Lesson-1.pdf

CARE OF MOTHER, CHILD & ADOLESCENT-WELL CLIENTS (NSG 107 LEC) LESSON 1  UNITIVE & PROCREATIVE HEALTH UNITIVE HEALTH ü Focuses on the union of 2 people ü Psychological, Emotional, Spiritual bonding between partners PROCREATIVE HEALTH ü Focus on potential for procreation ü C...

CARE OF MOTHER, CHILD & ADOLESCENT-WELL CLIENTS (NSG 107 LEC) LESSON 1  UNITIVE & PROCREATIVE HEALTH UNITIVE HEALTH ü Focuses on the union of 2 people ü Psychological, Emotional, Spiritual bonding between partners PROCREATIVE HEALTH ü Focus on potential for procreation ü Conceiving through sex  STATISTICS ON MATERNAL & CHILD HEALTH Statistics is the science of collecting and interpreting numerical data. -midwives may use statistical data in: ü reproductive trends ü at risk population ü prenatal care evaluation ü comparison of relevant information from other regions  Definitions Recommended by the National Center for Health Statistics & CDC Perinatal Period -all births weighing 500g or more & ends @ 28 completed days after birth. Birth -the complete expulsion or extraction from the mother of a fetus, irrespective of whether the umbilical cord has been cut or placenta is attached.  Definitions Recommended by the National Center for Health Statistics & CDC Birthweight -the weight of a neonate determined immediately after delivery, expressed to the nearest gram. Birth Rate -number of births per 1000 population in 1 year.  Definitions Recommended by the National Center for Health Statistics & CDC Fertility Rate -number of pregnancies per 1000 women of childbearing age. Live Birth -whenever the infant at or sometime after birth breathes spontaneously, or shows any other sign of life such as heartbeat or definite spontaneous movement of voluntary muscle.  Definitions Recommended by the National Center for Health Statistics & CDC Stillbirth (fetal death) -no signs of life are present at or after birth. Neonatal Death -early ND refers to death of a live- born infants during the first 7days after birth. Late ND refers to death after 7days, but before 29 days.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Infant Death -includes all deaths of live-born infants from birth through 12 months of age.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Fetal Death Rate: Number of fetal deaths (fetuses weighing more than 500 g) per 1000 live births.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Fetal Death Rate -it reflects the overall quality of maternal health and prenatal care. -maternal factors such as maternal disease, premature cervical dilation, or maternal malnutrition or fetal factors such as fetal disease, chromosome abnormality, or poor placental attachment.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Neonatal Death Rate -Number of deaths per 1000 live births occurring at birth or in the first 28 days of life. -the first 28 days of life are known as the neonatal period, and an infant during this time is known as a neonate.  Definitions Recommended by the National Center for Health Statistics & CDC Neonatal Death Rate Majority of newborns die due to stressful events or conditions during labor, delivery, and the immediate postpartum period. Out of 4 newborn deaths 3 occur in the first week of life  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Neonatal Death Rate Causes of Deaths ,2010 Prematurity (27%) Asphyxia (26%) Infection (sepsis + pneumonia) (10%) Neonatal tetanus (2%) Diarrhea (2%)  Definitions Recommended by the National Center for Health Statistics & CDC What Can We Do To Save Newborns Lives? Preventive Interventions Breastfeeding (13%) Insecticide-treated materials (7%) Complementary feeding (6%) Clean delivery (4%) Hib vaccine (4%) Water sanitation, hygiene (3%)  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Perinatal Death Rate -Number of deaths of fetuses weighing more than 500 g and within the first 28 days of life per 1000 live births. -perinatal period is the time period beginning when a fetus reaches 500 g (about week 20 of pregnancy) and ending about 4 to 6 weeks after birth. -the perinatal death rate is the sum of the fetal and neonatal rates.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Infant Mortality Rate -Number of deaths per 1000 live births occurring at birth or in the first 12 months of life. -IMR measures the quality of pregnancy care, nutrition, and sanitation as well as infant health. -major causes of infant death: prematurity, low birth weight, congenital malformations, and SIDS.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Low Birthweight -the first newborn weight obtained after birth is less than 2,500 g. Very Low Birthweight -the first newborn weight obtained after birth is less than 1,500 g. Extremely Low Birthweight - the first newborn weight obtained after birth is less than 1,000 g.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Term Infant -an infant born anytime after 37 completed weeks of gestation & up to 42 competed weeks of gestation (260-294 days). Preterm Infant -an infant born before 37 completed weeks (259th day) Postterm Infant -an infant born anytime after completion of the 42nd week (295↑)  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Abortus -a fetus or embryo removed or expelled from the uterus during the first half of gestation (less 24 weeks), weighing less than 500 g. Induced Termination of Pregnancy -purposeful interruption of an intrauterine pregnancy, which does not result in a live birth.  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Direct Maternal Death -this includes death of the mother resulting from obstetrical complication of pregnancy, labor, or puerperium, & from interventions, omissions, incorrect treatment, or a chain of events resulting from any of these factors. -ex. Maternal death due to hemorrhage during delivery  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Indirect Maternal Death -this includes a maternal death not directly due to an obstetrical cause. -ex. Maternal death from complication of heart failure  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Nonmaternal Death -death of a mother resulting from accidental or incidental causes not related to pregnancy. -ex. Death from vehicular accident  Definitions Recommended by the National Center for Health Statistics & CDC Statistical Terms Used to Report Maternal and Child Health Maternal Mortality Rate -Number of maternal deaths per 100,000 live births that occur as a direct result of the reproductive process.  Definitions Recommended by the National Center for Health Statistics & CDC Maternal Mortality Rate Causes of Maternal Deaths, 2006 1 Hypertensive disorders in pregnancy, childbirth and puerperium.P 2 Complications of labor and delivery 3 Pregnancy of abortive outcome  Definitions Recommended by the National Center for Health Statistics & CDC Maternal Mortality Rate “Big 5” of Direct Maternal Deaths (HOUSE) Hemorrhage Obstructed labor Unsafe abortion Sepsis Eclampsia WHO  Statistical Terms Used to Report Maternal and Child Health Childhood Mortality Rate -Number of deaths per 1000 population in children, 1 to 14 years of age. -motor vehicle crashes remain the leading cause of death in children.  STATISTICS ON MATERNAL & CHILD HEALTH Statistical Terms Used to Report Maternal and Child Health Childhood Mortality Rate -high incidence of homicide and suicide in the 10 to 19 year-old age group.  REPRODUCTIVE DEVELOPMENT Intrauterine Development -A gonad is a body organ that produces the cells necessary for reproduction (ovary in females, testis in males). -At about week 12, the external genitals develop. In males, under the influence of testosterone, penile tissue elongates and the urogenital fold on the ventral surface of the penis closes to form the urethra.  REPRODUCTIVE DEVELOPMENT Intrauterine Development -In females, with no testosterone present, the urogenital fold remains open to form the labia minora; what would be formed as scrotal tissue in the male becomes the labia majora in the female.  REPRODUCTIVE DEVELOPMENT Intrauterine Development  REPRODUCTIVE DEVELOPMENT Intrauterine Development  REPRODUCTIVE DEVELOPMENT Intrauterine Development  REPRODUCTIVE DEVELOPMENT Pubertal Development -Puberty is the stage of life at which secondary sex changes begin. -Hypothalamus releases gonadotropin- releasing hormone (GnRH), triggers the anterior pituitary to begin the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).  REPRODUCTIVE DEVELOPMENT Pubertal Development -FSH and LH initiate the production of androgen and estrogen, which in turn initiate secondary sex characteristics, the visible signs of maturity. Girls are beginning dramatic development and maturation of reproductive organs at earlier ages than ever before (9 to 12 years)  REPRODUCTIVE DEVELOPMENT Role of Androgen -Androgenic hormones are responsible for muscular dev’t, physical growth, and the increase in sebaceous gland secretions (acne). -In males, AH are produced by the (adrenal cortex & testes); in females, (adrenal cortex & ovaries).  REPRODUCTIVE DEVELOPMENT Role of Androgen -At age 12-14 years, testosterone levels RISE (further development of the testes, scrotum, penis, prostate, and seminal vesicles; the appearance of male pubic, a x i l l a r y, a n d f a c i a l h a i r ; l a r y n g e a l enlargement and its accompanying voice change; maturation of spermatozoa.  REPRODUCTIVE DEVELOPMENT Role of Androgen -In girls, testosterone influences enlargement of the labia majora and clitoris and formation of axillary and pubic hair. This development of pubic and axillary hair because of androgen stimulation is termed adrenarche.  REPRODUCTIVE DEVELOPMENT Role of Estrogen -When triggered at puberty by FSH, ovarian follicles in females begin to excrete a high level of the hormone estrogen. -Influences the development of the uterus, fallopian tubes, and vagina; typical female fat distribution and hair patterns; breast development (thelarche)  REPRODUCTIVE DEVELOPMENT Secondary Sex Characteristics - In girls, pubertal changes typically are manifest as: 1. Growth spurt 2. ↑ in the transverse diameter of the pelvis 3. Breast development (thelarche) 4. Growth of pubic hair 5. Onset of menstruation (menarche) 6. Growth of axillary hair 7. Vaginal secretions  REPRODUCTIVE DEVELOPMENT Secondary Sex Characteristics -Secondary sex characteristics of boys usually occur in the order of: 1. Increase in weight 2. Growth of testes 3. Growth of face, axillary, and pubic hair 4. Voice changes 5. Penile growth 6. Increase in height 7. Spermatogenesis (production of sperm) ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male. Reproductive System ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male External Structures -External genital organs of the male include the testes (which are encased in the scrotal sac) and the penis. -Scrotum is a rugated, skin-covered, muscular pouch suspended from the perineum. Its functions are to support the testes and to help regulate the temperature of sperm. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male External Structures -Testes are two ovoid glands, 2 to 3 cm wide, that lie in the scrotum. Seminiferous tubules produce spermatozoa. Leydig’s cells are responsible for the production of testosterone. -Testes in a fetus first form in the pelvic cavity. They descend, late in intrauterine life (34th-38th week), into the scrotal sac. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male External Structures -Penis is composed of three cylindrical masses of erectile tissue in the penis shaft: two termed the corpus cavernosa, and a third termed the corpus spongiosum. -it serves as the outlet for both the urinary and the reproductive tracts in men. -Glans is the distal end of the penis (bulge/sensitive). Prepuce is a retractable casing of skin that protects the glans. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male External Structures - With sexual excitement, nitric oxide is released from the endothelium of blood vessels. This results in dilation of blood vessels and an increase in blood flow to the arteries of the penis (engorgement). ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male External Structures -The ischiocavernosus muscle at the base of the penis then contracts, trapping both venous and arterial blood in the three sections of erectile tissue and leading to distention and erection of the penis. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male Internal Structures -Epididymis: coiled tube acts as a maturation and storage for sperm before they pass into the vas deferens -Vas Deferens (spermatic cord): a thin tube that carries mature sperm -Accessory gland: provide fluids for lubrication to nourish the sperm cells (bulbourethral/cowper’s gland) ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male Internal Structures -Bulbourethral gland: produces fluid serves to lubricate the urethra and neutralize the acidity -Seminal vesicle: are sac like structure attached to vas deferens produces a yellowish fluid that provides energy to the sperm cells and aids in motility. -Prostate gland: responsible for the proof semen, liquid mixture of sperm cells, prostate fluid and seminal fluid. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM. ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM Male Internal Structures -Semen, is derived from prostate gland (60%), the seminal vesicles (30%), the epididymis (5%), and the bulbourethral glands (5%). -Urethra is a hollow tube leading from the base of the bladder to the outside through the shaft and glans of the penis.