COURSE UNIT WEEK 2.docx

**BACHELOR OF SCIENCE IN NURSING:** **CARE OF MOTHER, CHILD AND** **ADOLESCENT (Well Clients)** +-----------------------+-----------------------+-----------------------+ | **COURSE MODULE** | **COURSE UNIT** |  | | | |...

**BACHELOR OF SCIENCE IN NURSING:** **CARE OF MOTHER, CHILD AND** **ADOLESCENT (Well Clients)** +-----------------------+-----------------------+-----------------------+ | **COURSE MODULE** | **COURSE UNIT** |  | | | | | | | | **WEEK** | +=======================+=======================+=======================+ | 1 | 2 | 2b | +-----------------------+-----------------------+-----------------------+ | REPRODUCTIVE | | | | DEVELOPMNT | | | | | | | | Anatomy of the Male | | | | and Female | | | | Reproductive System | | | +-----------------------+-----------------------+-----------------------+  - Read course and unit objectives
 - Read study guide prior to class attendance - Read required learning resources; refer to unit terminologies for jargons
 - Proactively participate in classroom discussions - 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 anatomy and physiology pertinent to reproductive and sexual health. 2. Identify areas of care in relation to reproductive and sexual health that could benefit from additional nursing research or application of evidence-based practice. 3. Identify appropriate outcomes for reproductive and sexual health education. **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. Integrate knowledge of reproductive health and sexuality with nursing process to achieve quality maternal and child health nursing care. 2. Use critical thinking to analyze ways in which clients' reproductive and sexual health can be improved for healthier childbearing and adult health within a family-centered framework. 3. Participate actively during class discussions 4. Follow Class rule and Apply Netiquettes  Adele Pilliteri, JoAnne Silbert-Flagg. (2018). Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family. (8 th Ed.). 1. **Intrauterine Development** - The sex of an individual is determined at the moment of conception by the chromosome information supplied by the particular ovum and sperm that joined to create the new life. - - In both sexes, two undifferentiated ducts, the mesonephric (wolffian) and paramesonephric - 2. **Pubertal Development** - Puberty is the stage of life at which secondary sex changes begin. These changes are stimulated when the hypothalamus synthesizes and releases gonadotropin-releasing hormone (GnRH), which in turn triggers the anterior pituitary to begin the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH initiate the production of androgen and estrogen, which in turn initiate secondary sex characteristics, the visible signs of maturity. 3. **Role of Androgen** - Androgenic hormones are the hormones responsible for muscular development, physical growth, and the increase in sebaceous gland secretions that causes typical acne in both boys and girls. In males, androgenic hormones are produced by the adrenal cortex and the testes; in females, by the adrenal cortex and the ovaries. 4. **Role of Estrogen** -- When triggered at puberty by FSH, ovarian follicles in females begin to excrete a high level of the hormone estrogen.This hormone is actually not one substance but three compounds (estrone \[E1\], estradiol \[E2\], and estriol \[E3\]). **Secondary Sex Characteristics** 1. Growth spurt 2. Increase in the transverse diameter of the pelvis 3. Breast development 4. Growth of pubic hair 5. Onset of menstruation 6. Growth of axillary hair 7. Vaginal secretions Secondary sex characteristics of boys usually occur in the order of: 1. Increase in weight 2. Growth of testes 3. Growth of face, axillary, and pubic hair 4. Voice changes 5. Penile growth 6. Increase in height 7. Spermatogenesis (production of sperm) **Anatomy and Physiology of the Reproductive System** 1. Scrotum - is a rugated, skin-covered, muscular pouch suspended from the perineum. Its functions are to support the testes and to help regulate the temperature of sperm. - - 2. Testes - are two ovoid glands, 2 to 3 cm wide, that lie in the scrotum. Each testis is encased by a protective white fibrous capsule and is composed of several lobules, with each lobule containing **interstitial cells (Leydig's cells)** and a **seminiferous tubule**. - Seminiferous tubules produce spermatozoa. - - - - 1. Epididymis - the seminiferous tubule of each testis leads to a tightly coiled tube, the epididymis, which is responsible for conducting sperm from the tubule to the vas deferens, the next step in the passage to the outside. - Because each epididymis is so tightly coiled, its length is extremely deceptive: it is actually over 20 ft long. - Some sperm are stored in the epididymis, and a portion of the alkaline fluid that will surround sperm at maturity (semen, or seminal fluid that contains a basic sugar and mucin, a form of protein) is produced by the cells lining the epididymis. - Sperm are immobile and incapable of fertilization as they pass or are stored at the epididymis level. - It takes at least 12 to 20 days for them to travel the length of the epididymis and a total of 64 days for them to reach maturity. - This is one reason that **aspermia** (absence of sperm) and **oligospermia** (20 million sperm/mL) are problems that do not appear to respond immediately to therapy but rather only 2 months. 2. Vas Deferens (Ductus Deferens) - is an additional hollow tube surrounded by arteries and veins and protected by a thick fibrous coating. It carries sperm from the epididymis through the inguinal canal into the abdominal cavity, where it ends at the seminal vesicles and the ejaculatory ducts. - Vasectomy (severing of the vas deferens to prevent passage of sperm) is a popular means of male birth control (Cook et al., 2009). 3. Seminal Vesicles - are two convoluted pouches that lie along the lower portion of the posterior surface of the bladder and empty into the urethra by way of the ejaculatory ducts. - These glands secrete a viscous alkaline liquid that has a high sugar, protein, and prostaglandin content. Sperm become increasingly motile with this added fluid, because it surrounds them with nutrients and a more favorable pH. 4. Ejaculatory Ducts - The two ejaculatory ducts pass through the prostate gland and join the seminal vesicles to the urethra. 5. Prostate Gland - is a chestnut-sized gland that lies just below the bladder. The urethra passes through the center of it, like the hole in a doughnut. - The prostate gland secretes a thin, alkaline fluid. When added to the secretion from the seminal vesicles and the accompanying sperm from the epididymis, this alkaline fluid further protects sperm from being immobilized by the naturally low pH level of the urethra. 6. Bulbourethral Glands - two bulbourethral or Cowper's glands lie beside the prostate gland and empty via short ducts into the urethra. Like the prostate gland and seminal vesicles, they secrete an alkaline fluid that helps counteract the acid secretion of the urethra and ensure the safe passage of spermatozoa. 7. Urethra - is a hollow tube leading from the base of the bladder, which, after passing through the prostate gland, continues to the outside through the shaft and glans of the penis. It is approximately 8 in (18 to 20 cm) long. **II. Female Reproductive System** 1. 2. 3. 4. 5. 6. 7. - Secretions from both of these glands help to lubricate the external genitalia during coitus. - The alkaline pH of their secretions helps to improve sperm survival in the vagina. 8. 9. - The function of the two ovaries (the female gonads) is to produce, mature, and discharge ova (the egg cells). In the process, the ovaries produce estrogen and progesterone and initiate and regulate menstrual cycles. - Ovarian function, therefore, is necessary for maturation and maintenance of secondary sex characteristics in females. - At birth, each ovary contains approximately 2 million immature ova (oocytes), which were formed during the first 5 months of intrauterine life. - By age 7 years, only approximately 500,000 are present in each ovary; by 22 years, there are approximately 300,000; and by menopause, none are left (all have either matured or atrophied). - Ovaries have three principal divisions: 1. Protective layer of surface epithelium 2. Cortex, where the immature (primordial) oocytes mature into ova and large amounts of estrogen and progesterone are produced 3. Central medulla, which contains the nerves, blood vessels, lymphatic tissue, and some smooth muscle tissue 2. 3. - The function of the uterus is to receive the ovum from the fallopian tube; provide a place for implantation and nourishment; furnish protection to a growing fetus; and, at maturity of the fetus, expel it from a woman's body. - Anatomically, the uterus consists of three divisions: 1. 2. 3. 1. 2. oxytocin during labor. 3. - Stratum functionalis -- shed during menstruation - Stratum basalis -- deeper, permanent layer, gives rise to new stratum functionalis - -  https://www.britannica.com/science/human[[-development]](https://www.britannica.com/science/human-development) **Reproductive Development -** is a part of prenatal development, and concerns the sex organs. It is a part of the stages of sexual differentiation. **Secondary sex characteristics -** any physical characteristic developing at puberty which distinguishes between the sexes but is not directly involved in reproduction.  Try to recall your experiences during puberty. How were you able to understand those changes? What are Be ready to share and discuss this with your classmates. **Textbook:** 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 Rosalinda Parado Salustiano. (2009). Dr. RPS Maternal & Newborn Care: A Comprehensive Review Guide and Source Book for Teaching and Learning. C & E Publishing, Inc.