in the corpus luteum which causes the glands of the uterine endometrium to become twisted in appearance and dilated with quantities of glycogen and mucin until the lining takes on the appearance of rich.excellent sperm survival Discomforts of Menstruation 1. GENDER IDENTITY = Is the sense of being feminine and masculine.cervical mucus becomes thick and scant. love later -Sexuality awakened by nature -need orgasm for procreation
Differences Between Man and Woman WOMAN
-love first. Hypomenorrhea abnormality shot menstruation 8. psychological. The word SEX has a more limited meaning. social. with minute hemorrhages. spongy velvet. GENDER-ROLE-STEREOTYPE = A generalization that reflects our beliefs as males and females.poor sperm survival At the time of ovulation: estrogen level is high. Dysmenorrhea painful menstruation 3. both genetic and anatomical. . Theories of Gender – Role Development Cognitive – Development theory – process that gender – role development emerges through children's growing cognitive awareness of their identity. Menses (Final phase of the menstrual cycle) Products discharged include: • Blood from the ruptured capillaries • Mucin from the glands • Fragments of endometrial tissue • Microscopic. SEXUAL ORIENTATION = Clear.Tendency towards fatigue 3. PATTERNS OF FUNCTIONING EROTIC SEXUALITY Eros. GENDER = The social meanings attached to being a female or male. As a result of life’s changes or a choice. premenstrual.because of hormonal influence and decreased levels of estrogen and progesterone 4. It has biological.Breast tenderness and feelings of fullness 2.Discomfort in pelvic area. and ethical components. desire or potency. socio-cultural influence. GENETIC SEX/ BIOLOGIC SEX = Biological maleness or femaleness as determined by our chromosomal make up. or secretory phase. Sex may be used for pleasure and reproduction. Social – Learning theory – gender – role are learned through invitation of sex-typed behaviors. Denotes specific sexual behavior such as sexual intercourse.occurs when the corpus luteum regresses after 8-10 days of ovulation which then decreases the production of progesterone and estrogen since fertilization did not take place. erotic preference of a person for one sex or the other TRANSEXUAL = The inner of sexual identity. Identification theory – a psychoanalytic theory that suggest a child develops a gender role by interacting closely with and emulating the behavior of the parent of the same sex. ANATOMICAL SEX = Physical characteristics and features that distinguish female from male. Polymenorrhea too frequent menstruation 5.Secretory Phase (second phase of the menstrual cycle) -happens after ovulation. GENDER ROLE = The way that a person acts as female or male. SEXUAL PREFERENCE = The choice of sexual partners. Menorrhagia excessive menstrual bleeding 6. Oligomenorrhea infrequent menstruation 4. Amenorrhea absence of menstrual flow 2.Retained fluids and weight gain Abnormalities of Menstruation 1. Metrorrhagia bleeding between periods 7.the degeneration of the endometrium approx. and the endometrium sloughs off. caring and intimacy shared between sexual partners MAN -Sex first. which does not match the biological body TRANSVESTITE = A heterosexual man who usually dresses like a woman for psychological and sexual relief.cervical mucus becomes thin and copious. persistent. .Greek name of the Lord of Love Love-a complex phenomenon and is variously defined and understood . lower back and legs 5. and unfertilized ovum The Cervix First half of the cycle: low hormone secretion. SEXUAL IDENTITY = One identity as either female /male based on biological characteristics. SEXUALITY is often described as the sense of being female or male.Temperament and mood changes -. Hypermenorrhea abnormality long menstruation CONCEPTS ON SEXUALITY Sexuality and sex are two different things. Ischemic Phase (third phase of the menstrual cycle) .often romanticized and create strong personal expectations Erotic Love-expressed as sexual relationship which may include affection. SEX = A person's biological status as either a male or female. Determine by biologic sex. atrophied.also termed as progestational. APHRODISIAC = A substance thought to increase sexual arousal. Behavioral theory – gender role behavior are conditioned by the environment. It usually describes the biological aspects of sexuality such as genital sexual activity. Sexual activity may be absent from a person’s life for brief or prolonged periods.
Obscene phone calling
. memories and images. b. particularly the skin.surgery or operation (synthetic vagina or penis is created). a. Extra marital – having sex with another man or woman. 4. Psychogenic – stimuli are processed through higher brain centers. thoughts. Breast -nipple f. Genitals – G (grabenburg) spot Pinpointing Erogenous Zones
B.excitement capable of multiple orgasm
Types of Sexual Relationships 1. The Sexual Response Pattern 1. Homosexuality B. touches. kissing or licking. Coitus – sexual intercourse. anxious. Foreplay – or pre-coital stimulation 1. Fellatio – oral stimulation of penis.having sexual encounters with children 3.simultaneous oral genital stimulation by 2 person's. Types of Sexual Expression 1.lesbian 3. fantasies. Genital Stimulation – sexual stimulation to the female organs. excitement. . Erogenous zones – parts of body richly supplied with nerve endings and give sexual pleasures.. Bisexuality – sexual satisfaction from both homosexual and heterosexual relationships. Buttocks g. labels concerning aspects of sexuality B. 4.stimulation center is on the lower part of the spinal cord. Transvestism – achievement of sexual gratification by dressing in the clothing of the opposite sex. 2. -biologic gender feels as he or she should be at the opposite gender. Human Sexual Response Cycle Sexual Physiology – is how the body responds to sexual arousal. Myotonia – muscle contractions Types of Sexual Orientation 1.is self-stimulation for erotic pleasure. Petting Orgasms – rhythmic contractions of genital organs & surrounding tissues. . images and fantasies. Forms: Cunnilingus – stimulation of female genitalia by tongue and mouth. . 4. taste and smell. fear C. 4. Masturbation – Normal self stimulation of genitals. 3. 5. Thighs – inner thigh h. it can also be a mutually enjoyable activity for sexual partners Other types of Sexual Expression 1.excitement easily and have single orgasm
-passive-submissive role -slow sexual response and in reaching sexual . 3. Soixante – neuf (“69”) . Transsexuality – individuals who are genetically of one sex but psychologically and emotionally of another. Informational response – consist of belief. Bisexual C. Celibacy – abstinence from sexual activity. Sodomy – penis entering the rectum. which reach an apex and culmination in sexual excitement. Forms of Sexual Stimulations 1. teeth and tongue or licking.finds sexual fulfillment with a member of the opposite gender. Non – traditionals A.joy. Neck/ nape d. sound. smile. 2. Lip to lip. Emotional -perception/ feelings about sexual stimulus. Pedophilia. Masturbation. Fetishism – use of objects for sexual arousal. Kissing – involves senses of touch. 2. Sadism – hurting somebody 5. 6. 3. sucking. Autosexual A. Post marital – having sex during after a death of a spouse. Psychological Mediators of Sexual Response: A. Anal stimulation Anilingus – oral anal stimulation. 2. 1.revealing genitalia in public 2. 2. Masochism – hurting oneself 6. women. Lips – respond to touch. reach sustained sexual . Body – the entire body. Back of the Ears e.include sensory. Exhibitionism. kissing. Heterosexuality. Breast Stimulation – tactile stimulation of the breast which can produce pleasurable contractions in m the pelvic region. c. Voyeurism – sexual arousal by looking at another's body. Sexual Fantasies – involved idealized sexual stimulation. quiet.-active-aggressive role -rapidly aroused. Homosexuality – finds sexual fulfillment with a member of his/her own sex. Kissing 2. happy. knowledge.sexual connection between man and woman while using the vagina to receive the penis. Reflexogenic – cerebral cortex and higher brain centers are not involved. inputs as sight. . Tactile stimulations – touching any body area. Imaginative Capacity – memories. men -gay. Premarital – having sex before marriage. taste.
STAGE MODEL (HELEN SINGER KAPLAN) DESIRE PHASE – specific neural system in the brain produces sexual desire or libido. spontaneous excitement. vagina widens in diameter and increases in length Plateau Phase. vaginal lubrication occurs arterial dilation and venous constriction in the genital area overall muscle tension increase nipples. elevation of testes heart rate.vasoconstriction and myotonia developed from sexual stimuli are released. Clitoris increase in size. the family and friends.
THE KAPLAN THREE. OROGENITAL STIMULATION or oral stimulation of the vulva or the male genitals Cunnilingus – oral stimulation of the female genitalia. In freudian psychoanalytic theory. COITAL POSITION – diversity of coital position for greater satisfaction under certain situational indications such as pregnancy. usually the labia and the clitoris Fellatio – oral stimulation of the penis.Self-stimulation of the genitals to the point of sexual arousal
ILLNESS AND SEXUALITY Illness alone has a great impact on sexuality.occurs with physical and psychological (i. 2.Highlights characteristics of human beings that differentiate us from other animals.
EXCITEMENT PHASE – characterized primarily by genital congestion. emotion.1998) the shortest stage in the sexual response cycle strong muscular contractions both voluntary and involuntary in many parts of the body including rectal sphincter muscle contraction of uterine muscles respiratory rate reaching a peak of two or three times normal. heart rate doubling and blood pressure increasing as much as one third above normal ejaculation of male’s semen. respiratory rate and blood pressure increase. ORGASM PHASE . 3. . or thought) stimulation causes parasympathetic nerve stimulation.a form of sexual expression since the entire body surface is a sensory organ. Some pharmaceutical agents to treat diseases interfere with normal sexual functioning. Autoeroticism. 3. thighs and back breathing becomes deeper. There are very few Chronic Illnesses that affect sexuality and these are: Diabetes Mellitus Myocardial Infraction
. Some illnesses cause physiological changes that may interfere with normal sexual functioning.. formation of orgasmic platform in men. CELIBACY or the choice not to engage in genitals sexual intercourse MASTURBATION .the emotion that encompasses care of another person.
TYPICAL SEXUAL BEHAVIORS involve sexual activities that are statistically common and acceptable Examples of these are: LOVE . and physical/ sexual expression.PHASES OF MASTERS AND JOHNSON'S SEXUAL RESPONSE CYCLE Excitement phase: . erection increase and scrotal thickening. Orgasmic Phase . become erect and breast size increase in men. Depression.occurs when stimulation proceeds through the plateau stage to a point at which the body suddenly discharges accumulated sexual tension (Masters et al.
2. medical or post-surgical conditions or handicapped. the driving force of the id. orgasm and variation. ANAL STIMULATION . sight. sound. may lead to decrease libido. heart rate and blood pressure increase markedly Secretions from Cowper’s gland in male. which leads a person seeds out or become responsive to sexual experiences.such as dreams that serve to enhance sexual arousal and erotic dreams SHARED TOUCHING .reached just before orgasm nipples become further engorged in women. LIBIDO – sexual desire.or self-stimulation of the genitals intended to produce sexual pleasure TYPICAL AND ATYPICAL SEXUAL BEHAVIORS
EROTIC FANTACY . Resolution Phase generally takes approximately 30 minutes for both men and women general muscle relaxation occurs flushing disappears heart rate and blood pressure return to normal external and internal genital organs return to an unaroused state
1.e.is engaged in by couples for arousal. full distention of the penis flushing may spreads to abdomen. a common side effect of illness. instinctual sexual drive.
• Sexual Aversion Disorder .4. 6. and emotions in relation to sexual matters. attitudes. 3. chronic pulmonary disorders 2. threatened.is a condition in which an erection is maintained but ejaculation is delayed for prolonged period. neurological disorders and arthritis Surgical Procedures – removal of prostate gland. it is similar to impotence in men. 5. STDs. Zoophilla = Bestiality or sexual contacts between humans and animals. B. or has orgasms that are difficult to achieve despite appropriate stimulation.. evaluate your own past
. Paraphilias = ( deviant attractions ) in extreme forms are socially unacceptable deviations form the traditionally held norms of sexual relationships. and knowledge concerning sexual matters. Guilt Anxiety Ignorance or inhibitions about sexual behavior. Problems that prevent an individual or couple from engaging in or enjoying satisfactory sexual intercourse and orgasm. of dependence on another person. or abused. Necrophilla = Sexual interest in having intercourse with corpses. Previous traumatic sexual experiences ( for example rape. Both disorders have physical or psychologic causes. ask for feedback on yourself from another person or from group members. sometimes in preference to contact with humans. excision of both testes Spinal cord injuries
SEXUAL DYSFUNCTION The term sexual dysfunction refers to an impairment in the ability to obtain gratification from sexual intercourse. emotions. values.is persistent. Chronic diseases. read as extensively as possible on the subject of sexuality while practicing keeping an open. The following are beginning steps the nurse can take to be more effective when she plans to have help provide sexual health care: 1. Learn to know one self.e. emphysema. Masochism = it constitutes sexual enjoyment in being physically harmed.
Dyspareunia – painful intercourse.is a persistent loss of sexual fantasy and little desire for sexual activity. stroke. . peptic ulcers. 7. or of pregnancy. She should study her own feelings. a woman prefers to wear men’s clothing. Obesity 3. Transvetism = a man occasionally prefers to wear women’s clothing. People with this disorder believe that they are a victim of a biologic accident (that occurred before birth).
The role of the nurse includes dealing with patients experiencing sexual problems. nurses are sexual being and their nursing practice is influenced by their beliefs. The nurse must first be comfortable with her own sexuality before she can effectively deal with sexual matters concerning her patients. .
IMPLICATIONS FOR NURSING Just like all other humans. or less commonly. genital or deep pelvic pain experienced during intercourse. incest or sexual abuse.is the persistent failure to attain or maintain sexual excitement despite adequate sexual stimulation. or sexual failure ) Performance anxiety ( worrying about performance during intercourse ) Feeling like a spectator rather than participant Discord or boredom with a partner PSYCHOSEXUAL DISORDERS Transsexualism = is a distinct gender identity disorder. is a sexual enjoyment a person receives from inflicting actual physical or psychologic suffering on a sex partner. Pedophilia = is a preference for sexual activity with young children.g. • Sexual Arousal Disorder in Women . Use various techniques when learning to promote self-awareness: discuss sexual matters with others in group discussions or with one other person for whom you have respect. has orgasms that are delayed much longer than she and her partner desire.e. Female • Inhibited sexual desire/orgasm . • Orgasmic dysfunction/ anorgasm – inability to achieve orgasm. Fetishism = sexual activity makes use of physical objects. SECONDARY SEXUAL DYSFUNCTION Causes: 1.g. naked. genital herpes PSYCHOLOGIC CAUSES OF SEXUAL DYSFUNCTION Anger toward a partner. or engaged in sexual activity. Exhibitionism = ( usually a man ) exposes his genitals to unsuspecting strangers and becomes sexually excited when doing so.
• • •
Vaginismus – involuntary contraction of muscles at the outlet of vagina when coitus is attempted. is an involuntary contraction of the lower vaginal muscles that prevents the penis from penetrating the vagina. 2. PRIMARY A. Voyeurism = a person becomes sexually aroused by watching someone who is disrobing. Male Impotence/Erectile dysfunction – inability to achieve or maintain an erection Premature ejaculation – exclusively short period of orgasm or before penile – vaginal contact. extreme aversion to virtually sexual activity. Depression Fear of losing control. CHF. characterized by fear and sometimes accompanied by panic attacks.
Hypertension Miscellaneous illness – chronic renal disease.is a disorder in which a woman either has no orgasms. Retarded ejaculation – inability to ejaculate into vagina.. vaginal infection or hormonal changes such as during menopause Low Sexual Desire Disorder/ Inhibited sexual desire . Learn about sexuality.can be due to endometriosis. Sadism = an opposite of masochism. and the nurse’s background influences her practice. unbiased mind.
As in legal separation or divorce. this will entail changes and adjustments in sexual. There may be many reasons why a patient may act out such sexual behavior. proper spacing 2. Parents who are positive models to their children influence the sexual behavior of their children as they grow.pregnancy is planned and a child us desired and is assured of parent's love.behaviors carefully and objectively and purposefully work on establishing self-awareness on sexual matters. Therefore. 5. Fertile/ Fertility – capable of growing. whether dealing with sexual matters or any other aspect of care. Widowhood Widowhood happens with the death of one partner. 4. Recognize that knowledge and attitudes change. Sex education for adolescents should start with their parents. Responsible Parenthood – the essence of family planning. 2. first ejaculation or wet dreams not nocturnal orgasm can be discussed with the parent taking the initiative. The less sex information young people have. Fertilization -a process of union of germ cell. Ovulation -a discharge of a mature ovum from the ovary. breeding or reproducing or a state of being fertile. Topic such as menstruation. Hence. Issues and Concerns on Sexuality Sexual education in the home Relationship of adolescents and parents Sex education for adolescents and parents Extramarital relationships Legal separation/ annulment/divorce Negative feelings about one’s own sexual anatomy Widowhood Sexuality in later years
Sexual education in the home Parents are the key influence on the psychosexual development of their children. Control time at which birth occur. 4. expose themselves needlessly. . Regulate the intervals between pregnancies. A helping nurse patient relationship. 3 important elements in family planning 1. Convey empathy and understanding in relation to how hospitalization leads to an interruption of sexual life. water. employment. developing. avoid unwanted birth. Basal Body Temperature – lowest body temperature of a healthy person. If they don’t ask. Produce a change in the no. health and education).
. the more likely they are sexually involved. which in turn. There are several appropriate actions the nurse can take when sexual advances are made to her: Assess the patient’s need to talk about sexual matters and attempt to meet his need to converse.
FAMILY PLANNING Fertility Management/ Responsible Parenthood Contraception – the planned prevention of pregnancy/ contraception. they need to establish an atmosphere in the home where they can comfortably share concerns of children that are usually shared with peers. interpersonal relations and lifestyle. parents can initiate by sharing feelings through non-stressful questions. requires revising. parents should be in a position to provide factual sex information to their children. INTERVENTION IN SPECIAL SITUATIONS There may be times when patients may flirt with staff members. and put their hands on parts of the nurse’s body. depends on sound communication. 5. 3. . number of pregnancies Family welfare – a state of well – being of the family as a whole and the individual. Continually practice developing communications skills. etc.
Relationship of adolescents and parents Sex education at home should start when the children start asking questions about sex. They may make suggestive comments. of children born. Sexuality in later years Sexuality in later years can continue to be expressed by partners in non-procreation terms. and expanding one’s view on sexuality over time. modifying. proper timing 3. Family Planning – (WHO) the use of a range of methods of a fertility regulation to help individuals or couples attain certain objectives: 1. Establish limits in the nurse-patient relationship. protection. shelter. Sex education for adolescents and parents Adolescent and parents relations maybe strained by their changing roles.means a level of satisfaction of the basic needs of family (adequate food. tell off-color jokes. bring about wanted birth. Define the nurse-patient relationship and indicate that there is no intention of acting on the patient’s suggestions.
2.uses cervical mucus characteristics • With ovulation (the peak day) the mucus becomes thin and watery.Importance of Family Planning Family planning is concerned and efforts to promote physical.
B. 2. At risk of developing complications during pregnancy. 2.8 degree with ovulation in response to production of progesterone from the corpus luteum c. A. Contraceptive pill . the man withdraws and spermatozoa are omitted outside the vagina. transparent.o. 6. The couple proceeds with coitus until the movement of ejaculation.Oral contraceptive have protective effect against ovarian CA and endometrial CA. 4. Help reduce number of maternal death due to abortion. Prevent birth defects. Phil. D. . 3. Family Planning Program Statistics 60% of 9 million married woman of reproduction ages are at risk.4 –0. 3. Benefits to Mother 1. Benefits to Whole Family Health . Vital 1.help the family enjoy the better kind of life. More relaxed sexual relationships. Symptothermal method. A. Daily Basal Body Temperature – uses the single sign of rise in EBT to predict ovulation a. safe motherhood and child survival. 2. Family as foundation of nation. Improvement of family welfare with main focus on women's health. Reduce the health risk by helping woman bear them children during their healthiest years. Constitution Recognizes: 1. Health Benefits to Children 1. Those more than 4 children – considered high risk. Ejaculation may occur before withdrawal is complete and some spermatozoa may be deposited in the vagina.confident not to produce unwanted pregnancy. Suffering from medical condition that contraindicated pregnancy. 4. Methods of Natural Family Planning 1. 4. Lactational Amenorrhea Method use of lactation for natural suppression of ovulation Ovulation Awareness the use of over-the-counter ovulation detection kit detects the midcycle surge of LH in urine that occurs 12-24 hours before ovulation 98%-100% accurate in predicting ovulation
5. 3. 4. Abstinences begins the first day of menses and continues until the third day of temperature elevation 2. 5.combines observation of cervical mucus and basal body temperature.Comprises of synthetic estrogen combined with small amount of synthetic progesterone. sanctity of family life and the need to protect the life of mother and the unborn from conception. Right of spouse to found a family in accordance with their religious conviction and demands of responsible parenthood. 3. 2.o. • the woman notes other changes often associated with ovulation such as breast tenderness and a more anterior position of the cervix to help confirm her time of ovulation. Ensures better chance of survival at birth. 4. mental and social well -being of its members and reduce the risk of mortality and morbidity in the country. Promote better childhood nutrition. benign breast masses. social. Then. Below 20y.preventing STD. And above 35 y. have had 4 deliveries. Health Benefits to Father 1. Spacing between 2 deliveries is less than 24 months. Promotion of Family Solidarity and Responsible parenthood. . Promote physical growth and development. It prevent ovulation by inhibiting FSH
. Offers non -contraceptive heath benefits. Right of family association to participate in the planning and implementation of policies and program that affect them. Legal Mandate Executive Order 119 – a legal mandate which considered FP as basic Human right. mental. Freedom of choice 3. Temperature is take orally or rectally each morning before rising b. NATURAL CONTRACEPTIVES METHODS = Abstinence from coitus during the fertile (ovulation) phase of the menstrual cycle. Help mother to fully recover from physical strain of child bearing. • All days the mucus is present and the 3 days after the peak day are fertile days or days the woman must maintain sexual abstinence to avoid conception. ARTIFICIAL CONTRACEPTIVES METHODS 1. Billing’s Method. -
B. 3. Below 20 or above 35. Increase father sense of respect because he is able to to provide the type of education and home environment. 3. 2. well -being. Program Policies: 1. A. B. Coitus interruptus – the oldest and the least effective method of contraception. Allows father to keep a constant balance between their physical. EBT lowers before ovulation: EBT rises 0. feels slippery. C. and stretches a distance of at least 1 inch before strand breaks.
scarring at insertion site. over the cervix and forms a barricade against the entrance of the spermatozoa. Heavy menstrual bleeding a. Bleeding f. The man can resume sexual coitus within one week. Side effects a. Ectopic (tubal) pregnancy d. It changes the vagina pH to strong acid level. . As with diaphragm.medroxyprogestration acetate single injection that is given every 12 weeks inhibits ovulation.disadvantages: weight gain. Fever c. 7. hair loss. Diaphragm A circular rubber disk that fits. DM g. Spermicidal Creams Inserted into the vagina causing the death of spermatozoa before they can enter the cervix. May be used with vaginal cream to be effective. Contraindications: a. 35 year old and above e. 5. The testes will continue to produce sperm and the man will still have full erection and ejaculation capacity.a subdermal hormonal implant. unconducive to sperm survival. The most common operation for female sterilization is laparoscopy. Hx of liver disease
2. It should not be undertaken unless the woman view it as a permanent irreversible produce. Nausea b. It interferes with the ability of the ovum to develop as it transverse the fallopian tube. alters the endometrium. clamping or blocking the tube and prevents passages of the sperm into the tube to meet the ova. Cervical Cap Soft rubber shaped like a thimble and fits snugly over the uterine cervix. Prolapsed and retroverted uterus b. History PID b.release hormone suppressing ovulation.
. Breast tenderness e. rapidly moving an ovum through the fallopian tube.
Chromosomes are comprised of DNA (deoxyribonucleic acid) that is further subdivided into genes. Subcutaneous Implants Norplant. high cost Intramuscular Injections DMPA or Depo-Provera. The woman should not take more than 2 pills a day and the arrow on the peak should be followed. PERMANENT METHODS 1. Tubal Ligation Occluding the fallopian tubes cautery. Condoms A rubber of synthetic sheath that is placed the erect penis before coitus. blocking the passage of spermatozoa. It can be placed longer than the diaphragm and it does not put pressure on vaginal walls. Mild hypertension Contraindications a. It also prevents the spread of sexually transmitted disease. Weight pain c. Effectiveness rate: nearly 100% C. Cystocele and rectocele (walls of vagina are displaced by bladder or bowel c. 2. . Acute cervicitis 4.and decrease the permeability of cervical mucus. If should remain in place 6 hour following coitus and may be left for 24 hours. Hx of thromboembolic disease c. Side effects Contraindications a. There is no contraindications to the use of condoms except for rare rubber sensitivity. and changing the endometrium so implantation is difficult. The vas deferens at the point is then cut and tied. Intrauterine devices (IUD) A small plastic object inserted into uterus where it remains in place. an additional birth control should be used until two negative sperm reports have been examined. Smoking b. It should placed one hour before the coitus and douching is avoided 6 hours following coitus to complete spermicidal action. Cramping d. It prevents pregnancy because spermatozoa are deposited in the tip of the condom. it is filled with spermicidal jelly before insertion. Dysmenorrhea b. Abnormally shaped uterus c. stimulating thick cervical mucus. • Rx indicates that only about half of all conceptions are likely to survive to birth. Monileal vaginal infection g. which contains 23 chromosomes – Gametes – cells that have only 23 chromosomes. Menorrhagia 3. CONCEPTION AND GENETICS • Process of Conception: – Every 28 days egg is released. Hypertension f. crushing. 6. potential depression. Vasectomy A small incision is made in each side of the scrotum. and changes the cervical mucus. Headache d. irregular menstrual cycle. • Male gamete + female gamete = zygote Two Types of Chromosomes: • 22 of the pairs of chromosomes are called autosomes • Sex chromosomes = X or Y – Female has two X chromosomes (XX) – Male has one X and one Y – Gender of a child is determined by the sex chromosome from the sperm (because mom only has X chromosomes) 8. CVA d. a form of contraception that received the US Food and Drug Administration (FDA) approval in 1991.
which contains 23 chromosomes – Gametes – cells that have only 23 chromosomes. • Rx indicates that only about half of all conceptions are likely to survive to birth. red hair red hair straight hair baldness* normal hairline
facial features Other eye coloring vision
DOMINANT AND RECESSIVE CHARACTERISTICS Characteristics in the left-hand column dominate over those characteristics listed in the right-hand column. our genetic instructions either=
Conception & Genetics • When does life begin? • Process of Conception: – Every 28 days egg is released. blue eyes no freckles normal vision thin lips nearsightedness Susceptibility to poison ivy night blindness Congenital deafness color blindness* Hemophilia albinism blonde. What are some reasons for this large number of fertilized eggs not surviving? • Male gamete + female gamete = zygote Two Types of Chromosomes: • 22 of the pairs of chromosomes are called autosomes
Sex chromosomes = X or Y – Female has two X chromosomes (XX) – Male has one X and one Y – Gender of a child is determined by the sex chromosome from the sperm (because mom only has X chromosomes) Chromosomes are comprised of DNA (deoxyribonucleic acid) that is further subdivided into genes. green. blonde hair) DOMINANT AND RECESSIVE CHARACTERISTICS Characteristics in the left-hand column dominate over those characteristics listed in the right-hand DOMINANT TRAITS DOMINANT TRAITS dimples unattached earlobes brown eyes freckles farsightedness broad lips normal vision Immunity to poison ivy normal vision Normal hearing normal vision Normal blood clotting Normal pigmented skin dark hair non-red hair curly hair full head of hair widow's peak RECESSIVE TRAITS RECESSIVE TRAITS no dimples attached earlobes grey.•
Pregnancy Pregnancy begins when the zygote (male gamete + female gamete) implants itself in the lining of the woman’s uterus.
Genetics Genotype – specific genetic material on an indiv’s chromosomes. light. hazel.
Dominant-Recessive Genes • Simplest set of genetic rules = dominant-recessive pattern • a single dominant gene strongly influences phenotype • Because inherit one chromosome from each parent. Phenotype – the observed characteristic of the indiv (brown eyes.
or emotionally neglected. TERMS TO DENOTE FETAL GROWTH Name Ovum Zygote Embryo Fetus Conceptus Time Period From ovulation to fertilization From fertilization to implantation From implantation to 5-8 weeks From 5-8 weeks until term Developing embryo or fetus and placental structure throughout pregnancy
. poorly nourished. s/he may be smaller than others her/his age. • Zygote send chemical messages for menstruation to stop. – Height is an example: If a child is ill.
Multi-Factorial Traits • Physical traits influenced by both genes and environment. – Psychological traits (intelligence. • Heterozygous if received a gene for curly hair from mom and a gene for straight hair from dad.• •
Homozygous (the same) Heterozygous (different) • Homozygous for curly hair if received a gene from each parent for curly hair. personality) influenced by both nature and nurture (multi-factorial) Pregnancy • Pregnancy begins when the zygote (male gamete + female gamete) implants itself in the lining of the woman’s uterus.