MATERNAL NURSING

Q1. How she will be convinced to attend antenatal care and to deliver at the facility.

It's essential to address her concerns with empathy and factual information. Explanation
can be given that, attending antenatal care increases the chances of a safe and healthy
delivery for both her and the baby. Share statistics and benefits of hospital deliveries,
emphasizing the availability of medical expertise and necessary equipment in case of any
complications. Building trust and understanding her fears can help encourage her to make
an informed decision for the well-being of herself and her baby.

Some if the ways by which she can be convinced include:

 Expert medical care: Attending antenatal care in a hospital ensures that qualified
healthcare professionals monitor her pregnancy closely, providing expert guidance
and interventions if needed during the prenatal period.

 Emergency preparedness: Hospitals are equipped to handle any potential

complications that may arise during delivery. Having access to emergency facilities
and specialists increases the chances of a successful outcome for both the mother
and the baby.

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  Early detection and prevention: Regular antenatal visits help identify and address
any health issues early on, reducing the risk of complications and ensuring
appropriate management throughout the pregnancy.

 Access to advanced technology: Hospitals offer access to advanced medical

technology and diagnostic tools, which aid in accurately monitoring the baby's
development and detecting any potential problems.

 Postnatal care: Hospital deliveries allow for immediate postnatal care, ensuring
both the mother and baby receive essential medical attention, support, and guidance
during the crucial period after childbirth.

Q2A.

A primigravida, or a woman pregnant for the first time, can have a normal delivery if she
maintains a healthy lifestyle, follows her doctor's advice, attends prenatal classes, and has
no underlying medical complications that might require a cesarean section. It's important
to have regular check-ups and communicate openly with the healthcare provider to
increase the chances of a successful normal delivery.

Some other factors that can promote normal delivery include:

 Physiological Ability: Just like any woman, a primigravida has the potential to go
through a normal delivery as her body is designed to give birth. The female anatomy
and reproductive system are equipped for the process.

 Prenatal Education / antenatal care visit: It's important for primigravidas to attend
regular antenatal care visits, communicate openly with their healthcare providers,
and be aware of any risk factors that might affect their delivery. Early identification
and proper management of potential issues can improve the chances of a safe and
healthy childbirth. It’s also important to learn about childbirth, breathing
techniques, and pain management strategies. This knowledge can empower her to
cope effectively during labor and delivery.

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  Healthy Lifestyle: Maintaining a healthy lifestyle through proper nutrition, exercise,
and rest can contribute to a smoother pregnancy and birth experience. This can
reduce the likelihood of complications that might necessitate a cesarean section.

 Supportive Healthcare: With proper medical care and regular prenatal check-ups,
any potential issues can be detected early and managed, increasing the chances of a
normal delivery. Healthcare providers can guide primigravidas on making
informed choices.

Q2B. Education that can be given to primigravida:

It's essential to provide education and reassurance to a primigravida who may have
concerns about having a normal delivery. These include:

 Educate the client about childbirth: Help her understand that most primigravidas
can have a normal delivery with proper prenatal care and support. Share positive
stories of successful vaginal deliveries to instill confidence.

 Teach client about labor process, breathing techniques, and coping strategies, which
can boost her confidence and preparedness for childbirth.

 Communicate with healthcare providers: Encourage her to discuss her concerns

openly with her healthcare team. They can address her fears, provide guidance, and
create a personalized birthing plan that aligns with her preferences.

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  Seek emotional support: Encourage her to talk to friends, family, or other expectant
mothers who have gone through childbirth. Emotional support can help alleviate
anxiety and create a positive mindset.

 Educate client on other options: Inform her about various delivery options and the
possibility of medical interventions if needed. Understanding that there are options
available can reduce fear and empower her to make informed decisions during labor

Q3A. PEKVIC FLOOR MUSCLE DYSFUNCTION/ WEAK PELVIC FLOOR MUSCLE

Q3B.

This condition causes inability of the client to correctly relax and coordinate her pelvic
floor muscles to have a bowel movement.

It can also be referred to the loss of voluntary control over urination and bowel movements
that may occur during labor and delivery. This is caused by the stretching and pressure of
the muscles and tissues in the pelvic floor as fetus moves through the birth canal. This can
further be backed by he following points:

1. Urinary incontinence: This is the involuntary leakage of urine during activities such as
coughing, sneezing, or exercising. It is often caused by weakened or stretched muscles in
the pelvic floor.

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2. Fecal incontinence: This is the inability to control bowel movements, resulting in
involuntary leakage of feces. It may be caused by weakened or stretched muscles in the
pelvic floor or a disruption of nerve pathways that control bowel function.

3. Weakness of the pelvic floor: Repeated childbirth can strain and weaken the pelvic floor
muscles, leading to urinary and fecal incontinence. This is a common symptom of delivery-
induced loss of control and can manifest as difficulty in holding a full bladder or rectum. It
is caused by the stretching and weakening of the pelvic floor muscles during childbirth.

4. Urgency of urination and defecation: As stated in the question, this is the sudden and
persistent urge to urinate or defecate. It is caused by weakened muscles in the pelvic floor,
which can fail to close off the bladder or rectum sufficiently.

5. Painful urination: This is a common symptom of delivery-induced loss of control caused

by damaged or stretched nerves in the bladder and pelvis. It can cause discomfort or
burning sensation when urinating.

6. Episiotomy or tear complications: If there were complications during previous deliveries,

such as extensive episiotomies or severe perineal tears, they may contribute to difficulties
controlling micturition and defecation.

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Q4.

 Early marriage refers to a young age, typically before reaching adulthood or before
the age at which an individual is legally considered capable of giving informed
consent to marriage. The age at which early marriage is considered varies widely
across cultures and countries, but it often involves individuals marrying
before the age of 18.

 The bony pelvis, also known as the pelvic girdle or pelvic bones, is a complex
structure formed by several bones in the human body. It plays a crucial role in
supporting the body's weight, facilitating movement, and protecting the
reproductive and digestive organs

Q4A. Early marriages needs not to be advocated for, and should be abolished. There should
be sensitization or education on the effects of early marriages.

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Q4B.

Some of the reasons that can be raised against early marriages include:

Early marriage can have significant effects on the bony pelvis, particularly in young girls
who are not fully physically developed. The bony pelvis, which includes the hip bones,
sacrum, and coccyx, plays a crucial role during childbirth. Here are some potential effects of
early marriage on the bony pelvis:

 Pelvic Immaturity: Young girls who get married before their pelvis is fully
developed may have a smaller and less mature pelvis. This can lead to difficulties
during childbirth, as the baby's head may not have enough space to pass through the
birth canal.

 Obstructed Labor: A smaller and less developed pelvis can result in obstructed
labor, where the baby's head gets stuck in the birth canal. This condition can be life-
threatening for both the mother and the baby and may require medical
interventions such as cesarean sections.

 Birth Injuries: An immature pelvis can increase the risk of birth injuries for both the
mother and the baby. For the mother, prolonged and difficult labor can lead to tears
in the pelvic muscles and tissues. For the baby, there's an increased risk of skull
fractures or nerve damage during a difficult passage through the birth canal.

 Pelvic Floor Disorders: Early marriage and childbirth can contribute to pelvic floor
disorders such as urinary incontinence and pelvic organ prolapse. These conditions
occur when the muscles and ligaments that support the pelvic organs are weakened
or damaged, often due to the strain of childbirth.

 Malnutrition: Early marriage can be associated with limited access to proper

nutrition and healthcare, which might lead to malnutrition. Inadequate nutrition
during adolescence can impact overall bone health and development.

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  Teen Pregnancy: Early marriage often coincides with early childbearing. Teenage
pregnancy can put additional strain on the growing pelvis during childbirth, and the
lack of proper prenatal care may increase the risk of complications.

Q5. Educating a community on malnutrition

Malnutrition refers to a condition where an individual's intake of nutrients, such as

vitamins, minerals, proteins, and energy (calories), is insufficient to meet their body's
needs. Malnutrition can result from both inadequate consumption of essential nutrients
and poor absorption or utilization of these nutrients by the body. This can lead to various
health problems, including stunted growth, weakened immune system, fatigue, cognitive
impairment, and even increased susceptibility to diseases. Malnutrition can manifest in
different forms, including under nutrition (not enough nutrients), over nutrition (excessive
intake of certain nutrients), and micronutrient deficiencies (lack of specific
vitamins and minerals)

To address the issue of malnutrition in a community with malnourished children, a

comprehensive education program is essential. These may include:

Nutrition Education: Educate the community about the importance of a balanced diet,
including the essential nutrients needed for proper growth and development. Teach them
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about locally available nutritious foods and ways to prepare affordable and nutritious
meals.

Breastfeeding Support: Promote exclusive breastfeeding for the first six months and
continued breastfeeding with appropriate complementary feeding until two years of age.
Educate mothers about the benefits of breastfeeding and proper breastfeeding techniques.

Hygiene and Sanitation: Teach the community about the significance of clean water, proper
hygiene practices, and sanitation to prevent waterborne diseases and improve overall
health.

Early Childhood Development: Highlight the critical role of early childhood nutrition in
cognitive and physical development. Encourage parents and caregivers to provide a
nurturing and stimulating environment for their children.

Access to Healthcare: Raise awareness about the importance of regular health check-ups
for children, especially for monitoring growth and nutritional status. Advocate for
improved access to healthcare services in the community.

Community gardening and farming: Promote community-based initiatives for gardening

and farming, encouraging the cultivation of diverse crops to enhance food security and
access to fresh produce.

Monitoring and Support: Set up systems to monitor the progress of malnourished children
and provide appropriate support through counseling, nutritional supplements, or referral
to specialized healthcare facilities if needed.

Involvement of Local Leaders: Involve local leaders and influential members of the
community to support and champion the cause of combating malnutrition.

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Behavior Change Communication: Utilize various communication channels, including
workshops, posters, and community meetings, to deliver consistent and engaging messages
on nutrition and health.

Sustainable Solutions: Work with the community to develop sustainable solutions that
address the root causes of malnutrition, such as poverty, food insecurity, and lack of access
to education and healthcare.

It's crucial to tailor the education program to the specific needs and cultural context of the
community. Involving community members in the planning and implementation process
will foster ownership and a sense of responsibility for the health and well-being of their
children.

REFERENCES

Navarro-Zarza JE, Villaseñ or-Ovies P, Vargas A, Canoso JJ, Chiapas-Gasca K, Herná ndez-Díaz
C, Saavedra MÁ , Kalish RA. Clinical anatomy of the pelvis and hip. Reumatol Clin. 2012 Dec-
2013 Jan;8 Suppl 2:33-8. 

Abitbol MM. The shapes of the female pelvis. Contributing factors. J Reprod Med. 1996
Apr;41(4):242-50. [PubMed]

Elia M, editor. Guidelines for detection and management of malnutrition. Malnutrition

Advisory Group, Standing Committee of BAPEN. Maidenhead: BAPEN, 2000. [Google
Scholar]

Stratton R, Green CJ, Elia M. Disease-related malnutrition: an evidence-based approach to

treatment. Oxon: Cabi Publishing, 2003. [Google Scholar].

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