maternal and child nursing notes

8/14/2019 maternal and child nursing notes

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NCM 101 Lecture Notes PRELIMS Handout 4 _____________________

TYPES OF SEXUAL ORIENTATION

1. HETEROSEXUALITY: one who finds sexual fulfillment with a meme! of theo""osite sex. #e$ause inte!est in the o""osite sex and sexual !elationshi"s ma% e&in asea!l% as the e&innin& of "ue!t%. '1()1* Y!s old.+ , H- "!oide!s need to "!oide info!mationon safe sex "!a$ti$es as ea!l% as this a&e fo! the info!mation and the /nowled&e to e mosthel"ful.

*. HO0OSEXUALITY: is findin& sexual fulfillment wit a meme! of hishe! own sex. 2h%homosexual &ende! identit% deelo"s is un/nown, althou&h most indiiduals who a!ehomosexual !e"o!t a !eali3ation that the% a!e 4diffe!ent5 een as ea!l% as efo!e "ue!t%. It is"!oal% du!in& thei! adoles$en$e in see/in& a sense of identit% that the% !eali3e that the!eason the% feel 4diffe!ent 4is e$ause the% a!e homosexual. It is im"o!tant that health $a!e"!oide!s e sensitie to thei! needs in this time of identit% fo!mation. The!e is a hi&he!sui$ide !is/ found in &a% and lesian adoles$ents e$ause of eithe! fea! of so$ial sti&ma, o!hain& the tu!moil of identit% $onfusion.

6. #ISEXUALITY: "eo"le who a!e isexual a$hiee sexual satisfa$tion f!om oth homosexual andhete!osexual !elationshi"s. 7a% and isexual men hae a hi&he! !is/ fo! a$8ui!in& ST9s. The!ole of the H- "!oide! is to ensu!e that suffi$ient info!mation and /nowled&e aout HI; and

ST9s a!e &ien.


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NCM 101 Lecture Notes PRELIMS Handout 4 _____________________*. it atta$hes to the su!fa$e of the endomet!ium 'adhesion+6. and then settles down into the soft folds of the endoment!ium

'inasion+- The im"lantation "oint is usuall% hi&h in the ute!us, on the "oste!io! su!fa$e. If

the "oint of im"lantation is low in the ute!us, the &!owin& "la$enta ma% o$$lude the $e!ix,and ma% ma/e the delie!% of the fetus diffi$ult 'FLA-E=TA FRE;IA+

EM#RYONI% AND FETAL STRU%TURES

1. The decidua-afte! fe!tili3ation, im"lantation ha""ens in the endomet!ium of the ute!us. Thede$idua, the la%e! that thi$/ens in o!de! to $ushion the e&& does not slide off ut instead$ontinues to &!ow in thi$/ness. The de$idua has 6 se"a!ate a!eas:

a. de$idua asalis) the "a!t of the endomet!ium l%in& di!e$tl% unde! the em!%o. de$idua $a"sula!is) the "o!tion of the endomet!ium that st!et$hes o! en$a"sulates the

t!o"holast$. de$idua e!a) the !emainin& "o!tion of the ute!ine linin&

*. chorionic villi-on$e im"lantation is a$hieed, the t!o"holasti$ la%e! of the $ells of thelasto$%st e&in to matu!e !a"idl%. As ea!l% as the 11tho! 1*thda%, fin&e! li/e "!o@e$tions o!$ho!ioni$ illi !ea$h out f!om the sin&le la%e! of $ells into the ute!ine endomet!ium.) The oute! la%e! of the $ho!ioni$ illi deelo"s into a se"a!ate ho!mone "!odu$in& s%stem

"!odu$in& the followin&:a. H-7 'human $ho!ioni$ &onadot!o"in+ this is the 1stho!mone to e "!odu$ed. It $ane found in mate!nal lood and u!ine as ea!l% as the time of the fi!st missed menst!ual"e!iod until aout the 1((thda% of "!e&nan$%.. est!o&en: "!ima!il% ESTRIOL $ont!iutes to the mothe!s mamma!% &landdeelo"ment in "!e"a!ation fo! la$tation and it also stimulates ute!ine &!owth toa$$ommodate the deelo"in& fetus.$. "!o&este!one: is essential to maintain the endomet!ial linin& of the ute!us du!in&"!e&nan$%. This ho!mone also a""ea!s to de$!ease $ont!a$tilit% of the ute!ine mus$lesdu!in& "!e&nan$%, thus "!eentin& "!ematu!e lao!.d. Human "la$ental la$to&en: is a ho!mone with eithe! &!owth "!omotin& andla$to&eni$ o! mil/ "!odu$in& "!o"e!ties. It is "!odu$ed as ea!l% as the thwee/ of"!e&nan$%. It "!omotes mamma!% &land &!owth in "!e"a!ation fo! la$tation in the

mothe!. It also se!es to !e&ulate mate!nal &lu$ose, -HO=, and fat leels so thatade8uate leels of these a!e alwa%s aailale to the fetus.

6. Placenta-the "la$enta 'Latin fo! "an$a/e+ a!ises out of t!o"holast tissue. It se!es as thefetal lun&s, /idne%s, &ast!ointestinal t!a$t, and as a se"a!ate endo$!ine o!&an th!ou&hout"!e&nan$%. A "la$enta wei&hs (()1*((ml.- Amnioti$ fluid is sli&htl% al/aline with a "H of aout ?.*- The amnioti$ fluid is an im"o!tant "!ote$tie me$hanism fo! the fetus:

a. it shields a&ainst "!essu!e o! a low to the mothe!s adomen. It "!ote$ts the fetus f!om $han&es in tem"e!atu!e, e$ause li8uid $han&es

tem"e!atu!e mo!e slowl% than ai!.$. It aids in mus$ula! deelo"ment e$ause it allows f!ee moement of the fetusd. It "!ote$ts the umili$al $o!d f!om "!essu!e, "!ote$tin& fetal ox%&enation.

FETAL DEVELOPMENT MILESTONES: THIS FART OD THE HA=9OUT IS YOUR A99ITIO=AL REA9I=7ASSI7=0E=T

- The len&th of the "!e&nan$% is &ene!all% measu!ed f!om the fi!st da% of the last menst!ual"e!iod ' 7ESTATIO=AL A7E +

e"d of &'e (&')es&$&!o"$l wee*

2 GreywolfRedMs. Ar!l A""e D. #$l$"o"


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NCM 101 Lecture Notes PRELIMS Handout 4 _____________________- At the end of the


4/7

NCM 101 Lecture Notes PRELIMS Handout 4 _____________________ 1er"!0 $seos$ -e)!"s &o for,. T'!s !s $ 'eesy w'!&e

s+-s&$"e rod+ed -y &'e se-$eo+s )l$"ds.

Def!"!&e slee $"d $&!1!&y $&&er"s $re d!s&!")+!s'$-le

e"d of 3(&')es&$&!o"$l wee* 4 3"d&r!,es&er5

len&th is *>)6$m

wei&ht is aout (&

$ss!1e $"&!-ody &r$"sfer fro, ,o&'er &o fe&+s ro-$-ly -e)!"s $s e$rly

$s &'e 38&'wee* of )es&$&!o"

me$onium is "!esent as fa! as the !e$tum

$&!1e rod+&!o" of l+") s+rf$&$"& -e)!"s

e%e!ows and e%elashes a!e well defined

e%elids "!eiousl% fused sin$e the 1*thwee/ now o"en

+!ls $re $$-le of re$&!") &o l!)'&

e"d of &'e 3/&')es&$&!o"$l wee*

len&th is 6)6>$m

wei&ht is aout 1*((&

l+") $l1eol! -e)!" &o ,$&+re $"d s+rf$&$"& $" -e de&e&ed !" &'e

$,"!o&! fl+!d

&es&es -e)!" &o dese"d !"&o &'e sro&$l s$ fro, &'e lower $-do,!"$l

$1!&y !" ,$les

the lood essels of the !etina a!e hi&hl% sus$e"tile to dama&e f!om hi&h o*

$on$ent!ations

e"d of &'e 93"d)es&$&!o"$l wee*

len&th is 6>)


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NCM 101 Lecture Notes PRELIMS Handout 4 _____________________P=YSIOLOGI% %=ANGES IN PREGNAN%Y

SI=:

As the ute!us $han&es in si3e, the adominal wall must st!et$h to

a$$ommodate it. This st!et$hin& $an $ause !u"tu!e and at!o"h% ofsmall se&ments of the $onne$tie la%e! of the s/in. This leads to "in/ o! !eddishst!ea/s 'STRIAE 7RA;I9ARU0+ a""ea!in& on the sides of the adominal wall andsometimes on the thi&hs.

The umili$us is also st!et$hed that it e$omes olite!ated and smooth e$ause it

has een "ushed so fa! outwa!d. Ext!a "i&mentation also a""ea!s on the adominal wall. A !own line 'LI=EA

=I7RA+ !unnin& f!om the umili$us to the s%m"h%sis "uis ma% also e "!esent.

9a!/ened a!eas ma% also a""ea! on the fa$e "a!ti$ula!l% on the $hee/s and a$!oss

the nose ' 0ELAS0A+ o! the mas/ of "!e&nan$%

All these a!e due to the melano$%te stimulatin& ho!mones se$!eted % the

"ituita!%. This ho!mone leel de$!eases afte! "!e&nan$% and the on$e da!/eneda!eas a&ain li&hten.

;as$ula! s"ide!s a!e sometimes seen on the thi&hs of the woman du!in&

"!e&nan$%. This is $aused % an in$!ease in the leel of est!o&en du!in& "!e&nan$%.

-AR9IO;AS-ULAR:

#lood loss at a no!mal a&inal delie!% is aout 6(()(()1(((ml.

almost all women need i!on su""lements du!in& "!e&nan$% e$ause of the

followin& !easons:a. women hae a $om"a!atiel% low i!on sto!a&e of less than ((m& e$ause of

thei! monthl% menst!ual loss. The fetus !e8ui!es aout 6())*( !eaths "e! min.+

The mothe! ma% also $om"lain of stuffiness o! $on&estion of the naso"ha!%nx.

This is no!mal e$ause of the in$!ease in the leels of est!o&en.

#REAST:

#!east $han&es ma% e one of the fi!st "h%siolo&i$ $han&es a woman will feel

du!in& "!e&nan$% e$ause of the $han&e in the leels of est!o&en and"!o&este!one.

A feelin& of fullness, tin&lin&, o! tende!ness in the !east ma% e felt e$ause of

the in$!eased leels of est!o&en. As "!e&nan$% "!o&!esses, !east si3e also in$!eases e$ause of the h%"e!"lasia of

the mamma!% aleoli

The a!eola also da!/ens in $olo! and its diamete! in$!eases f!om aout 6.$m to

?.$m

The sea$eous &lands of the a!eola ' 0O=T7O0ERY5S TU#ER-LES+ enla!&e. The

se$!etions f!om these hel" "!eent the ni""les f!om $!a$/in& and d!%in&.

5 GreywolfRedMs. Ar!l A""e D. #$l$"o"


6/7

NCM 101 Lecture Notes PRELIMS Handout 4 _____________________ #% the 1thwee/ of "!e&nan$%, -OLOSTRU0 o! the thin hi&h "!otein

fluid that is the "!e$u!so! of !east mil/ $an e ex"elled f!om theni""les.

URI=ARY:

alte!ations in fluid !etention, and !enal, u!ete!, and ladde! fun$tion

U!ina!% f!e8uen$% is also noted to $han&e. 9u!in& the 1stt!imeste!, and du!in& the

last * wee/s of "!e&nan$% to a !ate of 1()1* time of oidin& "e! da%.

-han&es in the u!ina!% s%stem !esult f!om the followin&:

a. effe$ts of est!o&en and "!o&este!one a$tiit%. $om"!ession of the ladde! and u!ete!s % the &!owin& ute!us$. in$!ease lood olumed. "ostu!al influen$es

Dluid !etention is also seen du!in& "!e&nan$%. This !in&s aout edema es"e$iall%

in the lowe! ext!emities. 2ate! is !etained du!in& "!e&nan$% to aid in the in$!easein lood olume and to se!e as a !ead% sou!$e of nut!ients fo! the fetus.

A#9O0I=AL 2ALL A=9 7IT:

As the ute!us $ontinues to &!ow in si3e, it dis"la$es the stoma$h and intestines

towa!ds the a$/ of the adomen. This "ushin& "!essu!e ma% $ause a de$!ease in

the "e!istalti$ moement leadin& to hea!tu!n, $onsti"ation, and flatulen$e. #e$ause lood is also d!awn to the ute!us, de$!eased lood su""l% to the

&ast!ointestinal t!a$t is de$!eased and ma% $ause a de$!ease in the &ast!i$motilit%. This is $aused % RELAXI=, a ho!mone "!odu$ed % the oa!ies.

F!o&este!one also has an effe$t on smooth mus$les 'intestines+ ma/in& them less

a$tie.

0o!nin& si$/ness $an e noti$ed at the time H-7 and "!o&este!one leels e&in to

!ise... This ma% e also att!iuted to the de$!ease in &lu$ose leels of the mothe!e$ause the &!owin& fetus utili3es &!eat 8uantities of &lu$ose as it deelo"s.

Hea!tu!n !esults f!om the !eflux of the stoma$h $ontents into the eso"ha&us as a!esult of the u"wa!d "ushin& of the ute!us to the stoma$h

#e$ause of RELAXI=, whi$h !elaxes the eso"ha&eal s"hin$te!, hea!tu!n ma% alsoe felt

The!e ma% also e in$!eased salia fo!mation 'HYFERFTYALIS0+ e$ause of thein$!eased leels of est!o&en.

SELETAL

-al$ium and "hos"ho!ous needs a!e in$!eased du!in& "!e&nan$% e$ause the fetal

s/eleton must e uilt

The!e is &!adual softenin& of the "eli$ li&aments to fa$ilitate the "assa&e of the

a% du!in& i!th

2ide se"a!ation of the s%m"h%sis "uis as mu$h as 6)


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maternal and child nursing notes

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