Intro to maternity nursing, family/culture, female reproductive system

Discuss current issues and concerns related to the provision of modern maternity care. (CO 1-2) Compare and contrast different family structures and theories. (CO 1-2) Identify cultural, religious, and other determinants of health that impact the family. (CO 1) Explain elements of female health assessment and health promotion (e.g. reproductive anatomy/physiology, the menstrual cycle, social determinants of health, disease prevention, risk factors that contribute to women’s health, and common assessments in women’s health). (CO 1-4)

menarche

1st menstrual period

menses

the time of menstruation

perimenopause

interval of menstrual irregularities leading up to the total cessation of cycles

menopause

cessation of menses for 12 mos or more

follicular phase

• represents the time during which the follicle and its oocyte develop, leading up to ovulation

• spans from menses onset (day 1) to the day before the surge of luteinizing hormone (LH), leading to ovulation

• length: 14-21 days (may be shorter, especially in perimenopause)

luteal phase

• the time after ovulation when the ovary produces hromones to support a potential pregnancy and maintain a healthy endometrium

• spans from the day of LH surge until the onset of the next menses

• length: 14 days

endometrial cycle phase

desquamation: shedding of the endometrial lining

proliferative phase: endometrial proliferation with straight, tubular glands

secretory phase: maturation of the spiral arteries and endometrial glands, preparing the endometrium for potential pregnancy

hypothalamus

releases gonadotropin-releasing hormone (GnRH) → stimulates gonadotropes of the anterior pituitary

anterior pituitary

stimulated by GnRH → releases FSH and LH → stimulates the ovaries

FSH

• stimulates follicular development and egg maturation

• stimulates the granulosa cells within the ovary to produce estradiol

LH

• stimulates theca cells within the ovary to produce testosterone (most of which is converted to estradiol in the granulosa cells)

• a surge of LH midcycle triggers ovulation

negative feedback inhibition

during most of the menstrual cycle, estrogens inhibit further secretions of FSH, LH, and GnRH

positive feedback

for a short time midcycle, estradiol stimulates FSH and LH secretion from the pituitary → results in high estrogen production in the ovaries and causes the surge of LH, which triggers ovulation

uterine effects from progestins

• dec endometrial growth

• stabilizes and causes maturation of the endometrium → prepares the endometrium for implantaion

• inc endometrial secretion (inc secretion thickness)

• progestin withdrawal at the end of the luteal/secretory phases triggers menstrual bleeding

breast effects from progestins

• inc lobular development

• inhibition of milk production

• inc body temp → can be used to track ovulation

• required for the development of placenta during pregnancy

breast anatomy and fxn

mammary gland contains

lobes → lobules → acini

acini contain epithelial cells that secrete colostrum and milk

BSE

brest size/changes are at their minimum about 5-7 days after menstruation stops, and this is the best time to self examine

prostaglandins

uterus moves/contracts

inc in prostaglandins → inc uterine activity → dysmenorrhea/cramping

cocaine

placental abruption

phase 1 cycle of violence

tension building

• inc tension

• victim may minimize the problem

  • tension becomes intolerable

phase 2 cycle of violence

abusive incident

• abuser becomes highly abusive

• abuse occurs

phase 3 cycle of violence

honeymoon

• loving

• apologetic

• promises to change

pap smear

used to detect carcinogenic/cellular changes, usually associated w HPV

sample contains epithelial cells from the cervix

HPV vaccination

start before 15

if between 15-26: 3 doses