NSG6430 Week 1 Discussion

Week 1 Discussion

Discussion Questions

The focus of this discussion is adolescent healthcare. Please address the following points in your initial response:

In your opinion, what are the two most important factors that influence adolescent development? Give rationales for your choices.

In the Western culture, there are a variety of health services available for adolescents, but what is missing in Western society that would benefit health promotion for adolescents?

How do the health problems that adolescents face impact their health and wellness in their lifetime?

A fourteen-year-old female comes into the clinic accompanied by her mother. The teen states she feels a “lump” in her right breast. How would you address this complaint with the patient and her mother? What history and physical examination (PE) would be important to assess? What teaching would you do with the patient? Hint: Remember she is fourteen years old. NSG6430 Week 1 Discussion

Discuss how you would take a sexual history from an adolescent. What are all the areas you would need to address?

Adolescent means “to grow to maturity” and is an important period in life span. Reproduction means “production of offspring “. Health means “state of complete physical, mental, and social well being. After birth the child grows towards maturity and makes them a contributing member of the society.

ADOLESCENT REPRODUCTIVE HEALTH:

ANATOMY AND PHYSIOLOGY OF FEMALE SEXUAL ORGANS:

The principal organs are ovaries, uterus, uterine tubes, and vagina.

Female reproductive cycle includes both ovarian cycle and menstrual cycle.

Female reproductive function begins with the development of “ova” in the ovaries. The oogonia (primitive germ cell) are dominant from fetal period and are transformed to mature oocyte at puberty.

OVARIAN CYCLE OR MENSTRUAL CYCLE:

A single ovum is expelled from an ovarian follicle in to the abdominal cavity in the middle (14th day) of each month (28 days) menstrual cycle this process of rupture of grafian follicle with release of the ovum is called ovulation. Thus the 12-18 days in a 28days cycle is called fertile period.

This ovum is engulfed by fimbrae and is transported to a uterus by the fallopian tube. When fusion of sperm and ovum which develop in to fetus, thus menstruation stops. This process is called as fertilization.

When the ovum is not fertilized then menstruation starts which is cyclical discharge of blood, mucus, unfertilized ovum, and torn endometrial from the uterus per vagina.

PUBERTY:

Puberty is the period during which the secondary sex characteristics begin to develop and capability of sexual reproduction is attained where boys attained manhood and girls attained womanhood.NSG6430 Week 1 Discussion

PUBERTY IN FEMALES:

Girls begin there growth spurt between

9-13 yrs of age

Increase in body fat

Development of sexual character like pubic hair, and auxiliary hair appear.

Development of breast tissue

Rapid increase in height and weight

begin to menstruate

ASPECTS OF ADOLESCENT REPRODUCTIVE HEALTH:

Menstrual hygiene

Teenage pregnancy

Sex education and sexual behavior

Sexually transmitted disease

Contraceptive devices

MENSTRUAL HYGIENE

Menstrual hygiene refers to the hygiene during menstrual period.

It includes use of clean pad changing of soaked pad proper disposal of used pad, perineal and personal hygiene with daily activities like diet, exercise, and rest.

During menstruation Daily twice bathing is essential because to reduce body heat and fatigue.

Washing the genital region daily with soap and water to prevent genital infection.

The diet should consist of vegetables and fruits which gives nourishment and normal diet.

During menstruation iron rich foods helps to maintain the hemoglobin level.

Sanitary napkins can be used to observe the menstrual flow.

Use sanitary napkins or use clean cotton cloth. If cloth is to be reused wash with soap dry in sunlight and preserve in with napthalin balls in plastic bags. Change the napkin three times a day and every 4-6hrs per day.NSG6430 Week 1 Discussion

Used napkins should not be reused because its very unhygienic and lead to reproductive tract infection.

Used napkin should be burned immediately.

When the blood stained napkin rub against the thigh the skin of the thigh gets sore and walking may become uncomfortable. So the thigh region should be kept dry.

From the onset of the first day of menstruation it is better to carry a spare napkin in your bag.

Moderate exercise and adequate rest is also important during menstruation.

Maintain personal hygiene by bath, washing the perineum with soap and water after micturation and defecation

Clean the pubic hair before the menstruation.

TEENAGE PREGNANCY

Adolescent girls become fertile following the menarche (first menstrual period). After menarche, sexual intercourse (especially without contraception) can lead to pregnancy. The pregnant teenager may then miscarry, have an abortion, or carry the child to full term.

CAUSES OF TEENAGE PREGNANCY:

Poverty

Poor academic achievement

Substance abuse

Early puberty

Lack of awareness

PROBLEMS OF TEENAGE PREGNANCY:

MATERNAL PROBLEM:

Anemia, hypertension, cervical trauma, premature delivery, obstructed labour

SOCIO ECONOMIC PROBLEM:

Dropout from the school, less education, unemployment, increased divorce, poor socio economic status.

PSYCHOLOGICAL PROBLEM:

Teenage pregnancy is not socially acceptable, so girls feel guilty, afraid and upset and think they have done some wrong and worry for it.

SEXUAL BEHAVIOUR AND SEX EDUCATION

Adolescent sexuality refers to sexual feelings, behavior and development in adolescents and is a stage of human sexuality. Sexuality is often a vital aspect of teenagers’ lives. The sexual behavior of adolescents is, in most cases, influenced by their culture’s norms and mores, their sexual orientation, and the issues of social control such as age of consent laws.NSG6430 Week 1 Discussion

Sex education, also called “Sexuality Education” or informally “Sex Ed” is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, human sexual behavior, and other aspects of sexuality, such as body image, sexual orientation, dating, and relationships. Common avenues for sex education are parents, caregivers, friends, school programs, religious groups, popular media, and public health campaigns.

Adolescent are physically capable of sexual functioning and even of emotionally falling in love, but they must realize that it is always wiser to wait they become adults and are married before they try to convert their curiosity in to actual practice.

During adolescent young people will find that, their friends are very important to them, what their friends and the parents think about them is very important. This is normal and prepares them to become independent. However this also makes them want to be like their friends and their friends may urge them to do things which they should really not be doing, for eg) homo and hetero sexual relationship.

Homosexual relationship is not healthy practice in girls.

Adolescent must understand that, they have a choice of saying, ‘No’ to pressure from their friends. Sexual curiosity and fantasies may arouse string sexual feeling in adolescents and they may attempt to satisfy these feelings by masturbation. (self stimulation of the genitals to achieve sexual satisfaction). This is common activity among adolescent but it is not a healthy practice. Many religions and cultures donot approve of masturbation.

Physical attraction between sexes through, natural cannot be the sole basis for a lifelong relationship. Premarital sex must be avoided. A girl can get pregnant it she has sex only one.

Sexual relationship belongs with the marriage most religious, cultural and social traditional and family values favor postponing intercourse until marriage. Safe sex means use of condom or other contraceptive devices. Some of the adolescents may find it difficult to divert their mind from sexual matters. It may help to take up some physical activity like sports or some hobby. This will help them to growth and developing balanced manner. Adolescent girls can protect herself from sexual abuse by going for outing with family members. Avoid to outing with girls friends and boy friends. Adolescent girls must be prepared psychologically before menarche. Explanation about sexual behavior and sex education will reduce sexual curiosity in the adolescents. Marriages should be arranged by parents and love marriages are not appropriate in Indian society.NSG6430 Week 1 Discussion

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REPRODUCTIVE TRACT INFECTON, SEXUALLY TRANSMITTED DISEASE(STD):

RTI include the variety of bacterial, viral, and protozoa infections of the lower and upper reproductive tract of both sexes. Common STD are gonorrhea, syphilis, human papiloma virus, HIV, herpes AIDS.

COMMON CAUSES OF REPRODUCTIVE TRACTINFECTIONS:

Infections due to inadequate personal, sexual, and menstrual hygienic practices.

Sexually transmitted diseases (STD) that are transmitted through unsafe sexual contact.

Infections which are due to unsterile medical procedures such as, unsafe delivery or unhygienic copper T insertion.

SIGNS AND SYMPTOMS OF RTI/ STD:

Foul smelling vaginal discharge in women

Urethral discharge in men

Genital ulcers in both men and female

Lower abdominal pain in women can be pelvic inflammatory diseases(PID)

Scrotal swelling of inguinal lymph nodes in both men and women.

PREVENTION AND TREATMENT OF RTI / STD:

Avoid premarital sex and multiple partners

Both husband and wife should be faithful

Practice safe sex

Approach the health personnel immediately in case of onset of any signs and symptoms

ACQUIRED IMMUNO DEFICIENCY VIRUS:

It’s a serious illness it impaired the body’s ability to fight infections. Its caused by the germ called HIV. Normally human blood contains the white blood cells, which act like an army and kills all infected germs when the person affected with HIV. The end result of AIDS is death.

HOW TO HUMAN IMMUNO DEFICIENCY VIRUS SPERAD:

multiple sex partners. NSG6430 Week 1 Discussion

sexual intercourse with affected person

blood transfusion

sharing an infected needles

parental transfusion – mother to fetus

HIV CANNOT ENTER OR SPERAD THROUGH:

sharing clothes and foods

cough, saliva, hugging and kissing

SIGNS AND SYMPTOMS:

loss of body weight

chronic diarrhea more than a month

prolong fever more than one month

persistent cough for more than one month

general itching and skin diseases

HIV IS FOUND IN THE FOLLOWING BODY FLUIDS:

blood,

semen,

Vaginal fluids.

PREVENTION OF AIDS:

Avoid homo and hetero sexual relationship before marriage. Stay faith fully to your partner after marriage.

If blood transfusion is needed. Check to ensure that it has been tested for HIV.

Sterile syringes and needles should be used every time.

Do not demand injections from your doctor.

Adequate knowledge and safe behavior are the two ways to prevent AIDS. Teach your friends and others to be safe.

CONTRACEPTIVES

MEANING:

Refers to the measures taken to prevent pregnancy by avoiding union of sperm and ovum.

PURPOSE:

To avoid unwanted pregnancy

To use at various stages of reproductive life as after marriage

To delay first pregnancy

To ensure spacing between two pregnancies.NSG6430 Week 1 Discussion

TYPES:

Temporary method

Permanent method

TEMPORARY METHOD:

CONDOMS – it is a sheath or covering made of thin latex rubber to fit over the man’s reproductive organ to prevent the entry of sperms in to vagina and gives effective protection against sexually transmitted diseases including AIDS.

ORAL CONTRACEPTIVE PILLS-it is a set of 28 tablets containing estrogen and progesterone hormones and iron arranged in sequence called mala D and mala N. the pill works by suppressing the release of the ovum from the ovaries, by making cervical mucus scanty and thick there by reducing transportation of sperms and by altering the inner lining of uterus thus affecting implantation.

INTRA UTERINE DEVICE / COPPER T:

IUD is a small T- shaped device made of polyethylene having copper T wire wound around its vertical arm with a thread attached at the lower end of the vertical arm.

Action – inhibits migration of sperm in upper genital tract, inhibits ovum transportation

Timing of insertion-at hospital and PHC by medical officer, 1-10 days of beginning of menstruation have to insert copper T

TERMINAL METHOD:

TUBECTOMY FOR FEMALES: It’s a surgical procedure involves blocking the fallopian tubes by cutting it: thus, preventing the passage of egg in the female.

VASECTOMY FOR MALES: It’s a quick surgical procedure where a part of vas deference is cut.

CONCLUSION:

The teacher summarizes the anatomy and physiology of reproductive health and its aspect regarding menstrual hygiene, teenage pregnancy, sex education and sexual behavior, and contraceptive devices.NSG6430 Week 1 Discussion