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MCN-LEC- Reviewer - MCN
Bachelors of science in nursing (University of Iloilo - PHINMA)
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MCN LEC REVIEWER
 MDG’s – 8 goals, set by the United Nations back in 2000 to eradicate
poverty, hunger, illiteracy and disease, expire in 2015.
 SDG’s - are a collection of 17 global goals set by United Nations General
Assembly in 2015 for the year 2030.
- It aims to transform our world and to improve people’s lives and prosperity
on a healthy planet.
 Family Structures
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 CHARACTERISTICS OF A FAMILY
- Small social system- interrelated; actions of 1 affect the other
- Performs certain basic functions: provides for the physical, spiritual,
mental health, socialization of member, provision of economic well-being
- Has structure- who are the members?
- Has its own cultural values and roles
- Moves through stages in the life cycle
 STAGES OF FAMILY LIFE CYCLE
 PARTS OF FEMALE INTERNAL REPRODUCTIVE SYSTEM
- Ovaries – to produce mature and discharge ova. Organ of ovulation,
oogenesis, and hormone production.
- Fallopian tube – (8-10cm long) to convey the ovum from the ovaries to
the uterus and to provide a place for fertilization of the ovum by the
sperm.
- Uterus- it is a hollow, muscular, pear-shaped organ located in the lower
pelvis. FUNCTIONS: receives the ovum from the oviduct, implantation
and nourishment, protection of the fetus, expulsion during birth
- Vagina – organ of intercourse and birth canal
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 FUNCTIONS OF REPRODUCTIVE ORGANS
o TESTES - manufacture male sex (gametes) or spermatozoa
- produce several steroid hormones primarily testosterone
o OVARIES – to produce, mature, and discharge ova (egg cells). In the
process of producing ova, the ovaries also produce estrogen and
progesterone and initiate and regulate menstrual cycles.
- organ of ovulation, oogenesis, and hormone production
 REPRODUCTIVE DEVELOPMENT (INTRO AND EXTRA UTERINE)
o INTRAUTERINE DEVELOPMENT
-BY WEEK 5 – mesonephric (Wolffian) and paramesonephric
(Mullerian) ducts, the tissue that will become ovaries and testes, have
already formed.
-BY WEEK 7 OR 8 – in chromosomal males, this early gonadal tissue
begins formation of testosterone. Under the influence of testosterone,
the mesonephric duct develops into male reproductive organs and
the paramesonephric duct regresses.
-BY WEEK 10 – if testosterone is not present, the paramesonephric
duct becomes dominant and develops into female reproductive
organ.
-BY WEEK 12 – the external genitals begins to develop. In
chromosomal males, penile tissue elongates and the ventral surface
of the penis closes to form a urethra. In chromosomal females, with
no testosterone present, the uterus, labia minora and labia majora
form.
 ROLE OF HORMONES IN REPRODUCTIVE DEVELOPMENT
o ANDROGEN – responsible for muscular development, physical
growth, and the increase in sebaceous gland secretion that cause
typical acne in adolescents.
o ESTROGEN – increases the development of uterus, fallopian tubes.
And vagina; typical fat distribution; hair patterns; and breast
development.
 ANATOMY OF HUMAN REPRODUCTIVE SYSTEM
 MAMMARY GLANDS
- Mammary glands or breasts, form early in intrauterine life. They then
remain in a halted stage of development until a rise of estrogen at
puberty causes them to increase in size.
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- GYNECOMASTIA – males, especially those who are obese, developed
an increase in breast size
 BREAST SELF-EXAMINATION
- When palpating the breast, always include the axillary region because
breast tissue extends into the axilla.
 PHASES OF MENSTRUAL CYCLE
o PROFILERATIVE PHASE - after menstrual flow
o SECRETORY PHASE – the uterine endometrium become corkscrew
or twisted in appearance
o ISCHEMIC PHASE – the endometrium of the uterus begins to
degenerate.
o MENSTRUAL PHASE – first day of the menstrual flow to 5 days
 OVULATION TEST
- Ovulation occurs 14 days before the beginning of the next menstrual
cycle
o FERN TEST
o SPINNBARKEIT TEST
 CHANGES DURING MENOPAUSE
o PERIMENOPAUSAL – the period during which menopausal changes
occur
o POSTMENOPAUSAL - the time of life following the final menses
 PARTS OF OVUM AND THE SPERM CELL
 AREA OF ASSESSMENT IN DIVERSITY AND MCN
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 SEXUAL ORIENTATION
 SOCIAL PSYCHOLOGY IN MCN
 CULTURAL COMPETENCE
 GENETIC DISORDERS
- Inherited or genetic disorders are disorders that can be passed from one
generation to the next because they result from some disorder in the
gene or chromosome structure
 PATTERNS OF INHERITANCE
o Dominant allele is expressed even if it is paired with a recessive allele
o Recessive allele is only visible when paired with another recessive
allele
o HOMOZYGOUS – a person who has two like genes for a trait – 2
healthy genes
o HETEROZYGOUS – if the genes differ (a healthy gene from the
mother and an unhealthy gene form the father, and vice versa)
o AUTOSOMAL RECESSIVE – disease does not occur unless 2 genes
for the disease are present (homozygous recessive pattern)
o AUTOSOMAL DOMINANT – either a person has 2 unhealthy genes
or is heterozygous
o X-LINKED DOMINANT INHERITANCE – genes are located on and
transmitted only by the female sex chromosome (X chromosome)
o X-LINKED RECESSIVE INHERITANCE – usually, only males will
have the disorder
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 ASSESSMENT OF GENETIC DISORDERS
o A. HISTORY
 Document diseases in family members
 Ethnic background
 Mother’s age, spontaneous miscarriage
o B. PHYSICAL ASSESSMENT
 Physical examination of family member with a disorder, siblings,
and the couple
 Check: space between the eyes, height, contour, shape of eras,
number of fingers & toes, webbing, dermatoglyphics (markings
on skin), abnormal fingerprints, palmar creases, abnormal hair
whorls or hair coloring
 PARTS OF OVUM AND SPERM CELL
 FERTILIZATION
- It is the union of the ovum and spermatozoon in the outer 3rd of the
fallopian tube, in the ampullar segment
 EMBRYONIC AND FETAL STRUCTURES
o DECIDUA
o CHORIONIC VILLI
o PLACENTA
o UMBILICAL CORD
o PLACENTAL MEMBRANE
 FETAL CIRCULATION
o 12TH DAY OF GESTATION – maternal blood begins to collect at the
intervillous spaces of the uterine endometrium surrounding the
chorionic villi
o 3rd WEEK – O2 and nutrients like glucose,a mino acids, fatty acids,
minerals, vitamins & water diffuse from the maternal blood through
the layers of the chorionic villi to the capillaries and are transported to
the developing embryo.
 PHASES OF IMPLANTATION
o IMPLANTATION OR NIDATION is the contact between the blastocyst
and the endometrium occurs 8 to 10 days of fertilization.
o 3 PHASES OF IMPLANTATION:
 APPOSITION – blastocyst brushes against the endometrium
 ADHESION – blastocyst attaches to the surface
 INVASION – blastocyst settles down
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 UMBILICAL CORD
- Arising from the chorion and amnion, it provides a circulatory pathway
that connects the embryo to the CV of the placenta
- FUNCTION: transports O2 & nutrients to the fetus from the placenta and
to return waste products to the placenta
- 55cm (21 in) long at term & 2cm (3/4 in) thick
 GERM LAYERS
o ECTODERM
 CNS (brain and spinal cord)
 PNS
 Skin, hair, nails
 Sebaceous glands
 Sense organs
 Mucous membranes of anus, mouth and nose
 Mammary glands
o MESODERM
 Supporting structure (connective tissue, bones, cartilage,
muscle, ligaments, and tendons)
 Dentin of the teeth
 Upper portion of the urinary system (kidneys & ureters)
 Reproductive system
 Heart
 Circulatory system
 Blood cells
 Lymph vessels
o ENDODERM
 Lining of the pericardial, pleural & peritoneal cavities
 Lining of the GI tract, respiratory tract, tonsils, parathyroid
 Thyroid, thymus glands
 Lower urinary system (bladder & urethra)
 AMNIOTIC FLUID
 Fetus continually swallows AF
 Volume at term: 800 to 1200 ml
 Slightly alkaline: pH 7.2
 If unable to swallow may cause esophageal atresia or
anencephaly
o FUNCTION:
 shields fetus from pressure or blow of the abdomen\
 regulates temperature
 aid in muscular development since it allows fetus to move freely
 protects umbilical cord from pressure thus protecting the fetal
O2 supply
 PLACENTA
 Arises from the trophoblast tissue
 Serves as a fetal lungs, kidneys, GIT, a separate endocrine
organ throughout the pregnancy
 15 to 20 cm in diameter & 2 to 3 cm in depth at term, covering
about half the surface area of the internal uterus
 AMNIOCENTESIS
- Aspiration of AF from the pregnant uterus for analysis
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- 15 ml of AF is aspirated
- Done at 14th to 16th week
- Ask women to void
o PURPOSE
 COLOR
 NORMAL – colorless or slightly yellow
 STRONG YELLOW COLOR – suggest blood
incompability
 GREEN-MECONIUM STAINING – suggest fetal
distress
 LECITHIN/SPINGOMYELIN RATIO
 SHAKE TEST – if bubbly, the ratio is mature
 LABORATORY ANALYSIS – 2:1 is the normal ratio
suggesting lung maturity
 INFANTS OF DIABETIC MOMS – falsely mature
readings because stress matures lecithin pathways
early (N= 2.5:1 OR 3:1)
 FETOSCOPY
- Fetus is visualized by a fetoscope (an extremely narrow, hallow tube
inserted by amniocentesis technique)
- A photograph may be taken of the fetus
o PURPOSES
 Confirms intactness of the spinal column
 Obtain biopsy samples of the fetal tissue & fetal blood
samples
 Perform elemental surgery (shunt for hydrocephalus)
 Can be performed 16th or 17th week of life
 PSYCHOLOGICAL CHANGES DURING PREGNANCY
o PSYCHOLOGICAL TASKS OF PREGNANCY BY REVA RUBIN
 1ST TRIMESTER: ACCEPTING THE PREGNANCY – “I AM
PREGNANT”
 TASK: accept the reality of the pregnancy
ND
 2 TRIMESTER: ACCEPTING THE BABY – “I AM GOING TO
HAVE A BABY”
 TASK: accepting the reality of having a baby
RD
 3 TRIMESTER: PREPARING FOR PARENTHOOD – “ I AM
GOING TO BE A MOTHER”
 Nest building
 RELIEF OF DISCOMFORTS OF PREGNANCY
o Module 7; page 69
 FETAL DEVELOPMENT ASSESSMENT
 BIOPHYSICAL PROFILE SCREENING
o Fetal breathing
o Fetal movement
o Fetal tone
o Amniotic fluid volume
o Fetal heart reactivity
 HAASE’S RULE
o Determines length of fetus in cm
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o 1st half (1-5 months) = month2
o 2nd half = months x 5
 LEOPOLD’S MANUEVER
o Fundic grip/ fundal grip
o Lateral grip
o Pawlik’s grip
o Pelvic grip
 EDC & AOG
o EDC
 JANUARY TO MARCH  APRIL TO DECEMBER o AOG
+9
-3
+7
+7
+1
 CALORIE REQUIREMENT FOR WOMEN
o NONPREGNANT – 2,200 calories/day
o PREGNANT - +300 calories (2,500 calories/day)
o LACTATING - +500 (2,700 calories/day)
 DIET AND NUTRITION DURING PREGNANCY
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