I.

1. What is the importance of Family, Maternal and Child Health Nursing?

For me,Family is the basic unit of our life.Because we grow together in one home.They are
the ones that can support us.For this reason,promotion of health is needed to maintain the life
of each family member.There are certain needs that the family should meet and they can
achieve this through the assistance in health nursing.To promote healthy growth and
development of the child and the mother during childbearing or pregnancy.Health nursing is
also essential to ensure stability of the baby’s health inside the mother’s womb.

2.Find an article about Ethico-legal topics and make a reaction from it. 5-10 sentences only.

After reading the article Im not happy because 30%of women are abusing the baby and its very
dangerous to the life of a mother. While 70% of women are happy when the baby arrives
because they know that the baby is gift from GOD. Aborting a baby somehow can affect the
mother and bring her in a critical condition. If they plan to abort again they must not plan to
create it. Abortion may lead the mother to uncontrolled bleeding. Its potentially life threatening
to the woman’s well being .If due to another cause, treatment would depend on the condition or
problem identified.

II.

1.Pick 1 disorder of sexual functioning. Give its description, pathophysiology, treatment,

laboratories and nursing intervention.

Inhibited sexual desire

Inhibited sexual desire (ISD) refers to a low level of sexual interest. A person with ISD will not
start, or respond to their partner's desire for, sexual activity.

ISD can be primary (in which the person has never felt much sexual desire or interest), or
secondary (in which the person used to feel sexual desire, but no longer does).

ISD can also relate to the partner (the person with ISD is interested in other people, but not his or
her partner), or it can be general ( the person with ISD isn't sexually interested in anyone). In the
extreme form of sexual aversion, the person not only lacks sexual desire, but may find sex
repulsive.

Sometimes, the sexual desire is not inhibited. The two partners have different sexual interest
levels, even though both of their interest levels are within the normal range.

Someone can claim that his or her partner has ISD, when in fact they have overactive sexual
desire and are very demanding sexually.
Causes

ISD is a very common sexual disorder. Often it occurs when one partner does not feel intimate or
close to the other.

Communication problems, lack of affection, power struggles and conflicts, and not having
enough time alone together are common factors. ISD also can occur in people who've had a very
strict upbringing concerning sex, negative attitudes toward sex, or traumatic sexual experiences

Illnesses and some medications can also contribute to ISD, especially when they cause fatigue,
pain, or general feelings of malaise. A lack of certain hormones can sometimes be involved.
Psychological conditions such as depression and excess stress can dampen sexual interest.
Hormonal changes can also affect libido.

Commonly overlooked factors include insomnia or lack of sleep, which lead to fatigue. ISD can
also be associated with other sexual problems, and sometimes can be caused by them. For
example, the woman who is unable to have an orgasm or has pain with intercourse, or the man
who has erection problems (impotence) orretarded ejaculation can lose interest in sex because
they associate it with failure or it does not feel good.

People who were victims of childhood sexual abuse or rape, and those whose marriages lack
emotional intimacy are especially at risk for ISD.

Symptoms

The primary symptom is lack of sexual interest.

Laboratories

Most of the time, a medical exam and lab tests will not show a physical cause.

However, testosterone is the hormone that creates sexual desire in both men and women.
Testosterone levels may be checked, especially in men who have ISD. Blood for such tests
should be drawn before 10:00 a.m., when male shormone levels are at their highest.

Once physical causes have been ruled out, interviews with a sex therapy specialist may be
helpful to reveal possible causes.

Treatment

Treatment must be targeted to the factors that may be lowering sexual interest. Often, there may
be several such factors.

Some couples will need relationship or marital therapy before focusing on enhancing sexual
activity. Some couples will need to be taught how to resolve conflicts and work through
differences in nonsexual areas.

Communication training helps couples learn how to talk to one another, show empathy, resolve
differences with sensitivity and respect for each other's feelings, learn how to express anger in a
positive way, reserve time for activities together, and show affection, in order to encourage
sexual desire.

Many couples will also need to focus on their sexual relationship. Through education and
couple's assignments, they learn to increase the time they devote to sexual activity. Some couples
will also need to focus on how they can sexually approach their partner in more interesting and
desirable ways, and how to more gently and tactfully decline a sexual invitation.
Problems with sexual arousal or performance that affect sexual drive will need to be directly
addressed. Some doctors recommend treating women with either cream or oral testosterone,
often combined with estrogen, but there is no clear cut evidence yet. There are studies underway
looking at the possible benefit of testosterone supplementation for women with decreased libido.

Outlook (Prognosis)

Disorders of sexual desire are often difficult to treat. They seem to be even more challenging to
treat in men. For help, get a referral to someone who specializes in sex and marital therapy.

Possible Complications

When both partners have low sexual desire, sexual interest level will not be a problem in the
relationship. Low sexual desire, however, may be a sign of the health of the relationship.

In other cases where there is an excellent and loving relationship, low sexual desire may cause a
partner to feel hurt and rejected. This can lead to feelings of resentment and make the partners
feel emotionally distant.

Sex is something that can either bring a relationship closer together, or slowly drive it apart.
When one partner is much less interested in sex than the other partner, and this has become a
source of conflict, they should get professional help before the relationship becomes further
strained.

Prevention

One good way to prevent ISD is to set aside time for nonsexual intimacy. Couples who reserve
time each week for talking and for a date alone without the kids will keep a closer relationship
and are more likely to feel sexual interest.

Couples should also separate sex and affection, so that they won't be afraid that affection will
always be seen as an invitation to have sex.

Reading books or taking courses in couple's communication, or reading books about massage
can also encourage feelings of closeness. For some people, reading novels or watching movies
with romantic or sexual content also can encourage sexual desire.

Regularly setting aside "prime time," before exhaustion sets in, for both talking and sexual
intimacy will improve closeness and sexual desire.

III.

1.Among all contraceptives, choose 1 and describe how it is used, what are its effects and
contraindications.

What is a Diaphragm?

A diaphragm is a flexible, latex, dome-shaped cup with a bendable rim. It is designed to fit
securely in the vagina to cover the cervix. Diaphragms have been used since the 1830s and
require a prescription to obtain. They are considered to be the first major innovation for women
seeking personal control to protect themselves from an unintended pregnancy. Due to
improvements in design and effectiveness, diaphragm use still remains a popular birth control
choice for many women.

How It Works:

A diaphragm acts as a physical barrier or barrier method. By blocking the opening of uterus,
sperm are prevented from joining an egg. The diaphragm is held in place over the cervix by the
vaginal muscles. Before being inserted, a diaphragm is coated with spermicidal cream, jelly, or
foam; if any sperm manage to get over the rim of the diaphragm, they will be immobilized by the
spermicide.

Types of Diaphragms

Diaphragms are available in many sizes and designs, so this increases your chances of finding
one that is a good fit. In addition to size, there are two kinds of diaphragms:

 A flat ring option: This type of diaphragm can be squeezed into a flat oval and is then
inserted. The flat ring type also comes with an applicator, so this makes insertion a little
easier.

 An arcing or coil spring option: This type of diaphragm forms a bent circle when
squeezed. You can insert an arcing or coil spring diaphragm with your fingers.

Advantages of a Diaphragm:

 It has no effect on a woman's natural hormones

 Is reversible, so fertility immediately returns
 Usually cannot be felt by either partner
 Very few side effects
 Breastfeeding mothers can use a diaphragm
 Is effective immediately
 Can be easily carried in a pocket or purse
 It may lower the risk of catching certain sexually transmitted diseases
 May prevent against some types of precancerous changes in the cervix
 Can be inserted hours ahead of time, so it does not interrupt sexual activity

Disadvantages:

 Some women report that this method is messy and inconvenient

 Requires some planning ahead (must be in place every time you have sex)

 Some women find diaphragms difficult to insert

 They may require refitting

 Diaphragms may be pushed out of place by some sexual positions, penis sizes, and
thrusting angles and techniques

 The spermicide and/or semen may leak out during the 6 hours after intercourse (which
some women report as being uncomfortable) - wearing a panty liner may help

Who Can Use:

In general, most women can use a diaphragm. However, this method is not recommended for
women who are uncomfortable touching their genitals or for those with allergies to latex or
spermicide (some women who have a mild reaction to spermicide find that switching brands can
help lessen this issue).

Additional conditions that may rule out diaphragm use include:

 Having given birth within in the last 6 weeks

 History of frequent urinary tract infections
 Recent cervical surgery
 If you have a sagging uterus or vaginal obstructions
 Recent abortion (after the first trimester)
 History of toxic shock syndrome
 Poor vaginal muscle tone

Possible Side Effects:

The most concerning side effect is the slight risk of toxic shock syndrome (TSS) if the
diaphragm has been left in place for longer than 24 hours. In these rare cases, symptoms of TSS
include diarrhea, vomiting, a sunburn-type rash, dizziness, sudden high fever, faintness,
weakness, and sore throat, aching muscles and/or joints. If you are experiencing these symptoms,
remove your diaphragm and contact your doctor immediately.

Some women who use diaphragms may get repeated urinary tract/bladder infections. This may
be alleviated by urinating before inserting the diaphragm. Sometimes, if your diaphragm is too
large, the rim can press against the front wall of the vagina thereby irritating the urethra (the tube
that carries urine from your bladder), so you may need to have your diaphragm refitted.

Diaphragm Effectiveness:

Typical use: 84% effective

Perfect use: 94% effective

Of every 100 women who use diaphragms with spermicide, 16 will become pregnant (with
typical use) and 6 will become pregnant with perfect use during the first year of use.
Maternal & Child
Health Nursing

Submitted by: Angeli Bophine Francia

Submitted To: Ms Mary Roxanne Nerpiol,

RN MN