PRELIM Care of Mother, Child & Adolescent

’LEC
GOALS OF MATERNAL AND and child during pregnancy, childbirth, and
postpartum to ensure the health of both.
CHILD HEALTH NURSING
 Promotion and maintenance of optimal family ROLES AND RESPONSIBILITIES
health.
OF A MATERNAL AND CHILD
o Preconception health care
o Care of women during the 3 trimesters of
NURSE
 Considers the family as a whole and as
pregnancy and the puerperium (the 6
partner in care when planning or
weeks after childbirth, sometimes termed
implementing or evaluating the effectiveness
the 4th trimester of pregnancy.
of care.
o Care of infants during the prenatal
 Serves as an advocate to protect the rights of
period (the time span of pregnancy to 4
all family members, including the fetus.
weeks [28 weeks] after birth).
 Demonstrates a high degree of independent
o Care of children from birth through late
nursing functions because teaching and
adolescent.
counseling are major interventions
o Care in variety of hospital and home care
 Promotes health and disease prevention
settings.
because these protect the health of the next
generation.
PHILOSOPHY OF MATERNAL &
 Serves as an important resource for families
CHILD HEALTH NURSING during childbearing and childrearing as these
 Maternal and child health nursing is:
can be extremely stressful times in a life
o Family centered: assessment should
cycle
always include the family as well as an
 Respects personal, cultural, and spiritual
individual.
attitudes and beliefs as these so strongly
o Community centered: the health of
influence the meaning and impact of
families is both affected by and
childbearing and childrearing
influences the health of communities
 Encourages developmental stimulation
o Evidenced-based: this is the means
during both health and illness so children
whereby critical knowledge increases,
can reach their ultimate capacity in adult life
 Assesses families for strengths as well as
 A challenging role for nurses and a major factor
specific needs or challenges
in keeping families well and optimally
 Encourages family bonding through
functioning.
rooming-in and family visiting in maternal
GLOBAL HEALTH and child healthcare settings
 Encourages early hospital discharge options
GOALS
 To end poverty and hunger to reunite families as soon as possible in
 To achieve universal primary education order to create as seamless, helpful transition
process.
 To promote gender equality and empower
 Encourages families to reach out to their
women
community so the family can develop a
 To reduce child mortality
wealth of support people they can call on in
 To improve child maternal health
a time of a family crisis.
 To combat HIV/AIDS, malaria, and other
diseases. THE SUSTAINABLE
 To ensure environmental sustainability
DEVELOPMENT
 To develop a global partnership for  Goals are a UN Initiative.
development  The Sustainable Development Goals
(SDGs), officially known as Transforming
THEORIES RELATED TO our world: the 2030 Agenda for
MATERNAL AND CHILD NURSING Sustainable Development, are an
intergovernmental set of aspiration Goals
PERINATAL with 169 targets.
NURSING THEORY
 Perinatal nursing is the care and support of
women and their families before, during, SUSTAINABLE
and after childbirth. Perinatal nurses provide DEVELOPMENT GOALS
education and resources about pregnancy  Poverty - End poverty in all its forms
and childbirth, and help oversee the mother everywhere
PRELIM Care of Mother, Child & Adolescent
 Hunger and Food Security - End hunger,
LEC  Penis:
achieve food security and improved nutrition
is the male organ for sexual
intercourse. It has three parts: the root, shaft
and promote sustainable agriculture. and glans
 Good Health and Well-Being - Ensure  Scrotum: is the loose pouch-like sac of
healthy lives and promote well-being for all skin that hangs behind the penis. It contains
at all ages. the testicles has a protective function and
 Education -Ensure inclusive and equitable acts as a climate control system for the testes
quality education and promote lifelong  Testicles / Testes: are responsible for
learning opportunities for all. making testosterone, the primary male sex
 Gender Equality and Women's hormone (endocrine function), and for
Empowerment - Achieve gender equality generating sperm (exocrine function)
and empower all women and girls.  Epididymis: It functions in the transport
 Water and Sanitation - Ensure availability and storage of the sperm cells that are
and sustainable management of water and produced in the testes
sanitation for all.  Vas Deferens: transports mature sperm to
 Energy - Ensure access to affordable, the urethra in preparation for ejaculation
reliable, sustainable and clean energy for all.  Urethra: carries urine from the bladder to
 Economic Growth - Promote sustained, outside of the body
inclusive and sustainable economic growth,  Seminal Vesicle: produce a sugar-rich fluid
full and productive employment and decent (fructose) that provides sperm with a source
work for all. of energy and helps with the sperms'
 Infrastructure, Industrialization - Build motility
resilient infrastructure, promote inclusive  Prostate gland: contributes additional fluid
and sustainable industrialization and foster to the ejaculate. Prostate fluids also help to
innovation. nourish the sperm.
 Inequality - Reduce inequality within and
among countries. TERMS RELATED TO SEXUALITY
 Cities - Make cities and human settlements
inclusive, safe, resilient and sustainable. BIOLOGIC
 Sustainable Consumption and Production SEX/GENDER
- Ensure sustainable consumption and  Used to denote chromosomal sexual
production patterns. development male (XY) & female (XX)
 Climate Change - Take urgent action to
combat climate change and its impacts. GENDER
 Oceans - Conserve and sustainably use the IDENTITY
oceans, seas and marine resources for  Is the individual’s persisting inner sense of
sustainable development. being male or female, masculine & feminine
 Biodiversity, Forests, Deforestation -  Its development was based on biologic sex
Protect, restore and promote sustainable use & sociocultural reinforcement, which brings
of terrestrial ecosystems, sustainably at birth with identification of the baby as
manage forests, combat desertification, and male or female
halt and reverse land degradation and halt
biodiversity loss. SEXUALITY
 Peace and Justice - Promote peaceful and
inclusive societies for sustainable  It includes all those aspects of the human
development, provide access to justice for being that relate specifically to being a boy
all and build effective, accountable and or girl, man or woman
inclusive institutions at all levels.  As a function of total personality, it is
 Partnerships - Strengthen the means of concerned with biological, psychological,
implementation and revitalize the global sociological, spiritual & cultural variables of
partnership for sustainable development. life

REPRODUCTIVE AND SEXUAL SEXUAL IDENTITY

HEALTH
 Is the preference of one person for one sex
FEMALE / MALE REPRODUCTIVE
or the other.
SYSTEM
MALE
REPRODUCTIVE
 PRELIM Care of Mother, Child & Adolescent
TYPES OF SEXUAL
IDENTITY/ORIENTATION
LEC The plateau stage is reached just before the
orgasm
 Heterosexual- one who is sexually attracted  In women, the clitoris is drawn
to one person of the opposite sex (“straight”) forward and retracts under the
clitoral prepuce; lower part of female
 Bisexual – one who is attracted to persons
vagina becomes congested; there is
of both sexes
increased nipple engorgement
 Homosexual - one who is sexually attracted
 In men, vasocongestion leads in full
to persons of the same sex (“gay”) &
distention of the penis
(“lesbian”)
 Transsexual- one`s belief that one is not the ORGASM
sex of one`s physical body but of the
opposite sex
 It occurs when stimulation proceeds through
o Ex. trapped in the wrong body: sex
the plateau stage to a point at which the
change surgery body suddenly discharges accumulated
sexual tension
GENDER ROLE BEHAVIOR
 A vigorous contraction of muscles in the
pelvic area dissipates blood and fluid from
 The way a person acts, female or male
the area of congestion.
including the expression of what is
 The average number of contractions in
perceived as gender appropriate behavior.
women is from 8-15 at intervals of one in
HUMAN SEXUAL RESPONSE every 0.8 sec
 In men, muscle contraction surrounding the
 feelings & attitudes about sex vary widely; the seminal vessels and prostate project semen
sexual experience is UNIQUE to each into the proximal urethra
individual. It is a combination of physiological  These contractions are followed by 3-7
responses and emotional responses (thoughts & propulsive ejaculatory contractions which
feelings). force semen into the penis
 A cycle with four discrete stages
RESOLUTION
HUMAN SEXUAL
 It is the period during which the external and
RESPONSE
internal organs return to an unaroused state –
EXCITEMENT 30 mins.
 More than 50% of the erection is lost
 It occurs with physical and psychological  General muscle relaxation occurs, in men
stimulation that causes parasympathetic nerve
 The inner 1/3 of the vagina gradually shrink
stimulation (sight, sound, emotion or thought).
and color returns to pre excitement phase
 This leads to arterial dilation and venous
 HR and RR returns to normal
constriction in the genital area; the blood supply
 For the MALE, a REFRACTORY
in this area increases resulting in vasocongestion
PERIOD occurs
and increase muscular tension
 during which further orgasm is impossible.
 For the FEMALE, there is MULTIPLE
 In women, this vasocongestion results in:
ORGASM.
✓ increased size of clitoris
✓ increased mucus in the vagina
✓ vagina widens its diameter and length
✓ nipples become erect
✓ increased cardiac and respiratory rate SEXUALITY ISSUES &
 In men: CONCERNS
✓ erection of the penis and nipples  Teenage sex
✓ there is scrotal thickening and testicle  Premarital sex
elevation  STD
✓ increased cardiac and respiratory rate  HIV/AIDS
 Sexual harassment
PLATEAU  Sexual abuse
PRELIM Care of Mother, Child & Adolescent
ADOLESCENT HEALTH IN
THE PHILIPPINES
LEC  HYPOTHALAMUS – secretes / release
GnRH
 ANTERIOR PITUITARY GLAND –
WHY DO TEENAGERS releases:
ENGAGE IN SEX?  LH – responsible for ovulation
REASONS PERCENTAGE  releases mature egg cell from ovary
To express love 40%  FSH – maturation of ovum
Curiosity 20%  OVARIES – releases:
Release urge 14%  ESTROGEN – secondary sex
Partners wanted sex 8% characteristics
Under influence of  PROGESTERONE – thickens
6%
drugs endometrium
 UTERUS – flow of blood
MENSTRUAL
HUMAN SEXUAL
CYCLE
 Is the periodic uterine bleeding in response RESPONSE
to cyclic hormonal changes PROLIFERATIVE
 Is the process that allows for conception &
implantation of a new life  Produces ESTROGEN in the follicular fluid
o Endometrium proliferates up to 8
CHARACTERISTICS DESCRIPTIONS folds
Beginning (Menarche) Onset: 12 or 13 y/o, o Termed as “estrogenic, follicular,
Average: 9-17
postmenstrual”
Interval between cycles Usual: 28 days, 23-35
days
not usual
SECRETORY
Duration Usual: 2-7 days, 1-9
days not  Formation of PROGESTERONE in the
abnormal corpus luteum.
Amount Average: 30-80ml  Endometrium corkscrew/ twisted.
Color dark red, combination  Termed as “progestational, luteal,
of blood, mucus, & premenstrual”.
endometrial cell
ISCHEMIC

 Decreased estrogen & progesterone

MENSES

 products discharged during menstrual flow:

o blood from the ruptured capillaries
o mucin from the glands
HUMAN o fragments of endometrial tissue
SEXUALITY  microscopic, atrophied &
 Is a multidimensional phenomenon that unfertilized ovum
includes feelings, attitudes, beliefs and
actions
 It encompasses and gives direction to a
person’s physical, emotional, social and
intellectual responses throughout life

FOUR BODY STRUCTURES

INVOLVED IN THE MENSTRUAL
CYCLE:
PRELIM Care of Mother, Child & Adolescent
LECCYCLE
MENSTRUAL

Low levels of Estrogen

Stimulates hypothalamus to
signal Anterior Pituitary Gland

Release LHRH/GnRH

Release of FSH/LH

Growth (trophy) in the gonads (ovaries)

Ovum matures

Graafian Follicle

DAY 14

Before the end of the cycle,

increase in LH from the
pituitary

Release of Prostaglandins

Graafian follicle ruptures

(OVULATION)

FSH decreases, Increase

in LH

Corpus Luteum

If unfertilized, regression of
corpus luteum after 8-10
days

Menstrual Flow

TEACHINGS ABOUT AREA OF

MENSTRUAL CYCLE CONCERN:
PRELIM Care of Mother, Child & Adolescent
 Exercise
 • Sexual Relations
LEC periods of abstinence or contraceptive use
during that time
 • Activities of Daily Life
 • Pain relief CALENDAR
 • Rest (RHYTHM) METHOD
 Requires a couple to abstain from coitus on
 Nutrition
the days of a menstrual cycle when the
RESPONSIBLE woman is most likely to conceive (3-4 days
before until 3-4 days after ovulation)
PARENTHOOD
o Ex. Longest cycle is 29 days and her
3 AREAS shortest cycle is 25 days, she should
abstain on the 7th to 18th day of her
1. Planned childbearing cycle
2. Prenatal care and support
 Woman should keep a diary of sex
3. Parent education support
menstrual cycles
CONTRACEPTION BASAL BODY
S TEMPERATURE
IMPORTANT THINGS TO  Basis is just before the day of ovulation, a
CONSIDER IN CHOOSING woman’s BBT falls about half a degree. At
CONTRACEPTIVES the time of ovulation, her BBT rises a full
 Personal values degree because of the influence of
 Ability to choose a method correctly progesterone.
 How the method will affect sexual  Woman takes her temperature each AM
enjoyment immediately after waking, before she
 Financial factors undertakes any activity.
 Status of couple’s relationship  She refrains from sex for the next 3 days
 Prior experiences
 Future plans CERVICAL MUCUS
(BILLINGS) METHOD
CHARACTERISTICS OF IDEAL  Predicting ovulation by using changes in
CONTRACEPTIVES cervical mucus. Before ovulation, the
 Safe cervical mucus is thick and does not stretch
 100% effective when pulled between the thumb and finger
 Free of side effects (spinnbarkeit). Just before ovulation, mucus
 Affordable secretion increases.
 Acceptable to the user and sexual partner  With ovulation (peak day), cervical mucus
 Free of effects on future pregnancies becomes copious, thin, watery, and
transparent; it feels slippery and stretches at
NATURAL FAMILY least 1 inch before the strand breaks. All the
days mucus is copious and the 3 days after
PLANNING
 No chemical or foreign material being the peal days are considered to be fertile
introduced into the body days, or days the woman should abstain
 Safest way for the body from sex to avoid conception.

ABSTINENCE SYMPTOTHERMA
L METHOD
 Abstain from sexual intercourse.  Combines the cervical mucus and BBT
methods
 The most effective way to protect against
conception and prevent sexually transmitted
diseases (STD).

OVULATION
FERTILITY AWARENESS AWARENESS
METHODS (FAM)  Predict ovulation by using over-the-counter
 Rely on detecting when the woman will be ovulation detection kit
capable of impregnation (fertile) and using
PRELIM Care of Mother, Child & Adolescent
24 hours before ovulati
LEC  Auterussmallthrough
 It detects luteinizing hormone in urine 12 to plastic object inserted into the
the vagina during the
menstrual period
LACTATION  Instruct the client to comply with regular
AMENORRHEA METHOD health care visits
 As long as a woman is breastfeeding an  Instruct the client to comply with regular
infant, there is some suppression of health care visits
ovulation.  Instruct the woman to check the string
before coitus
COITUS  Side effects:
INTERRUPTUS o Spotting or uterine cramping the first
 The couple proceeds with coitus until the
2-3 weeks after insertion
moment of ejaculation o Higher than usual risk of Pelvic
 The man withdraws and spermatozoa are
Inflammatory Disease (PID)
emitted outside the vagina
o Higher risk of ectopic pregnancy
o Heavier than usual menstrual flow
ARTIFICIAL FAMILY
for 2-3 months
PLANNING
o Experience more dysmenorrhea than
ORAL other woman
CONTRACEPTION
 Composed of varying amounts of synthetic BARRIER
estrogen combined with small amount of METHOD
synthetic progesterone. Failure rate of 1%.  Are forms of birth control that work by the
 May start to take the first pill 7 days after placement of chemical or other barrier
delivery between the cervix and advancing sperm so
 Not taken by nursing mothers. sperm cannot enter the uterus or fallopian
 SIDE EFFECTS: nausea, weight gain, tubes and fertilize the ovum.
headache, breast tenderness, spotting outside
menstrual period, monilial vaginal VAGINALLY INSERTED
infections, mild hypertension and depression SPERMICIDAL
 Missed pill- take the pill as soon as she  Spermicidal agents cause the death of
remembers it spermatozoa before they can enter the
cervix.
INTRAMUSCULAR  It changes the vaginal pH to a strong acid
INJECTION level, a condition not conducive to sperm to
 A single injection of medroxyprogesterone survive
acetate (DMPA or DepoProvera) given
every 12 weeks inhibit ovulation, alter the DIAPHRAGM
endometrium and change the cervical
mucus.  A circular rubber disk that is placed over the
cervix prior to intercourse.
SUBCUTANEOUS/
HORMONAL IMPLANTS VAGINAL RING
 Consists of six non-biodegradable silastic
implants about the width of a pencil lead,  New type of protection that consists of thin,
embedded just under the skin on the inside flexible plastic ring about 2 inches across
of the upper arm that contains a combination of estrogen and
 Over the nest 5years, implants release the progestin.
hormone suppressing ovulation and  Inserted into vagina and left in place for 21
changing the endometrium so implantation days, then removed for 7 days, then
is difficult following menses a new ring is inserted
 No estrogen side effect.
MALE/FEMALE
CONDOM
 The inner ring covers the cervix and the
INTRAUTERINE
outer ring rests against the vaginal opening
DEVICE (IUD)  Latex rubber or synthetic sheath that is
placed over that erect penis before coitus
PRELIM Care of Mother, Child & Adolescent
SURGICAL METHOD
(INCLUDES STERILIZATION)
LEC
VASECTOMY

 a small incision is made in each side of

scrotum.

LIGATION

 Fallopian tubes are occluded by cautery,

crushing, clamping or blocking the tubes and
thereby preventing passage of both sperm
and ova
 PRELIM Care of Mother, Child & Adolescent
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