MATERNAL AND CHILD
NURSING
University of Sto. Tomas
College of Nursing/JSV
, Maternal and Child Nursing
OVERVIEW OF THE REPRODUCTIVE SYSTEM • Imperforate
FEMALE o May lead to
Breast Pseudoamenorrhea/Cryptomenorrhea
• Dependent on the ovary for hormones o Management is surgery; put to sleep to prevent
• During menopause → stop supply of hormones → prone to damage to vagina
cancer • Rigid
Mons Pubis o Problem with intercourse
Labia o Management is surgery
• Serves as a covering • Carunculae Myrtiformes - remnants of hymen after tearing
• Majora and minora
• Minora - has erectile tissues (clitoris) Doderlein’s bacillus
• Normal flora
- Clitoris • Bacteria that protects the woman from bacterial infection
• Anterior • Makes vagina acidic
• Basis for catheterization • Candida albicans (candidiasis) (moniliasis)- most common
• Avoid touching the clitoris when inserting the infection in the woman
catheter – may cause convulsion in precclamptic o Yeast infection
patients o Color (#1 assessment) - Yellowish creamy color
- Fourchette o Consistency of discharge: thicker
• Posterior of minora o Smell: no smell
• Stretch during delivery →napupunit→ o Pruritus
• Ritgen’s Maneuver o Vaginal suppository (MICONAZOLE, MONISTAT)
o Perineal support ▪ Local effect only
o Protect the are from overstretching ▪ Best time to insert the vaginal
• Episiotomy suppository: night time → patient not
o Prevents laceration upright → drug is dissolved in vagina
o Cut during peak of contraction → all the ▪ 6 hours for drug to take effect
muscles are pulled up and no muscles are ▪ Should report MORE discharge; drug
cut and infection (only 1 day)
o Should have anesthesia ▪ Only needs a single dose
o How many strong contractions before o Effect on Baby: infection on baby’s MOUTH (Oral
episiotomy: 3 moniliasis)
o Mediolateral- hindi mag eextend to anus
but many layers of tissues are affected • Trichomonas vaginalis
(Most common incision made) o SMELLY!!!!!!!!!
o Median- used for immediate delivery, may o Greenish grayish frothy
extend to anus • Gonorrheal
- Vestibule o Effect on baby: eyes
o Triangle • Chlamydial
o Two important openings- 2 (urethra and o Effect on baby: eyes
vagina) Cervical Mucus
o All openings- 6 • From cervical glands - Spinbarkeitt
Urethra • Endocervical gland in cervix
• Urethral canal is very short → at risk for infection 2 hormones that affects the cervix
o 8-10 glasses of fluid / 50% should be plain water • Estrogen
• UTI- increase fluids because no matter how much you do • Progesterone
perineal care, the proximity of the urethra to still
predisposes it to infection Estrogen Progesterone
-Dilates the cervix -Closes the cervix
*Because of hormone change, pregnant is more at risk for infection -Released before ovulation: -Released on the 16th day
→ progesterone → decreased renal threshold of sugar → small 14th day -Mucus is decreased in amount,
amount leak out → sugar in vagina is good medium for bacterial -Mucus is watery, clear, sticky, cloudy
growth stretchy -Spinnbarkheit: 3 cm
-Spinnbarkheit: 6-12 cm -Safe Period
Vagina -Unsafe period -Ph: 6
• Discharge: Fleshy smelling (Normal: 6-8 soaked napkin = -13th day of the 28th day -Hormone that protects the
30ml of blood) cycle baby
• More than 2000ml = shock -For 3-5 days -Dec. progesterone (AP) = Inc.
• Organ for copulation -Ph: 8 oxytocin (PPG)
• During birth passage →no ruggae (less resistance)→ for
easier passage of the baby Operculum
• Has ruggae (folds of muscles) which allow to stretch • Mucus that plugs the cervix
• Kegel’s exercise- to promote formation of ruggae • More discharge → formation of mucus plug
o Pubo-coccygeal muscle • Protects the baby from possible entry of infection
o Contract the muscle to hold the urine, then • “Show”- sign of cervical dilation
release the muscle
• Cervical dilation- indication that the woman has started
o Done as much as she wants
labor
Hymen
• Pag nastretch ang vagina, stretch din ang hymen
University of Santo Tomas – College of Nursing / JSV
, Maternal and Child Nursing
Uterus ▪ Baby suckes→ stimulation of prolactin
• Estrogen- thickens the muscle (hypertrophy) and oxytocin
• Progesterone- relaxes the uterus, maintains the pregnancy ▪ Baby suckles → stimulation of anterior
• Upper Segment(Fundus) pituitary (estrogen and prolactin)
o most active segment of the uterus • Only 1 or the other can be
o Muscles are found in all directions ”figure of 8” released
o Upper central and posterior segment- best site ▪ Estrogen stimulates ovulation so during
for implantation of placenta breastfeeding prolactin I released
• Placenta previa- bigger placenta instead of estrogen
o Placenta obstruct the passage way ▪ Prolactin → increase production of milk,
o Bleeding from the placenta insulin antagonist
▪ Painless ▪ Oxytocin → ejection of the milk, uterine
▪ Last trimester contraction, released during labor
• Lower Segment ▪ 8 times of feeding
o Passive segment • 6 times daytime
o Longitudinal muscles • 2 times at night
• During contraction, same shape of uterus (globular ▪ at 6 months, introduction of other foods
shaped) to baby → decreased breastfeeding →
• Physiologic retraction ring (normal) estrogen instead of prolactin released
o Imaginary line that separates the upper and the o Is there a difference between menstrual and
lower segment of the uterus during labor lochial discharge?
o Not seen but palpable • *Menstrual blood: NEVER CLOTS
• Pathologic retraction ring (Bandle’s ring) ▪ Color: SAME
o There is an overstretching of the uterus ▪ Smell: SAME
o Visible separation of the upper and lower ▪ Amount: DIFFERENT (more on lochia)
segment of the uterus • Menstruation: 30-50 ml (max
o There is an obstruction of the baby’s 80 ml)
passageway • Lochia: difficult to estimate
▪ Distended bladder ▪ #of days of menstrual flow: 2-6 days
✓ Make sure the patient voids o Lochia
every 2 hour intervals ▪ Rubra: 3 days
✓ Straight catheter • Actual bleeding
▪ Cephalo-pelvic disproportion • Presence of clots: report
• Perimetrium ▪ Serosa: at least 1 week
• Myometrium ▪ Alba: 3 weeks or more (3-5 weeks)
• Endometrium • Braxton Hicks
o 1.5 cm thick due to influence of estrogen and o Started at 4 months
progesterone (supplied by the ovary) (release o Contractions more significant at 7th month
estrogen and progesterone simultaneously) o Decreasing level o progesterone at the last
o During pregnancy → 6 cm thick trimester → increase frequency of contraction
▪ Protective mechanism of the hormones • Labor
to maintain the lining for the o Decrease progesterone → release of oxytocin
▪ DECIDUA- endometrium during o Prostaglandin theory
pregnancy ▪ Hormone release by the when the
▪ Estrogen and progesterone released at body is stressed
the same time ▪ Acts on the muscles
▪ Hormones in the ovary are at rest, ▪ From the placenta, uterus, fetus
PLACENTA takes over supply of ▪ Sudden increase in prostaglandin
hormones ▪ Mefenamic acid- prostaglandin
▪ 3 months before the woman starts inhibiting drug
menstruating again • Take on the day before you
• Decidua Basalis – where menstruate or at the onset of
placenta is attached; E and P menstruation
maintain it
o Zona basalis – o Uterine Stretch theory
remains when ▪ When uterine is stretch to its max
decidua is shed; new capability and capacity, it will naturally
endometrium for contract and expel its contents
next pregnancy ▪ Natural protective capacity of the
• Decidua Vera organ
• Decidua Capsularis o *Conditions will stretch early
▪ Lochia – shedding of the deciduas ▪ Twins (needs delivery; will deliver earlier)
• Alba and serosa are odorless 2 weeks earlier
▪ Menstruation – shedding of the lining ▪ polyhydramnios
o Breastfeeding ▪ macrosomic baby
▪ Form of birth control *Safe ang Sex even during pregnancy
▪ Only up to 6 months • Safe up to 34th week of pregnancy
▪ Suppress the activity of the ovary o Semen contains prostaglandin → increase
prostaglandin → early onset of labor
University of Santo Tomas – College of Nursing / JSV
NURSING
University of Sto. Tomas
College of Nursing/JSV
, Maternal and Child Nursing
OVERVIEW OF THE REPRODUCTIVE SYSTEM • Imperforate
FEMALE o May lead to
Breast Pseudoamenorrhea/Cryptomenorrhea
• Dependent on the ovary for hormones o Management is surgery; put to sleep to prevent
• During menopause → stop supply of hormones → prone to damage to vagina
cancer • Rigid
Mons Pubis o Problem with intercourse
Labia o Management is surgery
• Serves as a covering • Carunculae Myrtiformes - remnants of hymen after tearing
• Majora and minora
• Minora - has erectile tissues (clitoris) Doderlein’s bacillus
• Normal flora
- Clitoris • Bacteria that protects the woman from bacterial infection
• Anterior • Makes vagina acidic
• Basis for catheterization • Candida albicans (candidiasis) (moniliasis)- most common
• Avoid touching the clitoris when inserting the infection in the woman
catheter – may cause convulsion in precclamptic o Yeast infection
patients o Color (#1 assessment) - Yellowish creamy color
- Fourchette o Consistency of discharge: thicker
• Posterior of minora o Smell: no smell
• Stretch during delivery →napupunit→ o Pruritus
• Ritgen’s Maneuver o Vaginal suppository (MICONAZOLE, MONISTAT)
o Perineal support ▪ Local effect only
o Protect the are from overstretching ▪ Best time to insert the vaginal
• Episiotomy suppository: night time → patient not
o Prevents laceration upright → drug is dissolved in vagina
o Cut during peak of contraction → all the ▪ 6 hours for drug to take effect
muscles are pulled up and no muscles are ▪ Should report MORE discharge; drug
cut and infection (only 1 day)
o Should have anesthesia ▪ Only needs a single dose
o How many strong contractions before o Effect on Baby: infection on baby’s MOUTH (Oral
episiotomy: 3 moniliasis)
o Mediolateral- hindi mag eextend to anus
but many layers of tissues are affected • Trichomonas vaginalis
(Most common incision made) o SMELLY!!!!!!!!!
o Median- used for immediate delivery, may o Greenish grayish frothy
extend to anus • Gonorrheal
- Vestibule o Effect on baby: eyes
o Triangle • Chlamydial
o Two important openings- 2 (urethra and o Effect on baby: eyes
vagina) Cervical Mucus
o All openings- 6 • From cervical glands - Spinbarkeitt
Urethra • Endocervical gland in cervix
• Urethral canal is very short → at risk for infection 2 hormones that affects the cervix
o 8-10 glasses of fluid / 50% should be plain water • Estrogen
• UTI- increase fluids because no matter how much you do • Progesterone
perineal care, the proximity of the urethra to still
predisposes it to infection Estrogen Progesterone
-Dilates the cervix -Closes the cervix
*Because of hormone change, pregnant is more at risk for infection -Released before ovulation: -Released on the 16th day
→ progesterone → decreased renal threshold of sugar → small 14th day -Mucus is decreased in amount,
amount leak out → sugar in vagina is good medium for bacterial -Mucus is watery, clear, sticky, cloudy
growth stretchy -Spinnbarkheit: 3 cm
-Spinnbarkheit: 6-12 cm -Safe Period
Vagina -Unsafe period -Ph: 6
• Discharge: Fleshy smelling (Normal: 6-8 soaked napkin = -13th day of the 28th day -Hormone that protects the
30ml of blood) cycle baby
• More than 2000ml = shock -For 3-5 days -Dec. progesterone (AP) = Inc.
• Organ for copulation -Ph: 8 oxytocin (PPG)
• During birth passage →no ruggae (less resistance)→ for
easier passage of the baby Operculum
• Has ruggae (folds of muscles) which allow to stretch • Mucus that plugs the cervix
• Kegel’s exercise- to promote formation of ruggae • More discharge → formation of mucus plug
o Pubo-coccygeal muscle • Protects the baby from possible entry of infection
o Contract the muscle to hold the urine, then • “Show”- sign of cervical dilation
release the muscle
• Cervical dilation- indication that the woman has started
o Done as much as she wants
labor
Hymen
• Pag nastretch ang vagina, stretch din ang hymen
University of Santo Tomas – College of Nursing / JSV
, Maternal and Child Nursing
Uterus ▪ Baby suckes→ stimulation of prolactin
• Estrogen- thickens the muscle (hypertrophy) and oxytocin
• Progesterone- relaxes the uterus, maintains the pregnancy ▪ Baby suckles → stimulation of anterior
• Upper Segment(Fundus) pituitary (estrogen and prolactin)
o most active segment of the uterus • Only 1 or the other can be
o Muscles are found in all directions ”figure of 8” released
o Upper central and posterior segment- best site ▪ Estrogen stimulates ovulation so during
for implantation of placenta breastfeeding prolactin I released
• Placenta previa- bigger placenta instead of estrogen
o Placenta obstruct the passage way ▪ Prolactin → increase production of milk,
o Bleeding from the placenta insulin antagonist
▪ Painless ▪ Oxytocin → ejection of the milk, uterine
▪ Last trimester contraction, released during labor
• Lower Segment ▪ 8 times of feeding
o Passive segment • 6 times daytime
o Longitudinal muscles • 2 times at night
• During contraction, same shape of uterus (globular ▪ at 6 months, introduction of other foods
shaped) to baby → decreased breastfeeding →
• Physiologic retraction ring (normal) estrogen instead of prolactin released
o Imaginary line that separates the upper and the o Is there a difference between menstrual and
lower segment of the uterus during labor lochial discharge?
o Not seen but palpable • *Menstrual blood: NEVER CLOTS
• Pathologic retraction ring (Bandle’s ring) ▪ Color: SAME
o There is an overstretching of the uterus ▪ Smell: SAME
o Visible separation of the upper and lower ▪ Amount: DIFFERENT (more on lochia)
segment of the uterus • Menstruation: 30-50 ml (max
o There is an obstruction of the baby’s 80 ml)
passageway • Lochia: difficult to estimate
▪ Distended bladder ▪ #of days of menstrual flow: 2-6 days
✓ Make sure the patient voids o Lochia
every 2 hour intervals ▪ Rubra: 3 days
✓ Straight catheter • Actual bleeding
▪ Cephalo-pelvic disproportion • Presence of clots: report
• Perimetrium ▪ Serosa: at least 1 week
• Myometrium ▪ Alba: 3 weeks or more (3-5 weeks)
• Endometrium • Braxton Hicks
o 1.5 cm thick due to influence of estrogen and o Started at 4 months
progesterone (supplied by the ovary) (release o Contractions more significant at 7th month
estrogen and progesterone simultaneously) o Decreasing level o progesterone at the last
o During pregnancy → 6 cm thick trimester → increase frequency of contraction
▪ Protective mechanism of the hormones • Labor
to maintain the lining for the o Decrease progesterone → release of oxytocin
▪ DECIDUA- endometrium during o Prostaglandin theory
pregnancy ▪ Hormone release by the when the
▪ Estrogen and progesterone released at body is stressed
the same time ▪ Acts on the muscles
▪ Hormones in the ovary are at rest, ▪ From the placenta, uterus, fetus
PLACENTA takes over supply of ▪ Sudden increase in prostaglandin
hormones ▪ Mefenamic acid- prostaglandin
▪ 3 months before the woman starts inhibiting drug
menstruating again • Take on the day before you
• Decidua Basalis – where menstruate or at the onset of
placenta is attached; E and P menstruation
maintain it
o Zona basalis – o Uterine Stretch theory
remains when ▪ When uterine is stretch to its max
decidua is shed; new capability and capacity, it will naturally
endometrium for contract and expel its contents
next pregnancy ▪ Natural protective capacity of the
• Decidua Vera organ
• Decidua Capsularis o *Conditions will stretch early
▪ Lochia – shedding of the deciduas ▪ Twins (needs delivery; will deliver earlier)
• Alba and serosa are odorless 2 weeks earlier
▪ Menstruation – shedding of the lining ▪ polyhydramnios
o Breastfeeding ▪ macrosomic baby
▪ Form of birth control *Safe ang Sex even during pregnancy
▪ Only up to 6 months • Safe up to 34th week of pregnancy
▪ Suppress the activity of the ovary o Semen contains prostaglandin → increase
prostaglandin → early onset of labor
University of Santo Tomas – College of Nursing / JSV
