Maternal and Child Nursing PDF

PRELIM TRANS/ MATERNAL FAMILY STRUCTURES MATERNAL AND CHILD NURSING NUCLEAR FAMILY CENTERED composed of a husband, wife, and children (traditional) Family – the basic un...

PRELIM TRANS/ MATERNAL FAMILY STRUCTURES MATERNAL AND CHILD NURSING NUCLEAR FAMILY CENTERED composed of a husband, wife, and children (traditional) Family – the basic unit of society SINGLE-PARENT the level of a family’s functioning affects the health Challenges: little to no support; difficulty with role status of its members modeling; develop low self-esteem (parent) teaching health awareness and good health habits is EXTENDED accomplished chiefly by role modeling. Nuclear family + other family members (Grandparents, COMMUNITY CENTERED Aunts, Uncles, Cousins, & Grandchildren) “Multigenerational” health care services available BLENDED EVIDENCED - BASED A divorced or widowed person with children marries Safe practice – health promotion, maintenance, someone who has children restoration, rehabilitation Ongoing research - provide guidelines for future actions. SAME-SEX PARENT WHAT IS FAMILY? same-sex living together as partners for companionship, financial security, and sexual fulfillment. Family – the basic unit of society ADOPTIVE “A group of people related by blood, marriage, or adoption living together”, by U.S. Census Bureau Agency Vs. International Adoption vs Private adoption? “two or more people who live in the same household refers to a family where the parents have adopted a child (usually), share a common emotional bond, and perform who is not biologically related to them. certain interrelated social tasks.”, by Allender and CHILDLESS/ CHILD-FREE Spradley Two people living together without children Family structures change over time as they are affected by birth, work, death, divorce, and the growth of family COHABITATION members. Composed of couples, perhaps with children who live Family of Orientation (the family one is born into; or together but remained UNMARRIED. oneself, mother, father, and siblings, if any) BINUCLEAR Family of Procreation (a family one establishes; or Created by divorce when the child is raised in two oneself, spouse or significant other, and children) families. WHAT IS COMMUNITY? FOSTER Community- refers to a limited geographic area in which Children whose parents can no longer care for them; the residents relate to and interact among themselves by temporary while minor (Allender & Spradley, 2008). Ex: City, District, Subdivision, Barangay, Purok FAMILY ROLES Families exist within communities → assessment → more info on its functioning & abilities. Nurturer Financial Manager Provider  Problem Solver 86% - Pregnant Filipino women receive iron Decision Maker supplementation Health Manager Culture Bearer Gatekeeper REPRODUCTIVE SYSTEM Environmentalist HOW WELL DO YOU KNOW YOUR BODY? DEVELOPMENTAL STAGES The Reproductive system is among the most important systems in the entire body because it is solely responsible for reproduction. Without the reproductive system organisms such as humans, would be unable to reproduce and eventually would cause our species to go extinct. WHAT ARE THE MAIN FUNCTIONS OF YOUR REPRODUCTIVE SYSTEM? To produce egg and sperm cells (Gametes) To transport and sustain these cells (site for fertilization) To nurture the developing fetus (female) To produce hormones MALE SELF-EXAMINATION? GENOGRAM Digital Rectal Exam (DRE) – checks prostate gland for A diagram that details family structure and provides lumps or bumps information about the family’s health history and the roles of various family member across several IS IT PAINFUL? generations. uncomfortable, it’s usually not painful ECOMAP FEMALE SELF-EXAMINATION? Refers to a diagram of a family’s relationship to its community to help identify what community resources Breast Self-Exam– checks breasts for lumps or bumps are being used by a family, or the family’s “fit” into the ASSESSMENT? community. Size, shape, and color TRENDS IN MATERNAL AND CHILD HEALTHCARE Swelling or dimpling 1 Increased Divorce Rate 2 Decreased Family Size Discharges 3 Increased Dual-parent Employment Pain 4 High Levels of Violence HOW TO DO IT? 86% - Filipino women receive antenatal care from skilled providers during their pregnancy 83% - Pregnant Filipino women receive more than four ANC visits WHEN TO DO IT? 5 to 10 days after the start of your period Menopause – same day of the month REPRODUCTIVE SYSTEM TERMS: Puberty: period of development of the reproductive system o 10-11 years old (female) o 11-12 years old (male) o Complete puberty: ▪ 15-17 (female) ▪ 16-17 (male) Menstruation: discharge of blood and tissues o Menses from the uterus at the end of the female reproductive cycle Endometrium: o Stratum functionalis o Sloughed off during menstruation o Innermost layer of uterus Ovulation: rupture of Ovarian or Graafian follicle with the release of ovum o Located in the ovary Erection: engorgement of erectile vascular tissue (with blood) Ejaculation: forceful discharge of semen from erect penis Spermatocyte: immature male cell Spermatozoa: mature male cell Oocyte: immature female cell Ovum: mature female cell Menopause: end of women’s reproductive capabilities Menarche: start of menstruation Gametes: mature cells (ovum/spermatozoa)  Spermatogenesis: formation or development of ACCESSORY DUCTS sperm in testes Oogenesis: formation or development of egg cell Epididymis: Zona Pellucida: o Protects ovum Highly coiled tube, 6 m (20 ft) long o Thick transparent membrane Cups the superior testes, runs down to the posterolateral sides Site of sperm maturation Stores spermatozoa MALE REPRODUCTIVE SYSTEM Functions: Functions: 1. Provides temporary storage sites for immature 1. Production of male gametes cells 2. Transmission of spermatozoa to female 2. It takes 20 days for sperm to travel to the epididymis PARTS (INTERNAL): o Male sexually stimulated: walls of the epididymis contract to allow sperm to TESTES: pass and go to the ductus deferens Male reproductive gonads Ductus deferens (vas deferens): Also called testicles Produces testosterone Runs upward from the epididymis through the Oval-shaped, 1.75 inches long, 1 inch wide inguinal canal into the pelvic cavity Formed just below the kidney inside the Enclosed by the spermatogenic duct abdominopelvic cavity during fetal development End of this empties into the ejaculatory duct and 3rd fetal month: descended in the abdomen into merges with the urethra the inguinal canal Inguinal canal: passageway to scrotum Function: Descend shortly before birth Contains over 800 tightly coiled seminiferous Propel live sperm from the epididymis and distal tubules per testis part of the ductus deferens to the urethra Sustentacular cells: Ejaculation: peristaltic movement squeezes o Provide nourishment to germinal sperm sperm forward o Secretes fluid that provides a liquid medium and outward flow on Urethra: developing sperm Extends from the base of the urinary bladder to Cryptorchidism: undescended testes, remains in the the tip of the penis abdominal cavity; can be corrected through surgery o a.) Prostate o b.) Membranous Sperm: normally, 300-500 million released per o c.) Spongy ejaculation o 20-30 million is infertile and unable to During ejaculation, the sperm prostatic urethra bladder fertilize an egg sphincter constricts to prevent sperm from entering the Acrosome: contains enzymes to help the sperm urethra. penetrate an ovum o Located at the tip of sperm cell Compact nucleus: located at the center of the sperm o Contains chromosomes Mitochondria: supply ATP to provide energy for sperm movement  ACCESSORY GLANDS o Divided sac of skin that hangs outside the abdominal cavity between the legs 1. Seminal Vesicles: located at the base of the and at the penis bladder o Maintains temperature of testes at o Produce 60% of fluid volume of semen approximately 30°C, necessary for o Rich in sugar, vitamin C, and sperm production prostaglandins o Warm temperature: hangs loosely o Club-shaped gland o Cold: wrinkled o Yellowish secretion 2. Penis o Nourishes and activates sperm cells o Designed to deliver sperm o Sperm and seminal fluid enter the a. Glans penis urethra together during ejaculation ▪ Skin-covered penis that consists 2. Prostate Gland: secretes alkaline fluid to help of a shaft, which ends in an neutralize the acidic environment of the vagina enlarged tip o Single gland, size of a chestnut o Anterior to the rectum, can be palpated b. Prepuce (foreskin) by a finger o Enhances the motility of spermatozoa ▪ Skin covering the penis folds o Encircles the upper prostatic part of the downward to form a cuff of skin urethra just below the urinary bladder o Urethra o Secretes a milky fluid that plays a role in ▪ Surrounded by three elongated activating sperm erectile tissues called spongy tissue, which fill with blood Prostate cancer: 3rd most prevalent in men during sexual excitement → ERECTION Slow-growing, hidden, but can also be swift and o Hypothalamus and Sacral Plexus deadly ▪ Control erection o Smegma 3. Bulbourethral Gland: tiny pea-sized gland ▪ Secretion of sebaceous glands, inferior to the prostate gland; cleanses the becomes cheesy sebaceous urethra of traces of acidic urine matter that collects between o Produces thick, clear mucus, drains into the glans penis and foreskin or the penile urethra between the clitoris and labia o Serves as lubricant during sexual minora in females intercourse o Also called Cowper’s Gland HORMONAL REGULATION Semen: milky white mixture of sperm and accessory Leydig cells (Interstitial endocrinocytes) gland secretion o Secrete the main male hormone pH: 7.2-7.6 (alkaline) a. Follicle stimulating hormone Vagina pH: 3.5-4.0 Contains chemicals that inhibit bacterial ▪ Stimulates luteinizing hormone, multiplication spermatogenesis, and Per ejaculation: 2-5 mL of semen (50-130 million testosterone secretion sperm per mL) b. Testosterone PARTS (EXTERNAL) ▪ Affects not only 1. Scrotum spermatogenesis but also the o Encloses and protects testes development of organs  FEMALE REPRODUCTIVE SYSTEM o Attached to the lateral wall of the pelvis by the Suspensory Functions: Ligament/Infundibulopelvic Ligament 1. Formation of female gametes Functions: 2. Reception of male gametes 3. Provision of a suitable environment for the 1. Site of implantation of zygote fertilization of ovum and fetus 2. Sustains life of embryo and fetus 4. Parturition - childbirth 3. Plays an active role in parturition and 5. Lactation menstruation PARTS (INTERNAL) Layers: 1. Ovaries 1. Epimetrium (serosal layer) oProduce ova and female hormones (estrogen, progesterone) o Located in the pelvic part of the Outermost layer, a fold of the peritoneum abdomen, one on each side of the uterus Thin sheet of epithelial cells that envelops the 2. Uterine Tubes/Oviducts/Fallopian Tubes uterus o Receive secondary oocytes from the ovary and convey them to the uterus 2. Myometrium o Superior end opens to the abdominal cavity; inferior end opens to the uterus Middle, smooth muscle layer, which makes up o Passageway for oocytes and site of the bulk of the uterine wall fertilization Coordinated contractions help expel the fetus 3. Endometrium a. Infundibulum Innermost layer, lines the uterus, composed of ▪ End of the oviduct nearest the specialized mucous membrane ovary Two layers: b. Ampulla a. Basilar Layer (stratum basalis) ▪ Second portion of the uterine tube, common site of Adjacent to the myometrium, vascular, and a fertilization permanent layer that regenerates the new stratum functionalis after menstruation c. Isthmus b. Functional Layer (stratum functionalis) ▪ Narrower, thicker-walled portion of the uterine tube Lines the uterine cavity, regenerated and lost closest to the uterus during each menstruation cycle Under the influence of estrogen and d. Fimbriae progesterone, blood vessels thicken this layer in preparation for a possible embryo ▪ Finger-like projections that may actually overlay the ovary Cervix 3. Uterus o "Hotel of baby," pear-shaped organ o Lowermost part of the uterus, made up o 7 cm (3 in) long, 2 cm (less than 1 in) wide in non-pregnant state of strong muscle  Functions: 2. Skene’s Gland (lesser vestibular gland) 1. Provides passageway for sperm Located on the anterior wall of the vagina 2. Allows flow of menstrual blood around the opening of the urethra. from the uterus to the vagina Source of fluid expelled during female 3. Directs semen during ejaculation. intercourse Lubricates during intercourse as it produces fluid continuously. o During labor, the cervix thins and stretches to open around the baby’s EXTERNAL GENITALIA head o Dilation: Opening and stretching of the Two flaps of skin on either side of the vagina. cervix (complete dilation is 10 cm) 1. Labia/Labium Majora Vagina o Outer folds of the reproductive organ. o Contains numerous sebaceous glands. o Birth canal o Forms the margin of the pudendal cleft – o Smooth muscle, fibro-elastic tissue a space between the two labia majora. o Can enlarge to accommodate a baby o Encloses and protects other internal during childbirth organs. o A distensible, 3-inch tubular organ o Two large folds covered with hair. 2. Labia Minora o Inner flaps of the reproductive organ. Functions: o Anteriorly, they meet to form a hood called the clitoris. 1. Conveys uterine secretions outside the body o Forms the margin of the vestibule, 2. Receives penis/semen during coitus protecting the vagina and urethra. 3. Passageway for the fetus 3. Clitoris o Consists of erectile tissue. o Hymen: A fold of vaginal mucosa that o Highly sensitive organ involved in female partially blocks the vaginal entrance, sexual intercourse. may rupture during the first sexual o Provides pleasure during sexual intercourse, tampon insertion, or intercourse. physical activities (biking, horse riding, 4. Mons Pubis etc.) o Mound of fatty tissue that covers the o Endocervical canal/Endocervix: Tunnel symphysis pubis. through the cervix, a passageway from o Covered with pubic hair. the uterus to the vagina 5. Vestibule o Internal Os: Opening in the uterus o Space between the labia minora. o External Os: Opening in the vagina o The floor contains the greater vestibular gland near the openings of the urethra FEMALE GLANDS and vagina. o Secretes alkaline mucus. 1. Bartholin’s Glands (Greater vestibular gland) 6. Perineum o Two pea-sized racemose glands slightly o Diamond-shaped region bounded by the posterior, located left and right of the symphysis pubis, coccyx, and ischial vaginal opening tuberosities. o Secrete mucus for lubrication of the o Episiotomy: A surgical cut made at the vagina opening of the vagina during childbirth. ▪ Aids in difficult delivery and prevents tissue rupture. ▪ Types: ▪ Midline episiotomy  ▪ Mediolateral o Released from the ovaries and corpus episiotomy luteum after the egg is released. o Increases protein anabolism, including building strong bones. o Inhibits the release of GnRH and the 7. Mammary Glands secretion of FSH and LH. o Modified sweat glands that produce and 5. Progesterone secrete milk. o Produced by the corpus luteum and in o Composed of adipose tissue and 15-20 small amounts by the adrenal glands and areolar glands containing lactiferous placenta (during pregnancy). ducts to carry milk. o Helps maintain pregnancy and prepares ▪ Areolar glands produce milk breasts for milk production. during pregnancy, which enters the glands but dilates before FSH and LH stimulate the ovaries to produce reaching the nipple. estrogen and progesterone to regulate the ▪ Before reaching the nipple, the menstrual cycle. duct dilates into the lactiferous Hormonal imbalances can cause the absence or sinus (milk storage). irregularities in menstruation. ▪ Areola: Pigmented area around the nipple that enlarges and MENSTRUAL CYCLE darkens during pregnancy. ▪ Nipple: Dense connective and Begins with the first day of bleeding. smooth muscle fibers with The length of the menstrual cycle is measured sensitive nerve endings. from the first day of the period to the day of the ▪ Prolactin (from the anterior next cycle. pituitary gland) causes the Cycle changes in the uterus are controlled by actual synthesis of milk during estrogen and progesterone. pregnancy. Some cycles last 25 days, others 36, with an ▪ Infant sucking average of 28 days. stimulates the Ovulation occurs at the midpoint, before hypothalamus, sending menstruation. a nerve impulse to the anterior pituitary gland, PHASES: which releases oxytocin, leading to milk ejection. 1. Menstrual Phase/Period/Menstruation o Days 1-4 or 1-5 (average). Female Hormones o Composed of sloughed cells, secretions, and blood. 1. Follicle Stimulating Hormone (FSH) 2. Proliferative/Follicular Phase o Produced by gonadotropic cells. o Days 3-14 or 5-14. o Initiates follicular growth and the o Epithelial cells multiply and form glands. secretion of estrogen by growing o Repair and regeneration of the follicles. endothelium. 2. Luteinizing Hormone (LH) o Part of the menstrual cycle where o Stimulates the further development of follicles inside the ovary develop and ovarian follicles and their full secretion mature in preparation for ovulation. of estrogen. 3. Ovulation 3. Gonadotropin-Releasing Hormone (GnRH) o Process of maturation and rupture of o Stimulates the release of FSH and LH. Graafian follicles with the discharge of 4. Estrogen the ovum. o Causes the appearance of secondary sex o Occurs 14 days before the next characteristics. menstrual flow is expected.  ▪ 5-6 follicles start to develop in TYPES OF TWINS the ovary, but only one follicle fully develops, and the others 1. Identical Twins (Monozygotic Twins) recede. o One fertilized egg splits and develops ▪ The follicle that releases the egg with exactly the same genetic codes becomes the corpus luteum. 2. Fraternal Twins (Dizygotic Twins) ▪ The lifespan of the egg after o Two eggs are fertilized by two sperms, ovulation is 12-24 hours. producing two genetically unique ▪ If there is no conception, the children corpus luteum breaks down. 3. Triplets 4. Secretory Phase/Luteal Phase o One single egg is fertilized by one sperm, o Days 15-28. and the fertilized zygote divides into o The endothelium becomes thicker, and three endometrial glands secrete substances o The fertilized egg splits into two, and one to prepare the uterus for implantation of of the two splits again a fertilized ovum by day 21. EMBRYOLOGY TERMS HORMONES Follicle: Sac-like structure 1. Estrogen Morula: Solid mass resulting from the cleavage o Stimulates the proliferation of a fertilized ovum during embryonic o Increases the bulk of tissue development 2. Progesterone Chorionic Villi: Finger-like extensions of o Causes hypertrophy – normal thickening trophoblasts growing into the endometrium of the endometrium Chorion: Outermost embryonic membrane o Without LH, the corpus luteum forming the placenta and producing human deteriorates, and estrogen and chorionic gonadotropin progesterone drop rapidly, triggering Amnion: Membrane surrounding the embryo to the endometrium to shed, causing form the amniotic cavity and produce amniotic menstruation fluid Amniotic Fluid: Protects the fetus from trauma FERTILIZATION and permits free movement with adhesion Yolk Sac: Embryonic membrane connecting to Impregnation of an ovum by a spermatozoon the midgut; a component of the placenta Occurs 24 hours after ovulation Gastrulation: Process of forming a gastrula Sperm is viable in the female tract for up to 72 Gastrula: Early embryo developing from a hours blastula to a gastrula Zona Pellucida: Enzyme that facilitates the Blastula: Early embryo in the form of a hollow entrance of sperm through the outer wall of the fluid-filled structure bounded by a single layer of ovum cells Enzymes are released to thicken the zona Pre-Embryo: Becomes an embryo as the three pellucida, making it impenetrable to other sperm germ layers form Cell division of the ovum occurs after penetration, forming 2 haploid cells (23 PRIMARY GERM LAYERS chromosomes each) Fertilization is completed when a diploid zygote 1. Ectoderm (Outermost layer) (46 chromosomes) is formed, and embryonic o Neural tissue gives rise to: development begins ▪ Brain, spinal cord, and nerves The zygote remains in the fallopian tube for ▪ Cornea and lens of the eyes approximately 3 days, then travels to the uterus ▪ Outer skin and accessory and stays for 5 days structures (hair, skin) ▪ Enamel of the teeth  ▪ Linings of nasal, oral cavities, and anal canals 2. Mesoderm (Second layer) o Gives rise to: ▪ Muscle (smooth, cardiac, skeletal) ▪ Connective tissue (cartilage, bone, adipose) ▪ Bone marrow, blood, lymphatic tissues ▪ Endothelial linings of blood and lymphatic vessels ▪ Visceral peritoneum of organs in the ventral cavity ▪ Fibrous and vascular tunics of the eye ▪ Organs of the urogenital system (kidneys, gonads, reproductive organs) 3. Endoderm (Innermost layer) o Gives rise to: ▪ Epithelial lining of the digestive tract ▪ Liver and pancreas ▪ Epithelial lining of the respiratory tract and tonsils ▪ Epithelial lining of reproductive glands and ducts ▪ Thyroid, parathyroid, and thymus glands ▪ Epithelial lining of the bladder and urethra