CARE OF MOTHER, CHILD, and ADOLESCENT

NCM 107

PROCREATIVE
HEALTH
Module 1

Espiritu, Gizzi Asbelle P.

BSN 2102
 Contents

I. Definition and theories related to Procreation.................................................................................. 4

II.The Family.........................................................................................................................................5

III. Causes of Genetic problems...........................................................................................................7

IV. Common tests for determination of genetic abnormalities..............................................................9

V. Prevention of genetic alteration and in the care of clients

seeking services before and during conception...............................................................................10

VI. Activity.............................................................................................................................................12

VII. References.....................................................................................................................................13

Espiritu, Gizzi Asbelle P.

 LEARNING OBJECTIVES:

To identify theories related to procreation

To describe the human reproduction process
To classify risk factors and common test
To identify genetic abnormalities
·To utilize nursing process in the prevention of genetic alteration and in all patients care aspects

Espiritu, Gizzi Asbelle P.

 I. Definition and theories related to Procreation

Procreative Health is the moral obligation of parents to have the healthiest children through all natural and
artificial means available.

Procreation is the physical act of joining a sperm and an egg together to create another biological
being. With procreation, the link between the parent and child is direct in that the child has genetic
make-up based on both parents biological contributions. (Pagliocca et al. 1915)

Different Theories
Creation is the making of all things from nothing, by an act of God, at some time in the past. God's
action could have taken a second, or 6 days, or a million years. Evolutionary theory is the theory that all
things came about by the repeated random actions of natural selection, whereby:
1. Life came into existence, and then
2. Primitive life evolved into more and more complex organisms, and eventually producing mankind.
Evolutionary theory requires the assumption of billions of years for its processes.

A Malthusian catastrophe (also called a Malthusian check, crisis, disaster, or nightmare) was originally
foreseen to be a forced return to subsistence-level conditions once population growth had outpaced
agricultural production. Later formulations consider economic growth limits as well. Based on the work
of political economist Thomas Malthus (1766–1834), theories of Malthusian catastrophe are very
similar to the subsistence theory of wages. The main difference is that the Malthusian theories predict
over several generations or centuries, whereas the subsistence theory of wages predicts over years
and decades.

Espiritu, Gizzi Asbelle P.

 II.The Family

The family is a very important social institution.

It is generally accepted that the family is the first and oldest social institution in society. The family is
consist of parents and children who interact with one another.
Refers to a group of people united by ties of marriage, blood or adoption. As a group, the members of
the family live together under one roof and that they constitute a single housekeeping unit.
It is a universal institution that has the following common characteristics:

Associate with one another in their respective role as husbands and wife, mother and father,
son and daughter or brother and sisters.
As the members of family enjoy life together playing their different roles, they tend to create a
common culture.
There have been significant changes in the way people regard the family as a social institution. Friedman
(1992) defines it as "two or more persons who are joined together by bonds of sharing and emotional
closeness and who identify themselves as being part of the family"

Functions of the Family

Provision of Physical needs: food, shelter, clothing, safety and healthcare.

Allocation of Resources: careful planning and use of family money, material good, space and
abilities.
Division of Labor: assigning the workload, including responsibility for household income and
household management.
Socialization: guiding towards acceptable standards of elimination, food intake, sexual drive, respect
for others and their possession and sense of spirituality.
Reproduction, recruitment, and release: bearing or adopting children new members by marriage,
and allowing members to leave.
Maintenance of Order: interaction and communication opportunities , discipline, affection, sexual
expression.
Assistance with fitting into the larger society: community, schools, spiritual center and
organization.
Maintenance of motivation and morale: recognition, affection, encouragement, family loyalty, help in
meeting crisis, philosophy in life, spirituality.

Espiritu, Gizzi Asbelle P.

Family structures

Children grow up in many different structures of families, and, at different times in their lives, their family
structure may change.

Classifications of Family Based on Internal Organization:

CONJUGAL FAMILY
NUCLEAR FAMILY
EXTENDED FAMILY

Classification of Family Based on Family Descent:

PATRILINEAL FAMILY
MATRILINEAL FAMILY
BILATERAL FAMILY

Classification of Family Based on Authority:

PATRIARCHAL FAMILY
MATRIARCHAL FAMILY
EGALITARIAN FAMILY
MATRICENTIC FAMILY

Classifications of Family Based on Residence:

PATRILOCAL Residence
MATRILOCAL Residence
BILOCAL Residence
NEOLOCAL Residence
AVUNCOLOCAL Residence

Espiritu, Gizzi Asbelle P.

 III. Causes of Genetic problems

Genetic disorder is caused by a mutation to a gene, group of genes, or entire chromosome.

Remember, genes carry instructions to build proteins.
When these instructions are mutated, proteins can't get build correctly.
Genetic disorders generally occur in two different varieties.
a). Chromosomal defect (chromosomal mutations)
b) Gene defect (gene mutations)

Sex Chromosomes

Espiritu, Gizzi Asbelle P.

 Genetic disorder is caused by a mutation to a gene, group of genes, or entire chromosome.
Remember, genes carry instructions to build proteins.
When these instructions are mutated, proteins can't get build correctly.
Genetic disorders generally occur in two different varieties.
a). Chromosomal defect (chromosomal mutations)
b) Gene defect (gene mutations)

Gene Defects
Gene defects occur when an individual gene is mutated on a chromosome.
Since only one gene is affected, usually only one protein is affected.
Many gene defects can be inherited, however, many of them can occur spontaneously (without being
inherited) through being exposed to mutagens like chemicals or radiation.

Inheriting a Gene Defect

There are generally three different patterns of inheritance.
Autosomal recessive
Autosomal dominant
Sex linked recessive

Espiritu, Gizzi Asbelle P.

 IV. Common tests for determination of genetic abnormalities

Factor causing Genetic abnormalities:

A genetic disorder is disease caused in whole or in part by a change in the DNA sequence away from
the normal sequence.
Changes in the genes causes mutation, alter the structure function of the gene product which give rise
to diseases.
Combination of gene mutations and environmental factors.
Damage to chromosomes.
Translocation.
Inversion.

Different categories of genetic tests are:

Predictive genetic testing can tell you the chances that a healthy person with or without a family
history of a certain disease might develop that disease. These diseases can include some types of
cancer and heart disease.
Presymptomatic genetic testing can tell if a person with a family history for a genetic disease but
does not have symptoms or has a genetic alteration associated with the disease.
Carrier testing can determine if a person carries one copy of a gene linked to a certain disease. An
"autosomal recessive" disease means that the disease will appear only if two copies of the altered gene
are inherited.
Prenatal diagnosis is used to diagnose a genetic disease or condition in the developing fetus. Prenatal
tests include screening blood, ultrasound (sonograms), amniocentesis, chorionic villus sampling (CVS),
and percutaneous umbilical blood sampling (PUBS).
Preimplantation studies are used only in in vitro fertilization to diagnose a genetic disease in an
embryo before it is implanted into the mother's uterus.
Newborn screening is used to check for certain genetic disorders that can be diagnosed and treated
early in life.

Espiritu, Gizzi Asbelle P.

 V. Prevention of genetic alteration and in the care of clients seeking services
before and during conception.

Commit to Healthy Choices to Help Prevent Birth Defects:

1. Plan ahead
Get 400 mcg of Folic acid everyday, a vitamin B.
See a healthcare professional regularly.

2. Avoid harmful substances.

Avoid alcohol at any time during pregnancy.
Avoid smoking cigarettes.
Avoid marijuana and other drugs.
Prevent infections.
Avoid overheating and treat fever promptly.

3. Choose a healthy lifestyle

Keep Diabetes under control.
Strive to reach and maintain a healthy weight.

4. Talk with your health care provider.

Talk to health care providers about taking any medications.
Talk to a healthcare provider about vaccinations (shots).

Common Tests During Pregnancy

First Trimester Prenatal Screening Tests

First trimester screening is a combination of fetal ultrasound and maternal blood testing performed
during the first trimester of pregnancy. This screening process can help to determine the risk of the
fetus having certain birth defects. Screening tests may be used alone or in combination with other
tests.
There are three parts of first trimester screening:
Ultrasound test for fetal nuchal translucency (NT)
Nuchal translucency screening uses an ultrasound test to examine the area at the back of the fetal
neck for increased fluid.
two maternal serum (blood) tests
o pregnancy-associated plasma protein screening (PAPP-A) - a protein produced by the
placenta in early pregnancy. Abnormal levels are associated with an increased risk for chromosome
abnormality.
o human chorionic gonadotropin (hCG) - a hormone produced by the placenta in early
pregnancy. Abnormal levels are associated with an increased risk for chromosome abnormality.

Espiritu, Gizzi Asbelle P.

 When used together as first trimester screening tests, nuchal translucency screening and maternal
blood tests have a greater ability to determine if the fetus might have a birth defect, such as Down
syndrome, trisomy 18, or trisomy 13.
If the results of these first trimester screening tests are abnormal, genetic counseling is recommended.
Additional testing such as chorionic villus sampling or amniocentesis may be needed for accurate
diagnosis.

Second Trimester Prenatal Screening Tests

Second trimester prenatal screening may include several blood tests, called multiple markers. These
markers provide information about a woman's risk of having a baby with certain genetic conditions or birth
defects. Screening is usually performed by taking a sample of the mother's blood between the 15th and 20th
weeks of pregnancy (16th to 18th is ideal).

The multiple markers include:

Alpha-fetoprotein screening (AFP) - a blood test that measures the level of alpha-fetoprotein in the
mothers' blood during pregnancy. AFP is a protein normally produced by the fetal liver and is present in
the fluid surrounding the fetus (amniotic fluid), and crosses the placenta into the mother's blood. The
AFP blood test is also called MSAFP (maternal serum AFP).

Abnormal levels of AFP may signal the following:

o open neural tube defects (ONTD) such as spina bifida
o Down syndrome
o other chromosomal abnormalities
o defects in the abdominal wall of the fetus
o twins - more than one fetus is making the protein
o a miscalculated due date, as the levels vary throughout pregnancy

hCG - human chorionic gonadotropin hormone (a hormone produced by the placenta)

estriol - a hormone produced by the placenta.
inhibin - a hormone produced by the placenta.

Abnormal test results of AFP and other markers may indicate the need for additional testing. Usually an
ultrasound is performed to confirm the dates of the pregnancy and to look at the fetal spine and other body
parts for defects. An amniocentesis may be performed to assess for elevated amniotic fluid levels of AFP
and other chemicals which may indicate the presence of spina bifida.
Multiple marker screening is not diagnostic. It is only a screening test to determine who in the population
should be offered additional testing for their pregnancy. There can be “false positive” results, indicating a
problem when the fetus is actually healthy. There can also be “false negative” results, indicating a no
abnormality when the fetus actually does have a health problem.
When a woman has both first and second trimester screening tests performed, the ability of the tests to
detect an abnormality is greater than using just one screening independently. Over 80 percent of fetuses
affected with Down Syndrome can be detected when both first and second trimester screening are used.

Espiritu, Gizzi Asbelle P.

 Activity 1.1

Instruction: Please choose the letter which represents the best answer:

1. The moral obligation of parents to have the healthiest children through all natural and artificial
means available.
a. Health c. Procreative Health
b. Procreation d. Creation

2. Which classifications of family based is NOT on internal organization?

a. Conjugal family c. Extended family
b. Nuclear family d. Matrilineal family

3. Which of the following is NOT included on three different patterns of inheritance?

a. Autosomal dominant c. Sex linked recessive
b. Sex linked dominant d. Autosomal recessive

4. This screening process can help to determine the risk of the fetus having certain birth defects.
a. First trimester screening c. Third trimester prenatal screening
b. Second trimester prenatal screening d. Fourth trimester prenatal screening

5. These markers provide information about a woman's risk of having a baby with certain genetic
conditions or birth defects.
a. First trimester screening c. Third trimester prenatal screening
b. Second trimester prenatal screening d. Fourth trimester prenatal screening

Answer Key:
1. c. Procreative health
2. d. Matrilineal family
3. b. Sex linked dominant
4. a. First trimester screening
5. b. Second trimester prenatal screening

Espiritu, Gizzi Asbelle P.

References:

https://www.slideshare.net/ballplayer23/care-of-the-mother-child-and-family-ncm-101?
qid=fb7ccfb7-2c1e-41d7-9cfd-d15d186ba9d8&v=&b=&from_search=2
https://www.scribd.com/document/59823553/Procreative-Health-is-the-Moral-Obligation-
of-Parents-to-Have-the-Healthiest-Children-Through-All-Natural-and-Artificial-Means-
Available

https://www.childrenshospital.org/conditions-and-treatments/conditions/g/genetic-disorders/diagnosis-and-
treatments

https://www.cdc.gov/ncbddd/birthdefects/prevention.html

https://www.slideshare.net/Ritu_A/genetic-disorders-61218866

https://contemporaryfamilylife-pnu.weebly.com/types-and-forms-of-families.html

Espiritu, Gizzi Asbelle P.