CARE OF MOTHER, CHILD ADOLSCENT Standard 3 OUTCOME IDENTIFICATION – The

pediatric nurse indentifies expected outcome

Goals of maternal and child health nursing individualize to the child and the family

• Pre conceptual healthcare Standard 4 PALNNING – The pediatric nurse

• Care of women during three trimesters of develops a plan of care that prescribe
pregnancy and puerperium interventions to obtain expected outcome
• Care of children during the prenatal period
• Care of children from birth through adolescence Standard 5 Implementation – The pediatric nurse
• Care in settings as varied as the birthing room, the implements the intervention indentified in the
peridatric intensive care unit, the home plan of care

Philosophies of maternal and child health nursing Standard 6 EVALUATION – The pediatric nurse
evaluates the children and families progress
• Maternal and child birth nursing is family- towards attainment of outcome
centered; assessment data must include a family
and individual assessment FRAME WORK FOR MATERNAL AND CHILD
• Maternal and child health nursing is community- HEALTH NURSING
centered
DEFINITION AND EXAMPLES OF PHASES OF
• Maternal and child health nursing is research- HEALTH CARE
oriented TERM DEFINITION
• Both nursing theory and evidence-based practice Health promotion Educating clients to be
provide a foundation for nursing care aware of good health
• A maternal and child health nurse serves as an through teaching and
advocate to protect the rights of all family role modeling
Health maintenance Intervening to
• Members including fetus
maintain health when
• Maternal and child health nursing includes a high risk of illness is
degree of independent nursing functions present
• Promoting health is an important nursing role Health restoration Promptly diagnosis
• Pregnancy nor child illness can be stressful and can and treating illness
alter family life in both subtle and extensive ways using intervention
that will return client
• Personal, cultural and religious attitudes and
to wellness most
beliefs influence the meaning of illness and its rapidly
impact on the family Health rehabilitation Preventing further
• Maternal and child health nursing is a challenging complications from
role for a nurse and is a major factor in promoting and illness; bringing ill
high level wellness in families client back to optimal
state of wellness or
STANDARDS OF MATERNAL AND CHILD HEALTH helping client to
accept inevitable
NURSING PRACTICE
death
Standards of care – PEDIATRIC NURSES

Standard 1 ASSESSMENT – The pediatric nurse

collect patient health data

Standard 2 DIAGNOSIS – The pediatric nurse

analyze the assessment data in determining
diagnosis
 WHO’s 17 Sustainable Development Goals? 3. Vas Deferens
4. Ejaculatory Duct
1. NO POVERTY 5. Seminal Vesicle
2. ZERO HUNGER 6. Prostate Glands
3. GOOD HEALTH AND WILL-BEING 7. Cowper’s Gland
4. QUALITY OF EDUCATION
5. GENDER EQUALITY External Organs
6. CLEAN WATER AND SANITATON
7. AFFORDABLE AND CLEAN ENERGY 1.) PENIS – male organ of copulation and urina
8. DECENT WORK AND ECONOMIC
Parts:
GROWTH
9. INDUSTRY, INOVATION AND A. shaft/ body
INFRASTRUCTURE B. Glans penis – enlarged end; most
10. REDUCED INEQUALITY sensitive
11. SUSTAINABLE CITIES AND COMMUNITIES C. Prepuce/foreskin – fold of retractable
12. RESPONSIBLE CONSUMPTION AND skin covering the glans and is removed
PRODUCTION during circumcision – if it can not be
13. CLIMATE ACTION retracted: phimosis
14. LIFE BELOW WATER D. urethral meatus – slit like opening
15. LIFE ON LAND located at the tip of the penis;
16. PEACE, JUSTICE AND STRONG passageway for both semen and urine
INSTITUTION
17. PARTNERSHIP FOR THE GOALS Penile Opening Abnormalities

Anatomy & Physiology of the Male and Female • EPISPADIAS – a rare type of malformation
Reproductive System of the penis in which the urethra ends in
an opening on the upper aspect (dorsum)
Male Reproductive Organs of the penis
• HYPOSPADIAS – penile opening at the
anterior aspect of the penis

Epispadias vs Hypospadias

Male Reproductive System

External Organs

1. Penis
External Organs
2. Scrotum
2.) SCROTUM – saclike structure containing the
Internal Organs
testes darker coloration than the rest of the body
1. Testes covered with sparse hair and wrinkled
2. Epididymis environmental temperature affects the scrotum:
too hot---the dartos muscle relaxes and the testes • passageway for the semen
hangs or descend away from the body too cold ----
- the testes contracts and pull closer to the body 5. Seminal Vesicle
spermatogenesis is affected by extremes
• a pouch like organ lying behind the
Internal Organs bladder and in front of the rectum

1.) TESTES – oval shaped glandular organ lying 6. Prostate Gland

within the abdominal cavity in early fetal life and
• walnut shaped body lying below the
descend in the scrotum after 28 weeks gestation
bladder
undescended testes /cryptorchidism
• Surrounds the urethra and the 2
functions: ejaculatory ducts

1. Hormone production – testosterone that 7. Cowper’s Gland

stimulates spermatogenesis and responsible for
• located behind the prostate gland
the secondary males characteristics
• secretes an alkaline secretions that helps
2. Spematogenesis – production and maturation to neutralize the acidic nature of the
of sperm cells; begins in puberty urethra and provides lubrication during
intercourse
1. Testes • Bulbourethral Glands

parts of the testes: SEMEN

1. seminiferous tubules – long coiled tubes • seminal fluid

where spermatogenesis takes place • an organic fluid that may contain
2. Leydig/interstitial cells – produce spermatozoa
testosterone
• it contains fructose and other elements of
3. Sertoli cells – supporting cells which play
seminal fluids that promote survival of
a role in sperm transport
the spermatozoa and provide a medium
2. Epididymis through which spermatozoa can move or
swim
• long coiled tube approximately 20 feet
Seminal Fluid
long; where sperm travels for 12- 20 days
• takes 64 days for the sperm cells to A mixture of secretions from:
mature; rationale why therapy for
azoospermia and oligospermia becomes 1. Ejaculatory ducts
effective only after 2 months 2. Seminal Vesicles
• epididymitis – inflammation of the 3. Prostate glands
epididymis 4. Cowpers Gland

3. Vas Deferens Semen Color: Translucent with white, grey or

yellowish tint; if reddish: hematospermia
• passageway of the sperm cells from the
epididymis; contractile power of this area Seminal Fluid
propels the spermatozoa to the urethra
during ejaculation • Semen Quality: measured by its ability to
• cut during vasectomy accomplished fertilization
• Normal volume : 2-5ml/ejaculation
4. Ejaculatory Duct • 100 million sperm cells/ml
 • a sperm count of below 20 million is Vulva
associated with infertility and sterility
• structures that form the entire female
Spermatozoa external reproductive genitalia
• from the latin word meaning for covering

ANATOMY & PHYSIOLOGY

Divided into:

1. External
2. Internal

External Reproductive Organs

1. Mons Veneris / Mons Pubis

2. Labia Majora
3. Labia Minora
4. Clitoris
5. Vestibule
6. Vaginal Opening
7. Urethral Opening
8. Hymen
9. Skene’s Glands
10. Bartholin’s Glands
11. Fourchette

Sperm Motility Grading Mons Pubis – pad of adipose tissue located over
the symphysis pubis (pubic bone joint)
1. progressive motility
2. non linear motility; moves forward but in -function:
crooked motion
3. more on tails ➢ protect the junction of pubic bone from
4. immotile trauma
➢ richly supplied with sebaceous glands
Terms ➢ Childhood: hairless and smooth
➢ Puberty: covered by a triangular coarse of
Emission – is the discharged of semen from the curly hairs (escutheon)
urethra ➢ Pattern of hair growth: Female:
Triangular; Male:Diamond- shaped
Ejaculation – forceful expulsion of the semen from
➢ Growth of pubic hair is stimulated by
the urethra caused by contraction of muscles in
Testosterone while the pattern of hair
the penis (male orgasm)
growth is governed by estrogen
FEMALE REPRODUCTIVE SYSTEM

Labia Majora

• Two thick folds of adipose tissues

originating from the mons pubis and
terminating in the perineum
 • It unites anteriorly to form the anterior • Grafenberg or G spot is a very sensitive
commissure and posteriorly to form the area located at the inner anterior surface
posterior commissure of the vagina
• Its outer surface is thick and covered by
hair; inner surface is smooth and moist Urethral Opening
• Main function: provide covering and
• cexternal opening of the female urethra
protection to the external organs located
located in the midline of the vestibule just
under it
below the clitoris
• Nulliparous women: in close apposition to
• shortness of the female urethra makes
each other; but tends to gape wider after
women more susceptible to UTI than men
birth
Hymen
Labia Minora
• thin but tough and elastic semicircular
• Two thin folds of connective tissue that
membrane that covers the opening of the
joins anteriorly to form the prepuce and
vagina; often torn during the first sexual
posteriorly to form the fourchette
contact
• It is most highly vascular, sensitive and
• women may be born without a hymen;
richly supplied with sebaceous glands
can be torn by active sports and tampon
• Nulliparous women: covers the vaginal insertion
introitus, vestibule and urethra
• Imperforate Hymen – a hymen that
• Obliterated during vagina
completely covers the vaginal opening
Clitoris preventing coitus and passage of
menstrual discharge
• highly sensitive and erectile tissue • Hymenotomy/Hymenectomy – is the
situated under the prepuce of the labia surgical incision of an imperforate hymen
minora
Skene’s Glands
• Known as the “seat of woman’s sexual
arousal and orgasm” being the most • paraurethral glands; minor vestibular
sensitive part of the female external glands
genitalia
• A pair of glands situated on each side of
• Covered by a fold of skin called prepuce; the urethral meatus
Sensitive to both touch and temperature
• Its secretion help to lubricate the external
Vestibule genitalia during coitus

Triangular space between the labia minora where Bartholin’s Glands

the six (6) openings are located:
• vulvovaginal glands; major vestibular
1. Urethral Opening glands; paravaginal glands
2. Vaginal Opening • Situated on each inner side of the vagina
3. Opening of Bartholin’s Glands • Lubricates the external vulva during
4. Opening of Skene’s Glands coitus with an alkaline secretions that
enhances sperm survival
Vaginal Opening
Fourchette
• the external opening of the vagina
located just below the urethral meatus • the ridge of tissue formed by the
posterior joining of the two labia minora
and majora; sometimes cut during
episiotmomy
 • Episiotomy – perineotomy; surgically • Rugae – transverse folds of skin in the -
planned incision on the perineum and the vaginal wall absent in childhood - appear
posterior vaginal wall during the second at puberty
stage of labor • disappear at menopause
• function: allow the vaginal canal to
stretch and enlarge during deliver
Internal Reproductive Organs

UTERUS

• a hollow muscular canal resembling an

inverted pear that is situated in the true
pelvis

Functions:
Vagina – a tubular musculomembranous structure
about 8-12 cm long that extends from the vulva to A. Organ of reproduction (main) – serves for
the uterus reception, implantation, retention and
nutrition of the fetus
Functions:
B. Organ of menstruation
C. Uterine contraction for the expulsion of
A. excretory canal of the uterus through
the fetus during delivery and to seal torn
which uterine secretions and menstrual
blood vessels after placental deliver
flow escape
B. Female organ of copulation UTERUS
C. Forms part of the birth canal
Intrinsic motility – capable of contraction even if
the nerves that supply them is being cut

Parts of the uterus

1. Fundus
2. Cornua
3. Corpus
4. Isthmus
5. Cervix

Uterus
1. FUNDUS - uppermost convex triangular
portion between the points of insertion of
the fallopian tubes
Vagina
Most muscular part Ideal site: Zygote
implantation
 Obstetrical landmark: Fallopian Tubes – pair of tube like structures
A. palpation of fundic height to assess fetal originating from the cornua of the uterus with
growth distal ends located near the ovaries
B. assess uterine contractions and progress
of labor Parts:
C. assess uterine
1. INTERSTITIAL/INTRAMURAL
UTERUS 2. ISTHMUS – narrowest portion; site for
2…CORNUA – area where the fallopian tubes are tubal ligation
attached 3. AMPULLA – middle, widest part; site for
3…CORPUS – body of the uterus; houses the fetus fertilization
4…ISTHMUS - becomes only prominent near the 4. INFUNDIBULUM – has fimbrae (funnel
end of pregnancy and during labor to form the shaped opening at the distal end)
LOWER UTERINE SEGMENT together with the
OVARIES – almond shaped glandular organs
cervix
located on each side of the uterus; movable on
5…CERVIX - neck of the uterus chiefly composed of palpation
elastic and collagenous tissues and only 10 %
Functions:
muscle tissues
1. OOGENESIS – growth, development and
parts: a) Internal cervical os – opens into the
maturation of the egg cell
corpus b) Cervical Canal – Continuation of the
2. OVULATION – release of the mature egg
uterine cavity c) external Cervical os – opens into
cell
the vagina
3. HORMONE PRODUCTION – synthesis and
Layers of the Uterus secretion of steroid hormones

1. Perimetrium – outermost serosal layer OVARIES

attached to the broad ligament
2. Myometrium – Middle muscular layer -
responsible for uterine contractions and
thickest at the fundal area
3. Endometrium – innermost ciliated
mucosal layer - contains numerous glands
that secretes thin alkaline fluid that keep
the uterine cavity moist

Layers of the Uterus

Different Stages of Follicles

Layers of the Ovary

1. Tunica Albuginea – outermost protective

layer
2. Medulla – contains blood vessels, nerves
and lymphatics
3. Cortex – functional layer; site for ovum
formation and maturation - becomes
thinner in advancing age and the
follicles decreases in number

Layers of the Ovary