Maternal and Child Health Nursing - Lectures
LECTURES • Serves as an important resource for
families during childbearing and
WEEK 1 childrearing
as these can be extremely stressful times
What is Maternal and Child Nursing? in a life cycle.
• A field in nursing which focuses on the • Respects personal, cultural and spiritual
care of the childbearing and childrearing attitudes and beliefs as these so
families. strongly influence the meaning and impact
• Its primary goal is the promotion and of childbearing and childrearing.
maintenance of optimal family health to
ensure cycles of optimal childbearing and A Framework for Maternal and Child
childrearing. Health Nursing
• Nursing Process
Scope and Practice • Nursing Theories
• Preconceptual health care • Quality and Safety Education for Nurses
• Care of women during three trimesters of (QSEN)
pregnancy and puerperium • Concerned with the Four Phases of
• Care of infants during the perinatal Health Care:
period • Health Promotion
• Care of children from birth through late • Health Maintenance
adolescence • Health Restoration
• Care in variety of hospital and home care • Health Rehabilitation
settings • Evidenced Based Practice
Philosophies of MCN The Nursing Process
Maternal and Child Health Nursing is: • a form of problem solving process based
• Family-centered on the scientific method, serves as the
• Community centered basis for assessing, making a nursing
• Evidence-based diagnosis, planning, organizing, and
• A challenging role to keep families well evaluating care.
and optimally functioning
QSEN - Quality and Safety Education
A maternal and child health nurse: for Nurses
• Considers the family as a whole and as a 6 Competencies
partner in care when planning, • Patient centered care
implementing or evaluating effectiveness • Teamwork and Collaboration
of care. • Quality Improvement
• Serves as an advocate to protect the • Informatics
rights of all family members, including the • Evidence based practice
fetus. • Safety
• Demonstrates high degree of
independent nursing functions because Four Phases of Health Care:
teaching • Health Promotion
and counseling are major interventions. • Health Maintenance
• Promotes health and disease prevention • Health Restoration
because these protect the health of the • Health Rehabilitation
next generation.
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Maternal and Child Health Nursing - Lectures
Evidence-based practice (EBP) is the Intrauterine Development: Female
conscientious, explicit and judicious use of Reproductive Organ Development
current best evidence to make decisions
about the care of the patients.
WEEK 2
REPRODUCTIVE AND SEXUAL
HEALTH
❖ Reproductive development
❖Anatomy and physiology of the
reproductive system
❖ Menstruation
❖ Sexuality and sexual identity
❖ Human sexual response PUBERTY DEVELOPMENT
REPRODUCTIVE DEVELOPMENT Pubertal Development
Intrauterine Development
Week 5 of uterine life
Role of Androgen
❏ Muscular development
❏ Physical growth
❏ Increase in sebaceous gland
Intrauterine Development:
Male Reproductive Organ Role of Androgen
Development Male
❏ Further development of the
testes, scrotum, penis, prostate,and
seminal vesicles;
❏ Appearance of male pubic, axillary,and
facial hair
❏ Laryngeal enlargement accompanying
voice change
❏ Maturation of spermatozoa
❏ Closure of growth in long bones
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Maternal and Child Health Nursing - Lectures
Female Testes
❏ Enlargement of the labia majora and ❏ Male gonad contains lobules which is
clitoris and formation of axillary and pubic made up of:
hair. ❏ Interstitial cells (Leydig’s cells)
❏ The development of pubic and axillary ❏ Seminiferous tubules
hair because of androgen stimulation is
termed adrenarche. Penis
Parts include:
Role of Estrogen ❏ Penis shaft
❏ Estrogen compounds: enstrone (E1), ❏ Glans penis
estradiol (E2) and estriol (E3) Penis shaft is consist of: Two corpus
❏ Development of uterus, fallopian tubes cavernosa, Corpus spongiosum, Urethra,
and vagina Prepuce - protect the gland
❏ Typical female fat distribution
❏ Hair patterns Male Internal Reproductive Organs
❏ Breast development – THELARCHE
❏ Closes epiphyses of long bones ❏ Epididymis
❏ Vas Deferens or
Female Secondary Characteristics Ductus deferens
❏ Growth spurt ❏ Seminal vesicles
❏ Increase in the transverse diameter of ❏ Ejaculatory ducts
the pelvis ❏ Prostate Gland
❏ Breast development ❏ Bulbourethral glands
❏ Growth of pubic hair ❏ Urethra
❏ Onset of menstruation or MENARCHE
❏ Growth of axillary hair Epididymis - Conducts sperm from the
❏ Vaginal Secretions tubule to the vas deferens
Anatomy and Physiology of the Vas Deferans
Reproductive System ❏ Carries sperm from the epididymis
through the inguinal canal into the
Definition of terms abdominal cavity
❏ Sperm mature as they passed through
Gynecology.
❏ The study of the female reproductive Seminal Vesicles
organs ❏ Secrete a viscous alkaline liquid that is
Andrology high in sugar, protein and prostaglandin
❏ is the study of the male reproductive content
organs ❏ Pass through the prostate gland and
join the seminal vesicles to the urethra
MALE REPRODUCTIVE ORGAN
Prostate Gland
Male External Structures ❏ Secretes a thin alkaline fluid to further
❏ Scrotum protect the sperm from being immobilized
❏ Testes
❏ Penis Bulbourethral Glands
❏ Or Cowper’s glands
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Maternal and Child Health Nursing - Lectures
❏ Lies beside the prostate gland and also Parts:
secretes alkaline fluid ❏ Interstitial portion
❏ Isthmus
Semen ❏ Ampulla
Produced by: ❏ Infundibular portion
❏ Prostate gland (60%)
❏ Seminal vesicles (30%) Uterus
❏ Epididymis (5%) ❏ Hollow, muscular, pear-shaped organ
❏ Bulbourethral glands (5%) located in the lower pelvis, posterior to the
bladder and anterior to the rectum.
Female Reproductive Organ ❏ Receives the ovum from the fallopian
tubes
Female External Structures ❏ Provide a place for implantation and
❏ Mons Veneris / Pubis nourishment
❏ Labia Minora ❏ Protect the growing fetus
❏ Labia Majora ❏ Expel the fetus from the woman’s body
❏ Vestibule
❏ Clitoris Uterus
❏ Skene’s glands (paraurethral Three divisions:
glands) ❏ Body or corpus Fundus
❏ Bartholin’s glands (vulvovaginal ❏ Isthmus
glands) ❏ Cervix
❏ Fourchette
❏ Perineum Uterus
❏ Hymen Three layers:
❏ Endometrium
Female Internal Organ ❏ Myometrium
❏ Perimeruim
❏ Ovaries
❏ Fallopian tubes Vagina
❏ Uterus ❏ Hollow musculomembranous canal
❏ Vagina located posterior to the bladder and
anterior to the rectum
Ovaries ❏ Act as the organ of intercourse and to
❏ Female gonad convey sperm to the cervix
❏ Function to produce, mature and ❏ It expands to serve as birth canal
discharge ova during
❏ Produce estrogen and progesterone Childbirth
and initiate and regulate the menstrual
cycle. Menstruation
Episodic uterine bleeding in response to
Fallopian Tubes cyclic hormonal changes
❏ Arise from the uterine body, extend
outward and backward and its distal end
opens next to the ovary Its purpose is to bring an ovum to maturity
❏ Convey the ovum from the ovary to the and renew uterine tissue bed that will be
uterus responsible for the growth of the fertilized
ovum.
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Maternal and Child Health Nursing - Lectures
A process that allows conception and ❏ Immediately after menstrual flow and
implantation of a new life. the endometrial lining begins to increase
in thickness
The length of one menstrual cycle is ❏ After ovulation, the endometrium
determined from the beginning of one become corkscrew or twisted and rich,
menstrual flow to the beginning of the next spongy velvet appearance
❏ As corpus luteum regresses, estrogen
and progesterone decreases that the
endometrial lining begins
❏ Menses
Composition of Menses
❏ Blood from the ruptured capillaries
❏ Mucin from the glands
❏ Fragments of endometrial tissue
❏ Atrophied and unfertilized ovum
Structures Involved in Menstrual Cycle
❏ Hypothalamus
❏ Pituitary Gland
❏ Ovary
❏ Uterus
❏ Cervix
Ovulation
❏ When the grafiaan follicle ruptures and Menstrual Disorders
releases the ovum from the surface of the
ovary Dysmenorrhea - Painful menstruation
❏ Occurs on approximately 14th day Menorrhagia- Abnormally heavy
before the onset of the next cycle. Signs menstrual flows
of ovulation: Metrorrhagia - Bleeding between
❏ Increase in LH menstrual period
❏ Basal body temperature drops slightly - Menstrual migraine
by 0.5 – 1 degree F just before the day of - Premenstrual dysphoric syndrome
ovulation
❏ Cervical mucus becomes thin and Menopause
copious ❏ Refers to the cessation of menstrual
cycles
Phases of the Menstrual Cycle
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Maternal and Child Health Nursing - Lectures
❏ Perimenauposal is a term used to Plateau
denote the period during which ❏ In men, vasocongestion leads to
menopausal changes occur distention of penis
❏ Postmenopausal describes the time of ❏ In women, clitoris is drawn forward and
life following the final menses. retracts under the clitoral prepuce,
❏ Average age for menopause is 51.3, formation of the orgasmic platform – lower
but may range between 40 and 55 years part of the vagina that is extremely
of age congested, increased breast nipple
❏ Menopause can cause physiologic elevation
stress, ovaries begin to atrophy hence
reducing Orgasm
❏ “hot flashes” and heart palpitations ❏ The shortest stage in the sexual
❏ Vaginal dryness response cycle but intense pleasure
❏ Osteoporosis affects the whole body and a highly
❏ Urinary incontinence personal experience
❏ Involves vigorous contraction of
Sexuality and Sexual muscles in the pelvic area expels or
dissipates blood and fluid from the area of
Definition of terms congestion
❏ In men, characterized by 3 to 7
BIOLOGICAL GENDER propulsive ejaculatory contraction forcing
❏ Denotes a person’s chromosomal sex: semen from the penis
male (XY) or female (XX) ❏ In women, 8 to 15 contractions at
GENERAL IDENTITY/ SEXUAL intervals of 1 every 0.8 seconds
IDENTITY
❏ The inner sense a person has of being Resolution
male or female which may be the same as ❏ A 30-minute period during which the
or different from biologic gender external and internal genitalia return to an
GENDER ROLE unaroused state
❏ The male or female behaviour a person ❏ Men experience refractory period
exhibits, which may or may not be the where further orgasm
same as biologic gender or gender identity
Types of Sexual Orientation
Excitement
❏ Occurs with physical and psychological HETEROSEXUALITY - A person who
stimulation (sight, sound, emotion, or finds sexual fulfilment with a member of
thought) that causes parasympathetic the opposite gender
stimulation. HOMOSEXUALITY - A person who finds
❏ Characterized by arterial dilation and sexual fulfilment with a member of his or
venous constriction in the genital area, her own sex.
increase in HR, RR and BP, and muscular BISEXUALITY - A person who achieve
tension sexual satisfaction from both homosexual
❏ In men, penile erection, scrotal and heterosexual relationships.
thickening and elevation of the testes TRANSEXUAL OR TRANSGENDER - A
occurs person who desired or underwent sex
❏ In women, clitoris increase in size, change operations
vaginal lubrication and erection
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Maternal and Child Health Nursing - Lectures
Types of Sexual Expression
Sexual Abstinence - separation from
sexual activity
Masturbation - Self-stimulation for
Erotic Pleasure - The use of visual
materials for sexual arousal
Fetishism - Sexual arousal resulting from
the use of certain objects or situation
Transvestim - Dresses in the clothes of
the opposite sex
Voyeurism - Obtaining sexual arousal by
looking at another person’s body
Sadomasochism - Involves inflicting pain
(sadism) or receiving pain (masochism) to
achieve sexual satisfaction
Exhibitionism - Is revealing one’s
genitals in public
Bestiality - Is sexual relations
Pedophiles - Individuals who are
interested in sexual
encounters
Disorders of Sexual Functioning
❏ Inhibited sexual desires
❏ Failure to achieve orgasm
❏ Erectile dysfunction
❏ Premature ejaculation
❏ Persistent sexual arousal syndrome
(PSAS)
❏ Pain disorders
❏ Vaginismus
❏ Dyspareunia
❏ Vestibulitis
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