LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
08/ 15
NCM 107 | CONCEPT OF UNITIVE
PROCREATIVE HEALTH
UNITIVE
• Union of two individuals that is mutually
agreed to become one
PROCREATIVE
• Create and produce another life
• Thus, unitive, and procreative are sacred
MARRIAGE
• Man and woman unite as one flesh (sex is
unitive)
• Needs to be open to possibility of having
children (sex is procreative)
SEXUAL RELATIONSHIP IN MARRIAGE HAS TWO
PURPOSES
1. Strengthen the couple and allows them to
express their love in a powerful way
(unitive)
2. Leads to the creation of new life
(procreation)
SEXUALITY | the whole you
• Is the totality of each individual’s
personhood
• This encompasses the individual’s total
personality, way of thinking, behaving,
loving, and relating with God and other
individuals
BEING ABLE TO TALK OPENLY AND HONESTLY
ABOUT SEXUALITY WILL
1. Help us sort our feelings
2. Develop our own personal sexual
standards
3. Enable us to understand others point of
view
4. Obtain information needed to make
responsible sexual decisions
Ignorance on sexuality or lack of information
about your body can also cause disappointments
and inability to give and receive sexual pleasure
• Our body is a gift from God | it is
something to be appreciated and should
not be ashamed of
Sophia Lynre Celestial
Human sexuality is defined as the characteristics
AND that make a man, a man, or a woman, a woman
• Include the man or woman’s capability for
sexual feelings and behavior
• Includes his or her total personality
(personality encompasses individuals
characteristics)
Human sexuality is complex, it goes beyond mere
physical expressions and sexual organs
5 MAJOR COMPONENTS
1. BIOLOGICAL SEX – this pertains to being
a male or female; includes biological
concerns on reproductive anatomy and
physiology
• Humans have 2 sexes – male and female
• Men’s sperm has 2 types of chromosomes
(X and Y) that determines the sex of the
baby | XX – female; XY – male
2. SEXUAL ORIENTATION – sexual
preference of an individual with regards
to the sex of a person he/ she is attracted
to or the sex of his/ her partner in a
sexual relationship
• Many scientists share the view that sexual
orientation is shaped for most people at
an early age through complex interactions
of biological, psychological, and social
factors (these 3 interacts with each other
to shape one’s sexual orientation thus
early age is a critical age)
3. SEXUAL IDENTITY (body image) – this
pertains to a person’s feelings about the
body and being a man or woman
• It includes concerns on relationships and
intimacy, sexual response, sexual
awakening, and other sexual concerns,
such as frigidity and impotence
• Two major questions associated with
sexual identity
a. Who am I sexually?
b. How do I relate to others as a sexual
partner?
4. GENDER IDENTITY – psychological sense
of being male or female, and personal
and or social norms for feminine or
masculine behavior
1
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

a.Is about an individual’s sex roles – social • For male

norms and values that develop the a. Distention of the penis
relative power, responsibilities, and b. Heart rate increases to 100 to 175 beats
behavior of women and men per minute
b. Prescribed gender roles, however, can be c. RR 40 per minute
influenced and changed 3. Orgasm (shortest stage)
5. VALUES AND ATTITUDES, FEELINGS, AND • Usually experienced as intense pleasure
EMOTIONS – about life, love, and people affecting the whole body | highly
each individual life has touched personal experience: descriptions of
HUMAN SEXUAL RESPONSE orgasms vary greatly from person to
• Sexual experience is unique to each person
individual but sexual physiology has • Occurs when stimulation proceeds
common features through the plateau stage at which the
SEXUAL RESPONSE CYCLE: 4 STAGES body suddenly discharges accumulated
1. Excitement sexual tension
2. Plateau • Vigorous contraction of muscles in the
3. Orgasm pelvic area; expels or dissipates blood
4. Resolution and fluid from the area of congestion
a. For female: average number of
1. Excitement contractions: 8 to 15 at intervals of 1 q
• Occurs with physical and psychological 0.8 seconds
stimulation b. For male: muscle contraction surrounding
the seminal vessels and prostate project
semen-followed by 3 to 7 propulsive
ejaculatory contractions
4. Resolution
• The period during which the external and
internal genital organs return to an
unaroused state
• For female • For female
a. Clitoris increases in size a. Do not go through this refractory period;
b. Mucoid fluid to appear on vaginal walls possibly for women who are interested
as lubrication and properly stimulated to have
c. Vagina widens in diameter and increase additional orgasms immediately after the
in length first
d. Nipples become erect • For male
• For male a. Refractory period occurs during which
a. Penile erection scrotal thickening further orgasm is possible
b. Elevation of testes • Here, both men and women have a 30-
• For both sexes – increase in heart and minute resolution period
respiratory rates and blood pressure
2. Plateau
• Is reached before orgasm MATERNAL CHILD NURSING | anatomy and
• For female physiology; male and female reproductive system
a. Clitoris is drawn forward and retracts
under the clitoral prepuce
b. Lower part of vagina becomes extremely
congested
c. Increase nipple elevation

Sophia Lynre Celestial 2

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
FEMALE REPRODUCTIVE SYSTEM; GENITALS
a. VULVA – the outer genital area; includes
the clitoris, the labia majora, and labia
minora
b. CLITORIS – most sensitive part of the
genital area; a pea shaped organ that’s
full of nerve endings since its only
purpose is to provide sexual pleasure
c. LABIA MAJORA (outer lips) – surrounds
the opening to the vagina; made out of
fatty tissue that cushions and protects the
vaginal opening | between these outer
lips are labia minora
d. LABIA MINORA (inner lips) – sensitive to
sexual pleasure; as they are stimulated,
they get deeper in color and swell
e. VAGINA – a muscular tunnel that
connects the uterus to the outside of the
body; provides an exit for the menstrual
fluid; and an entrance for the semen
f. UTERUS (the so-called womb) – place
where the fertilized egg grows and
develops into a baby during pregnancy; a
hollow organ shaped like a pear and
most of the time it is relatively small,
about the size of a fist | largest organ in
the female reproductive system; best
place where the baby grows; on both
sides of the uterus are pouches called
ovaries
g. OVARIES – contain unfertilized eggs or
ova; when one of these ova (called an
ovum) unites with a man’s sperm, it is
fertilized and may eventually produce a
child
• Semen – contains sperm
• No ova, no fertilization thus no pregnancy
Sophia Lynre Celestial
h. CERVIX – narrow opening of the vagina;
helps to protect the uterus from outside
contaminants; connection between the
uterus and the vagina
i. FALLOPIAN TUBE – an important
passageway for an egg and a sperm to
meet and for a fertilized egg (embryo) to
make its way to your uterus
• These are narrow tubes that are attached
to the upper part of the uterus and serve
as pathways for the ova (egg cells) to
travel from the ovaries to the uterus
j. PELVIS (bony pelvis or pelvic girdle) – it
is a basin-shaped structure that supports
the spinal column and protects the
abdominal organs; lower part of the
torso; located between the abdomen and
the legs; bony part that will take part
during pregnancy; abdominal organs are
protected by this
PELVIC DIVISIONS
1. FALSE PELVIS
• Shallow upper basin of the pelvis
• Supports the enlarging uterus but not
important obstetrically
2. LINEA TERMINALIS
• Plane dividing upper of false pelvis from
lower or true pelvis
3. TRUE PELVIS
• Consists of the pelvic inlet, pelvic cavity,
and pelvic outlet
• Bony canal through which the infant pass
• Measurements of true pelvis influence the
conduct and progress of labor and
delivery
3
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

1. They produce, maintain, and transport

sperm (the male reproductive cells) and
semen (the protective fluid around sperm)
2. They discharge sperm into the female
reproductive tract
3. They produce and secrete male sex
hormones

MALE EXTERNAL STRUCTURES

TYPES OF PELVIS
1. GYNECOID – normal female pelvis, well-
rounded, and most favorable for
successful labor and birth
2. ANDROID – wedge-shaped or angulated;
seen normal in males; not favorable for
labor
3. ANTHROPOID – oval shaped and the
outlet is adequate with a normal or
narrow pubic arch (vertically longer)
4. PLATYPELLOID – flat in shape with an
oval inlet (horizontally longer)
MALE REPRODUCTIVE SYSTEM; GENITALS
(external and internal divisions)
• Includes a group of organs that make up
a man’s reproductive and urinary system
| these organs do the following jobs
within your body:
a. TESTICLES (pl. testes) – are encased in
the scrotal sac, the testes are oval organs
about the size of very large olives that lie
in the scrotum, secured at either end by a
structure called the spermatic cord |
responsible for making testosterone, the
primary male sex hormone, and for
producing sperm
b. SCROTUM (holds the testicles, also called
as testes) – rugated, skin-covered,
muscular pouch suspended from the
perineum
• Supports the testes to help regulate the
temperature of the sperm
• Special muscles in the wall of the scrotum
allow it to contract (lighten) and relax,
moving the testicles closer to the body
for warmth and protection or farther away
from the body to cool the temperature
c. PENIS – male organ for sexual
intercourse; contains many sensitive
nerve endings
• The opening of the urethra – the tube
that transports both semen and urine out
of the body is located at the tip of the
glans penis
• Semen (contains sperm) is expelled
(ejaculated) through the end of the penis
when a man reaches sexual climax
(orgasm); when the penis erect, the flow
of urine is blocked from the urethra,
allowing only semen to be ejaculated at
orgasm

Sophia Lynre Celestial 4

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
• Hypospadias – abnormal opening on the
bottom of the urethra
• Epispadias – abnormal opening on the
top of the urethra
d. EPIDIDYMIS – long, coiled tube that rests
on the backside of each testicle; it carries
and stores sperm cells that are created in
the testes
• Brings the sperm to maturity – the sperm
that emerge from the testes are immature
and incapable of fertilization; during
sexual arousal, contractions force the
sperm into the vas deferens
MALE INTERNAL STRUCTURES
a. VAS DEFERENS – long, muscular tube
that travels from the epididymis into the
pelvic cavity, to just behind the bladder |
transports mature sperm to the urethra in
preparation for ejaculation
b. EJACULATORY DUCTS – are formed by
the fusion of the vas deferens and the
seminal vesicles; the ejaculatory ducts
empty into the urethra
c. URETHRA – tube that carries urine from
the bladder to outside of your body | in
males, it has the additional function of
expelling (ejaculating) semen when you
reach orgasm; expels urine and semen
d. SEMINAL VESICLES – sac-like pouches
that attach to the vas deferens near the
base of the bladder
• Make a sugar-rich fluid (fructose) that
provides sperm with a source of energy
and helps with the sperms’ ability to
move (motility); the fluid of the seminal
vesicles makes up most of the volume of
your ejaculatory fluid or ejaculate | no
fructose, sperm cannot meet the ovum
e. PROSTATE GLAND – a walnut-sized
structure that’s located below the urinary
bladder in front of the rectum
Sophia Lynre Celestial
• Contributes additional fluid to the
ejaculate; prostate fluids also help to
nourish the sperm
• The urethra, which carries the ejaculate to
be expelled during orgasm, runs through
the center of the prostate gland
• These glands produce a clear, slippery
fluid that empties directly into the
urethra; this fluid serves to lubricate the
urethra and to neutralize any acidity that
may be present due to residual drops of
urine in the urethra
f. BULBOURETHRAL GLANDS (Cowper’s
glands) – are pea-sized structures located
on the sides of the urethra, just below the
prostate gland
08/ 23
NCM 107 | PHYSIOLOGY OF MENSTRUATION
Four body structures are involved:
a. Hypothalamus
b. Pituitary gland
c. Ovaries
d. Uterus
• All structures must contribute their part
to complete the menstrual cycle
• Inactivity of any part, incomplete/
ineffective cycle
a. HYPOTHALAMUS
• The release of GnRH (Gonadotropin-
releasing hormone) (also called luteinizing
hormone releasing hormone or LHRH) by
the hypothalamus initiates the menstrual
cycle
• When the levels of estrogen (produced by
the ovaries) rises, release of the hormone
is repressed thus no menstrual cycle
b. PITUITARY GLAND
• Under the influence of the GnRH
(Gonadotropin-releasing hormone), the
anterior lobe of the pituitary gland
produces two hormones that act on the
ovaries to further influence menstrual
cycle
1. FSH – active in early cycle; responsible for
maturation of the ovum
5
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
2. LH – most active at the midpoint of the
cycle; responsible for ovulation, or release
of the mature egg cell from the ovary;
growth of the uterine lining during the
second half of the menstrual cycle
c. OVARY
• One of the ovary’s primordial follicles is
activated by FSH to begin to grow and
mature – at the stage of maturation it is
termed as Graafian follicle
• After the upsurge of LH from the
pituitary, prostaglandins are released and
the Graafian follicle ruptures (termed as
Corpus Luteum)
• The ovum is set free from the surface of
the ovary, a process termed as ovulation
d. UTERUS
• Stimulation from the hormones produced
by the ovaries causes specific monthly
effects on the uterus
MENSTRUAL CYCLE
• Begins on the first day of menstrual
bleeding and ends on the day before the
next menstrual bleeding begins again
• Menstrual bleeding is due to the
shedding of the uterine lining previously
prepared for implantation, indicating that
no implantation has occurred
• When the menstrual bleeding begins,
several eggs have begun to grow in the
ovaries
• The fertility cycle of a women varies in
length from below 24 days (short cycle),
Sophia Lynre Celestial
within 25-35 days (average cycle), to
more than 36 days (long cycle)
• The post-ovulatory days are usually fixed
in all of these cycles (11 – 16 days)
• It is the pre-ovulatory days that vary in
length
PHASES OF THE MENSTRUAL CYCLE
a. MENSTRUAL PHASE
• The first day of the cycle is the first day of
menstruation
• Includes all days of menstrual bleeding
• Bleeding: the shredding of the thickened
uterine lining
b. MENSTRUAL PHASE
• During menstruation: ovaries are resting,
cervix is open
• Basal body temperature is low, 36 to
35.5 degree Celsius when a drop in
estrogen and progesterone occurs
• Menstrual flow contains approximately
30-80 ml of blood (Marieb | 50-150 ml)
• Iron loss approximately 11 mg – need to
take iron supplement to prevent iron
depletion
c. PROLIFERATIVE PHASE (also called as
estrogenic, follicular, and postmenstrual)
• Immediately after a menstrual flow
endometrium or lining of the uterus, is
very thin (1 cell layer in depth)
• As the ovary begins to produce estrogen
(produced by the growing follicles) – the
endometrium begins to proliferate
• This growth is very rapid and increases
the thickness of the endometrium
approximately eightfold
d. SECRETORY PHASE (also known as luteal,
pre-menstrual, and progestational phase)
• Rising levels of progesterone production
by the corpus luteum of the ovary act on
the estrogen-primed endometrium and
increase its blood supply even more
• Progesterone causes the endometrium to
increase in size and to begin to secreting
nutrients into the uterine cavity (e.g.,
glycogen and mucin – proteins)
• Capillaries of the endometrium increase in
amount until the lining takes on the
appearance of rich, spongy velvet
6
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
e.ISCHEMIC PHASE
• If fertilization does not occur, corpus
luteum degenerates after 8 to 10 days
• As it regresses, the production of
estrogen and progesterone decreases
• With the withdrawal of progesterone
stimulation, the endometrium of the
uterus begins to degenerate (approx. day
24 or day 25 of the cycle)
• The capillaries rupture, with minute
hemorrhages, and the endometrium
sloughs off
CHARACTERISTICS OF A NORMAL CYCLE
• Average age of onset is about 12.4 years
average range 9-17 years old
• Average cycle is 28 days; cycles 23-35
days in length not unusual
• Duration of the average flow is 2-7 days
• Average amount of menstrual flow is 30-
80 ml per menstrual period | saturating
pad in less than an hour is heavy
bleeding
• Color is dark red (blood, mucus, and cells)
• Odor resembles a marigold flower
PROBLEMS IN MENSTRUATION
• Dysmenorrhea – painful menstruation
• Amenorrhea – absence of menses
• Menorrhagia – excessive blood flow
• Metrorrhagia – bloody vaginal discharge
between periods (spotting)
INDICATIONS OF OVULATION
• Occurs 12-14 days before the onset of
the next menses
• Uterine lining continues to thicken ready
to receive the fertilized egg
• Slight drop of temperature about 0.5
degree Celsius
• Cervical mucus is abundant, wet, slippery,
stretchy and clear | this mucus helps
sperms live and swim to reach the egg; it
nourishes the sperms
• Vaginal sensation is wet
• Cervical os (the opening in the cervix at
each end of the endocervical canal)
dilates slightly and soft
• Estrogen drops a bit, but remains high
• Progesterone begins to rise
Sophia Lynre Celestial
• Spinnbarkeit test also known as fibrosity
(it can be stretched into long strands) and
fern test (cervical mucus forms fernlike
patterns)
CONCEPTION
1. Natural conception – interaction of many
factors including:
a. Correct timing between release of mature
ovum at ovulation
b. Ejaculation of enough healthy, mature,
motile sperm into the vagina | although
exact viability is unknown, the ovum may
survive no longer than 24 hours after its
release at ovulation
• Most sperm survive no more than 24
hours in the female reproductive tract
• Although few may remain fertile in the
woman’s reproductive tract for as long as
5 days (Guyton and Hall, 2000)
PREPARATION FOR CONCEPTION-FEMALE
• Before ovulation, several oocytes begin to
mature under the influence of:
1. FSH (follicle-stimulating hormone); and
2. LH (luteinizing hormone) from the
woman’s anterior pituitary gland
• Each maturing oocytes is contained within
a sac called the graafian follicle, which
produces estrogen and progesterone to
prepare the endometrium for possible
pregnancy
RELEASE OF THE OVUM
• Ovulation occurs approx. 14 days before
next menstrual period would begin
• The follicle develops a weak spot on the
surface of the ovary and ruptures,
releasing the mature ovum with its
surrounding cells onto the surface of the
ovary
• The collapsed follicle is transformed into
the corpus luteum, which maintains high
estrogen and progesterone secretion for
final preparation of the uterine lining for
a fertilized ovum
OVUM TRANSPORT
• Mature ovum is released where it is
picked up by the fimbriated (fringed) ends
of the fallopian tube
• Ovum – transported through the tube by:
7
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
1. Muscular action of the tube; and
2. Movement of cilia within the tube
• Fertilization normally occurs in the distal
third of the fallopian tube (ampulla)
• The ovum, fertilized or not, enters the
uterus approx. 3 days after its release
from the ovary
PREPARATION FOR CONCEPTION-MALE
• Includes:
1. Ejaculation;
2. Movement of the sperm in the female
reproductive tract; and
3. Preparation of the sperm for actual
fertilization
EJACULATION
• When male ejaculates, average of 2.5 ml
semen containing 50-200 million (40-
250 million) sperm/ ml
• The sperm are suspended in 2 to 5 ml of
seminal fluid (average: 2.5 ml) which:
1. Nourishes; and
2. Protects the sperm from acidic
environment of the vagina (Blackburn,
2003)
• Many sperm are lost as the ejaculate
drips from the vaginal introitus
• Other sperm are inactivated by acidic
vaginal secretions
• Or digested by vaginal enzymes and
phagocytes
• The seminal fluid coagulates slightly after
ejaculation to hold the semen deeply in
the vagina
• Many sperm are relatively immobile for
approx. 15 to 30 minutes until other
seminal enzymes dissolve the coagulated
fluid and allow the sperm to begin
moving upward through the cervix
TRANSPORT OF SPERM IN THE FEMALE
REPRODUCTIVE TRACT
• Whiplike movement of the tails of
spermatozoa propels them through the
cervix, uterus, and fallopian tubes
• Only sperm cells enter the cervix; the
seminal fluid remains in the vagina
PREPARATION OF SPERM FOR FERTILIZATION
Sophia Lynre Celestial
• Sperm does not immediately ready to
fertilize the ovum when they are
ejaculated
• During the trip to the ovum, the sperm
undergo changes that enable one to
penetrate the protective layers
surrounding the ovum, a process called
capacitation
CAPACITATION
• During capacitation, a glycoprotein coat
and seminal proteins are removed from
the acrosome (tip of the sperm head)
• After capacitation, the sperm look the
same but are more:
1. Active; and
2. Can better penetrate the corona radiata
and zona pellucida surrounding the ovum
• Sperm also undergo an acrosome
reaction to further prepare them to
fertilize the ovum
• Sperm that reach the ovum release:
1. Hyaluronidase
2. Acrosin
• To digest a pathway through the corona
radiata and zona pellucida
• Their tails beat harder to propel them
toward the center of the ovum
• Eventually, 1 spermatozoon penetrates
the ovum
FERTILIZATION (e.g., conception, impregnation, or
fecundation)
• Is the union of an ovum and a
spermatozoon
• Usually occurs in the outer third of a
fallopian tube, the ampullar portion
• Usually only one ovum reaches maturity
each month
• Once it is released, fertilization must
occur fairly quickly because an ovum is
capable of fertilization for only 24 hours
(48 hours at the most)
• After that time, it atrophies and becomes
nonfunctional
• Because the functional life of a
spermatozoon is about 48 hours,
possibly as long as 72 hours, the total
critical time span during which sexual
relations must occur for fertilization to be
8
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

successful is about 72 hours (48 hours

before ovulation plus 24 hours afterward)
CONDITIONS FOR FERTILIZATION
• Live, motile, and normal sperm
• Semen is supportive to pregnancy
• Fallopian tube patent
• Female hormones are present
IMPLANTATION
• Fertilization takes place in the ampulla
• Zygote formation 12-14 days after
fertilization EMBRYONIC STAGE
• The zygote (fertilized ovum) takes 3-4 Week I
days to enter the uterus • Zygote formation
• It takes 7-10 days to complete the • Free flowing blastocysts
process of nidation or implantation Week III
2 FETAL (two chorioamniotic) MEMBRANES • 2 mm. in length
1. Amnion – inner membrane • Midline of the back are formed
2. Chorion – outer membrane • Heart is beginning to beat
Week V
• 4-6 mm. in length
• 4 g in weight
• Budding of limbs occur
Week VI
• 3 cm. in length
• 2 g in weight
• Eyelids begin to appear
Week VIII
• 8 cm. in length
•The two membranes are so close as to be • 45 g in weight
one (the bag of waters), but they can be • Face well formed
separated • Spontaneous movement occur
• If the membranes rupture in labor, FETAL CIRCULATION
amnion and chorion usually rupture • As early as the third week of intrauterine
together, releasing the amniotic fluid life, fetal blood begins to exchange
within the sac nutrients with the maternal circulation
DEVELOPMENTAL STAGE across the chorionic villi
1. Zygote • Fetal circulation differs from extrauterine
• 12-14 days after fertilization circulation in several aspects
• Time the ovum is fertilized until implanted • During intrauterine life, the fetus derives
in the uterus O2 and excretes CO2 not from O2
2. Embryo exchange in the lungs but from the
• 3-8 weeks after fertilization placenta
• Most vulnerable to teratogens • Blood does enter the blood vessels of the
3. Fetus lungs (utero) but this blood flow is to
• 9 weeks from fertilization to term supply the cells of the lungs themselves,
• Up to 38-42 of gestation not for O2 exchange

Sophia Lynre Celestial 9

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
• Blood arriving at the fetus from the
placenta is highly oxygenated
• Then, this blood enters the uterus thru
the umbilical vein (called vein even
though it carries oxygenated blood
because the direction of the blood is
toward the fetal heart)
• This vein carries the blood to the inferior
vena cava thru the ductus venosus, which
allows oxygenated blood to be supplied
directly to the fetal liver
• Oxygenated blood then empties into the
inferior vena cava
• Carried to the right side of the heart
(right atrium of the heart)
• Because there is no need for the bulk of
blood to pass thru the lungs since fetal
lungs are nonfunctional, it is shunted, as
it enters the right atrium, into the left
atrium thru the opening in the atrial
septum, called the foramen ovale
• From the left atrium, it follows the course
of normal circulation into the left ventricle
and into the aorta
• A small amount of blood that returns to
the heart via the vena cava does leave the
right atrium by the adult circulatory route;
that is, thru the tricuspid valve into the
right ventricle and then into the
pulmonary artery and lungs to service the
lung tissue
• However, the larger the portion of even
this blood is shunted away from the lungs
thru the additional structure, the ductus
arteriosus, directly into descending aorta
• Most of the blood flow from the
descending aorta is transported by the
umbilical arteries (called arteries, even
though they are now transporting
deoxygenated blood, because they are
carrying blood away from the fetal heart)
• Back through the umbilical cord to the
placental villi, where new oxygen
exchange takes place
FETAL DEVELOPMENT AT 4 WEEKS
• At this point of development, the
structures that eventually form the face
and neck are becoming evident
Sophia Lynre Celestial
• The heart and blood vessels continue to
develop
• And the lungs, stomach, and liver start to
develop
• A home pregnancy test is now positive
FETAL DEVELOPMENT AT 8 WEEKS
• The baby is now a little over half an inch
in size
• Eyelids and ears are forming, and the tip
of the nose is visible
• The arms and legs are well formed
• The fingers and toes grow longer and
more distinct
FETAL DEVELOPMENT AT 12 WEEKS
• The fetus measures about 2 inches and
starts to make its own movements
• You may start to feel the top of your
uterus above the pelvic bone
• Your doctor may hear the baby’s
heartbeat with special instruments
• The sex organs of the baby should start
to become clear
FETAL DEVELOPMENT AT 16 WEEKS
• The fetus now measures about 4.3 to 4.6
inches and weighs about 3.5 ounces
• The top of your uterus should be felt
about 3 inches below your belly button
• The baby’s eyes can blink, and the heart
and blood vessels are fully formed
• The baby’s fingers and toes should have
fingerprints
FETAL DEVELOPMENT AT 20 WEEKS
• The baby weighs about 10 ounces and is
a little over 6 inches long
• Your uterus should be at the level of your
belly button
• The baby can suck a thumb, yawn,
stretch, and make faces
• Soon, if you haven’t already, you will feel
your baby move, which is called
quickening (first fetal movement)
TIMES FOR AN ULTRASOUND
• An ultrasound is generally performed for
all pregnant women at 20 weeks of
gestation
10
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
• The baby’s heartbeat and movement of
its body, arms, and legs can also be seen
on the ultrasound
• The gender of the baby can usually be
determined at 20 weeks
FETAL DEVELOPMENT AT 24 WEEKS
• The fetus weighs about 1.4 pounds now
• It responds to sounds by moving or
increasing its pulse
• You may notice jerking motions if it
hiccups
• With the inner ear fully developed, it may
be able to sense being upside down in
the womb
FETAL DEVELOPMENT AT 28 WEEKS
• The fetus weighs about 2 pounds 6
ounces
• It changes position frequently at this
point in pregnancy
• There’s a good chance of survival if your
baby is born prematurely now
a. Ask your doctor about preterm labor
warning signs
b. Register for birthing classes; birthing
classes prepare you for many aspects of
childbirth, including labor, and delivery
and parenting the newborn
FETAL DEVELOPMENT AT 32 WEEKS
• Often moving, the fetus weighs almost 4
pounds
• Baby’s skin has fewer wrinkles as a layer
of fat starts to form under the skin
• It will gain up to half its birth weight
between now and delivery
FETAL DEVELOPMENT AT 36 WEEKS
• Babies differ in size, depending on many
factors (such as gender, the number of
babies being carried, and the size of the
parents) so your baby’s overall rate of
growth is as important as the actual size
• On average, it’s about 18.5 inches and
weighs close to 6 pounds
• Brain has been developing rapidly
• Lungs are nearly fully developed
• Head is usually positioned down into the
pelvis by now
• A pregnancy is considered at term once
37
Sophia Lynre Celestial
BIRTH
• A mother’s due date marks the end of her
40th week
• Pregnancy can last between 38 and 42
weeks with a full-term delivery occurring
around 40 weeks
• Some post-term pregnancies – those
lasting more than 42 weeks – are not
truly post-term
• A common cause is an incorrect due date,
for safety reasons, most babies are
delivered by 42 weeks, inducing labor if
necessary
ESTIMATED DATE OF CONFINEMENT (EDC)
1. Naegele’s rule – count back 3 months
from the first day of LMP and add seven
and one year (-3+7+1)
2. Ultrasonography – estimates fetal age
from head measurements
3. Fundal height – measurement of fundal
height from the top of symphysis pubis to
the top of the fundus with a flexible, non-
stretchable tape measure; used as a gross
estimate of dates
• Above the level of symphysis (between
12-14 weeks)
• At the umbilicus (20 cm, about 20 weeks)
• Rises about 1 cm/ week until 36, after
which it varies
09/ 13
NCM 107 | BIOPSYCHOSOCIAL ASPECTS OF
PREGNANCY
DETERMINATION OF PREGNANCY
• Diagnosis of pregnancy is based on
pregnancy-related physical and hormonal
changes and is classified as presumptive,
probable, or positive | we can only
diagnose if a patient is pregnant if we see
different hormonal or physical changes
unto a woman
PRESUMPTIVE SIGNS AND SYMPTOMS
• These changes may be noticed by the
mother/ health care provider but are not
conclusive for pregnancy
11
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023
------------------------------------------------------------------------------------------------------------------------------
a. Amenorrhea (cessation of menstruation)
b. Urinary frequency (6-12 weeks)
c. Breast changes
d. Skin changes | e.g., melasma or chloasma
- darker skin patches, linea nigra - dark
line that extends from your bellybutton to
your pubic area, and striae gravidarum -
atrophic linear scars)
e. Nausea and vomiting (5-12 weeks) | due
to increase of HCG (Human Chorionic
Gonadotropin)
f. Fatigue
g. Weight change
h. Vaginal changes including leukorrhea
(leukorrhea - flow of a whitish, yellowish,
or greenish discharge from the vagina of
the female that may be normal or that
may be a sign of infection)
i. Quickening (maternal perception of fetal
movement occurring between 16-20
weeks of gestation)
PROBABLE SIGNS AND SYMPTOMS (OBJECTIVE)
• These changes are usually noted by the
health care provider but are still not
conclusive for pregnancy | uterine
enlargement; changes in pelvic organs
1. CHADWICK’S SIGN – pinkish to violet
color; vagina
2. GOODELL’S SIGN – softening of the cervix
3. HEGAR’S SIGN – softening of the lower
uterine segment; uterus
• BALLOTTEMENT – fetus rebounds against
the examiner’s hand when pushed gently
upwards
• BRAXTON HICK’S CONTRACTIONS –
intermittent contractions of the uterus
occurring throughout pregnancy;
generally painless but may cause
discomfort late in pregnancy can be felt
by the 4th month of pregnancy | how to
know: palpate the abdomen; it is a mild
discomfort but not painful
• (+) HCG TESTS (hydatidiform moles – H
mole)
• UTERINE SOUFFLE – soft, blowing sound
at the rate of material pulse (cause by the
increased vascularity of pregnancy)
Sophia Lynre Celestial
POSITIVE SIGNS AND SYMPTOMS
• These signs emanate from the fetus, are
noted by the health care provider, and
are conclusive for pregnancy
a. FETAL HEARTBEAT – audible at 10-12
weeks gestation by Doppler ultrasound,
and 10-20 weeks gestation with a
fetoscope; the normal fetal heart rate is
120-160 bpm
b. FETAL MOVEMENTS – palpable by
examiner
c. Palpation of FETAL OUTLINE
ANTEPARTUM CARE
• Refers to the medical and nursing care
given to the pregnant woman between
conception and the onset of labor
• Consideration is given to the physical,
emotional, and social needs of the
woman, the unborn child, her partner,
and other family members
CLASSIFICATIONS OF PREGNANCY
• GRAVIDA – number of times pregnant,
regardless of duration, including the
present pregnancy
• PRIMAGRAVIDA – pregnant for the first
time
• MULTIGRAVIDA – pregnant for second or
subsequent time
• PARA – any woman who has given birth
once or more; a pregnancy to count as
“birth”; it must go to at least 20 weeks
gestation, regardless of outcome
• NULLIPARA – a woman who has not given
birth to a baby beyond 20 weeks
gestation
• PRIMIPARA – a woman who has given
birth to one baby more than 20 weeks
gestation
• MULTIPARA – a woman who has had two
or more births at more than 20 weeks
gestation | note: twins or triplets counted
as 1 para
12
 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

• TPAL – para subdivided to reflect births NUTRITION

that went to term, premature births,
abortions, and living children
• PRETERM – newborn born before 37
weeks of gestation
• TERM – newborn born after 37 weeks to
40 weeks of gestation
• POST-TERM – newborn born after 40
weeks of gestation
• Assess diet, note for malnutrition
• Teach minimum nutritional increases
• Record recommended weight gain
• Provide a copy of daily food guide
• Iron supplementation is needed
FETAL/ MATERNAL ASSESSMENT TECHNIQUES

OBTAIN THE FOLLOWING DATA EVALUATION OF FETAL WELL-BEING

• Medical history, obstetric history (TPAL), • FETAL HEART RATE – FHR usually
and history of current pregnancy (e.g., auscultated at the midline of suprapubic
has edema, thus have complication) region with Doppler ultrasound
• Vital signs transducer at 10-12 weeks gestation;
a. Temperature: 97-100-degree Fahrenheit normal FHR is 120-180 bpm | do the
b. P: 60-90 beats leopold’s maneuver first to determine the
c. R: 16-24 breaths position of the fetus; before locating the
d. BP: 90/ 60 – 140/90mmHg FHR; appropriate equipment is very
important
COMPLETE PHYSICAL EXAMINATION (so that • FUNIC SOUFFLE – caused by blood
appropriate management can be provided) | e.g., rushing through the umbilical arteries;
to avoid preeclampsia that complicates severely synchronous with the FHR
the mother and the baby during pregnancy • UTERINE SOUFFLE – caused by the sound
• Cardio-respiratory changes of blood passing through the uterine
• GIT changes vessels; synchronous with the maternal
• Renal system changes pulse
• Reproductive changes
• Skin changes 1. ULTRASONOGRAPHY – transducer on
• Skeletal changes abdomen transmit sound waves that
show fetal image on screen
• Metabolic/ endocrine changes
• Provide useful information when
PRENATAL CARE | SCHEDULE OF VISITS assessing fetal growth and well-being; it
provides direct information about the
• Every 4 weeks, up to 32 weeks
fetus during each trimester
• Every 2 weeks from 32-36 weeks (more a. Assessment of gestational age
frequently if problems exist) b. Evaluation for congenital anomalies
• Every week from 36-40 weeks c. Diagnostic evaluation of vaginal bleeding
d. Confirmation of suspected multiple
OBTAIN LABORATORY DATA gestation
• Hemoglobin and hematocrit e. Evaluation of fetal growth
• WBC and differential f. Adjunct to prenatal testing
• Pap smear (amniocentesis or chorionic villi sampling)
• Antibody screens
• Tuberculin skin testing PREPARATION
• Rh blood typing and urinalysis a. Client must drink fluids prior to test to
have full bladder to assist in clarity of
image

Sophia Lynre Celestial 13

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

b. No known harmful effects for fetus or b. A ratio between 1.5:1 and 1.9:1 – this
mother means that your baby may be at risk for
c. Noninvasive immature lungs and breathing problems
c. A ratio of more than 2:1 – this means
2. CHORIONIC VILLI SAMPLING that your baby has mature lungs and is
• Earliest test possible on fetal cells ready for life outside the uterus
alternative to amniocentesis to diagnose • Complications are premature labor,
fetal karyotype and genetic anomalies infection, Rh isoimmunization
(sickle-cell anemia, PKU, down syndrome, • Monitor fetus and uterine contractions
Duchenne muscular dystrophy) after procedure
• Done between 10-12 weeks; before 10 • Teach client to report deceased fetal
weeks, higher incidence of associated movements or increase abdominal
limb defects discomfort
• Complications are bleeding, spontaneous
abortion, premature rupture of PREPARATION
membranes a. Prior to procedure, the patient’s bladder
• Ultrasound used to guide; test results are should be emptied
usually out within 2-10 days b. Ultrasound used prior to procedure to
guide needle to prevent fatal and
3. AMNIOCENTESIS (skin-uterine wall- placental trauma
amniotic cavity) | to detect certain birth c. Test results are usually within 2-4 weeks
defects
• Used to determine fetal maturity and
detect certain birth defects such as down
syndrome, spinal bifida, hemolytic disease
of the newborn, sex and chromosomal
abnormalities
• Amniotic fluid is aspirated by a needle
which is inserted through the abdominal
wall and uterine walls
• Done at 16 weeks to assess L/S ratio
(Lecithin-Sphingomyelin) and detect
genetic disorder; possible after week 14
• This test measures the amount of 2
substances L/S found in the amniotic fluid
during pregnancy
• They are surfactants; without them, the
small air sacs in your lungs (alveoli) would 4. ALPHA-FETOPROTEIN SCREENING |
collapse
alpha-fetoprotein is a glycoprotein
• Test results are given as a ratio of lecithin produced by fetal yolk sac, GIT, and liver
to sphingomyelin; the range of results
• Maternal serum screens for open neural
are:
tube defects
a. A ratio of less than 1.5:1 – this means
• Test is done between 16-18 weeks
that your baby’s lungs are immature. If
gestation
born now, your baby may have breathing
problems • High levels indicate neural tube defects
and anencephaly and spinal bifida; also
associated with congenital nephrosis,
esophageal atresia, fetal demis

Sophia Lynre Celestial 14

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

HOW IS AN ALPHA-FETOPROTEIN TEST 8. CONTRACTION STRESS TEST

PERFORMED • Evaluates fetal response to stress of
• A healthcare professional will use a small labor; performed after 28 weeks
needle to withdraw blood from a vein, • Can be done either thru nipple
usually in your arm or hand stimulation or oxytocin stimulation
• A laboratory specialist will analyze the • For the preparation, woman in semi-
sample fowlers or side-lying position; monitor for
• Results are typically available within one post-test labor onset
to two weeks a. Positive result: late decelerations with at
least 50% of contractions; potential risks
5. PERCUTANEOUS UMBILICAL BLOOD to the fetus which may necessitate to C-
SAMPLING (an intrusive kind of section | abnormal and known as
evaluation; finding blood sample through positive window
the umbilical cord by inserting a sterile b. Negative results: no late decelerations
needle) with a minimum of 3 contractions lasting
• Involves inserting a needle into the fetal 40-60 seconds in 10-minute period |
umbilical cord and aspirating blood for normal and known as negative window
analysis
• The procedure is guided by U/ S and is 9. FETAL ACTIVITY DETERMINATION | kick
used to screen karyotypes counts
(chromosomes), examine antibodies for • Daily recording of fetal movements to
teratogenic viruses and provide assess active and passive fetal states
assessment for fetal blood transfusions • Non-invasive test done while pregnant
woman is side lying
6. ELECTRONIC FETAL HEART MONITORING • Interpretation of results:
• May be used to evaluate fetal status a. Normal or positive: 3 or more movements
• It can demonstrate FHR changes in felt in 1 hour (vary normally especially
response to fetal movement and during fetal sleep and activity)
spontaneous or induced uterine b. Abnormal or negative: 2 or less
contractions movements/ hour with marked decrease
• An increase in FHR with fetal movement from usual pattern of activity
indicates adequate oxygenation, a
functioning neural pathway to the heart MATERNAL ADAPTATIONS TO PREGNANCY
and the ability of the heart to respond to 1. FIRST TRIMESTER
stimuli • Ambivalence, fear, fantasies, and anxiety
• Pregnant woman places main focus on
7. NON-STRESS TEST self
• Tocodynamometer records fetal 2. SECOND TRIMESTER
movements and Doppler ultrasound • Tranquil period
measures fetal heart rate to assess fetal • Acceptance of the reality of pregnancy
well-being after 28 weeks • Increased interest in fetus
• For the preparation, patient should eat 3. THIRD TRIMESTER
snacks • Anticipates labor and delivery; assumes
• For the favorable results, 2 or more FHR mothering role
accelerations of 15 beats/ minute for 15 • Fantasies and dreams about labor
seconds or more occurring after fetal common
movements in a period of 20 minutes • Nestling behaviors

Sophia Lynre Celestial 15

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

DEVELOPMENTAL TASKS OF PREGNANCY 9-12 WEEKS (all systems are not developed yet
but are working)
“I AM PREGNANT” • Transparency of the heart in ultrasound
Acceptance of the biological fact of pregnancy • Weight is 19-28 grams
“I AM GOING TO HAVE A BABY” • Embryo becomes a fetus
Acceptance of the fetus as a distinct individual • Lower body develops
and a person to care for
• Very productive kidneys
“I AM GOING TO BE A MOTHER”
Prepare realistically for the birth and parenting of
a. MATERNAL CHANGES
the child
• The uterus rises above the pelvic brim
DANGER SIGNS OF PREGNANCY • Braxton hicks contractions are present
• Any bleeding from vagina • Potential for UTI increases
• Gush of fluid from vagina (clear, not • Weight gain 2.5 to 4 lbs. during the first
urine) trimester
• Regular contractions occurring before due • Placenta fully functioning and producing
date hormone
• Severe headaches or changes in vision • Goal: teach prevention of UTI; discuss
• Epigastric pain nutrition and exercise and effects of
pregnancy on sexual relationship
• Vomiting that persists and is severe
17-20 WEEKS
(hyperemesis gravidarum)
• Touch is important
• Change in fetal activity pattern
• Weight is 200-400 grams
• Temperature elevation, chills or sick
feeling • Eyebrows are present
• Swelling in upper body, especially face • Note for vernix
and fingers • Total body functioning
• Young hair present (lanugo)
MARKERS IN FETAL DEVELOPMENT 26-28 WEEKS
• The mother experiences increasing
8 WEEKS (abbrev. EIGHT) heartburn
• Ears develop • Weight is 1100 grams or 2.5 lbs.
• Increasing development of limb, brain, • Eyelids open
and facial features • Normal lung surfactant is formed
• Grams is 2 (Lecithin-Sphingomyelin)
• Heart begins to pump • Total discomfort is felt
• Tiny muscles • Young hair is abundant
• Encourage discussions about labor
a. MATERNAL CHANGES delivery
• Nausea and vomiting persists • Indicate period of rest
• Uterus changes from pear to globular • Good fetal outline
shape • Hearing is possible
• Leukorrhea increases • Treat hemorrhoids of the mother
• Ambivalence noted
• No noticeable weight gain a. MATERNAL CHANGES
• Goal: prevention of nausea, safety, and • The fundus is halfway between umbilicus
preparation for pregnancy and xiphoid
• Thoracic breathing observed

Sophia Lynre Celestial 16

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

• Woman is tired and eager to deliver COMMON DISCOMFORTS OF PREGNANCY |

• Heartburn begins RELIEVING THE COMMON DISCOMFORTS OF
• Hemorrhoids develop PREGNANCY
• Goal: treat hemorrhoids; teach comfort
measures; teach measures to avoid a. ANKLE EDEMA
heartburn; prepare for delivery and • Rest with your feet elevated
parenthood • Avoid standing for long periods of time
30-32 WEEKS • Avoid restrictive garments on the lower
• Height is 15-17 inches half of your body
• Indicate rest period
• Review signs of labor to the mother b. BREAST TENDERNESS
• Teach comfort measures • Wear a supportive bra
• You advise storage of Ca and Fe • Decrease the amount of caffeine and
carbonated beverages ingested since
• Teach childbirth process
caffeine causes discomfort and pain in the
• Weight is 1800-2200 grams breasts
a. MATERNAL CHANGES c. CONSTIPATION
• Breasts full and tender • Increase fiber in your diet
• Urinary frequency returns • Drink additional fluids
• Swollen ankles may occur • Have a regular time for bowel movements
• Sleeping problems may develop
• Dyspnea may develop d. FATIGUE
• Goal: decrease edema; teach comfort • Schedule rest periods daily; have a
measures; prepare for childbirth regular bedtime routine
38-40 WEEKS (full term) • Use extra pillow for comfort
• The average fetus is 360 mm in length
and weighs 3400-3600 grams e. FAINTNESS
• Has smooth skin • Move slowly
• Immunity for 6 months is present • Avoid crowds
• Restricted activity to the mother • Remain in a cool environment
• The chest is prominent • Lie on your left side when at rest
• You observe for lightening
• Eyes are uniformly slate colored f. HEADACHE
• Increasing bone ossification • Avoid eye strain
• Get ready for labor and delivery • Visit your eye doctor
• Has skill sutures nearly together • Rest with a cool cloth on your forehead
• Take Tylenol in a regular adult dose, as
a. MATERNAL CHANGES needed
• Placenta weigh approximately 20 oz. • Report frequent on persistent headaches
• Mother have burst of energy to your primary care provider
• Backache and urinary frequency increases
• Cervix and uterine segment prepare for g. HEARTBURN
labor • Eat small, frequent meals each day
• Goal: teach safety measures for delivery • Avoid overeating, as well as spicy, fatty,
and fried foods

Sophia Lynre Celestial 17

 LICEO DE CAGAYAN UNIVERSITY
Paseo del Rio Campus, Rodelsa Circle, Macasandig, Cagayan de Oro City
COLLEGE OF NURSING
2nd Year, 1st Semester A.Y. 2022-2023

------------------------------------------------------------------------------------------------------------------------------

h. HEMORRHOIDS o. VAGINAL DISCHARGE

• Avoid constipation and straining with a • Wear cotton underwear
bowel movement • Bathe daily
• Take a sitz bath; apply a witch hazel • Avoid tight pantyhose
compress
p. VARICOSE VEINS
i. LEG CRAMPS • Walk regularly; rest with feet elevated
• Avoid pointing your toes • Avoid long periods of standing
• Straighten your leg and dorsiflex your • Don’t cross your legs when sitting
ankle • Avoid knee-high stockings; wear support
hosiery
j. NAUSEA
• Eat 6 small meals/ day rather than 3 q. BACKACHE
• Eat a piece of dry toast or some crackers • Apply local heat
before getting out of bed • Avoid long periods of standing
• Avoid foods or situations that worsen the • Stoop to pick up objects
nausea; if it persist, report this problem • Tylenol in usual adult dose may help
to your primary care provider
• Wear low-heeled shoes
• Drink fluids separately rather than with
• Maintain correct posture
your meals
• Tailor sitting, pelvic rocking and shoulder
• Avoid fried, greasy, gas-producing, or
circling exercises strengthen back
spicy foods, and foods with strong odors
WEIGHT GAIN
k. NASAL STUFFINESS
• Variable but a total gain of 24-30 lbs. is
• Use cool air vaporizer or humidifier,
recommended
increase fluid intake, place moist towel on
a. 2-4 lbs. in the first trimester
the sinuses, and massage the sinuses
b. 11-14 lbs. in the second trimester
c. 8-11 lbs. in the third trimester (i.e., 0.5lb
l. ROUND LIGAMENT PAIN
weekly)
• Avoid twisting motions
• Gains mostly reflect maternal tissue in
• Rise to a standing position slowly and first half of pregnancy, and fetal issue in
use your hands to support the abdomen second half of pregnancy
• Bend forward to relieve discomfort
ANEMIA
m. SHORTNESS OF BREATH • Increase intake of foods high in iron |
• Use proper posture e.g., fish and dairy products, cereals and
• Use pillows behind head and shoulders at yellow vegetables, green leafy vegetables
night and citrus fruits, egg yolks and dried
fruits
n. URINARY FREQUENCY
• Void as necessary, at least every 2 hours VITAMIN DEFICIENCY
• Increase fluid intake • Increase intake of vitamins
• Avoid caffeine • Increase intake of Ca
• Practice Kegel exercises (contraction of • It is recommended that pregnant woman
the perineal area) drink one quart of milk per day

Sophia Lynre Celestial 18