Maternity Nursing - Lecture Notes
- Goal: Promote and maintain optimal family health to sustain cycles of childbearing and childrearing.
- Philosophy: Family-centered, community-centered, research-oriented; underpinned by nursing theory and evidence-based practice.
- Nurse's Role: Advocate for all family members (including fetus); high degree of independent functions; significant teaching and counseling.
Chapter 1: Scope and Standards of Nursing Practice
- Legal Basis: RA 9173 (The Philippine Nursing Act of 2002).
- Enforcement: Board of Nursing enforces quality standards for safe, moral, and professional practice.
- Core Competencies: Establish trust, involve client/support system, assess health status, implement safe interventions across antepartum, intrapartum, and newborn care, apply WHO Essential Intrapartal and neonatal care guidelines.
Chapter 2: Reproductive and Sexual Health
- Concept of Sexuality: Lifelong, dynamic human character beyond genital acts, including gender, identity, and role.
- Reproductive Anatomy: Female (external & internal genitalia) and Male (scrotum, penis, testes, duct system, accessory glands).
- Menstrual Cycle: Approximately 28 days (range 20-45 days).
- Key Hormones: Hypothalamus (GnRH), Anterior Pituitary (FSH and LH), Ovaries (Estrogen and Progesterone).
- Ovulation Signs: Breast tenderness, mittelschmerz, slight BBT rise, cervical mucus changes.
Chapter 3: Human Conception and Reproduction
- Fertilization: Union of egg (23 chromosomes) and sperm (23 chromosomes) in the ampulla of the fallopian tube; paternal sex chromosomes determine baby’s sex.
- Early Development: Zygote, cleavage, implantation (around day ~10); transitions to embryo then fetus. Germ layers (ectoderm, mesoderm, endoderm) form all tissues.
- Placenta: Discoid organ; produces hormones (estrogen, progesterone, HCG, HPL) and facilitates gas/nutrient exchange.
- Amniotic Fluid: Protective, metabolic reservoir; normal volume ~500-1200\ml.
- Polyhydramnios: >1500\ml
- Oligohydramnios: <500\ml
- Fetal Circulation: Specialized shunts (foramen ovale, ductus arteriosus, ductus venosus) bypass fetal liver and lungs.
Chapter 4: Antepartum Care
- Physiologic Changes in Pregnancy: Uterus (significant size/weight increase), Cervix (Goodell’s sign, mucus plug, Chadwick’s sign), Systemic (circulatory volume +30-50%, cardiac rate +10-15\bpm, risk of physiologic anemia).
- Weight Gain: Total ~11\kg recommended.
- Prenatal Care Aims: Promote maternal health, monitor fetal development, detect high-risk conditions, prepare for labor/breastfeeding, support quality of life.
- Key Assessments: Gravidity/Parity (GP or GTPAL), Nagele’s rule for EDD, quickening, McDonald’s method, Leopold maneuvers.
- Health Teaching: Nutrition (iron-rich foods, folic acid), lifestyle (avoid alcohol/drugs/smoking), safe sexual activity, adequate rest, moderate exercise.
Chapter 5: Intrapartum Care
- Components of Labor: Uterine contractions, cervical dilation and effacement, birth of baby, placental delivery.
- Monitoring: Essential Intrapartum and Neonatal Care (EINC) and Partograph for labor monitoring.
- Assessment: Leopold’s maneuvers (fetal presentation/position), vaginal exams, fetal heart monitoring, maternal vital signs.
Chapter 6: Postpartum Care
- Focuses on postpartum physiologic changes, psychosocial adjustments, nursing assessment/care planning in the puerperium, and family planning considerations.
Chapter 7: Legal Considerations and Issues in Maternal-Child Care
- Addresses legal and ethical considerations, advances in genetics/reproductive technologies, and the Reproductive Health Bill.
Chapter 8: Filipino Culture, Values and Practices in Relation to Maternal-Child Care
- Emphasizes cultural diversity in care planning, common myths and beliefs about pregnancy, and birth practices in selected cultural groups.
- Typical Pregnancy Duration: 38-42\weeks.
- Estimated Blood Volume Increase: 30-50\% over non-pregnant levels.
- Amniotic Fluid Volume: Polyhydramnios >1500\ml; Oligohydramnios <500\ml.
- Common Pregnancy Signs: Categorized as presumptive, probable, positive (tests).
- GTPAL: Gravida, Term, Preterm, Abortion, Living.
Full Terms for Abbreviated Expressions:
- RA 9173: The Philippine Nursing Act of 2002
- NNCCS: (Not explicitly defined in the provided text, but contextually refers to a standards document for nursing care of childbearing women – often National Nursing Core Competency Standards)
- IMCI: Integrated Management of Childhood Illness
- WHO: World Health Organization
- GnRH: Gonadotropin-Releasing Hormone
- FSH: Follicle-Stimulating Hormone
- LH: Luteinizing Hormone
- BBT: Basal Body Temperature
- HCG: Human Chorionic Gonadotropin
- HPL: Human Placental Lactogen
- EDD: Estimated Due Date
- GP: Gravidity/Parity
- GTPAL: Gravida, Term, Preterm, Abortion, Living
