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Welcome to N353 for Winter 2005!!. Joy Haskin, RN, MS with Shalise Pollock, RN, MSN & Maria Rubiolino, RN, MSN. Review of the Syllabus. Date & time Course description Prerequisites/co-requisites Course objectives Teaching methods Required textbooks Student evaluation.

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welcome to n353 for winter 2005

Welcome to N353 for Winter 2005!!

Joy Haskin, RN, MS

with

Shalise Pollock, RN, MSN &

Maria Rubiolino, RN, MSN

review of the syllabus
Review of the Syllabus
  • Date & time
  • Course description
  • Prerequisites/co-requisites
  • Course objectives
  • Teaching methods
  • Required textbooks
  • Student evaluation
syllabus review cont d
Syllabus Review (cont’d)
  • Student policies
    • Students with disabilities
    • Academic honesty
    • Absentee policy
    • Additional information
  • Guidelines for Formal Paper
  • Class/Reading/Assignment Schedule
contemporary maternity women s health care5
Contemporary Maternity & Women’s Health Care
  • Maternity Nursing
    • focuses on the care of child-bearing women and their families through all stages of pregnancy and childbirth, as well as the first 4 weeks after birth.
slide7

Perinatal Nurse

    • nurturer, educator, physical a care provider, critical thinker, support person, counselor, case manager, or researcher
slide8

Perinatal Nurse

    • nurturer, educator, physical a care provider, critical thinker, support person, counselor, case manager, or researcher
  • Care providers during perinatal period include:
slide9

Perinatal Nurse

    • nurturer, educator, physical a care provider, critical thinker, support person, counselor, case manager, or researcher
  • Care providers during perinatal period include:
    • Nurses
    • Nurse Practitioners (NPs)
    • Certified Nurse Midwives (CNMs)
slide11

Women’s Health Nursing

    • Focuses on physical, psychologic, and social needs of women throughout their lives.
slide12

Women’s Health Nursing

    • Focuses on physical, psychologic, and social needs of women throughout their lives.
    • Well-being, childbearing & diseases
slide13

Women’s Health Nursing

    • Focuses on physical, psychologic, and social needs of women throughout their lives.
    • Well-being, childbearing & diseases
    • Reproductive issues, socio-cultural and occupational factors related to health problems (poverty, lower wages, rape, incest, sexual harassment, and family violence) (see ICNM Vision)
contemporary issues trends
Contemporary Issues & Trends
  • Health care = 13% national spending
  • Nursing shortage=nurses leading unlicensed assistive personnel rather than caregiver
  • Integrative care practices of Eastern and Western healing practices
childbirth practices
Childbirth Practices
  • Prenatal care may promote better pregnancy outcomes by allowing early risk assessment and promoting healthy behaviors, such as improved nutrition and smoking cessation
  • 2000, 83.2% received early PNC
  • 3.9% had late (??100%)
delivery location
Delivery location
  • Hospital
  • Free-standing birthing center
  • Home
  • Delivered by whom?
    • Physician 92%
    • CNM 7%
changes in labor care
Changes in Labor Care
  • Change in mandatory 2hr delivery time after complete dilatation (10 cm)
  • Delay pushing
  • Conserve mother’s energy
  • Decrease episiotomy
  • Decrease intervention
changes in labor care cont d
Changes in Labor Care (cont’d)
  • Changes in analgesia care
    • No analgesia
    • Epidural
  • Family-centered care
    • Fathers
    • Grandparents
    • Siblings
    • Friends
other updates in care
Other Updates in Care
  • Some women labor-deliver-recover in the same room (LDR)
  • Some women may stay in the same room for the entire birth experience (labor-deliver-recover-postpartum LDRP)
  • Mother-baby couplets rather than 1 RN for mother and 1/baby
  • 24-48 hour discharge that challenges teaching
  • Newborn security
views of women
Views of Women

Language we use:

  • Incompetent cervix=premature dilatation of the cervix
  • Arrest of labor=fail to progress
  • Intrauterine growth retardation=intrauterine growth restriction
  • Abortion=miscarriage
education
Education
  • Classes for
    • Childbirth
    • parenting
  • Parent support groups after birth
slide22

Breastfeeding in the Workplace

Family leave

International concerns

  • Female genital mutilation
  • Circumcision
  • Infibulation

Health of Women

  • Caucasian 80 yrs
  • African-American 75 yrs
  • Breast CA
slide23

Violence @ 8% in pregnant women

  • Pregnancy and abortion in adolescents have declined
  • Still highest in US of industrialized nations
  • Infants developing AIDS declined from 8.9/100,000 in 1992 to 2.8/100,000 in 1996. Universal screening of pregnant women in 1999
healthy people 2010
Healthy People 2010
  • 28 of 467 objectives focus on maternal, infant and child health
  • Fertility rate=births/1000 women
  • Birth rate=live births/1000 women
trends in fertility birth and mortality rates
Trends in Fertility, Birth, and Mortality Rates
  • Fertility rate 15-44 yrs 67.6 inc. 3% in 2001
  • Birth rate 14.8 in 2000 (1997, 55% live births, 29% induced and 15% spontaneous)
  • Low-birth-weight (LBW) infants-<2500 gms=7.6% (highest since 1973)
slide26

Infant mortality rate=death < 1 yr = 6.9/1000 live births

    • This is an indicator of adequacy of prenatal care and health of a nation as a whole
    • Disparity between races
  • Neonatal mortality rate=death < 28 days
  • Perinatal mortality rate=stillbirths + neonatal deaths
maternal mortality
Maternal Mortality
  • 9.8/100,000 live births in US
  • 1600 women die each day world-wide; many preventable
  • In US, racial differences
    • African-American 4X
    • Hispanic 1.7X
    • HP2010 goal 3.3/100,000 live birth
involving the consumer
Involving the Consumer
  • Self-care
  • Reduce health disparities
  • High technology care
  • Community-based care
  • Increase in hi-risk pregnancies
  • High cost of health care
  • Limited access to health care
trends in nursing
Trends in Nursing
  • Nursing Intervention Classification (NIC)
  • Evidence-based Practice
  • Association of Women’s Health, Obstetrical, and Neonatal Nurses (AWHONN)
  • Cochrane Pregnancy and Childbirth Database
slide30

Nursing Outcome Classifications (NOC)

  • Health Care Financing Administration (HCFA)
  • Best practice
  • Benchmarking
  • World Health Organization (WHO)
  • Standard of Care
  • Legal=Policy
  • Ethical issues
slide31

It’s time for a break!!

  • Please return in 15 mins
conception fetal development33
Conception & Fetal Development
  • Conception
    • Union of single egg and sperm
    • Marks the beginning of pregnancy
conception fetal development34
Conception & Fetal Development
  • Conception
    • Union of single egg and sperm
    • Marks the beginning of pregnancy
  • Gamete
conception fetal development35
Conception & Fetal Development
  • Conception
    • Union of single egg and sperm
    • Marks the beginning of pregnancy
  • Gamete
    • Egg or sperm
conception fetal development36
Conception & Fetal Development
  • Conception
    • Union of single egg and sperm
    • Marks the beginning of pregnancy
  • Gamete
    • Egg or sperm
  • Fertilization
conception fetal development37
Conception & Fetal Development
  • Conception
    • Union of single egg and sperm
    • Marks the beginning of pregnancy
  • Gamete
    • Egg or sperm
  • Fertilization
    • Union of gametes
slide40

Cell Division

    • Mitosis
      • Yields 2 identical cells
slide41

Cell Division

    • Mitosis
      • Yields 2 identical cells
  • Meiosis
slide42

Cell Division

    • Mitosis
      • Yields 2 identical cells
    • Meiosis
      • Yields 2 germ cells w/ half the chromosomal number=haploid; 22 autosomes & 1 sex chromosome
  • Gametogenesis
slide43

Cell Division

    • Mitosis
      • Yields 2 identical cells
    • Meiosis
      • Yields 2 germ cells w/ half the chromosomal number=haploid; 22 autosomes & 1 sex chromosome
  • Gametogenesis
  • Spermatogenesis
slide44

Cell Division

    • Mitosis
      • Yields 2 identical cells
    • Meiosis
      • Yields 2 germ cells w/ half the chromosomal number=haploid; 22 autosomes & 1 sex chromosome
  • Gametogenesis
    • Spermatogenesis in testes (male) and oogenesis in ovaries (female)
slide45

Cell Division

    • Mitosis
      • Yields 2 identical cells
    • Meiosis
      • Yields 2 germ cells w/ half the chromosomal number=haploid; 22 autosomes & 1 sex chromosome
  • Gametogenesis
    • Spermatogenesis in testes (male) and oogenesis in ovaries (female)
  • Fertilization forms zygote
fertilization
Fertilization
  • Takes place in outer third of uterine tube
fertilization47
Fertilization
  • Takes place in outer third of uterine tube
  • Sperm penetrates membrane of ovum, become enclosed=zona reaction
fertilization48
Fertilization
  • Takes place in outer third of uterine tube
  • Sperm penetrates membrane of ovum, become enclosed=zona reaction
  • Cleavage=mitotic division continues as zygote floats down tube
slide50

Blastomere-smaller cells formed by this first mitosis

  • Morula-the ball formed by 16 cells surrounded by a protective zona pellucida
slide51

Blastomere-smaller cells formed by this first mitosis

  • Morula-the ball formed by 16 cells surrounded by a protective zona pellucida
  • Separates into 2 parts by fluid=trophoblast (placenta) and embryoblast (embryo)
slide52

Blastomere-smaller cells formed by this first mitosis

  • Morula-the ball formed by 16 cells surrounded by a protective zona pellucida
  • Separates into 2 parts by fluid=trophoblast (placenta) and embryoblast (embryo)
  • Blastocyst=cells that give rise to embryo (source of stem cells)
implantation
Implantation
  • Zona pellucida degenerates
implantation54
Implantation
  • Zona pellucida degenerates
  • 6-10 days p/ conception
implantation55
Implantation
  • Zona pellucida degenerates
  • 6-10 days p/ conception Anterior or posterior fundus
implantation56
Implantation
  • Zona pellucida degenerates
  • 6-10 days p/ conception Anterior or posterior fundus
  • Trophoblast burrows into endometrium
implantation57
Implantation
  • Zona pellucida degenerates
  • 6-10 days p/ conception Anterior or posterior fundus
  • Trophoblast burrows into endometrium
  • Chrorionic villi form finger-like projections for oxygen and nutrient provision/CO2 & waste removal
fetal development
Fetal Development
  • Pregnancy lasts 10 lunar mos. or 40 weeks or 280 days
fetal development59
Fetal Development
  • Pregnancy lasts 10 lunar mos. or 40 weeks or 280 days
  • Compute length of pregnancy = first day of LMP to day of birth
fetal development60
Fetal Development
  • Pregnancy lasts 10 lunar mos. or 40 weeks or 280 days
  • Compute length of pregnancy = first day of LMP to day of birth
  • Day of conception is 2 weeks later, so fetal development is in post-conceptual age
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