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Maternal and Child Health Nursing

Maternal and Child Health Nursing

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Published by deric

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Published by: deric on May 17, 2009
Copyright:Attribution Non-commercial


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Maternal and Child Health Nursing involves care of the woman and familythroughout pregnancy and child birth and the health promotion and illness carefor the children and families.Primary Goal of MCN1The promotion and maintenance of optimal family health to ensurecycles of optimal childbearing and child rearing
1.OvariesoAlmond shapedoProduce, mature and discharge ovaoInitiate and regulate menstrual cycleo4 cm long, 2 cm in diameter, 1.5 cm thickoProduce estrogen and progesterone
Estrogen: promotes breast dev’t & pubic hair distribution prevents osteoporosiskeepskeeps cholesterol levels reduced & so limits effects of atherosclerosis Fallopian tubes..
1Approximately 10 cm in length2Conveys ova from ovaries to the uterus3Site of fertilization4Parts: interstitialisthmus – cut/sealed in BTLampulla – site of fertilizationinfundibulum – most distal segment; covered with fimbria2. Uterus
Hollow muscular pear shaped organ
uterine wall layers: endometrium; myometrium; perimetrium2Organ of menstruation3Receives the ova4Provide place for implantation & nourishment during fetal growth5Protects growing fetus6Expels fetus at maturity
Has 3 divisions: corpus – fundus , isthmus (most commonly cut during CSdelivery) andcervix 3. Uterine Wall1Endometrial layer: formed by 2 layers of cells which are as follows:2basal layer- closest to the uterine wall3glandular layer – inner layer influenced by estrogen and progesterone; thickens and shedoff as menstrual flow4Myometrium – composed of 3 interwoven layers of smooth muscle; fibers are arranged inlongitudinal; transverse and oblique directions giving it extreme strength4. Vagina5Acts as organ of copulation6Conveys sperm to the cervix7Expands to serve as birth canal8Wall contains many folds or rugae making it very elastic
Fornices – uterine end of the vagina; serve as a place for pooling of semenfollowing coitus
Bulbocavernosus – circular muscle act as a voluntary sphincter at the external opening to thevagina (target of Kegel’s exercise)
1the stage of life at which secondary sex changes begins2the development and maturation of reproductive organswhich occurs in female 10-13 years old & male at 12-14 yrs old
serve as a
or regulationmechanism set to “
turn on
” gonad
at this age
2. Reproductive Development
Readiness for child bearing
1begins during intrauterine life2full functioning initiated at puberty
releases the
which triggers the APG to form and release FSH and LH 
. (FSH & LH initiates production of androgen and estrogen --->
Role of Androgen
1Androgenic hormones – are produced by the testes, ovaries and adrenal cortex which isresponsible for:muscular developmentphysical growthinc. sebaceous gland secretions
–primary androgenic hormone
Related terms
a. Adrenarche – the development of pubic and axillary hair (due to androgenstimulation)b. Thelarche – beginning of breast developmentc. Menarche – first menstruation period in girls (early 9 y.o. or late 17 y.o.)d. Tanner Staging2It is a rating system for pubertal development3It is the biologic marker of maturity4It is based on the orderly progressive development of:5breasts and pubic hair in females6genitalia and pubic hair in males
3. Body Structures Involved
1Hypothalamus2Anterior Pituitary Gland3Ovary4Uterus
4. Menstrual Cycle
1Female reproductive cycle wherein periodic uterine bleeding occurs in response to cyclichormonal changes
2Allows for conception and implantation of a new life3Its purpose it to bring an ovum to maturity; renew a uterine bed that will be responsiveto the growth of a fertilized ovum
5. Menstrual Phases
: 4-5 days after the menstrual flow; the endometrium is very thin, but begins toproliferate rapidly; thickness increase by 8 folds under the influence of increase in estrogenlevelalso known as: proliferative; estrogenic; follicular and postmentrual phase
y: after ovulation the corpus luteum produces progesterone which causes theendometrium become twisted in appearance and dilated; capillaries increase in amount(becomes rich, velvety and spongy in appearance also known as: secretory; progestational;luteal and premenstrual
if no fertilization occurs; corpus luteum regresses after 8 – 10 days causing decreasein progesterone and estrogen level leading to endometrial degeneration; capillaries rupture;endometrium sloughs off ; also known as:ishemic
Final phase
: end of the menstrual cycle; the first day mark the beginning of a new cycle;discharges contains blood from ruptured capillaries, mucin from glands, fragments of endometrial tissue and atrophied ovum.
Physiology of Menstruation
1.About day 14 an upsurge of LH occurs and the graafian follicle ruptures and the ovum isreleased2.After release of ovum and fluid filled follicle cells remain as an empty pit; FSH decreasein Amount; LH increase continues to act on follicle cells in ovary to produce lutein which ishigh in progesterone ( yellow fluid) thus the name corpus luteum or yellow body3.Corpus luteum persists for 16 – 20 weeks with pregnancy but with no fertilization ovumatropies in 4 – 5 days, corpus luteum remains for 8 -10 days regresses and replaced bywhite fibrous tissue, corpus albicans
Characteristics of Normal Menstruation Period
1.Menarche – average onset 12 -13 years2.Interval between cycles – average 28 days3.Cycles 23 – 35 days4.Duration – average 2 – 7 days; range 1 – 9 days5.Amount – average 30 – 80 ml ; heavy bleeding saturates pad in <1hour6.Color – dark red; with blood; mucus; and endometrial cells
Associated Terms
1. Amenorrhea - temporary cessation of menstrual flow2. Oligomenorrhea - markedly diminished menstrual flow3. Menorrhagia - excessive bleeding during regular menstruation4. Metrorrhagia - bleeding at completely irregular intervals5. Polymenorrhea - frequent menstruation occurring at intervals of less than 3 weeks 
1Occurs approximately the 14th day before the onset of next cycle (2 weeks before)2If cycle is 20 days – 14 days before the next cycle is the 6th day, so ovulation is day 63If cycle is 44 days – 14 days, ovulation is day 30.4Slight drop in BT (0.5 – 1.0 °F) just before day of ovulation due to low progesterone levelthen rises 1°F on the day following ovulation (spinnbarkheit; mittelschmerz)

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