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NSG 201H -Introduction to Maternity and Newborn Nursing

NSG 201H -Introduction to Maternity and Newborn Nursing

NSG 201H -Introduction to Maternity and Newborn Nursing

Chapter 1

Factors Affecting Change in Women’s Health Care

  • Changes in childbirth methods
  • Social trends
  • Changes in health care system
  • Federal and state regulations

 

Historical Development: Maternal and Newborn Nursing         

  • Colonial America: childbirth was a difficult and dangerous experience
    • Death due to exhaustion, dehydration, hemorrhage, infection, seizure
    • 50% children died before 5
    • All births at home
    • Midwives/family members
    • Men did not attend births
  • Early 1900s: physician assisted births; midwives for those who could not afford a doctor
    • Introduction of amnesiacs. Wealthier women attracted to hospitals due to pain management.
  • 1940: 75% of women gave birth I hospitals
  • 1950s: introduction of natural childbirth practices
    • Advocating birth without meds
  • Current: return of midwives and doulas; childbirth choices based on what works best for mother, child, and family
    • Child birth education classes
  • 1970’s C section rate was 5%, today it is 34%
  • Maternal mortality today is 11 in 100,000 live births
  • IMR is 6 in 1,000 live births
    • US ranks 41st in IMR

 

Childbirth Practices – have changed to become focused on family with alternatives for care

  • Certified Nurse-Midwives
    • Doula: birth assistant providing emotional, physical, and educational support
  • Birthing Centers
  • Conduct of Second Stage of Labor
    • 2nd stage is abdominal muscle contraction
  • Routine Episiotomies
  • Anesthesia

 

Core Concepts of Maternal and Women’s Health Nursing

  • Provide evidence-based care to the client within the context of the family unit
  • Implement an interdisciplinary plan in a collaborative manner to ensure cost-effective, quality-oriented, outcome-focused continuity of care
  • Focus on family-centered, evidence-based, case-managed care
    • Family centered care: safe satisfying high quality health care. Adapts to physical and psychosocial needs of the family. Support and respect for the family is essential. Empower mothers.
    • EBP: use research to establish plan of care and to implement care
    • Case management: process of assessment, planning, application, coordination, follow up and evaluation

NSG 201H -Introduction to Maternity and Newborn Nursing

Contemporary Issues and Trends

  • Views of women
  • Breastfeeding in the workplace
  • Family leave
  • Violence
  • HIV/AIDS in pregnancy and the newborn
  • International concerns

 

Question

Is the following statement True or False?

Natural childbirth classes were introduced in the 1900s.

  1. True
  2. False

Answer

  1. False.

 

Natural childbirth classes were introduced in the 1950s.

 

Concepts of Family-Centered Care

  • Childbirth is considered a normal, healthy event in the life of the family
  • Childbirth affects the entire family and relationships will change
  • Families are capable of making decisions about their own care if given adequate information and support

 

Focus of Evidence-Based Nursing Practice

  • Use of research to establish and implement a plan of care
  • Use of problem-solving approach to make clinical decisions
  • Use of various resources to collect, interpret, integrate, and validate research-derived evidence for use in practice

 

Components of Case-Managed Care

  • Advocacy, communication, and resource management
  • Client-focused comprehensive care across a continuum
  • Coordinated care with interdisciplinary approach

 

Mortality Rate

Maternal mortality: number of deaths of any cause during pregnancy/100,000 live births. Maternal deaths are during pregnancy and childbirth or within 42 das of termination of pregnancy

 

Fetal mortality: number of fetal deaths (over 20 weeks) in 1,000 live births. May be attributed to maternal factors such as malnutrition or preterm dilation or fetal factors like chromosomal abnormalities or poor placental attachment. US rate is 6.2/1000 live births

 

Neonatal mortality: number of infants death (in first 28 days) in 1,000 live births. US rate is 4.5/1000

 

Infant mortality rate: number of infant deaths (in first 12 months) in 1,000 live births. Us rate is 6.7/1,000

NSG 201H -Introduction to Maternity and Newborn Nursing

Morbidity: Disease State or Condition      

  • No state has focused enough attention on preventive measures
  • Too many women lack health insurance coverage
  • No state has adequately addressed the issues of reproductive health and violence against women
  • There is limited research on health conditions that primarily affect women or affect women differently
  • Cardiovascular disease is the number one cause of death in women regardless of ethnic group

Factors Impacting Maternal and Women’s Health

  • Family: change in parental roles
  • Genetics
    • Gender
    • Race: black women have mortality and morbidity rates 3-4x that of Caucasians. There is a large racial disparity
      • SES, language and legal barriers, limited or no insurance, lack of prenatal care.
    • Society
      • Social roles and socioeconomic status
      • Communities and violence
    • Culture
      • Cultural groups
      • Nutrition
      • Lifestyle choices
    • Environmental exposure: maternal infections, tobacco, drugs, chemicals, dietary agents
    • Stress and coping: stressors can decrease coping abilities
    • Health care cost containment
      • Access to health care: lack of insurance benefits. Women pay larger amount for same coverage
      • Preventive care focus: education
      • Continuum of care emphasis: cost effective way to provide efficient services. Integration of hospital to the continuum of the home and other community settings
    • Improvement in diagnosis and treatment
      • Empowerment of health care consumers: focus on prevention
        • Individuals taking on responsibility for their own health, decision, and treatment options

NSG 201H -Introduction to Maternity and Newborn Nursing

Question

Is the following statement True or False?

The definition of family and its structure have remained fairly constant over the years.

  1. True
  2. False

Answer

  1. False

The definition of family has changed over time, as has the typical family structure, such that the traditional nuclear family is no longer considered the dominant family structure in today’s society.

 

Factors Impacting Maternal and Women’s Health: Genetics

  • Study of heredity
  • Gender determination: influence on physical characteristics, personal attributes, and behaviors
    • Some diseases more prevalent in a specific gender
  • Race: biological differences in members of particular group
    • Some variations normal in a race but considered a disorder characteristic in other races

 

Factors Impacting Maternal and Women’s Health: Society

  • Social roles: important for developing self-concept
  • Socioeconomic status: poverty and homelessness
  • Violence: domestic violence
  • Community: schools, peer groups, neighborhoods
  • Global health for women
  • Violence: domestic violence
  • Community: schools, peer groups, neighborhood connectedness

Factors Impacting Maternal and Women’s Health: Health Status and Lifestyle            

  • Developmental level and disease distribution: variable with age
  • Nutrition: deficiencies or excesses
  • Lifestyle choices: exercise, use of tobacco, drugs, or alcohol
  • Environmental exposure
  • Stress and coping: exposure to traumatic events, crises, inadequate support systems, violence

 

Factors Impacting Maternal and Women’s Health: Health Care Cost Containment

  • Quality-of-care maintenance while attempting to reduce health care costs; shorter hospital stays; increased awareness of cost of supplies and services
  • Access to health care: provision of health care within a limited resource environment and access to services; health care insurance reimbursement
  • Preventive care focus: anticipatory guidance and education
  • Continuum of care focus: provision of more efficient and effective services

NSG 201H -Introduction to Maternity and Newborn Nursing

Factors Impacting Maternal and Women’s Health Care: Empowerment of Health Care Consumers

  • Increase in responsibility by individuals and families for own health
  • Family desire for information and participation in decision-making process
  • Respect for family’s views and concerns; addressing of issues and concerns; regard for client, partner, and parents as important participants

Question

Which of the following is a cost-effective strategy to provide more efficient and effective services to clients extending from acute care to outpatient settings?

  1. Cost containment
  2. Continuum of care
  3. Consumer empowerment
  4. Preventive care

 

Answer

  1. Continuum of care

A continuum of care provides cost-effective continuity of care from the acute care setting, such as a hospital, to outpatient settings, such as rehabilitative units. Cost containment refers to the effort to maintain quality care while reducing health care costs. Consumer empowerment  is the increased responsibility of consumers to take on their own health care as an informed consumer. Preventive care involves anticipatory guidance and client education.

 

Barriers to Health Care      

  • Finances: limited or no health insurance; poverty
    • Childbirth is leading reason for hospitalization
    • Many women have limited/no health insurance and cannot pay for maternity care
  • Transportation: lack of car; inability to use public transportation; need to bring smaller children along on visit
    • Reduced adherence to appointments and follow-ups
  • Language and culture: difficulties in communicating information; beliefs related to some forms of treatment. Language barrier can limit access to care, so can knowledge barriers (importance of prenatal care etc)
  • Health care delivery system: earlier discharge; possible limits for specialty care; clinic hours; negative attitudes toward poor or culturally diverse families by some health care providers
    • Idea is to discharge as early as possible and deliver care through home/community setting. This may limit specialty care

 

Legal and Ethical Issues in Maternal and Women’s Health Care         

  • Abortion: legal, social, and political issue; nurses struggling with personal beliefs and professional duty
  • Substance abuse: fetal injury if woman is pregnant; possible charges of negligence and child endangerment
  • Intrauterine therapy: medical technology vs. nature; better quality of life via surgical intervention

 

Stem Cell Research

  • Goal is to relieve human suffering
    • Benefits: Parkinson’s therapies, spinal injuries, organs for transplant
  • Ethical concerns vary depending on the origin of the stem cells
    • Adult stem cells – bone marrow transplants
    • Embryonic stem cells – from inner cell mass of embryo
  • Controversy focuses on the use of embryonic stems cells
    • Destruction of embryo according to some
  • Umbilical cord blood banking is a vast source of primitive hematopoietic stem and progenitor cells available for clinical application
    • Stem cells from cord blood cannot treat inborn errors of metabolism or genetic diseases in the same individual from which they were collected

 

Breastfeeding Friendly Workplace

NSG 201H -Introduction to Maternity and Newborn Nursing

Informed Consent

  • Nurse’s responsibility in the process:
    • Ensuring form completed with signatures
    • Serving as witness to signature process
  • Determining client, family understanding of what they are signing through appropriate questions
  • Components of informed consent
    • Disclosure
    • Comprehension
    • Competency
    • Voluntariness
  • Informed consent also rests on an assumption of competence (all adults are competent unless a court decides otherwise) and capacity (ability to understand alternatives and consequences of treatment and choose best option).

 

Health Insurance Portability and Accountability Act (HIPAA)

  • Confidentiality of health care is mandated by law
  • Primary intent is to protect health insurance coverage for workers when they change or lose jobs
  • Requires DHHS to establish national standards for electronic transmission of health information
  • Promotes the security and privacy of health care information for all clients
  • Exceptions exist, such as in cases of suspicion of abuse

 

Implications for Nurses       

  • Proactive role in advocating and empowering clients
  • Need for solid knowledge base about factors impacting health and barriers to health care
  • Need for anticipatory guidance
  • Work within the framework of the nursing process
  • Need to be alert to new technologies and treatments
  • Integration of evidence-based interventions in care

Chapter 2

NSG 201H -Introduction to Maternity and Newborn Nursing

Family-Centered Care

  • Collaborative partnership among individual, family, and caregivers to determine goals, share information, offer support, and formulate plans for health care
  • Types of support
    • Informational: designed to provide supportive communication by making available understandable information to the family about the patient’s condition
    • Emotional: listening and caring – being concerned in ways to help family cope
    • Appraisal or esteem: enhancing and supporting the family
    • Instrumental: assistance of any kind (financial, labor, environmental modification)

 

Philosophy of Family-Centered Care

  • Recognizes the family as the constant: the health of all the family members and their functional abilities influence the health of the client and other members of the family
  • Core concepts: dignity and respect, sharing health care information, allowing patients and families to participate in care, and providing collaborative care for the client and family

 

Community-Based Care

  • Definition of community: group of people in defined geographical area who share common interests, interact with each other, and function collectively in a defined social structure to address common concerns
    • Person is part of many communities
    • Community is the unit of service
    • Concern for clients as well as for the larger population of potential or at-risk clients
  • Population: group of individuals who share personal or environmental characteristics (e.g. geographic location)

 

Community Health Nursing

  • Focuses on prevention of illness and improvement of the health of populations and communities
  • Includes geographically and culturally diverse settings
  • Allows public health nurses to specialize in areas of community health nursing
  • Uses epidemiology to determine the health needs of populations and assist in planning services
    • Epidemiology: study of causes, distribution, ad control of disease in populations
      • Analyze and develop health policies and community health initiatives
    • Uses Healthy People 2020 for national health initiatives to follow
      • Increase quality of life and expectancy of individuals of all ages to decrease health disparities among different populations

Community-Based Nursing

  • Focus on health promotion and primary health care
  • Settings include ambulatory care; home health care; occupational health; school health; hospice
  • Clinical practice includes case management, research, quality improvement, and discharge planning
  • Employment opportunities in staff development, program development, and community education

 

NSG 201H -Introduction to Maternity and Newborn Nursing

Levels of Prevention in Community-Based Nursing

  • Primary prevention
    • Disease prevention before occurrence via health promotion activities, environmental protection, and specific protection against disease or injury
  • Secondary prevention
    • Early detection and treatment such as health screenings
  • Tertiary prevention
    • Reduction or limitation of disease progression or disability after injury
    • Only takes place if the condition results in permanent disability
    • Supportive and restorative

 

Question

Is the following statement True or False?

Health screenings are an important component of primary prevention.

  1. True
  2. False

 

Answer

  1. False

Health screenings are an important component of secondary prevention because they aid in the early detection of disease.

 

Cultural Competence

  • Knowledge, willingness, and ability to adapt health care to enhance its acceptability to and effectiveness with clients from diverse cultures
  • Cultural aspects: perspectives, traditions, values, practices, and populations
  • Dynamic, lifelong learning process

 

NSG 201H -Introduction to Maternity and Newborn Nursing

Complementary and Alternative Medicine (CAM) in Maternity Nursing

  • CAM not specific to one particular ethnic or cultural group; growing in popularity
  • 36% of adults and 12% of children use CAM therapy
  • Prayer is the most common form of CAM therapy
  • CAM is being used increasingly by midwives for childbirth

 

–Complementary medicine is used together with conventional medicine

–Alternative medicine is used in place of conventional medicine

Integrative medicine combines mainstream medical therapies and CAM therapies for which there is some scientific evidence of safety

 

Integrative Medicine

  • Focuses on treating the whole person, not just disease
  • Involves treating mind, body, and spirit at the same time
  • Combines conventional Western medicine with complementary treatments
  • Nurses need to understand all aspects of CAM, including cost, client knowledge, and drug interactions

 

Most Commonly Used CAM During Pregnancy

  • Massage
  • Acupuncture
  • Vitamins
  • Herbs

 

Instructions for Clients Using CAM Therapies

  • Do not take for granted that the substance is beneficial or harmless
  • Seek medical care when ill
  • Inform provider if taking herbs
  • Be sure package lists all ingredients and amounts
  • Be aware that large doses of CAM preparation may be harmful
  • Research CAM in books, Internet, articles

 

Community-Based Nursing Care Settings

  • Physicians’ offices
  • Clinics
  • Health departments
  • Urgent care centers
  • Hospital outpatient centers
  • Churches and shelters
  • Client homes
  • Types of Settings for Labor and Birth
    • Hospital
    • Birthing center
      • “Home-like” setting; close to hospital if complications; “normalcy” of birth
    • Home
      • Family-centered birth; appropriate for women at low risk for complications, least expensive, limited availability to pain medication

Question

Is the following statement True or False?

A home birth is typically advantageous for a woman because it allows her a variety of options for pain medication.

  1. True
  2. False
  • Answer

False

Pain medication is limited with a home birth.

 

Community Resources Available to New Mothers

  • Telephone consultation
  • Outpatient clinics
  • Postpartum home visits
    • Monitoring the physical and emotional well-being of the family members
    • Identifying potential or developing complications for the mother and newborn
    • Linking the family, as needed, to community social services and housing and governmental programs

 

  • Support groups for new mothers
    • Breast feeding
    • Infant care
  • High-risk newborn home care
    • Premies, low birth weight

NSG 201H -Introduction to Maternity and Newborn Nursing

Roles and Functions of the Community-Based Nurse

  • Communicator
  • Direct care provider
  • Educator
  • Discharge planner and case manager
  • Advocate and resource manager
  • The Nurse as Communicator
  • Using verbal and nonverbal communication
  • Communicating with deaf or hearing impaired clients
    • Working with an interpreter
  • Communicating with families
    • Being honest
    • Helping families understand long- and short-term effects of therapy
  • Ensuring confidentiality and privacy

 

Role of the Nurse as Educator

  • Providing client and family education
  • Assessing teaching and learning needs
  • Planning education
  • Intervening to enhance learning
  • Documenting teaching and learning

 

Techniques to Facilitate Learning

  • Slow down and repeat information often
  • Speak in conversational style using plain language
  • Chunk information and teach in small bits
  • Prioritize information teaching survival skills first
  • Use visuals such as pictures, videos, and models
  • Teach using interactive hands-on approach

Question

In the role as advocate, the nurse:

  1. Coordinates health care services
  2. Provides atraumatic care
  3. Assesses health literacy
  4. Ensures access to available resources

Answer

  1. Ensures access to available resources

As an advocate, the nurse ensures that the client’s and family’s needs are being met and that they have available resources and appropriate health care services. Coordinating health care services is a function of a case manager. Providing atraumatic care is a function of a direct care provider. Assessing health literacy is a function of an educator.

 

Role of the Discharge Planner and Case Manager

  • Developing and implementing a comprehensive plan for the safe discharge of a client from a health care facility
  • Continuing safe and effective care in the community and home
  • Coordinating health care services while balancing quality and cost outcomes
  • Initiating and maintaining the link between team members and the client
  • Standards of Practice and Legal Issues

NSG 201H -Introduction to Maternity and Newborn Nursing

Standards of Practice

  • ANA
  • AWHONN
  • ACNM
  • NANN
  • NCC

Guidelines for Nursing Practice

  • AWHONN developed standards of practice and identified essential knowledge and skills to provide safe perinatal home care
  • Wide range of professional services and health products can be used in the home with technology and telecommunication
  • Tele-health and tele-medicine make it possible for patients to be interviewed and assessed by specialists located hundreds of miles away

 

Chapter 3

Anatomy and Physiology of the Reproductive System

Components of the Male and Female Reproductive System

  • Female
    • Reproductive cells: eggs or ova
    • Organ for development of the fetus: uterus
  • Male
    • Reproductive cells: sperm
    • Organ for deposit of the sperm: penis

 

Function of the External Female Reproductive Organs  

  • Collectively called the “vulva”
    • Protects urethra and vaginal openings
    • Highly sensitive to touch to increase female’s pleasure during sexual arousal

 

External Female Reproductive Organs

  • Components of the vulva
    • Mons pubis: elevated, rounded fleshy prominence above symphysis pubis.
    • Labia majora and minora
    • Clitoris
    • Vestibular structures
    • Perineum: most posterior part of external female reproductive organs. Between vulva and anus. Made of skin, muscle, and fascia.

 

Function of the Labia and Clitoris

  • Labia majora: contains sweat and sebaceous glands; protects the vaginal opening
  • Labia minora: highly vascular and abundant in nerve supply; lubricates the vulva and swells with stimulation
  • Clitoris: small cylindrical mass of erectile tissue and nerves; function is sexual stimulation. Located at anterior junction of labia minora. Rich supply of blood vesssels
  • Prepuce: hood-like covering over the clitoris; also site of female circumcision practiced in some cultures

 

Structure and Function of the Vestibule

  • Vestibule: oval area enclosed by the labia minora laterally located inside the labia minora and outside the hymen. Perforated by 6 openings.
    • Opening into the vestibule: urethra from the urinary bladder, vagina, and two sets of glands
    • Opening into the vagina: introitus
    • Fourchette: half-moon area behind the opening
    • Glands: Bartholin’s and Skene’s glands secrete mucus to keep the opening moist

NSG 201H -Introduction to Maternity and Newborn Nursing

Internal Female Reproductive Organs

  • Vagina: distensible canal in front of the rectum and behind the bladder. Fibromuscular organ lines with mucous membrane that lies in a series of folds called rugae. Connects external genitals to uterus. Adult vaginal cavity is 3-4 inches long
  • Uterus: pear shaped muscular organ at top of vagina. Behind the bladder and in front of the rectum. Positioned by 8 ligaments. Uterine wall is relatively thick and composed of 3 layers
    • Main body of uterus is called the corpus
  • Fallopian tubes: 2-3 inches from upper edges of uterus towards ovaries. Fallopian tubes convey ovum from ovary to the uterus and sperm from uterus to the ovary. This is via ciliary action and peristalsis.
  • Ovaries: development and release of ovum and secretion of estrogen and progesterone are the 2 primary functions of the ovary. Link the reproductive system to the endocrine system

 

Question

Is the following statement True or False?

The clitoris is considered an internal reproductive organ.

  1. True
  2. False
  • Answer
  1. False

The clitoris is an external female reproductive organ. The internal organs include the vagina, uterus, fallopian tubes, and the ovaries.

 

Layers of the Uterine Wall

  • Endometrium: innermost layer
    • Lines the uterine cavity in non-pregnant women
    • 5-5 mm
    • abundant supply of glands and blood vessels
  • Myometrium: muscular middle layer
    • Makes up the major portion of the uterus
    • Composed of smooth muscle linked by connective tissue
    • Undergoes hypertrophy during pregnancy
  • Perimetrium: outer serosal layer
    • Covers the body of the uterus

Cervix

  • Lower part of uterus
  • Opens into vagina and as a channel that allows sperm to enter uterus
  • Covered by mucosa
  • Mucus is thick before ovulation to allow for fertilization

 

Breasts          

  • Accessory organs – specialized for milk secretion after pregnancy
    • composed of 9 lobes
  • Nipple
  • Areola
  • Lobes
  • Alveolar and lactiferous glands

 

Female Sexual Response

  • Sexual stimulation leading to vasocongestion
    • Increased heart rate, respiratory rate, lood pressure, excitement.
  • Vaginal expansion and elongation
  • Labia minora and majora swell/darken
  • Secretion of mucus by vestibular glands
  • Estrogen (preservation of vascular function) and testosterone (hormone of sexual desire in women)
    • Both must be present in adequate amounts for the brain to sense arousal
  • Orgasm (zenith of stimulation)
  • Rapid dissipation of vasocongestion and muscle contraction after orgasm

NSG 201H -Introduction to Maternity and Newborn Nursing

Female Reproductive Cycle

  • Ovarian cycle
  • Endometrial cycle
  • Hormonal regulation
  • Cyclical breast changes
  • Menstruation (absence of fertilization)

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Menstruation

  • Expulsion of inner uterine lining occurring monthly
  • Marks the beginning and end of each menstrual cycle
  • Menarche: establishment of menstruation in females. Average age is 12.8
  • Menopause: naturally occurring cessation of regular menstrual cycles
  • Frequency variable: 21 to 36 days; average 28 days

 

Menstrual Cycle: composed of 2 cycles

  • Ovarian cycle: begins when follicular cells swell and maturation starts. Maturing follicle is called graafian follicle.
    • Follicular phase (day 1 through ovulation, approximately day 10 to 14)
      • Follicles from ovary grow and mature egg
      • Increasing estrogen secreted from follicular cells and growth of dominant follicle cell induce proliferation of endometrium and myometrium (thickening of uterine wall)
      • Hypothalamus prompts pituitary gland to release FSH, which stimulates ovary to produce 5-20 immature follicles
      • Each follicle has immature oocyte
      • Surge of lutenizing hormone from anterior pituitary affects final development and rupture of mature follicle
    • Ovulation (day 14 of a 28-day cycle)
      • Follicle ruptures in response to LH surge
      • Mature oocyte released
      • Ovulation is usually 10-12 hrs after peak LH
      • Distal fallopian tubes become active and create currents to carry ovum into uterus
      • Ovulation takes place 14 days before menstruation
    • Luteal phase (day 15 through day 28 of a 28-day cycle
      • Beings at ovulation and lasts until menstrual phase of next cycle
      • After follicle ruptures, it closes and forms corpus luteum
      • Corpus luteum secretes progesterone
        • Prepares endometrium for implantation

 

  • Endometrial Cycle
    • Proliferative phase: enlargement of endometrial glands in response to increased estrogen. Increased thickness to prepare for ovum implantation. Thinner cervical mucus. Proliferative is day 5 of menstrual cycle and lasts until ovulation
    • Secretory phase: Begins are ovulation to about 3 days before next menstrual cycle. Progesterone from corpus luteum causes endometrial thickening and increased vascularity. Days 15-28 As estrogen and progesterone levels decrease, endometrium. Undergoes involution
  • Ischemic phase: If fertilization doesn’t occur, ischemic phase starts. Estrogen and progesterone drops and CL degenerates. Endometrium sheds
  • Menstrual phase: blood released into uterus and lining sloughs off

 

Question

A woman reports that her menstrual period occurs every 28 days. The nurse would determine that ovulation in this woman would occur at which time?

  1. Day 10
  2. Day 14
  3. Day 18
  4. Day 22

 

Menstrual Cycle Hormones

  • Gonadotropin-releasing hormone (GnRH): secreted by hypothalamus in pulsatile manner throughout reproductive cycle. Pulsates slowly during follicular phase and increases during luteal phase. Induces release of FSH and LH to assist with ovulation
  • Follicle-stimulating hormone (FSH): secreted by anterior pituitary and required for maturation of follicle. Highest secretion during 1st week of follicular phase
  • Luteinizing hormone (LH): Secreted by anterior pituitary. Required for final maturation of preovulatory follicles and lutenization of ruptured follicle. Estrogen declines as progesterone secretion continues.
  • Estrogen: secreted by ovaries. Necessary for development and maturation of follicle. Predominant at end of proliferative phase. Induces proliferation of endometrial glands.
  • Progesterone: Secreted by corpus luteum. Progesterone increases before ovulation. Induces swelling and section of endometrium.
  • Prostaglandins: primary mediators of body’s inflammatory processes. They increase during follicular maturation and help with freeing the ovum from the graafian follicle

NSG 201H -Introduction to Maternity and Newborn Nursing

External Male Reproductive Organs

  • Penis
    • Organ of copulation
    • Outlet for urine and sperm
  • Scrotum
    • Sac surrounding and protecting testes
    • Climate-control system for testes

Internal Male Reproductive Organs

  • Testes
    • Sperm production
    • Testosterone synthesis
  • Ductal system
    • Vas deferens (sperm transport): transports sperm from epididymis
    • Spermatic cord
    • Urethra

 

  • Accessory glands
    • Seminal vesicles: produce nutrient seminal fluid
    • Prostate gland: produces alkaline prostatic fluid
    • Bulbourethral glands
    • Question

 

Is the following statement True or False?

The testes need a temperature that is warmer than body temperature for normal sperm development.

  1. True
  2. False

Answer

  1. False

The testes need to be slightly cooler than body temperature to allow normal sperm development

 

Male Sexual Response

  • Excitement: The person experiences sexual arousal with specific changes such as the erection of the penis in males.
  • Plateau: Physiologic changes of the excitement phase level off.
  • Orgasm: The tension that built up during the previous two phases is released.
  • Resolution: The body returns to the physiologic non- stimulated state