HUMAN SEXUALITY Amy C. Chavarria, RN, MSN, MBA, HCM, CCE

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HUMAN SEXUALITYAmy C. Chavarria, RN, MSN,
MBA, HCM, CCE
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STRUCTURE

• MALE
• - External
• Penis
• Scrotum
• - Internal
• Prostate Gland
• Seminal Vesicles

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• MALE
• Reproductive Gland
• Testes
• produces male cells (spermatozoa)
• testosterone (male hormone).

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1-Testes The testes produces the spermatozoa
for the semen.   
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2- Epididymus The epididymus is like a storage
area for the spermatozoa. 
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3- Vas deferens Also called the "ductus
deferens,"
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4- Ampulla This is just a widened area of the
vas deferens.  
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5-Seminal vesicle The seminal vesicles secrete
a fluid that contains fructose
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6-Prostate gland The prostate gland also adds
fluid to the semen.   This fluid is milky in
appearance and alkaline.
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7-Bulbourethral gland a.k.a., Cowper's glands
secrete a mucus-like fluid that is not really a
semen component. 
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• FEMALE
• External

Vulva (VUHL-vuh) the name of the whole pubic
area, containing your external genitalia, or
outer genitals Pubic bone a roundish bone at
the top of the genital area Mons the fatty
tissue that covers the pubic bone
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• FEMALE
• External

Labia majora (LAY-bee-uh mah-JOHR-uh) soft flaps
of skin just below the mons, protection for the
vagina Labia minora (LAY-bee-uh muh-NOR-uh)
softer lips found inside the outer lips
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• FEMALE
• External

Urethra (yoo-REE-thruh) small opening found
around the middle of the vulva tube through
which urine passes through the body Vaginal
(VA-jih-nuhl) opening the pathway in and out of
your reproductive system larger opening below
the urethra
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• FEMALE
• External

Hymen (HI-muhn) a thin stretch of tissue that
may partially cover the vaginal opening Clitoris
(CLIT-or-is) an organ of mature female sexual
responsiveness, filled with nerve endings
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• FEMALE
• Internal

Ovaries (OH-vuhr-ees) two reproductive glands
that produce hormones and eggs Fallopian
(fuh-LOH-pee-uhn) tubes two tubes through which
the egg travels from the ovary to the uterus
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• FEMALE
• Internal

Uterus (YOOT-er-uhs) muscular organ in the body
where a fertilized egg develops Endometrium
(en-doh-MEET-ree-um) the lining of the uterus
that is shed every month
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• FEMALE
• Internal

Cervix (SER-viks) the lower part of the uterus
Vagina (vuh-JY-nuh) the canal that leads from
the cervix to the outside of the body and through
which menstrual fluid passes when a baby is
born, it also passes through the vagina
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REPRODUCTION

• Menstruation Menses occurs when levels of
  Estrogen and Progesterone fall.
• Conception - Occurs when fertilization of one
  ovum by one sperm occurs in the outer third of
  the Fallopian Tube
• Pregnancy Approximately 40 weeks from time of
  fertilization

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CHARACTERISTICS OF SEXUALITY

• Sexual Orientation
• Heterosexual
• Bisexual
• Homosexual

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• Gender Identity and Roles
• Sexual Expression
• Perception of Gender
• Transexual
• Transvestites

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FUNCTION OF SEXUALITY AND REPRODUCTION

• Reproduction is only one concept of sexuality .
• Humans can be sexual and not reproduce.
• Male
• Female

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FUNCTION OF SEXUALITY AND REPRODUCTION

• Master Johnson Sexual Response Cycle
• Excitement
• Plateau
• Orgasm
• Resolution

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EXCITEMENT PHASE

• Myotonia
• Vasocongestion
• Increase heart rate
• Increase blood pressure
• Sex flush
• Duration 1 minute to several hours

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PLATEAU PHASE

• Continued myotonia
• Continued vasocongestion
• Continued increased heart rate
• Continued increased blood pressure
• Duration few seconds to several minutes

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ORGASM PHASE

• Series of muscular contractions 0.8 sec
  frequency
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RESOLUTION PHASE

• Reversal in myotonia
• Reversal of vasocongestion
• Reduction in heart rate
• Reduction in blood pressure
• After glow
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LIFESPAN CONSIDERATIONS

• Prenatal - When ovum and
• spermatozoon unite sex is determined.
• Newborn and Infant Cuddling and touching helps
  develop normal psychosexual orientation.
• Often explore their bodies.

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LIFESPAN CONSIDERATIONS

• Toddler and Preschooler
• Independent and exploring
• May ask sexual questions
• Masturbate which is normal

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LIFESPAN CONSIDERATIONS

• Child and Adolescent
• Adopt sex behaviors and maintain friendships with
  same sex.
• May engage in masturbation.

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LIFESPAN CONSIDERATIONS

• Adolescence
• A turbulent time.
• Develop identity and independence.
• Surge of hormonal changes.
• Difficult time for child and parents.

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LIFESPAN CONSIDERATIONS

• Adult
• Often avoid their own sexual needs
• To get ahead financially.
• To raise children
• Fatigue and busy work schedules impact.
• Individualized with many variables.

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LIFESPAN CONSIDERATIONS

• Older Adult
• Individualized with many variables.
• Physical ability
• Physical changes
• Illness
• Change in body image
• Many myths and stereotypes.

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FACTORS AFFECTING SEXUALITY

• Relationships
• Quality
• Love and Trust
• Cognition and Perception
• Emotional State
• Culture, Value and Beliefs
• Values and Morals
• Religious Beliefs

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FACTORS AFFECTING SEXUALITY

• Self Concept
• Comfortable with themselves
• Previous Experience
• Abuse, ideas from past, rape
• Pregnancy
• Environment
• Illness
• Medication
• Surgery

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ALTERED SEXUALITY

• Manifestations
• Sexual Abuse
• To others
• Victims
• Inhibited Desire
• Dissatisfaction
• Relationships
• Inconguency
• Medications
• Impotence
• Inability to attain or maintain erection

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ALTERED SEXUALITY

• Manifestations
• Ejaculatory Dysfunction
• PrematureWhen ejaculation occurs before
  satisfaction is achieved
• Orgasmic Dysfunction
• Difficulty achieving orgasm
• Dysparnuia
• Painful Intercourse
• Vaginismus
• Involuntary contraction of vaginal orifice so
  penetration is painful or impossible

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IMPACT ON DAILY LIVING

• Emotionally - self esteem and self-confidence
• This can result in less emotional energy and a
  decrease in physical and mental activities
• Interpersonal difficulties
• Assessment subjective data - elicit a sexual
  history

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WHY DONT WE TAKE SEXUAL HISTORY?

• Lack of Training
• Fear of Arousal
• Awkwardness with sexual Language
• Personal Bias

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HOW DO WE GET STARTED?

• Address your feelings first.
• Identify what makes your feel uncomfortable.
• Develop a plan for asking questions that your are
  comfortable with and will obtain the information
  you need.
• Overcome embarrassment through experience and
  education.

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APPROACHING CLIENT FOR ASSESSMENT

• Comfort with sense of self
• Clarify own values and beliefs
• Nonjudgmental
• Professional
• Matter of factly

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TIPS

• Use sexual history as an outline.
• Dont be restricted by history outline.
• Adjust order of questions to meet client needs.
• Allow client to interject information about
  feelings or concerns.

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TIPS

• Use understandable language.
• Clarify terms not understood.
• Consider education cultural influences.
• Convey warmth, openness, honesty objectivity

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OBJECTIVE DATA

• Female - Pelvic Exam
• Bimanual exam
• Cultures chlamydia gonorrhea
• Blood VDRL
• Slide prep KOH-potassium hydroxide NS)
• Others Candidia, gardnerella, trichomonoas
• Pap Smear - cell changes, cervical cancer

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OBJECTIVE DATA

• Male Genitalia
• Penis
• Scrotum
• Testicles
• Urethra Opening
• Hypospadias - abnormal congenital opening on the
  undersurface of the penis rather than in the
  center.

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NURSING DIAGNOSES

• Sexual Dysfunction
• Client verbalizes problem
• Altered Sexuality Patterns
• Client verbalizes problem, subjective, own
  perception
• Rape-Trauma Syndrome

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NURSING DIAGNOSES

• Gender Identity Disturbance
• Sexual Dysfunction
• Paraphilias
• Pregnancy
• Infertility
• Abortion

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HEALTH PROMOTION

• Anticipatory guidance
• Client teaching
• Sex education
• Self care Monthly BSE, TSE, Kegel exercises
• Contraception
• Screenings
• Counseling
• Referral

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Time for the After glow