Review of Maternal-Infant Nursing,Trends in Maternal-Infant Nursing Care,Development standard of care, certification, advanced practice nurses Home Health care for postpartum women, discharge from Hops. 12-24 hours after delivery, high risk infants discharge home earlier than before Consumer involved in the childbearing care: Child birth class, sibling present, breast-feeding, birthing environment (LDR, LDRP), fathers involvement, parents leave option for family with newborn,Maternal Nursing concerns areas,Prenatal care Low birth weight Mother and infant with HIV infection Adolescent pregnancy Drug and substance abuse during pregnancy Social/family stress and impacts to pregnant women and family Use and care for pregnant women,Special Issues in Womens Health,Violence Sexual Transmitted Diseases: HIV/AIDS86% of pediatric AIDS cases are transmitted through vertical transmission of HIV Substance abuse Other diseases: Heart diseases, cancer, osteoporosis, eating disorders,The Menstrual Cycle,Ovarian Cycle: 1. Follicular phase: stimulated with FSH to promote the development of folliclesEstrogen-follicle mature-negative feedback to hypothalamus and anterior pituitary gland inhibiting FSH secretion 2. Ovulation: increase in body temperature (progesterone secretion), fern pattern of the cervical mucus, spinnbarkeit “elasticity of the ovulatory”due to secretion of the estrogen,The Menstrual Cycle,3.Luteal Phase: Corpus luteum and anterior pituitary gland will secret luteinizing hormones (the decrease in Estrogen and progesterone positive feedback to Hypothalamus and anterior pituitary- stimulating the secretion of FSH 4. Premenstrual phase: Decline in estrogen and progesterone,The Menstrual Cycle,Endometrial Cycle: Proliferative phase Secretary phase Menstrual phase,Question,FSH stimulates which processes in the menstrual Cycle? Thinking of endometrium Maturation of follicle Decrease in basal body temperature Increase in progesterone production,Infertility Care,Infertility affects 15-20% of the populations in the reproductive years Terms to be understood: Artificial insemination Endometriosis Laparoscopy Primary Infertility Secondary Infertility Varicocele Endometriosis,Terms related to Infertility Treatment,In vitro Fertilization/embryo Transfer Gamete intrafallopian tube transfer (GIFT) Zygote Intrafallopian Transfer (ZIFT) Testing of infertility: Ovulatory Analysis Sperm Analysis Testing of STDS Tubal Patency test,Question,In which phase of the menstrual cycle is thick, scant cervical mucus and an elevated BBT seen? Estrogenic phase Menstrual Phase Ovulatory phase Luteal Phase,Names of the infertility drugs,Clomiphene “Clomid”-risk of multiple ovulation hCG: to facilitate the ovulation , side effect ovarian over-stimulation hMG + Menotropin: Human Menopausal gonadotropin Danazol: suppresses ovulation and secretion of FSH and Luteinizing hormone to inactive ectopic endometrial tissue. Side effect-Wt gain, hot flashes, decreased breast size, vaginitis,Nursing care for infertile couple,Identify problems and strengths: Self-esteem disturbance related to diagnosis Personal Identity disturbance, related to unsuccessful infertility treatment Ineffective family coping, compromised live and decision making Nurse =supporter, advocate, counseling,Pregnancy Termination,Legal/ethical Decision making dilemmas Counseling regarding pregnancy termination Psychological impact of pregnancy termination Risk and complication associated Grief/guilt/ambivalence/uncertainty feeling after terminating of pregnancy,Sexually Transmitted Diseases,Chamydia trachmatis infection Gonorrhea Human Papillomavirus Herpes Simplex Virus type 2 infection Cytomegalovirus infection Syphilis Vaginitis Human Immunodeficiency Virus Infection,Quesiton,Women should be taught to be aware of early warning signs of HIV infection which are: Dyspareunia Severe dysmenorrhea Occasional Candida infection Recurrent episodes of genital warts,Question,The purpose of taking Tamoxifen after a mastectomy is to: Alleviate cancer pain Act as hormonal replacement therapy Block tissue uptake and utilization of estrogen Destroy any stray cancer cells in remaining breast tissue,Family System Changes During The Childbearing Cycle,Structure Power Boundaries Affect or feelings Intergenerational patterns and roles Communication patterns Cultural background and riturals,Bonding and Attachement,Bonding is affected by Maternal-Sensitive period. Attachment is developed through out the first year of life. Important for nursing practice: do not make inaccurate judgment, understand that childbearing is a major transition I the life of a family,Nursing intervention for the three Phases of crisis,Precrisis: Predictable and development events in the life cycle Discuss change with family structure, adding new member Assess risk factors, past coping and problem solving Implement health teaching Implement health promotion and maintenance strategies,Nursing intervention for the three Phases of crisis,