Chapter 5

The Nursing Role in Reproductive

and Sexual Health
Anatomy and Physiology of the
Reproductive System: The Male #1
Andrology: study of the male reproductive system

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Anatomy and Physiology of the
Reproductive System: The Male #2

o External structures
 Scrotum
 Testes
 Penis
Internal structures
o Epididymis
o Vas deferens
o Seminal vesicles
o Prostate gland
o Bulbourethral glands
o Urethra

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Anatomy and Physiology of the
Reproductive System: The Female #1

Gynecology: study of the female reproductive

system

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Anatomy and Physiology of the
Reproductive System: The Female #2

External structures
o Mons veneris
o Labia minora
o Labia majora
o Vestibule
o Clitoris
o Skene glands
o Bartholin glands
o Fourchette
o Hymen

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Anatomy and Physiology of the
Reproductive System: The Female #3

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Anatomy and Physiology of the
Reproductive System: The Female #4

Internal structures
o Ovaries
 Maturation of oocytes
o Fallopian tubes
o Uterus
 Uterine wall layers
 Uterine blood supply
 Uterine nerve supply
 Uterine supportive structures
o Vagina

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Anatomy and Physiology of the
Reproductive System: The Female #5

Uterine deviations
o Bicornuate uterus
o Anteversion
o Retroversion
o Anteflexion
o Retroflexion

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Anatomy and Physiology of the
Reproductive System: The Female #6

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Anatomy and Physiology of the
Reproductive System: The Female #7

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Anatomy and Physiology of the
Reproductive System: The Female #8

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Anatomy and Physiology of the
Reproductive System: The Female #9

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Menopause: Changes in Female
Reproductive Cycle

Signals the end of menstruation

Ends the fertile period in females
Stops the production of ova

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Human Sexual Response Cycle

 Excitement
 Plateau
 Orgasm
 Resolution
 Effect of menstrual cycle and pregnancy

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2020 National Health Goals Related to
Reproductive and Sexual Health #1

Increase the proportion of adolescents who, by age

15 years, have never engaged in sexual intercourse
to 80.2% of girls and 79.2% of boys from baselines
72.9% and 72.0%.
Increase to at least 91.3% the proportion of sexually
active 15- to 19-year-olds at risk for unintended
pregnancy who used contraception at last sexual
intercourse from a baseline of 83.0%.

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2020 National Health Goals Related to
Reproductive and Sexual Health #2

Reduce deaths from cancer of the uterine cervix to

no more than 2.2 per 100,000 women, from a
baseline rate of 2.4 per 100,000.
Reduce breast cancer deaths to no more than 20.6
per 100,000 women, from a baseline rate of 22.9
per 100,000.
Improve the health, safety, and well-being of
lesbian, gay, bisexual, and transgender (LGBT)
individuals.

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Example Questions to Include in a Sexual
History

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Common Features of Sexual Physiology

Sexual response cycle

Influence of menstrual cycle on sexual response
Influence of pregnancy on sexual response
Masturbation
Sexual harassment and violence
Individuals with unique needs or concerns

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Examples of Nursing Diagnoses Related to
Reproductive and Sexual Health

Risk for infection related to high-risk sexual

behaviors
Altered sexuality patterns related to chronic illness
Unsatisfactory altered sexuality patterns in an
uncomplicated pregnancy related to knowledge
deficits

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Examples of Nursing Diagnoses and
Outcomes Related to Reproductive and
Sexual Health

Nursing Diagnosis Outcome

Risk for infection related to high- Patient will identify at least two
risk sexual behaviors actions that he or she can take to
reduce risk of sexually transmitted
disease.
Altered sexuality patterns related Patient will identify two strategies
to chronic illness that will assist in restoring previous
pattern of sexuality.
Unsatisfactory altered sexuality Couple will be able to identify
patterns in an uncomplicated factors that may contribute to the
pregnancy related to knowledge altering of their usual pattern of
deficits sexuality.

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Quality & Safety Education for Nurses
(QSEN)

Patient-Centered Care
Teamwork & Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics

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Interventions Related to Promoting
Reproductive and Sexual Health
Nursing Diagnosis Possible Nursing and
Therapeutic Interventions
Risk for infection related to high-risk • Teach patients strategies related
sexual behaviors to reducing their specific at-risk
behavior.
• Work with patients to identify
which strategies would best work
for them.
Altered sexuality patterns related to • Review with patients factors that
chronic illness might impact on their pattern of
sexuality, such as fatigue and
self-image, and suggest strategies
to minimize these factors.
Unsatisfactory altered sexuality • Explore with the couple what
patterns in an uncomplicated factors might be contributing to
pregnancy related to knowledge the change in sexuality pattern,
deficits including cultural and religious
beliefs, and give appropriate
information related to knowledge
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deficits.
Evaluating Outcomes Related to Promoting
Reproductive and Sexual Health

Nursing Diagnosis Possible Nursing and

Therapeutic Interventions
Risk for infection related to high- • Patient will report that he or she
risk sexual behaviors is taking precautions to prevent
contracting sexually transmitted
diseases.
Altered sexuality patterns related • Patient reports that a
to chronic illness satisfactory pattern of sexuality
has been achieved.
Unsatisfactory altered sexuality • Couple reports that their anxiety
patterns in an uncomplicated related to sexual relations during
pregnancy related to knowledge the pregnancy has decreased.
deficits • Couple reports achievement of a
mutually satisfying pattern of
sexuality.

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Question #1

During a sports physical, a 17-year-old male

adolescent asks the nurse when to begin testicular
self-exams. Which is the most appropriate patient
teaching?
A. In adolescence
B. In his early 20s
C. In his early 30s
D. In middle age

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Answer #1

A. In adolescence
Rationale: Beginning in adolescence will allow the
adolescent to establish a good baseline for later
changes and also develop the habit of performing the
examination.

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Question #2

The school nurse conducts a sports physical examination

on a 14-year-old gymnast, who voices a concern that
she has not begun menstruation, even though most of
her friends have. Which is the best nursing action?
A. Advise her to share her concerns with her family
doctor because this certainly is an abnormal
occurrence.
B. Explain that because of her low body fat, it is not
unusual for menstruation not to have begun yet.
C. Report these findings immediately to her physician
for further evaluation.
D. Encourage the use of hormone supplements to
promote puberty.

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Answer #2

B. Explain that because of her low body fat, it is not

unusual for menstruation not to have begun yet.
Rationale: Menstruation may begin as late as age 15
years and still be considered within normal limits.
Further, body fat and athletic participation may delay
the onset. Supplements are not needed or appropriate.

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Question #3

Which of the following statements best defines sexual

identity?
A. The chosen activities a person uses to express
masculinity or femininity
B. The male or female characteristics determined by
genetic factors
C. The feeling of being male or female
D. The male or female characteristics encouraged by
the culture

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Answer #3

C. The feeling of being male or female

Rationale: Sexual identity refers to whether individuals
see themselves as male or female, not to their activity
or to the cultural expectation.

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