MATERNAL AND CHILD HEALTH NURSING

Male Reproductive Organ

Female Reproductive Organ

External Genitalia

Internal Genitalia

ESTROGEN PROGESTERONE
MENSTRUAL CYCLE

NOTES ON MENSTRUAL CYCLE HERE:

OVULATION

1. Spinnbarkeit

2. BBT

3. Mittelschmerz

4. Ferning

CONTRACEPTION

A. NATURAL METHOD
a. Rhythm

b. BBT
c. Billings

d. Sympthothermal

e. LAM

f. Withdrawal

g. Abstinence

B. HORMONAL
a. Pills

b. Patch

c. Mini Pill

d. Morning after Pill

e. IM Depo-provera
 C. BARRIER METHOD
a. Intrauterine Device

b. Diaphragm

c. Cervical Cap

d. Condom

D. SURGICAL
a. TUBAL LIGATION

b. VASECTOMY

PRENATAL CARE

A. Assessment
a. Prenatal History

b. AOG

c. EDC/EDD

d. Nagele’s Rule

B. SIGNS AND SYMPTOMS OF PREGNANCY

PRESUMPTIVE PROBABLE POSITIVE

C. BP MONITORING

D. WEIGHT MONITORING

E. DIAGNOSTIC TEST
a. Rubella titer

b. Chorionic Villi Sampling

c. AFP

d. Amniocentesis

e. L/S Ratio

f. Leopold’s Maneuver
 F. Activities of Daily Living
a. Smoking
b. Alcoholism
c. Caffeine
d. Narcotics
e. Travelling/ Employment

f. Sexual Activity

G. Nutritional Requirements

H. Frequency of Prenatal Visit

a. 0-7 months
b. 8-9 months
c. Above 9 months

PHYSIOLOGIC CHANGES IN PREGNANCY

CARDIOVASCULAR

GIT Nausea and Vomiting

 Constipation

Heartburn

Hemorrhoids

ENDOCRINE Increased APG activity

a. Increase TSH b. ACTH

b. MSH

Increased HCG

Placental Hormones

Musculosketal Increased need for calcium

Muscle Relaxation

Lordosis

Reproductive Amenorrhea
Estrogen
Chadwicks
Goodells
Hegar’s
Colostrum Production

PSYCHOLOGICAL ADAPTATION
Emotional Reaction Rationale Management
First Trimester
A. Ambivalence
B. Denial
C. Rejection
Second Trimester
A. Acceptance
B. Fantasy
Third Trimester
A. Fear
B. Anxiety

FERTILIZATION

FETAL GROWTH AND DEVELOPMENT

A. AOG
B. Basis
a. LMP

b. Date of Quickening

c. Fundic Height (Barthlomew’s Rule)

C. Stages of Development

D. Emphasis of Development
a. First trimester
b. Second trimester
 c. Third Trimester

DEVELOPMENTAL LEVELS
First Month A. Germ Layer
Ectoderm
Mesoderm
Endoderm
B. Brian or NS Development
C. Fetal Heart beat
D. Development of Trachea and esophagus

Second Month 1.Organogenesis

2. Development of placenta
3. Development of sex organs
Third Month 1.complete placenta and barrier
2.Production of amniotic fluid

3. Audible HR by Doppler
Fourth Month Audible by Fetoscope
Visualization of skeletal outline
Human Face appearance
Development of external genitalia
Lanugo
Fifth Month Quickening
Vernix
Audible FHT by Stethoscope
Sixth Month Term size
Scalp hair
Pinkish, wrinkled skin
Seventh Month Development of alveoli
Production of surfactant
Eight Month Decreased lanugo and vernix
Rapid fat deposition
Viable
Ninth Month Lanugo and vernix disappears
Amniotic fluid decreases
Birth position assumed

COMPLICATED PREGNACY

A. HYPEREMESIS GRAVIDARUM

B. BLEEDING IN PREGNANCY
First Trimester Bleeding

1.Abortion

Types:

a. Induced

b. Spontaneous

Type Description Management

Threatened

Inevitable

Complete

Incomplete

Missed

Habitual

ECTOPIC PREGNANCY

SECOND TRIMESTER BLEEDING

1. H-Mole

2. Incompetent Cervix
THIRD TRIMESTER BLEEDINg

1. Placenta Previa 2. Abruptio Placenta

Placenta Previa Abruptio Placenta

Risk Factors
Pain
Bleeding
Uterus
Management

2. DIC

3. Preterm Labor

E. GESTATIONAL DIABETES MELLITUS

BIOPHYSICAL PROFILE
F. Pregnancy Induced Hypertension

BP Edema Proteinuria Others

Gestational HTN
Mild Pre
eclampsia
Severe Pre
Eclampsia
Eclampsia
Management:

G.Multiple Gestation

LABOR AND DELIVERY

4P’S

P-
P-
P-
P-
A. Passage

B. Passenger

1. Presentation

2. Attitude

3. Lie

4. Position
5. Station

C. POWER

Stages of Labor and Delivery

II

III

IV
 FHR VARIABILITIES

FHR Pattern Description Nursing Intervention

Early deceleration

Late deceleration

Variable deceleration

SECOND STAGE

Intrapartal Care

1. Assessment

2. Nutrition

3. Comfort Measures

a. Position

b. Sacral Pressure

c. Effleurage

d. Breathing Technique

e. Encourage voiding

f. Analgesics

g. Anesthesia

Cardinal Movements of Labor

THIRD STAGE

Signs of Placental Separation

Presentation:

1. Schultz

2. Duncan

LABOR AND DELIVERY PROBLEMS

A. Prolapsed Cord

B. Rh Incompatibility

FOURTH STAGE:

Involution

1. Uterus

2. After pains

3. Lochia

Pattern Duration Color

R
S
A
4. Onset of ovulation

5. Onset of Menstruation

6. Abstinence

7. Contraception

PSYCHOLOGICAL ADAPTATION
Stage Duration Feature Management
Taking in
Taking hold
Letting go
Other Normal Changes

 Blood

 Temperature

 Diuresis

POST-PARTAL PROBLEMS

A. Postpartal Bleeding

1. Early

a. Uterine Atony

b. Lacerations

c. Uterine Inversion

2. Late

a. Retained Placental Fragments

Others:

 DIC
 Subinvolution

 Hematoma

Postpartal Infection

1. Puerperal Infection

2. Endometritis

3. Thrombophlebitis

C. Breast Discomforts
DISCOMFORT ASSESSMENT MANAGEMENT
Engorgement

Sore Nipples

Mastitis

FEMALE REPRODUCTIVE SYSTEM DISORDERS

1. Infertility

2. PID

3. STI

Infection Sign and Symptoms

Chlamydia Tetracycline
Erythromycin
Gonorrhea Ceftriaxone
Doxycycline
Amoxicillin
Syphilis Benzanthine penicillin

Genital Herpes Acyclovir

Bathing with dilute NaHCO3
Analgesics
Trichomoniasis Metronidazole

Candidadiasis Nystatin
Fluconazole
Pubic lice Permethrin
Lindane
Genital warts Sitz bath
Yearly papsmear
Gardasil
NEWBORN CARE
CRITERIA 0 1 2
A