1. 1. Define important words in this chapter
benign prostatic hypertrophy a disorder that can occur in men as they age, in which the prostate becomes enlarged and causes problems with urination and/or emptying the bladder. cervical cancer a form of female reproductive cancer that begins in the cervix; can occur at any age and has few symptoms. chlamydia a sexually-transmitted infection caused by bacteria. endometrial cancer a form of female reproductive cancer that begins in the uterus; symptoms include vaginal bleeding and pelvic pain.

2. 1. Define important words in this chapter
genital herpes a sexually-transmitted, incurable infection caused by herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). genital HPV infection a sexually-transmitted infection caused by human papillomavirus. glands structures in the body that produce substances. gonads the male and female sexual reproductive glands.

3. 1. Define important words in this chapter
gonorrhea a sexually-transmitted infection caused by bacteria. hormones chemical substances produced by the body that control numerous body functions. impotence the inability to have or maintain a penile erection. menopause the end of menstruation.

4. 1. Define important words in this chapter
menstruation the shedding of the lining of the uterus that occurs approximately every 28 days; also known as the menstrual cycle or period. ovarian cancer a form of female reproductive cancer that begins in the ovaries; can occur at any age and has few symptoms. ovum female sex cell or egg.

5. 1. Define important words in this chapter
prostate cancer a form of male reproductive cancer that begins in the prostate gland; usually occurs in older men, and symptoms include urinating during the night, a weak flow of urine, painful urination, blood in urine, and problems with maintaining an erection. sexually-transmitted infections (STIs) infections caused by sexual contact with infected people; signs and symptoms are not always apparent. sperm male sex cells. syphilis a sexually-transmitted infection caused by bacteria.

6. 1. Define important words in this chapter
testicular cancer a form of male reproductive cancer that begins in the testes. trichomoniasis a sexually-transmitted infection caused by protozoa (single-celled animals). vaginal irrigation a rinsing of the vagina in order to clean the vaginal tract or to introduce medication into the vagina; also called a douche. vaginitis an inflammation of the vagina; symptoms include vaginal discharge, itching and pain.

7. 2. Explain the structure and function of the reproductive system
Define the following terms: sperm male sex cells. ovum female sex cell or egg. gonads the male and female sexual reproductive glands. glands structures in the body that produce substances

8. 2. Explain the structure and function of the reproductive system
Define the following terms: hormones chemical substances produced by the body that control numerous body functions. menstruation the shedding of the lining of the uterus that occurs approximately every 28 days; also known as the menstrual cycle or period.

9. 2. Explain the structure and function of the reproductive system
The reproductive system consists of the reproductive organs, which are different in men and women. This system allows human beings to reproduce, or create new human life. Reproduction begins when male and female sex cells, sperm and ovum, join. These sex cells are formed in the male and female sexual reproductive glands, called the gonads. Glands are structures in the body that produce substances. Hormones are chemical substances produced by the body that control numerous body functions, including the body’s ability to reproduce.

10. Transparency 17-1: The Reproductive System
Male Reproductive System

11. 2. Explain the structure and function of the reproductive system
Know these points about the reproductive system:
Reproductive organs and hormones are different in males and females.
The reproductive system allows human beings to reproduce, or create new human life.

12. 2. Explain the structure and function of the reproductive system
Function of the male reproductive system:
Manufacture sperm and the male hormone, testosterone
Functions of the female reproductive system:
Manufacture ova and female hormones, estrogen and progesterone
Provide environment for development of fetus
Produce milk for the nourishment of a baby after birth

13. 3. Discuss changes in the reproductive system due to aging
Define the following term: menopause the end of menstruation.

14. 3. Discuss changes in the reproductive system due to aging
Normal changes of aging in the male reproductive system:
Prostate gland enlarges.
Number and capability of sperm decreases.
Sexual response delays; it may take longer to achieve an erection and to reach orgasm.

15. 3. Discuss changes in the reproductive system due to aging
Normal changes of aging in the female reproductive system:
Menopause occurs when menstruation ends and ends the ability to reproduce.
Decrease in production of estrogen and progesterone leads to a loss of calcium, causing brittle bones, and, potentially, osteoporosis.
Vaginal walls become drier and thinner.

16. 4. Discuss common disorders of the reproductive system
Define the following term: sexually-transmitted infections (STIs) infections caused by sexual contact with infected people; signs and symptoms are not always apparent.

17. 4. Discuss common disorders of the reproductive system
Know these points about sexually-transmitted infections (STIs):
Transmitted through sexual contact, via needles, or through childbirth or breastfeeding
Transmission of some can be reduced or stopped by using latex condoms.

18. 4. Discuss common disorders of the reproductive system
Define the following term: chlamydia a sexually-transmitted infection caused by bacteria.

19. 4. Discuss common disorders of the reproductive system
Know these points about chlamydia:
Cause: bacteria
Symptoms: burning with urination, discharge from the penis or vagina, swelling of the testes, painful intercourse, abdominal and low back pain
In many cases, no symptoms are apparent.
May cause infertility or pelvic inflammatory disease
Treatment: antibiotics

20. 4. Discuss common disorders of the reproductive system
Define the following term: genital herpes a sexually-transmitted, incurable infection caused by herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2).

21. 4. Discuss common disorders of the reproductive system
Know these points about genital herpes:
Cause: herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2)
Cannot be cured
Symptoms: itching, painful red blisters or open sores, burning sensation during urination or intercourse, fever, headache, muscle aches
Infection can be spread even when sores are not present.
Treatment: anti-viral medications to lessen frequency of episodes

22. 4. Discuss common disorders of the reproductive system
Define the following term: genital HPV infection a sexually-transmitted infection caused by human papillomavirus.

23. 4. Discuss common disorders of the reproductive system
Know these points about genital HPV infection:
Cause: human papillomavirus (HPV)
Infects genital area of both men and women
May have no signs or symptoms
Symptoms: abnormal pap test, genital warts
Treatment: removal of warts, medication
Vaccine licensed by FDA is available.

24. 4. Discuss common disorders of the reproductive system
Define the following term: gonorrhea a sexually-transmitted infection caused by bacteria.

25. 4. Discuss common disorders of the reproductive system
Know these points about gonorrhea:
Cause: bacteria
Easier to detect in men than women
Symptoms: painful or burning urination; white, yellow, or green cloudy pus-like discharge from penis; swollen testes; cloudy vaginal discharge; vaginal bleeding; rectal itching, soreness; painful elimination of stool
Treatment: antibiotics

26. 4. Discuss common disorders of the reproductive system
Define the following term: syphilis a sexually-transmitted infection caused by bacteria.

27. 4. Discuss common disorders of the reproductive system
Know these points about syphilis:
Cause: bacteria
Easier to detect in men than women
Symptoms: chancres, rashes, headache, fever, sore throat, weight loss, muscle aches
Infection can spread to the heart, brain and other vital organs.
Can be fatal
Treatment: antibiotics

28. 4. Discuss common disorders of the reproductive system
Define the following term: trichomoniasis a sexually-transmitted infection caused by protozoa (single-celled animals).

29. 4. Discuss common disorders of the reproductive system
Know these points about trichomoniasis:
Cause: protozoa
May have no symptoms in men
Symptoms in men: mild discharge, irritation, burning sensation after urination or ejaculation
Symptoms in women: green-yellow vaginal discharge with strong odor, irritation, itching
Treatment: metronidazole

30. 4. Discuss common disorders of the reproductive system
Define the following term: vaginitis an inflammation of the vagina; symptoms include vaginal discharge, itching and pain.

31. 4. Discuss common disorders of the reproductive system
Know these points about vaginitis:
Cause: overgrowth of normal bacteria inside the vagina, overproduction of fungus, lower estrogen levels post-menopause, irritation, or an allergic reaction
Symptoms: vaginal discharge, itching, and pain
Treatment: creams, suppositories, antibiotics, and estrogen supplements

32. 4. Discuss common disorders of the reproductive system
Define the following terms: ovarian cancer a form of female reproductive cancer that begins in the ovaries; can occur at any age and has few symptoms. endometrial cancer a form of female reproductive cancer that begins in the uterus; symptoms include vaginal bleeding and pelvic pain. cervical cancer a form of female reproductive cancer that begins in the cervix; can occur at any age and has few symptoms.

33. 4. Discuss common disorders of the reproductive system
Know these points about female reproductive cancers:
Ovarian cancer begins in the ovaries. Symptoms are not always apparent. There is no definitive screening test for ovarian cancer. Pelvic examinations and ultrasound testing help diagnose this type of cancer. Treatment includes surgery, radiation, and chemotherapy.
Endometrial cancer begins in the uterus. Symptoms include vaginal bleeding and pelvic pain. Pelvic examinations and ultrasounds are used to diagnose this type of cancer. If detected early, endometrial cancer is highly curable by removing the uterus.

34. 4. Discuss common disorders of the reproductive system
Female reproductive cancers (cont’d.):
Cervical cancer begins in the cervix. Symptoms are not always apparent, but include vaginal bleeding, change in menstrual cycles, painful intercourse, and blood-tinged vaginal discharge. Pap tests, scopes, and biopsies are tests that check for cervical cancer. A vaccine for cervical cancer is available for younger women. If detected early, cervical cancer is curable.

35. 4. Discuss common disorders of the reproductive system
Define the following term: benign prostatic hypertrophy a disorder that can occur in men as they age, in which the prostate becomes enlarged and causes problems with urination and/or emptying the bladder.

36. 4. Discuss common disorders of the reproductive system
Know these points about benign prostatic hypertrophy:
Common in men over the age of 60
Cause: enlarged prostate causes pressure on urethra, making urination difficult.
Symptoms: feeling of incomplete urination, frequent urination, weak stream of urine, dribbling, need to urinate often at night, incontinence
Treatment: medication and surgery

37. 4. Discuss common disorders of the reproductive system
Define the following terms: prostate cancer a form of male reproductive cancer that begins in the prostate gland; usually occurs in older men, and symptoms include urinating during the night, a weak flow of urine, painful urination, blood in urine, and problems with maintaining an erection. testicular cancer a form of male reproductive cancer that begins in the testes.

38. 4. Discuss common disorders of the reproductive system
Know these points about male reproductive cancers:
Prostate cancer forms in the prostate gland, normally in older men. Symptoms of prostate cancer are urinating during the night, a weak flow of urine, painful urination, blood in urine, and problems with maintaining an erection. This type of cancer tends to be slow-growing and treatable, if caught early. Treatment includes removal of the prostate, hormone therapy, and chemotherapy.
Testicular cancer occurs in the testes. Symptoms include a noticeable lump in the testes, pain in the testicles, breast tenderness, and an ache in the groin. Testicular cancer is highly curable. Treatment includes surgical removal of the testes, chemotherapy, and radiation therapy.

39. 5. Describe sexual needs of the elderly
REMEMBER: Sexual needs continue throughout a person’s life. All people, regardless of age, have sexual needs and desires. You can help by providing privacy for sexual activity whenever necessary and by respecting your residents’ sexual needs.

40. 5. Describe sexual needs of the elderly
Remember these points about sexual needs:
Sexual needs continue throughout a person’s life.
The ability to engage in sexual activities continues unless a disease or injury occurs.
You can help by providing privacy and respecting residents’ sexual needs.

41. 5. Describe sexual needs of the elderly
Define the following term: impotence the inability to have or maintain a penile erection.

42. 5. Describe sexual needs of the elderly
Here are some factors that affect sexual activity in the elderly:
Illness affecting ability to perform sexually
Erectile dysfunction
Vaginal atrophy, pain and dryness
Fear of inadequate performance
Depression
Lack of privacy
Medications

43. 5. Describe sexual needs of the elderly
REMEMBER: Residents are sexual beings, like all adults, and have the right to choose how they express their sexuality. Respect for the dignity and privacy of residents is part of your job.

44. 6. Describe vaginal irrigation
Define the following term: vaginal irrigation a rinsing of the vagina in order to clean the vaginal tract or to introduce medication into the vagina; also called a douche.

45. 6. Describe vaginal irrigation
Vaginal irrigation is performed for various reasons. Sometimes it is required before certain surgical procedures or examinations or due to vaginal drainage. It can also be performed to introduce medication into the vagina in order to treat disorders or to reduce discomfort, such as itching or redness. You may be asked to assist with vaginal irrigations.

46. 6. Describe vaginal irrigation
Know these points about vaginal irrigation:
Done to clean the vaginal tract prior to surgical procedures or exams, due to vaginal drainage, or to introduce medication into the vagina
Done only with doctor’s order
May include additives such as vinegar, baking soda, or medication

47. 6. Describe vaginal irrigation
Remember these guidelines when performing vaginal irrigation:
Provide privacy.
Place the woman in the dorsal recumbent position.
First have fluid flow over the external vulva. Then insert the tip into the vagina.
Do not force the tip into the vagina.
Report pain or discomfort, increase or decrease in vaginal discharge, bleeding, itching or burning, or abdominal swelling.

48. 6. Describe vaginal irrigation
REMEMBER: Vaginal irrigations are only performed with a doctor’s order. Not all facilities allow nursing assistants to perform this procedure. Facility policy must always be followed.

49. Giving a vaginal irrigation
Equipment: vaginal irrigation kit, including bag, tubing and tip, lubricating jelly, gloves, bed protector, bath blanket, towel, bedpan and bedpan cover
Identify yourself by name. Identify the resident. Greet the resident by name.
Wash your hands.
Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible.
Provide for the resident’s privacy with a curtain, screen, or door.

50. Giving a vaginal irrigation
Adjust bed to safe working level, usually waist high. Lock bed wheels.
Lower head of bed. Position resident lying flat on her back.
Put on gloves.
Cover the resident with a bath blanket. Ask her to hold it while you pull down the top covers underneath. Do not expose more of her than is necessary.
Place a bed protector under the resident’s buttocks and hips.

51. Giving a vaginal irrigation
Hang prepared vaginal irrigation bag on IV pole and lower pole so that bag is 12 inches above resident’s perineal area.
Remove resident’s underpants, exposing only as much of the resident’s body as necessary.
Place the bedpan under the resident and make sure she is in the dorsal recumbent position.
Open the clamp and allow a little water to run from the tubing into the bedpan to clear air from the tubing.
Lubricate tip of tubing, if not already lubricated.

52. Giving a vaginal irrigation
Insert nozzle slowly and gently into vagina about two to three inches.
Begin slow flow of water or fluid by releasing clamp. Before vaginal irrigation bag is empty, clamp tubing.
Remove tubing slowly and gently and place tubing tip inside top of bag.
Raise the head of the bed so that the resident is in a semi-sitting position on the bedpan so that the solution can drain.

53. Giving a vaginal irrigation
After solution has drained into bedpan, remove bedpan and cover it. Remove the bed protector and discard.
Bring bedpan to bathroom and check contents for anything unusual. Empty bedpan unless nurse needs to check the contents.
Flush toilet. Place bedpan in area for cleaning or clean and store it according to policy.
Place soiled linens and clothing in proper containers.
Remove and discard gloves. Wash your hands.

54. Giving a vaginal irrigation
Put clothing back on. Remove bath blanket and replace top covers. Make resident comfortable.
Return bed to lowest position. Remove privacy measures.
Leave call light within resident’s reach.
Wash your hands.
Be courteous and respectful at all times.
Report any changes in the resident to the nurse. Document procedure using facility guidelines.

55. Exam
Multiple Choice. Choose the correct answer. 1. The male and female sexual reproductive glands are called: (A) Gonads (B) Hormones (C) Cowper’s glands (D) Fallopian tubes 2. Which of the following is a function of the female reproductive system? (A) Manufacturing ova, estrogen and progesterone (B) Manufacturing testosterone (C) Manufacturing sperm (D) Manufacturing insulin

56. Exam (cont’d.)
3. Which of the following is a normal age-related change for the male reproductive system? (A) The prostate gland shrinks. (B) Number and capability of sperm decreases. (C) Sexual response is faster. (D) Menopause begins. 4. Which of the following is a normal age-related change for the female reproductive system? (A) Lung capability increases. (B) The response to vaccines decreases. (C) The amount of calcium in the body increases. (D) Vaginal walls become drier and thinner.

57. Exam (cont’d.)
5. Sexually-transmitted infections are caused by sexual contact with an infected person. Sexual contact includes: (A) Mouth-to-mouth kissing (B) Contact of hands with the breasts (C) Holding hands (D) Contact of the mouth with the genitals 6. A person with ______ cannot be treated with antibiotics or cured, and may have repeated outbreaks of the disease for the rest of his or her life. (A) Chlamydia (B) Genital herpes (C) Gonorrhea (D) Syphilis

58. Exam (cont’d.)
7. A man with benign prostatic hypertrophy may have difficulty with: (A) Walking (B) Reproducing (C) Urinating (D) Ejaculating 8. Which of the following is true of sexual needs in the elderly? (A) As a person ages, he or she completely loses interest in sex. (B) Impotence is a normal change of aging. (C) Vaginal dryness cannot be treated. (D) Lack of privacy in a facility can affect sexual activity.

59. Exam (cont’d.)
9. If a nursing assistant encounters any sexual situation between two consenting adult residents, she should: (A) Tell the residents to stop (B) Tell the residents how cute they are (C) Provide privacy and leave the area (D) Tell the residents’ friends and families what she saw 10. A woman who is receiving a vaginal irrigation will be in the ______ position. (A) Lateral (B) Sims’ (C) Supine (D) Dorsal recumbent