Reproductive Health

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Maternal child nursing included in the scope of practice are

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Preconception care

Care of women during the three trimesters and puerperium (6 weeks after)

Care of infants during perinatal period (20 weeks pregnant to 28 days old)

Care of children from birth to young adulthood

Care in settings as diverse as a birthing room, pediatric intensive unit, or at home

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Family centered care

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Most important part of child care. A healthy family promotes healthy upbringing. Also includes hospitalization by including open visiting hours parents beds placed next to child. Important to let parents take care of child

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2020 healthy people goals

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Increase quality and years in life

Eliminate health disparities

Prelicensure nursing programs include counseling for health promotion and disease prevention.

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Global health goals

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End poverty and hunger

Achieve universal primary education

Promote gender equality and empower women

Reduce child mortality

Improve maternal health

Combat HIV, malaria, and other diseases

Ensure environmental stability

Develop a global partnership for development

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Magnet status for hospitals

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Credentialed by the American nurses credentialing center (ANCC). Has 5 criteria.

Transformational leadership

Structural empowerment

Exemplary professional practice

New knowledge, innovation, and improvements

Empirical quality results

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Phases of healthcare

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Health promotion- educating parents and children to follow sound health practivd6through teaching and modeling

Health maintenance- intervening to Maintain health when risk of illness is present

Health restoration- using Conscientious assessment to be certain that symptoms of illness are identified and intervention s are begun.

Health rehabilition- helping prevent complications from illness.

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Measurement of maternal child healthcare

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Birth rate-decreasing in US in all age groups but over 40

Fertility rate- low in poor countries due to health, high in countries with good nutrition

Fetal death rate-causes vary

Neonatal death rate- increased in the US. Mostly due to prematurity. Other causes is poor health in moms.

I fantastic mortality rate-good index of a couple tries general health. Decreased in the US overall but certain subgroups are still high; native americans, native alaskans, African american.

Maternal mortality rate-due to increased participation of women in prenatal care, greater detection of disorders, increased control of complications, decrease use of anesthesia, control hemorrhaging.

Child mortality rate-leading cause of death is unintentional accidents, assault or suicide in children 10 to 19.

Childhood morbidity rate-health problems such as respiratory disorders, GA disorders, consequences of injuries. Obesity is a big problem.

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Trends for healthcare environment

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Initiating cost containment

Increase g health insurance coverage cost

Increasing alternative health styles and settings for health care

Increasing use of technology

Meeting work needs of pregnant and breastfeeding women-PPACA mandates that an employer with more than 50 employees must give adequate breaks for a mother to express milk for our 1 year after birth and to provide a place other than a bathroom and free from intrusion.

Regionalizing intensive care- having one site to take care of emergent needs.

Increasing use of alternative treatment modalities

Increasing reliance of home care

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Wrongful birth

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Birth of a disabled child when if the parents knew of the disability they would have terminated the pregnancy

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Wrongful life

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Negligent prenatal testing resulting in disabled child

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Wrongful conception

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A contraceptive failed leading to the birth of a child

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Family of orientation

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Family you are born to

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Family of procreation

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Family you establish

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Dyad family

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Made up of Two people with no children. Often short term. (roommates)

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Cohabitation family

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Couples who live together with or without children who remain unmarried

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Nuclear family

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Consists of husband wife children. Important to help the reach out to extended family

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Extended family (multigenerational)

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Usually one income. Parent may not be the caregiver instead an aunt or grandparent will be

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Adopted children behavior

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May have a honeymoon phase where they act good for fear of being given away again. After they may exhibit test boundary behaviors to see how far the parents are willing to support the I'll behaved child

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Developmental stages of family

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Mark the stage by the oldest child.

Stage 1- marriage

Stage 2-early childbearing family. Important role is health education about well childcare.

Stage 3- the family with the preschooler

Stage 4-the family with the school age child

Stage 5-the family with the adolescent.

Stage 6- launching stage. Parent of a young adult. Boomerang generation.

Stage 7- family of middle years. Empty nesters..prepare for retirement second highest rate of divorce in this age group

Stage 8- retirement and old age

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Genogram

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Diagram that details family structure and provides family health history

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Ecomap

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A diagram of family and community relationships

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Recommendation of the ASAP on television watching

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Not till the age of two

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Nursing teaching in reproductive health examples

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Encouraging women over 40 to have mammograms

Explains to school aged boys that nocturnal emissions are normal

Teaching an early adolescent about anatomy and physiology

Teaching safer sex practice

Explaining reproductive physiology to a couple trying to conceive.

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When is testosterone started to be made in fetuses

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7 or 8 weeks

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When do the external sexual organs begin to develop

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About 12 weeks

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When does the secondary sex changes occur

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Puberty when the hormone GnRH gonado-tropin releasing hormones stimulate the pituitary gland to release follicle-stimulating hormone and luteinizing hormone

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What component is possibly linked to girls starting puberty

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Body fat

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Where is tester one produced

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Adrenal cortex and tests in males and adrenal cortex and ovaries in girls.

It causes boys voice to lower and changes to the events and other parts. Also closes growth plates. In girls testosterone causes enlargement of the criteria and labia major a and axillary hair and pubic hair

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Estrogen role in puberty

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Breastfeeding development

changes on the female reproductive system

Fat distribution

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Stages of puberty in girls

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Growth spurt

Increase in the transverse diameter of the pelvis

Breast development (thelarche- starts 1-2 years before menstruation)

Growth of pubic hair

Onset of menstruation

Growth of axillary hair

Vaginal secretions

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Is irregular menstruation normal at the start of menarche

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Yes. For the first two years until ovulation is established

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The stages of puberty in males

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Increase in weight

Growth of testes

Growth of face, axillary, and pubic hair

Voice changes

Penile growth

Increase in height

Spertogenesis

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Scrotum function

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Regale the temp of speed and support testes

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Testes function

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Testes descend between the 30th and th36rh weeks in users

Premature babies will not have testes that have descended (cryptosporidium)

Monitor this, as testes that do not descend have greater risk of not producing viable supermarket or developing testicular cancer

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Is it normal for males to have one testes lower than the other one

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Yes, usually the left

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Advantages of circumcision

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Better hygiene, protection from HIV, STIs, and penile cancer

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Epidymis

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Tightly coupled tubular in which sperm reside until full maturity. Takes 12 to 20 days for sperm to travel it's length and 65 to 75 days for full maturity and my be why men with aspermia oligospermia do not respond to treatment until 2 months.

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Vast deferens.

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Another tubular that connects the epidymis to the ejaculating ducts. A vasectomy is when this tube is cut.

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Prostate

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Chestnut sized gland in which the urethra passes through. It's main function is to secrete an alkaline fluid that protects sperm

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Mons veneris

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Fatty tissue that protects the pubic bone

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Labia majora

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Protects the external genitalia

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Fourchette

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This tears during childbirth sometimes and where epesiotomies occur

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Vulvar blood supply

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Rich blood supply to the vulva, if there is pressure on it from the head of the fetus it may lead to varicose veins. Or hematoma from bike seat injuries. The advantage is the it heals injuries from childbirth quickly.

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Ovaries

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Function is the mature eggs, produce estrogen and progesterone. Without estrogen production women can develop osteoporosis because calcium withdraw from the bones.

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Maturation of oocytes

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Between 5 and 7 million ova are formed intrauterine. By birth about 2milliin are present. By 7 years, only about 500,000 are still present in each ovary. By 22 years the count is down to 300,000. By menopause there is none left.

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Fallopian tubes

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Aid in the movement of the egg to the uterus. It can lead to infection of the peritoneum so vaginal assessment must be done with clean technique and both and labor done with sterile technique.

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Uterus

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Childhood is as small as an olive. About 7 years old it starts growing slowly at about 17 it's at adult size. May contribute to low birth weight in babies born to teen mothers because it is not fully grown. The body is the bulk, the fundus is the top and can be palates during uterine growth.

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Uterine wall

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3 layers endometrium, myometrium, perimetrium

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4 types of uterus

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Normal uterus

Bicornuate- two horns

Septum divided uterus- fundus splits uterus

Double uterus

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4 position s of uterus

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Anteversion- entire uterus tips forward

Retroversion-entire uterus tips far back

Anteflexion-body of the uterus is bent sharply forward at the junction with the cervix

Retroflexion-the body of the uterus is bent sharply back just above the cervix

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Menstruation

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4 body structures- the hypothalamus, pituitary gland,ovaries, uterus

Hypothalamus us releases gonado-tropin (luteinizing hormone release hormone)

Pituitary releases FSH (maturation of ovulation) and LH (midpoint of cycle and ovulation growth if uterine lining)

Ovaries- houses the ovum, midway through cycle ovum divides into 2 parts (primary oocytes and cytoplasm) ovulation happens 14 days before start of next cycle. Body temp drops 1 degree day before then rises 1 degree after. If no fertilization happens the corpus luteum a trophies and becomes corpus albicans.

Uterus-4 stages of menstruation: proliferative- immediately after menstrual flow, endometrium thin by day 5 ovaries begin to secrete estrogen because of FSH endometrium begins to thicken between day 5-17.

Secretory- endometrium becomes corkscrew in appearance

Ischemic-endometrium degenerates and sloughs

Menses-

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Spinbarkeit test

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When you can stretch cervical mucus in between fingers

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Menopause

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Between 40 and 55. Hot flashes, vaginal dryness osteoporosis

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Viagra

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25 to 50mg as needed 1 hour before sexual activity

May cause headache, facial flushing, upset stomach. Contraindicated with men with cardiovascular disease do not take drug within 4 hours of a beta blocker.

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Contraindications to contraceptives

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OC-LIVER disease, smoker, varicosities, diabetes, poor compliance

IUD-VALVULAR heart disease Retroflexion-the uterus, vaginal bleeding

Diaphragm- infection, cystocele,

Depot- osteoporosis, liver disease

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Spermacidals

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Contraindicated in women with cervicitis. May have leakage after

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Diaphragm

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Women should get fitted after pregnancy, abortion, miscarriage, cervical surgery, gains or loses 15 pounds

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Oral contrCeptives

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Monophasic-contain fixed doses of estrogen and progesterone throughout a 21 day cycle

Biphasic-costant amount of estrogen varying amount of progesterone

Triphasic-estrogen and progesterone both vary.

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Depot

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Progesterone shot. Every 12 weeks before the 5th day after period. Contraindications include diabetes and loss of of bone density due to calcium loss.

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Cocktail not good for postmenopausal women

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True

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Women who are Breastfeeding should not use estrogen based co taceptives

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True

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Sperm count

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33 to 46 million sperm per ml of seminal fluid

50 percent of sperm is mobile

30 percent that are normal in shape in form