MCN MIDTERM

Primary Goal of Maternal-Child Nursing

- Promotion and maintenance of optimal family health
- To reduce maternal and infant morbidity and mortality and promote the health and well-being of mothers and children
- Nurses promote quality care by undergoing training and continued professional development to stay knowledgeable in current evidence-based practices

Scope for MCN practice

- Preconception health care
- Care of women during the three trimesters of pregnancy and the puerperium

Nursing Process

a scientific form of solving nursing problem.
serves as the basis for assessing, formulating a nursing diagnosis, planning, implementing and evaluating care.

Nursing Theories

Are designed to offer helpful ways to view patients so nursing activities can be created to best meet patient's needs:

Maternal Role Attainment Theory

Ramona Mercer

Adaptation Model

Sister Callista Roy

Model of Nursing

Anne Casey

Human Becoming Theory

Rosemarie Rizzo Parse

Maternal Role Attainment Theory by Ramona Mercer

serves as a framework for nurses to provide appropriate health care interventions for nontraditional mothers in order for them to successfully adopt a strong maternal identity.
beneficial for adoptive mothers, foster mothers, or others who have had nontraditional motherhood unexpectedly, such as taking care of a relative or friends child as the result of a death.
primary concept of this theory is the developmental and interactional process, which occurs over a period of time.

Adaptation Model Theory by Sister Callista Roy

provides a framework for explaining maternal adjustment following the birth of an infant.
the birth experience provides a first time mother with multiple stimuli to which she must respond.

​

Model of Nursing by Anne Casey

developed in 1988
considered one of the earliest nursing theories developed specifically for child health nursing.
focuses on the nurse working in partnership with the child and his or her family.
The philosophy is that the best people to core for a child is the family with the assistance of health
professionals.

Human Becoming Theory by Rosemarie Rizzo Parse

emphasizes the client's perception of the experience and her wisdom to make choices in her own and that of the infant's health care.
Model helps nurses develop the ability to see the client's perspective.
Allows the nurse to be "with" the mother and the family and guide them toward health goals for the infant.

Quality and Safety Education for Nurses (QSEN)

is to address the challenge of preparing future nurses with the abilities necessary to continuously improve the quality and safety of the health care systems in which they work

QSEN Competencies required for MCN

Patient Centered
Teamwork & Collaboration
Evidence- Based Practice
Quality Improvement
Safety
Informatics

Nursing Research

the systematic investigation of problems that have implications for nursing practice usually carried out by nurses.
can influence nursing practice

Health Promotion, Maintenance, Restoration, Rehabilitation

4 Phases of Health Care

Maternal and Child Health Goals and Standards

UN and WHO established the millennium health goals in an effort to improve health worldwide.
established in 2000 and reviewed every 10 Years.
Two main national health goals set every 10 years:
To increase quality and years of healthy life
To eliminate for health disparities

​

Global Health Goals

To end poverty and hunger.
To achieve universal primary education.
To promote gender equality and empower women.
To reduce child mortality.
To improve maternal health.
To combat HIV/AIDS, malaria, and other diseases.
To ensure environmental sustainability.
To develop a global partnership for development

Vulva or Pudenda

refers to the externally visible structure of the female reproductive system extending from symphysis pubis to the perineum

Mons Pubis

fatty pad over the symphysis pubis; cushions & protects pubic bone
​

Labia Majora (labium majus)

longitudinal folds of pigmented skin extending from mons pubis to the perineum; covered with thick, curly hair.

labia minora (inner lips)

hairless folds of tissue within the labia majora, extending from clitoris to the fourchette

​

clitoris

small approx 1-2 cm) rounded organ of erectile tissue at the upper end of labia minora

prepuce

skin covering of clitoris

smegma

epidermal secretion with strong odor

vestibule

Almond-shape space between the labia minora, clitoris and fourchette contains structures

urethral meatus

skene's glands (paraurethral glands )

vaginal introitus

Bartholin's glands (vulvovaginal glands)

hymen

crescent-shaped membrane

fourchette

thin fold of tissue formed where labia minora meet
Episiotomy site

​

Vagina

Hollow, musculomembranous canal
Lining has multiple folds (rugae)
(8-12 cm) 4cm diameter

Fornix

anterior, posterior and lateral space surrounding the cervix

Doderlein's bacili

keep vagina acidic

Vagina

Organ of copulation/"birth canal"
Passage in delivery & menstrual blood
Secretory duct during menstruation

uterus

"the womb"
pear-shaped, thick-walled, hollow muscular organ
anteverted, directed forward
7-8 cm long

uterus

- Menstruation
- Houses & nourishes the fetus until birth/ environment for pregnancy
- Contracts rhythmically during labor to expel the fetus

perimetrium, myometrium, endometrium

Layers of the Uterus

perimetrium

outer layer of uterus

myometrium

middle layer
layers of smooth muscle fibers that interlace
Contraction
"living ligature"

endometrium

innermost layer
rich in gland and blood vessels
sloughs off as menstruation

​

corpus, isthmus, cervix

divisions of uterus

corpus

main contractile portion
forms bulk of muscles
uppermost part is the fundus
What is the role of the fundus in obstetrics?

isthmus

joins the corpus to the cervix
contains uterine canal

Cervix

forms the main opening of the uterus
2-4 cm long

operculum

acts as a seal for the uterus

internal os

opens into uterine cavity

external os

opens into vagina

broad, round, uterosacral, cardinal, ovarian, suspensory or inundibulopelvic

uterine ligaments

broad

2 wing-like structures that extends from the lateral margin to the uterus to the pelvic walls. Stabilize the uterus & ovaries

round

2 fibrous cords from the uterine walls that helps hold the uterus in its forward position
broad ligament - stabilize uterus and
round ligaments connects upper uterus to connective tissues of labia majora

uterosacral

2 cord-like folds of the peritoneum from the lower cervix to the sacrum

​

cardinal

Mackenrodt's ligaments
situated along the inferior border of the broad ligament and house the uterine artery and uterine veins.

ovarian

Connect the ovaries to the lateral uterine walls

suspensory or infundibulopelvic

Connect the lateral ovary & distal fallopian tubes to the pelvic side walls.
Carries blood vessels & nerve supply for the ovary

fallopian tubes

"Salphinges"
serves as a passageway for the expelled ovum
10-12 cm long

interstitial, isthmus, ampulla, infundibulum

parts of the fallopian tube

interstitial

part of tube that lies in the uterine wall

Isthmus

part that is cut or sealed during tubal ligation
attached tube to uterus

ampulla

site of fertilization

infundibulum

most distal portion
it's a funnel-shaped opening encircled with fimbriae
Fimbriae - finger-like projections which anchor the ovary to the fallopian tube

Ovaries

female gonads
the sex glands sized and shaped like almonds
Functions:
Ovulation
Secretion of sex hormones

estrogen, progesterone

female sex hormones

female pelvis

passageway of fetus
formed by:
the innominate bones
ilium (crest of ilium)
ischium /ischial tuberosity)
pubis
sacrum - wedge shaped, forms the back part of the pelvis
соссух

false pelvis

larger, shallow
lies above the inlet
aids in supporting abdominal viscera

true pelvis

low, deep

pelvic inlet

entrance to the true pelvis

mid pelvis

mid portion of pelvis; contains ischial spine

pelvic outlet

exit of the true pelvis

linea terminalis

the pronounced line separating the greater & lesser pelves, formed by the sacral promontory, the margin of ala, the arcuate line, the pectineal line, and the pubic crest.

diagonal conjugate, true conjugate, obstetric conjugate, bi-ischial diameter, tuber ischial diameter

anteroposterior diameters of pelvic inlet

diagonal conjugate

anterior sacral promontory to the inferior margin of symphysis pubis
12.5 - 13 cm

true conjugate

Known as Conjugate Vera
from anterior sacral promontory to the superior margin of symphysis pubis
11 - 11.5 cm

obstetric conjugate

Distance between midpoint of inner surface of symphysis pubis to midpoint of sacral promontory
10.5 - 11 cm (shortest distance)
Measured indirectly by subtracting 1.5 - 2 cm. from the diagonal conjugate

Bi-ischial diameter

distance between ischial spines
10 cm

Tuberischial diameter

transverse diameter of outlet
8 cm

gynecoid

most common type of female pelvis

android

is most common type of male pelvis

anthropoid

is more oval but still adequate for birthing.

platypelloid

refers to a flat female pelvis

acini cells

milk-producing cells
Milk is funneled into the ductal system toward the nipple

lactiferous ducts, collecting ducts, mammary ducts

responsible for delivering the milk to the surface of the skin through tiny pores in the nipple

prolactin

hormone for milk production

Oxytocin

hormone for milk expression

penis

organ of urination & copulation

shaft

corpus spongiosum
corpus cavernosa

glans penis

distal end of male repro organ

prepuce

protects glans at birth

scrotum

wrinkled pouch of thin skin, covering a tight muscle
protects the testes trom trauma and changes In temperature
maintains the temperature of the testes 2 degrees lower than body temperature.
Cremasteric reflex

​

testes

male sex glands or gonads
2-3 cm wide that lie in the scrotum

seminiferous tubules

site of spermatogenesis

Leydig's cells (interstitial cells)

secretes testosterone

Sertoli cells

provide nourishment to the sperm

epididymis

storage site tor maturing sperm
absorbs about 90% of the fluid secreted by the testis. Sperm remain stored here for 40-60 days and are absorbed if not ejaculated prior to that time.
approx 20 ff. Long

vas deferens (ductus deferens)

passage way for sperm from epididymis to seminal vesicles
Vasectomy

ejaculatory duct

allows the sperm to enter the urethra and then exit the body

seminal vesicles

located along the lower posterior surface of the bladder
30% semen produced

prostate gland

surrounds the prostatic urethra
60% semen produced

protaglandins

produced by the prostate and seminal vesicles
stimulate peristaltic contractions of the temale reproductive tract that may help draw semen into the uterus.

​

bulbourethral glands

Cowper's gland
located below the prostate
5% semen production

Urethra

passageway for urine and semen
18-20 cm hollow tube