Maternal Care (Lec)

health promotion

educating clients to be aware of good health through teaching and role modeling

health maintenance

intervening to maintain health when risk of illness is present

health restoration

diagnosing and treating illness that will return client to wellness

health rehabilitation

preventing complications; bringing an ill client back to wellness or helping a client to accept death

HUMAN SEXUALITY

• integrates somatic (bodily), emotional, intellectual & social aspects of being a human sexual being

• multidimensional concept; involves anatomy & physiology of human body, attitudes, and feelings about oneself

Standard 1

• every woman and newborn receives routine, evidence-based care and management of complications during labor, childbirth and the early postnatal period, according to WHO guidelines

STANDARD 2

the health information system enables use of data to ensure early, appropriate action

STANDARD 3

every woman and newborn with condition(s) that cannot be dealt with effectively with the available resources is appropriately referred

STANDARD 4

communication with women and their families is effective and responds to their needs and preferences

STANDARD 5

women and newborns receive care with respect and preservation of their dignity

STANDARD 6

every woman and her family are provided with emotional support that is sensitive to their needs and strengthens the woman’s capability

STANDARD 7

for every woman and newborn, competent, motivated staff are consistently available to provide routine care and manage complications

STANDARD 8

the health facility has an appropriate physical environment, with adequate water, sanitation and energy supplies, medicines, supplies and equipment for routine maternal and newborn care and management of complications.

clinical nurse specialists

nurses prepared at masters / doctoral level; capable of acting as consultants in their area & serves as role models, researchers, and teachers of nursing care

nurse practitioners

nurses educated at masters / doctoral level, play pivotal roles in health care systems

neonatal nurse practitioners (NNP)

advanced-practice role for nurses skilled in the care of newborns (well and ill)

family nurse practitioners (FNP)

advanced-practice role for nurses, providing care to family as whole

certified nurse midwife (CNM)

individual educated in the two disciplines of nursing and midwifery and licensed

nurses

legally responsible for protecting rights of client (ex. confidentiality) & accountable for the quality of nursing care and health care team members

documentation

essential for protecting nurse and their actions

NURSING THEORY

one of requirements of a profession (with other critical determinants like member-set standards, monitoring of practice quality, and participation in research) - concentration of a discipline’s knowledge flows from base of established theory

nursing theorists

offer helpful ways to view clients for nursing activities to meet client needs; with broad theoretical focus, nurses appreciate the effect on a family of a child’s illness / introduction of a new member

health promotion (major nursing goal)

• teaching, counseling, supporting, and advocacy are also common roles

• nurses care for clients who are more critically ill as it helps protect current health but also health of the next generation

healthy family

establishes environment conducive to growth and health-promoting behaviors sustaining family members during crises; health of an individual and own ability to function strongly influence health of family members & functioning

biologic gender

• chromosomal sexual development (male XY / female

• “male gives X/Y chromosomes to female”

sexual / gender identity

inner sense a person has of being male / female

gender role

behavior a person conveys about being male / female

reproductive sexuality

biological aspects of conception & procreation

gender sexuality

social & emotional aspects of being man / woman

heterosexuality

sexual fulfillment with opposite gender

homosexuality

sexual fulfillment with own sex; gay / lesbian

bisexuality

sexual satisfaction from homosexual & heterosexual relationships

transsexual / transgender

• one biologic gender feels that they’re the opposite gender

• may have sex change operations so that they appear cosmetically as the gender they feel (synthetic genitals)

erotic sexuality

sexual love and arousing sexual desire

EXCITEMENT

occurs with physical & psychological stimulation (sight, sound, emotion, & thought), causing parasympathetic nerve stimulation

women

• vasocongestion causes clitoris to increase in size & mucoid fluid appears on vaginal walls to lubricate

• vagina widens & increases in length; nipples become erect

men

penile erection occurs & increased heart BP and respiratory rates

ORGASM

• body discharges accumulated sexual tension

• shortest stage in cycle

• dopamine pumped & oxytocin released (love hormone); contractions pour semen into urethra and prostate gland secretes fluid to improve mobility of sperms → contractions = expels sperm

RESOLUTION

external & internal genital organs return to an unaroused state; taking 30 minutes for both genders

celibacy

abstinence from sexual activity (ex. priest)

masturbation

self stimulation for erotic pleasure

erotic stimulation

use of visual materials (ex. magazines / photographs)

fetishism

use of certain objects / situations

transvestism

individual dressing to take role of opposite sex

voyeurism

sexual arousal by looking at a person’s body

sadomasochism

inflicting pain (sadism) / receiving pain (masochism)

exhibitionism

revealing genitals in public

pedophiles

individuals interested in sexual encounters with children

erectile dysfunction / impotence

inability to produce / maintain erection for vaginal penetration or partner satisfaction

premature ejaculation

ejaculation before penile contact

failure to achieve orgasm (anorgasmia)

can be due to poor sexual technique / negative attitudes toward sexual relationships

vaginismus

• involuntary contractions of muscles at outlet of vagina when coitus attempted

• prohibits penile penetration

• “can happen due to rape = trauma”

dyspareunia

• pain during coitus

• can be due to endometriosis (“endometrium thickens in other places in uterus”)

inhibited sexual desire

• lack of desire for sexual relations in young / middle-aged adults

• support of caring sexual partner / relief of tension causing stress allows return to sexual interest.

persistent sexual arousal syndrome (PSAS)

• excessive and unrelenting sexual arousal in the absence of desire

• triggered by medications or psychological factors

vestibulitis

inflamed vestibule, vaginal infection, or hormonal changes occurring with menopauses which causes vaginal drying

GONADS

organs where gametogenesis occurs; appears as gonadal ridges

week 5 of intrauterine life

primitive gonadal tissue formed

week 7 / 8 (chromosomal males)

early gonadal tissue differentiates into primitive testes & begins testosterone formation

week 10, if testosterone isn’t present

gonadal tissue differentiates into ovaries; paramesonephric duct begins to develop into female reproductive organs (ovaries)

week 12

external genitals develop

ONSET PHYSIOLOGY

puberty initiated by hypothalamic pituitary (gonad complex)

androgenic hormones

responsible for muscular development & physical growth; produced by adrenal cortex & testes (males)

women (estrogen)

growth spurt, increased transverse diameter of pelvis, breasts developed, pubic hair growth, menstruation onset, axillary hair growth, & vaginal secretions

men (testosterone)

increased weight, testes growth, face axillary & pubic hair growth, voice changes, penile growth, increased height, & spermatogenesis

reproduction

essential characteristic of living organisms for humans to reproduce

gametes production (gametogenesis)

producing gametes (sperm in testis / egg in ovaries, reproductive cells produced in gonads)

fertilization

enables union of oocyte by sperm

ducts

epididymis, ductus deferens / vas deferens, & urethra

accessory glands

seminal vesicles, prostate gland, & bulbourethral glands

supporting structures

scrotum & penis

scrotum

saclike structure containing testes; dartos & cremaster muscles regulates temperature in testes

dartos muscle contracts

causes scrotum skin becomes firm & wrinkled; reducing size of scrotum

cremaster muscle contracts

pulls testes closer to body, increasing testes’ temperature

dartos & cremaster muscle relaxes

skin of scrotum becomes loose & thin

testes / male gonads

oval organs within scrotum

seminiferous tubules

where sperm cells develop

interstitial cells / leydig cells

endocrine cells secreting testosterone

ducts

epididymis, ductus deferens / vas deferens, & urethra

accessory glands

seminal vesicles, prostate gland, & bulbourethral glands

supporting structures

scrotum & penis

scrotum

saclike structure containing testes; dartos & cremaster muscles regulates temperature in testes

testes / male gonads

oval organs within scrotum

seminiferous tubules

where sperm cells develop

interstitial cells / leydig cells

endocrine cells secreting testosterone

sustentacular cells / sertoli

large & nourish germ cells; producing hormones

spermatogenesis

formation of sperm cells

spermatogonia

most peripheral germ cells dividing through mitosis

primary spermatocytes

other daughter cells dividing by meiosis & becomes sperm cells

secondary spermatocytes

product of first meiotic division

spermatids

product of secondary meiotic division

sperm cell / spermatozoon

developed spermatid with head, midpiece, & flagellum

acrosome

vesicle; anterior to nucleus and contains enzymes released during fertilization

epididymis

tightly coiled series of threadlike tubules forming comma-shaped structure

rete testis

tubular networks where each seminiferous tubule empties into

efferent ductules

carries sperm cells from testis to epididymis

capacitation

final changes in sperm cells occurring after semen ejaculation into vagina & prior to fertilization

ductus deferens / vas deferens

• emerges from epididymis & ascends along posterior side of testis

• contains smooth muscle, contracting in peristaltic waves to propel sperm cells from epididymis through ductus deferens.

spermatic cord

ductus deferens, testicular artery and veins, lymphatic vessels, & testicular nerve

ampulla of ductus deferens

increases in diameter