Reproductive Of Sexual Health

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Nursing Invdlv.es v.esdirecl personol core to mqternil moternity clientsond lhqir newborn infqnls or lo relqled ociivilies on thei)nQeholfduring the vqrious phosesof ihe childbegringexperience.

'Rgview of the Anotorhy.$ Physiology

of'rhg Reproductivd'system

Objeclive ol Mcilernlly t'tuninq

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To ensurethot every expeclcint,nursing mother moinlqinsgood heolth,leoms-thech ccrre,hcrs.cr normol delivery,qnd beors children.

wtqleReproductive System

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MdQExternolStructures 1. Penis \1 - the orgoirgf copulotion;o cylindricolshoftconsisling nt.

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Sffii.pubb

&r&! cawnogh &pa.F^gb5u6

2. Scrolum - o pouch honging below the penisthol contoinslhe tesles, epididymis,ond the lower \ poriion of the spermoiic \ the mediol seotum ihe scrotuminto two socs,eobh of which conloins o lestis.

o. Two loterol'betumnsof erectiletissue{corporo covernoso, ):.b. A column of ereclite..fissue on the undersideof me penis/corpusspongio\m/ ihot encosesihe t" urelhro. c. the glonspenis,o cone-shcilqd exponsionof ihe corpusspongiosumthol ishighllqensitiveio sexuol \r stimulus. // d. the prepuce or fore skin.o skinflop the glonspenisin uncircumcisedmole.

Mete InternolStructures .a.___ 't.. l. Tesfis - two solidovdN,orgons4-5cm long, divided into lobes. Eoch festlsQcomposed of o number of lobules,eoch conicjini,nginterstifiotceils{Leydig's cells)ond o seminiferorRtubule. - functionsof ihe lestistherdfqreinclude hormone production (tesiosferone)ondrqermotogenesis.

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2. EpidldyniK.. - o tubulorsbqlocoied next to eoch feqtisthot servesos reservohfer spermsloroge ond \ - ii h opproximotely20 ft, ond it tokes l2-20 doys for the sperm1olrovel the lengfh of epididymis.

4. EjoculoloryDucl '.. - ihe conol formed by the union\lhe vos deferens ond the excreloryducl of the sem)nglvesicle,which enten the urethrool the Orortot" n'ohd,,,.,rr

Accessory Orgons 5. Urelhro - lhe possogewoyfor bolh urineond semen, extendingftom the , blodder to the urethrol .'. \\.. meolus. :rit isopproximotely8 in (l&2Ocml lono.

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l. SemindLVesicles - ore two\sonvoluted pouches lh)r{ lie olono * lhe tower pori)bq of tnie E posteriorsurfoceiX,ttre j! blodder ond empty irrtq S the urelhro by woy of \ fl ' ' the ejoculoforyducls. - theseglondssecrele o viscousportion of the semen,which hos c high content of o bosic sugor,protein ond prosloglondinsond is olkoline.

4. Semehor Semlnol fluid - is o thi\/hifish ftuid ejocutoted by lhe mote during orgosm. cbqloins spermolozoo ond fruciose-rich nutrients. -t

- semenisderived'fro.1n the prostoteglond (60%),ihe seminolvesicles(30%),.iheepididymis(S%),ond the bulbourethrolglonds {5x1, - lhe normolvolume of semd\s 2 to 5 ml, eoch ml conioining obout l@ millionspegmcells. A sperm count below 20 millionisconsideibdobnormot_ - the semen (spermcells)con livewiih'leihe femole g e n i t o l t r o c t f o r o b o u i 2 4 l7 o 2 h o u r s . '. . \ , r /

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Motemal & Childtteslth Nursing: Reproductiveand SexuolHeolth

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FeqnoleRepro'ductive System The Vulva

- ii is covered by curly hoir, (hokpotterniscolled

ercuicheon), ofler puberty. Thehoir potlern in femole istriongulor with bose uo, ond in mole, diomond-shooed.

2. LoblolAojoro - longitudinolfolds of pigmented skin extendingfrom the mons pubisto the perineum. - contoinsthe Boriholin's glond thot secreleso \ \. yellowishmucusthot ocls bqo lubricontduring sexboloctivity. .-.{m

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:-0t'lsbr i-lwtF Y{ir :-

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Cliloris

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l. olons i'Fe{s - erectiletislue locoted ol the upper endqf lobio mtnoro. -.t' - it isthe primorysiteoF.. sexuolorousol. '.'. - the clilorisisusedos o guide in femole cotheterizotion.

3. l.obio - sofi longiiudihql skin

between the mojoro.

The Vulva

5. Voginol Veslibule - o norow spoce seen when lobio minoroore seporoted. lt contoinslhe voginol introitus,Bortholin' ond Skene'sglond,ond . -rr., urethrolmeotus. 6. fos\ttoviculoris - refers'*gthe spoce fourchetle ond vogir tus. usuollyob childbirth.

Marlon Bernardo,RN

h.Jrefhroll eolus :\oll opening befween thbqlitorisond voginol orifice$o,rthe purpose of urinotion.\. 8. Voglnol ortffcb'/.i4toiius/ \' opening - extemol opening ol*!e vogino thot conloinsihe, \. hymen. 9. Hymen - o membronoustissue ringingthe voginol inlroitus. l0.Pefineum - tissuebeiween lhe onus ond vogino. Thesile of episiolomy.

The VulYa lh6lFrill

r,i#:: liH$!'- *,n* ;';{#-ffi ogitro. *.-1i3,-1:-6** . oi*mhslF trfid"dild---3#"fFdtdde . -l-E--n!n l:1, lstlafi

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Maternot & chitd Heolth Nursing: Reproductiveond SexualHeolth

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Skene'sGlond! (PorcurelhrotGlonds) Skene'sglondsore locoted just loterol to the meotus,one on eoch side, 12,Borfholin'sElgnds(VulvovoglnolGtonds) - locoted justlot)rol to lhe voginol opening on bolh t'l sides.

* Secrefionsfrom bolh \fhe5eglondshetp to lubdcale fhe exfernorgenitolio durinqcoifus. Ihe otkofinepH of fheiisecrefion helps fo irnprqve spermsuwivol in the vogino. "\ I 3. Fourchelle - isthe ridge of tissueformed by the of the two lobio minoroond ihe lobio moioro.tr(is is somelimescut during childbirth. \ ,r'

IntemolStructures

lnternal Sexual I Heproductive 2. Uterus 0tgans{F) - o hollowpeor-shoped muscurororgon. - size:3 in. long. 2 in. wide, ond I in. ihick \. - weigth: 50 gms in non\. pregnonl :'qorts:fundus,corpus,ond cdrv.t - positioR;.onteverled - loyers:pdriqretrium, mvometrium','.ond endomelrium

conol betwee\he blodderond thelectum. - conloinsrugoe thoi\ permilsshetchingwithcii*tr teoring. - funclionsinclude: possogewoyfor menslruoldischorges, receivespenisduring intercourse,ond serves os ihe birih conol.

Itsbq!'dinolfunciion isos on orgon of reproduction. - Orgohqf menslruotion - Ulerinecbqtroction - io expel the felus during lobor ond to seol tom blood vesselsofter deliveryof plocento. \ Theporfs of the cervx ole1 a. lnfernolos - opens io corilup b.Cervlcolconol-ospindle -\ shdoed ored which i< ocftiolly anllrnllrr shoped oreo which is

trionguloruterinecovity locoted between the internol ond exlernolos. c. Exlernolos - opens lo vogino

Marlon Bernardo,RN

* Nervesupplyof lhe onterior comes moinly from the lllo-inguinol ond genllo leve[, while the pudendo, aerves{S3'teyel}moinly supplythe posteriorportion. Thisisthe rd'cqonwhy one type of onesthesioused for childbirthii pudendorblock

&frhq.*.r.rbtLix{$b

l. Vqginol 3.4in long)Qllotobte I - 3.4in

oconiinuotionofthe

.:. Yqe exlernolgeniiolio'sblood supplyismoinV from ihe pudendal aiqy ond o portiori of the infedorrecfur orlery. Relurnis through pudendol vein whictrlvhen whicllwhen impeded imDeded by bv the pressure oressrrreof the fha fetol heod dixing childbirfh,con produce voricosities.On\e otherhond, thisrich blood supply isodvontogeousfo)-tfe fosterheoling of lesions coused by troumo during childbirihl

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Loyers'btrfheuferus: o. perimeiltqm- the outermostserosolloyerottoched to the brooflligoments b. illyomefrium- inq mUOtemusculorloyerresponsible for ulerinecontroiliqns during lobor. c. Endomehlum- lhe innbrryrost cilioled mucosotloyer contoiningnumerousuterihqglondsfhot secreleso ihin olkolinefluid to keep theb grine coviliy moisl. Thisloyer undergo chonges in reipgnse to the hormoneof voriousphosesof menslftr-ol cycle ond during pregnoncy.

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Ugomenis: onsvetse-ceMcot/Mockenrodf ligomenf s portion of the brood ligomenis. lt is the

- ihe

morn ligomeni

of lhe uterus. Domoge io this to ligoment prolopse.

Ligomenls the corpus ond extends pelvic to fhe loierol wolls, ihe sides of lhe uterusond ossists in holding tn

- originolesfrom the onteversion.

c. Roundligomenls - connecis uterusto the lobio mojoro. Gives*Sb'flfi io ihe uterus. /,t'\,

2. FollopionTubeslOvlducls - 4 incheslong from eoch sidesof lhe fundus. - Funcfions:tronsport ovum from ovory to the \, uteru,ihe siteof '..fertilizotion.ond provides n'ou,rishment io lhe ovum durin'g(lsjoumey. - Porfs:islhgrus,ompullo, ondinfun\m ,

d. AnLiorligoments - providqssupportto ihe uterusin connection Wlh the bloddgr. Over slretchingof thisligomentwill leod to hentie{ionof lhe blodder to ihe vogino. o condition colfqd cystocere.

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e. Posleriorllgomenls'\- thisligomentsformsthe cDt-Qe-socof Dougtos. Domoge to ihisligomenlswihtAodto herniolion of rectum to the vogino, o cond*ion colled recfocele. \

'\.. 3. ovodes ta. - femole sexghnds locoted on eoch'siQeof \r. the uterus. - functionsinclude '... oogenesis,ovulotion, ond hormone production.

Structures The Pelvis-'\- iso bonyhqg locoted in lowerportion of the \. lrunk. \r

\, Sfrucfures: o. 2 innominote bones vlhich rbmode up of: lleum- upper extendedlqrt; curve upper border is the ilioc crest;on-leiorsuperiorilioc \\\. spinesore importont ,schium- under port; when siiiingihq bone reslson ihe ischioliuberosilies;ischicil-spines ore imporiont. Pubr3- front porl

Marlon Bernardo,RN

b. Sbqum -wedge-shoped, forinsthe bock port of fhq pelvis;consistsof 5 fused vertebroe. c. Coccyx\owest porl of the spine;mode up of 4 rudimedtqryvertebreoe. Atticulotion:pelvic bonbs ore held iogether by 4 joints: o. syrnohyslb oubis- joinsih'b,{ pubistogether b. 2 socroilioc joinfs - join the ibc.rum ond the ilio c. socrococcvoeo/jorirf- joinsthi'socrum ond \\\ thecoccyx.

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Moternol & ChildHealth Nursing: Reproductiveond SexualHealth

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{rrnudn IltiI

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muscles,between the second hond ond sixth ribs. O Thebreoslore supported by ihe Cowper's ' ligoments.

lnfernoiS*ruclures: o. lobes -'fs.lo 20 lobesore found in eoch breostthot ore divideb.inloseverollobules. b. Lobures- compoqed of clustersof ocini cells c. Acini ce/ls- milksebr€iingcellsthol isstimulotedby proloclin \ d. Locfiferousducfs - ducls\i serveos possogewoyof -.r milk e. Loclferoussinus- diloted porticihpf the ducts locoied behind the nipple thot serveos res\>r of milk. \r-

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Exlemo/S*{uclures: o. Nipole o)r\4ommoryPoo,rloe- locoted ol the center of lhe onteridn{urfoceof och breost. lt hos 15-20 opening condegted lo locliferousducts ond in which milkflowsout. \. b. Areoro- the pigmentdq.skinlhol sunoundsthe nipple. Bothnipple ond oreolohqve pigmenled ond wrinkledskin. c. MontaomeNt ubercles-glonds'h\theoreolo thot secreteon oilysubsionceihot keeBsthe oreolo ond -\\\ nipple lubricoted.

Hormoneslhol/nfluencethe Mommary Glonds o. Fslrooen- i"tiqrulolesdevelopmenl of the ductile structuresof\e breost b. Progresferone - stiixlloies the developmenl of the developmenl during

- promolesbreosl

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ond FemoleReproductive

Neuro\docrinology of

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MarlonBernardo, RN

Maternol & ChildHeolth Nursing: Reproductiveand SexuolHeslth

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Howj'i\ spermotozoJ-.. produced?

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'il(enstruotion \\\\\ - Monlhtydischor.qeof blood from the utbqs occuning from pubeily,. to menopousewherein obout3G60cc of blood, epitheliotcelts ond mucusore being dischorged.

Considerotions o Eoch contoins 300,000+ 400,000 immolure ihol were formed during the first5 of intrauierinelife, however, mony degenerotesond by 7 yeon of oge; holf remoinsin eoch ovory. By oge 22, only third cqn be found. Only 300-400 moture during the enfire reproduclive cycle o womon. o li isinitiotedby menorche qnd ends menopouse.

period lostgfrom 3- 5 dovs. o Mensfiwl cycle loslsfrom 2335 doys. Averoge:"?gdoy cycle. "a,

o Associoted lerm\.,. Amenonhea - morkb-elydiminished .,., menslruolflow Menorrhoqio- excessiveb'le.edinodurino regulormenstruqtion \ ". Polvmenanhea - frequentmensti occuning of inlervolsof lesslhon 3 Dysmenonheo- poinful

MarlonBernardo, RN

structures involved: -\''*qo, hypothoJomus, onlerior

gilyjtqry0le1d.ovories. ,g

ond ulerus. \\\\\\.

o Hormonesinvolved;-'\.. follicle stimuloling "',..@

Maternal & ChildHealth Nursing: Reproductiveand SexuolHealth

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Eshqgen \ - Theso c\led "Hormoneof Women",which isproduced.QyGrqofionlollicle. \ - lt is metqbotized bxthe liver ond excreled in lhe urine. \" - Thereore lhree kindsof esliogen: estrone (El), eslrodiol(E2).ond esrriot(EBl.

Ef\fsof Eslrogen: o Inhibiilollicle sllmuloiing hormone. o Stimuldlet deposition of fot in subcutoneous tissuestho{lives o femole shoDe ond developmenlo(secondory sexuolchorocleristics in femole (breost'dqvelopmenl. foi deposiiion thol gives o womon\eody femole shopel o Stimulotesgrowth of vog'ing ond uterus,ond lhe lhickening of lhe endometrii_x{r. o Cousesmucus to be thin, lronsd'or.ent, ond highly stretchoble. o Slimuloteslhe grovylhof ductile slructuiesof the breosls, "r.... ... o Menorcheond menstruolion. o Premenslruolwolerrefention.

),bqr,"ron' - Theso-c\s{ed "Hormoneis{ '\ Mother".

\ - Producedby corpus\.. \. luleum.

lirtenorche

fs of Progeslerone.. o Thehnogenic effecl.

o o o o

Reloxealjerinemuscles Promotesglqryth of the ocini cellsof lhe breosls. Cousesfluid retbniionthot resullin weight goin. lslhrough to be the"eguseof premensiruol Syndrome(PMS). o Cousessecreiorychonges")n.lheendomelriumin preporolion for implontciion.-.1 o Couseslinglingsensotionond fee}ng of fullnessin the breostbefore menslruotion. -\\\

MenstruolCycle

\

o Menorbtl,srsfers lo the very firstmenslruolion, on event ihgt signifiesthe end of puberty ond the beginninilqf the reproductiveyeorsof o womon, \ o Theoveroge oge oiV6icn menorche occurs is 12to 13yeon, but the\set of menstruotion moy occur onytime betwei}q.9to I Z yeorsold depending on nutrition,heredhyoroceond climole. o Thefirslmenstruolcyclesore usuolly onovulotory,poinlessond inegulor.

MarlonBernardo, RN

I

l. On the thkd'<{oyof ihe mensiruolcycle, serum esirogenlevelllqt loweslwhich stimulolesthe hypotholomus lolqduce follictestimutoting hormone releosingfo-etor(FSHRF). 2. FSHRF isresponsibleforslimu'totingthe onterior piiuiforyglond (ApG)io produle foilictestimutoting hormone (FSH)which will oct on

oocyle insideo primordiolfollicle,stimblQting its growth.

Msternol& ChildHealth Nursing: Reprodudiveond SexuolHeolth

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3. lh{ew

of the FSH,eslrogen is now going to be

S. bn.fne l3rhdoy of the menstruolcycte, ihere isnow o vely_lowlevel ot progesleronein the blood. This stimuloQhe hypotholomusto produce Luleinilng Hormoneri\sing foctor (LHRF).

in on increosingomount insidethe follicle. which is\und in the ovory. Once eslrogenis presenl, thb.Brimordiol follicle is now termed

GroofionfotlblsJcFr. TheGFisthe structure thereforethoicohteins high omountsof estrogen.

6. LHRF isresponsibldfgrstimulotingthe onteriorpituitory glond to produce Luteipilng Hormone{LH).

.\

4. Estrogenin the GFwill cbtrseihe cellsin lhe uteruslo proliferote(grow ropidly),in'creosingitsthicknessto obout eight fold. Thisiscolled ihg protiferotivel '\ Folliculorphose

7. TheLHin turn,isresponsiblefogstimulotingthe ovory to produce progesterone.Thdingreosedomountsof both esirogenond progesteroneilqsh lhe new molure ovum io ihe surfoceof the oiory untilthe followingdoy (l4rh),the GFrupturesond\eoses moture ovum.

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8. O\ce ovulofionhos token ploce, the GFwhich conloinsincreosedomount of progesleronewill tum to CORP{SIUTEUM, which isyeilowin oppeoronce. 9. Progesteronebquses the glond of lhe ulerine endolheliumlo bbqome corkscrewortwisted in oppeoronce. Thisislhe formone of pregnoncy becouse it preventsuleifirgcontrociions. Once ihe fertilizedovum develdped hnger{ikeprojections oround the bl*locyst, lhese OROPHOBTAST) trophoblosisore the onesihot wilDrqplonthigh on lhe onterioror posleriorsurfoceof IITIPtANTATION olsocotted NtDAT'ON, ploce obout o week ofler fertllizotion.

,. Phosesof MenstruolCycle

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\. rMPelqANr: > Despitri:'the voriobilityof o womon's cycle (2325 doys),ovul'dtionoccurs exocfly 2 weeksbefore lhe next menslruolion.ThefirstI 4 doys of lhe cycle is vorioble.Thus,ov\otion occun not on the l4h doy of the cycle, but I 4 doys priorto the firstdoy of the next menslruolcycle, un\s o pregnoncy occurs. F Firstdoy of the cycle isthe finilqy of menstruotion, ond one menstruolcycle isfrom the.Jirsidoy of the menstruolperioduntilthe firstdoy of ihqnext cycle.

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t$tgrineCycle: l. Prqliferotive Phose -

lmmedid{glyoflero menstruolflow(first4 orS doys of the cycle),-fte endomentriumisvery lhin. As ihe' ovory beginstbproduce estrogen,the endometrium beginsto prolifercitq.Thisincreosesihe thicknessof lhe endomelriumoplrgximoiely eighlfotd. Ihis holf of the menslruotcltq (opproximotelydoy $ I4) istermed interchongeoblylhe esirogenic, folliculor,or postmenstruolphqse.

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thnrcfii!(: Flr*

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MarlonBernardo, RN

Underlhe influenceof estrogen.the geniioJtroci prepored forsperm migrolion:cervicol becomes obundoni, ihin ond wotery to foc.fildte.lhe t joumeyofspermotozootoiheuterus.,r/ .

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3.'.lschemic Phose

2. SegretoryPhose After oiUlgfion, lhe formofionof progesteronein the couseslhe glondsof the uterine

omounl untilthe lining rich,spongyvelvet.

-

tf feihfiaotiondoes not occur. ihe corpusluteum in the ovory bdgi5rslo regressofier 8 to l0 doys. As it regresses, thqproduction of estrogenond progesteronedagreoses.

-

Withthe withdrowoloTprogesleronestimulofion,ihe endometriumof the uterts,beginsio degenerote (opproximolelydoy 24 or 29ie(the cycle. The copillcriesrupture,wilh minvte hqmonhoges,gnd the \. endomelriumsloughsoff.

\

Progesteronewithdrowqlresultsin formolionond releoseof prostoglondinsond possiblyof enlogrSinI which cousesorteriorolsposmsond contrgCiidrr.of i myometrium.

4)v\4enstruol FlowPhose - Themehs(uol flow or mensesinclude blood from ihe rupturedcdpillories;mucin from the glonds; frogmenlsof eihQomelrioltissue;ond the microscopic,otro\ed, ond unfertilizedovum. -

Mensfruolflowcontoinsfuy opproximoiely3G80cc -..r of blood. A womon lossesopproximotelyI l-fng of iron during thisphose. \.-

Cycle: ;:_ii :::: \orion ''.., #lli;::! x..#lni1*."_ r Folici,Nh:::_

- PrimohdPrimor-

lw l'"'""

$::;f

diolFotticte. r*-m diolFottibq, **--4fr

- Growing Follie[e :ii'---W

- c,.oqrro"n n;iiilrb.firX.\ffTm

ovulotion

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LuteolPhose - Corpus Luleum

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eqoofionFo/Ible

N{olliculor Phose

- The\m groofion follicleisderived from the nome of Regnerdq Groof, the Dufch onolomisiwho first describedit iQ1672. Primordiol the ovory thot

ore the irnmolurefolliclesinsioe Itoin immotureovo.

- Everymensfruolcycle, develop under the GrowingFolllrcte

of thesefollicles of FSH.

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- Sfillunder the influene of FSH,the fo grow, opproximotelyon doys 5-6 of the

menstruolcycle.

.

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- Atler puberty,sele(ol folliclesbegin to develop under fhe influenceof FSH.\

\. \

- Fromthe numerousfolliclei"t\ot showsignsof development,only one will be\osen tb reoch fult motudly ond releoselhg ovum. - Thegroofion fotlicleisdescribedos o bliiler like slructureborely visibleto the noked eye. develops,it produce lorge omountsof

Moternal & Child Heolth Nursing: Reproductive ond Sexual Heolth

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2.

lotion

- Al midpoin(of ihe cycle. lhe very high estrogentevel orrd very low irqrgesieronelevel triggersthe releoseof luieinizinghormohq(LH). - LHislhe hormonethoilromoies ovulotion. The exposedareo of the Grooftonfolliclewhich protrudes ol the ovorionsurfocegroducillathins,coupled by pressureof lhe folliculorfluidwithhr;..the Groofionfollicle finollyrupturesreleosingthe ovum, tir)a_tolliculor fluid ond o considergblenumber of gronuloib.e..ells.

lrrqeosed bosol body temperoture- the surgeof prouEsleroneofter ovulotionresultsin increosed restingbedy temperolure. Thisisso becouse progesterbnghos thermogeniceffect. Peokblood level\luteinizing hormone- there ore urinetestsnow thotbOuld determinethe level of LH ond thuspredicl when\yv-omon isovuloting. - Thefirstholf ot tne cycte extehUsfrom lhe fiat doy of menstruotionuntilovulotion,il cciVqnthe proliferotive phose. '\..

- Chqngesoccuring in o womon's body in relolionto her tnerslruolcycle:

-'\

Mittelschmbrq-the lower obdominol poin felt ot the sideof the ovo'ty\thotreleosedthe ovum.

\

Spinnborkheit- signo'b.thotthe womon isneoring ovulolion or isovuloting.)sqtdoes not indicote the exoci time of ovulolion. '\... - Thissignischorbc.terizedby cervicol mucoso thoi isihin, wolery or lron$greni, obundont ond highlystretchoble. \, - Whendried ond viewed\nder lhe microscope,the mucusreveolso fern potteirL.The pollem isdue io the elevoted levelsof sodiumb.lft

- Thefirs'itolf iso vorioble period while ihe second holf is o fixed pdriod becouse I 4 doys ofter ovulolion, menstruoiior}\ill occur. In prolonged cycles,if is olwoysihe prollffsrotiveor the firstholf of the cycle thol isexiended. "a

- Tocompule for the dote df.gvulotion,count bock l4 doys from the firstdoy of merisi(uoiionor subtroct l4 from the totol number of doys thbt compose o '.... menstruolcycle.

- Thesecond holf exlendsfrom ovulolion ovulotionto\hg to\l-re doy aav .,r/ before menstruolion,covgring the secretoryphopeond ischemicphoses. ,.-\

teol Phose Follicleconlinue lo proliferoteond - TheGroo'fio5r enlorgeuntifi{becomes o dense mossof cellsobout 'lto 3 mm in dioineter lhot produce o yellowishfluid colled lutein. Luteih.fi.lls ihe spoce thotwos once occupied by the ovur\iving it o yellowishcolorotion. Thisiswhy the follicleistefu1edCorpusLuteumofier ovulotion,which meonsyellci\body. - *rer

:tr:fitrtr rcrge ornount of prc!;esterone ond

lOrre esi:r.Dger-

Marlon Bemardo, RN

thq.corpusluteumhos o tifesponof Z io I doys. lf feXi(zoiiondo not toke ploce withinihisperiod. it willotrdp[yin i0- l2 doysond stopproducing progester\ - Complete regreiir:o{rof the corpustuieum occur before mensiruqtion,\.lqterii Wll be seenos o whiie fibrouslissue,colled co'ipqsolbiconsond corpus '-\r. olbicontio. - lt fertilizoiiontokesploce, the hurir\spchorionic gonodolropin produced by the troph)eblostcellsof the lygote will prolonglhe life of ihe cobvs luleum for ii lo continue producing progesieroneunfillueh time, when the plocenio is moture enough to ioke d!94h function of producing progeslerone. ,z' ".,.

Mqternol & Child Heolth Nursing: . Reprodudive ond Sexuol Heolth

CEU-Makati

truolProblems l. Dysmenorihqo - poinlul mensiruotion. o. fnmoy ay\nonheq - no known or idenlified couse l. Dbcomfort bbgins I - 2 doys befoe onset of menses ihen sub6ldesbhhe second doy. ii. Oiher symploms inihsqe: noueo. vomiting, dionheo, '\ syncope, leg poin Inferuenlions: - lmmediole eliet's by sdotives bnQ norcotic: ibuprcfen {Mofrin), mefenomic ocid'fp.onsion),

noproxensodium (Anofiox).

b.-.t€condory d)6meno.rheo - hos on undslying dlFose condilion inflommotory dismse {PlD} ii. Fnqomefrlcis - prolifsotion of endomelriollisues oulside the Oierus such os the ovories, inieslines ond ligomenls. iii. Ademyc}rs - ulerine mcs

iv. Uierineprolfupe v. Utsine myomos'oodpolyps tnteNentioft

Primory mondgrqmenl is lo treol lhe couse.

2. Amenffhe - obsence of meros).f$oy be due lo pregnancy, loctotion, obnmolity of the endociiqe syslem, ropid welght lo$, onorexio nervoF d slrenous
\/\./

-a,,

4. Mqntrhogio - h6vy ond prolonged mens. Mqy be due to endq{ne imbolonc, infectbn ond utsine fumoB. 5. MeAoarhogib\ d€ding by on underlyiigtdiffise

in between menses, Frequenlly cou€d proces.

6. Polymenonheo - bledlnq ot frequenl infwols. Frequenfly due lo o direose process. '..

\.-\\

\

'"

\\,\\\\\

Mqnopouse \

- Refersto ilibt time in o womon's life when she undergoeso lrbesilionfrom ihe reproduclivesioge to the non-reprodUqtivestoge.

\

- lt generollyoccun betwbqn the oges of 45 lo 55 or o lime eorlierin somewomen.\t thistime fertility decreosesond menstruotionb'6qomesinegulor, coused by very few folliclesleft in ihe ovory os most of lhem ore olreody spentin fhe prev'ibusmeniruol cycleS.

Sigqrs ond Sympfomsof Menopouse..

:deoch how fo monoge hof flushes:

b. Lossof brebel.mossond firmness,cnd olrophy of reproductivedrgons.

> Drbslin the loyerlook,remove ouler clothing during ottoc\ . F Avoid hot eirvironment.

c. Dysporeuniodue todqcrecsed voginol lubricolion.

> Avoid getiing exci{bQ.ond emotionolslress.

d. Musculoskeleiol symptom)'1

F Avoid foods thot could tri(1gerhot flushes:spicy foods, coffee, teo ond olcohbL\

e. Mood instobility,lossof sexuoldeile. depression ond onxietydue io fluctuoling hormdnq.levels.

F Usbcooling lechniques:fons,showbrs,icecubes

o. Hot\hes

\

\..

\

> Keep o diory to monitorhol flusheso""ufuqO fry ovoid precipitotingsituotionin the fulure. F Supplementsof vitomin B ond E.

MarlonBernardo, RN

,r'

'-'

r.3

Moternal & ChildHeolth Nursing: Reprodudiveand SexuolHeolth

CEU-Makati

Fncourogelhe women to engoge in regulor exprciseregimenlo mointginmuscletone but ovoid iodmqch weight lifiingto preveni ftoctures. ! Emhosizelhq.importonceof odequole intoke of colcuim ond \4{ominD to preveni osleoporosis- rich in milk. 'a...

GenderAexuotldentity- the innbr.sense o personhos

) ProvideemotionglsuBporfond understonding

of being mole or femole, which'rRoy be the some

os or differentfrom biologic

}' Referfor counsellingos lhe need orise.

Gender Role - the behovlor o oenon

,/

-'

'.

ituqnonSexuolResponse FourDiscfete Sloges of lhe Sexuo,ResponseCycrej l. Excitemenf\curs slimulotion. \

Sexuotit)'iqomullidimensionolphenomenonthot includelfgelings,ottitudes,ond octions. lt hqs both biolodiKrd cullurol compgnents. EiologrbGender* denbtes chromesomolsexuql '\!. development. \\\

> lnslructon proper usehqoler solublevoginol lubriconifor poinfvl interco\

> lnstructtoovoid smokingond olcohol.

FlueonSexuolity

with physicolond psychologicol

being mole or femole, which moy or moy the some os biologic gender or gender

ypesof SexuolOrientotion \.

Heferosexuo)rfy-findssexuolfulfitlmeniwith the opposile gender-

\

\_

2. Ploteau- reoched jusitbqforeorgqsm.

Homosexuality- finds i\uot futfillmentwith o member of hisor her own sex. '., .,.

3. Orgosm- stimulotionpro"eddr,throrgh ihe ploleou sfoge to o point ot which the bo-dgsuddenly dischorgesoccumuloted sexuoltenlie!.

Bisexuolily - people who ochievilsgxuol sotisfoction -'\. from both sexer.

\

4. Resolufirn-the exiernolond intemol returnlo on unorousedsiote.

of SexuolExpression i. cdio)\.

Ironssexuolify- on individuol who feels os hhe or she

shouldbe of the opposite gender.

Dis'oqders of SexuolFunctioning \

vi. Voyeurism

PrimorySexudfDysf unction o. EreclileDlMgrnclion b. PremotureEjdsploiion c. Foilure1oAchievbQrgosmor DecreosedSexuol Desire '... d. Voginismus- involuntorlgonlroction of the musclesot lhe oullet of the.vogino when -'\. coitusisoliempted. tr, e. Dysporeunio f. InhibitedSexuolDesire ,/

vii. Sodomosochism

SecondorysexuotDysfunciion

"a

ii. Mosturbotion\..

\.

iii. EroticStimulolion \ iv. Fefishism v. Tronsvestism

,.)>(,,

MarlonBernardo, RN

_

ttl.

Moternal & ChildHeotthNursing: Reprodudiveond SexuolHeolth

CEU-Makati

Brleflntroductionto Moternol ond'QhildHeolthNursing

Re.productive ond SbriuolHeolth

\ PrlmoryGool

'\\

\'..

It con be stoted shnplyos the promofion ond moinlenonce of optimol fomilyheollh fo ensurecyclesof optimol childbqoringond '\..\. , childreoring.

t'...

frfor|onArngrOo, Centro Bcolor

Fhllosophyof Moternolond Chil{Heoth Nursing \ o lt isfornily:Centered. s lt iscommunityr,ceniered os the heolthof the fomiliesdepdndson ond influences the heollh of commbeiiies. o lt isreseorch-oriented oi'rqseorch increosescrilicolknowledg'b1. o Nursingtheoryond evidenc proctice provide o foundoiion for hqr5ir core. r'4.

o'R()gnoncyor childhoodillness con be skdls{ulond con olier fomilylifein both subtle'o4dextensivewoys. -\\ o Personol, cultulcf ond religiousolfitudes ond beliefsinfluerleEr the meoningof illness ond ih impoct'onthe fomily. o Motemolondchild heolthniXlng iso chollengingrolefor fhe nurseon)d,[s o mojorfoctor in promotinghighJeve\" ''.. wellnessin fomilies.

MarlonBernardo, RN

,r"'

o A'.moternolond child heolthnurseserves os an{dvocole to protect the rightsof oll fomifyqnembers, includingthe felus. o lt useso high dbgree of independent nursingfunctionsdbqouseleoching ond counselingore so freQuqntlyrequired. '\ o Promoiingheolthison importbn{nursing role becouse thisprolects the heb(h of the next generotion. X.

\. Obslefrics

t'....

\. Primorilycoie-emed with the phenomenon ond the monogemeiht.ofpregnoncy.lobor ond puerperiumbolh underhermql ond qbnormol circumstonces.lt isderived'frpmthe Lotinword Obsfefrixwhich meons midwifb:.