Maternal Child Exam 1 (module 1 & 2)
• Family types o Nuclear (male partner, female
partner, their children)
o Extended (family unit plus other
... [Show More] family member in the same household)
o Married-blended (post death/divorce o Commune (group of men,
women, and children living together) o Cohabitation (unmarried man
and woman living together) o No-parent (children living independent, in
foster care, or with close relative)
• Family Systems Theory o Changes that occur in
one member affect the entire family o Sum of the
parts is greater than the whole o Balance and
homeostasis (strive to return to “normal” state) o
Subsystems
➢ Spouses
➢ Children
➢ Girls or boys
➢ Mother/child
• Duvall’s Family Developmental Theory o
Each stage has certain tasks that need to be
accomplished before moving on to next stage
➢ Beginning (just married)
➢ Childbearing (new child)
➢ Preschool (child’s life becomes parent’s life)
➢ School age (personal values are shaped and clarified)
➢ Adolescent/teenage (teaching about sex, drugs, and health
promotion)
➢ Launching (empty nest)
➢ Middle age (more socialization)
➢ Retiremento
• Structural-Functional Theory o Functioning of
the family and the roles assumed by each
member
Roles include: provider, housekeeper, child caregiver, socializer, sexual
partner, therapist, recreational organizer, and kinship (social
etiquette/moral teacher)
• Community Theory
o Emotional problems result from the way people interact with each other
in the context of the family
o Unhealthy families give mixed or double-binding messages, nonverbal
expressions that are inconsistent and incongruent with the verbal
message. o Healthy families have clear rules and communication is
clear and congruent and nonverbal cues match what is being said.
• Group Theory
o Norms (rules of conduct), roles, goals, and power structure o Division
of household chores, expectations of homework, and curfew
enforcement
o Stages of groups:
➢ Forming (through marriage or cohabitation)
➢ Storming (disordered time of confusion or chaos)
➢ Norming (adjust to members by applying rules that everyone
agrees to)
➢ Performing (accomplishes their goals and produces results)
➢ Adjourning/terminating (when member dies, divorce, or leaves the
family)
• Bowen Family Systems Theory o Views the
family as an emotional unit and uses systems
thinking to describe the complex interactions
within the family unit
o Useful when identifying family problems or challenges that are rooted in
communication, connecting between members, and teaching values
o Views birth order as a predictor of certain patterns of behavior o
Triangulation occurs when the dyad diverts attention away from its own
conflict by focusing on a third person such as the child, teacher of theo
problem child, or police officer who comes into a domestic disturbance.
o The multigenerational transmission process describes how one learnsor
transmits family emotional systems across generations.
o Family projection process is how and what children are taught
• Family Assessment o Family size and structure
Parenting style
➢ Authoritarian (dictatorial)
➢ Laissez-faire (permissive)
➢ Authoritative (democratic) o Religious, cultural, and
social-economical orientation
• Tools to facilitate the family assessment o
Qualitative and quantitative surveys
o Genogram or ecomap
o Strengths and problems list
• Components of the family assessment o
Communication patterns o Roles and
relationships o Family developmental stage o
Family rituals o Triangulation
o Presence of dyads and other subsystems
• Examples of Family Nursing Diagnoses o
Altered Family Process o Caregiver Role Strain
(actual and risk for) o Dysfunctional Family
Processes: Alcoholism o Family Coping:
Compromised Family Coping: Disabled o
Impaired Parenting (actual and risk for) o
Ineffective Family Therapeutic Regimen
Management o Readiness for Enhanced Family
Coping o Readiness for Enhanced Parenting o
Risk for Parent-Infant-Child Attachment o
Social Isolation
o Spiritual Distresso
• Family with special needs o The loss of a home,
job, family member, or close friend are all
unexpected and unplanned-for events that
initially send the family into a state of chaos and
often require outside help for the process of
reorganization
o Situational crises include environmental disasters such as floods,
hurricanes, or fires
Developmental crises occur as part of expected growth events that can
take place during any developmental stage of the family or its individual
members.
• Gene Inheritance o Nucleus has 23 pairs of
chromosomes (22 autosomes and 1 sex
chromosome)
o Multifactorial (combination of genetic and environmental factors) o
Unifactorial (single gene inheritance, such as autosomal dominant,
autosomal recessive, X-linked disorders)
• Autosomal Dominant
o Single altered gene o Can be from one parent
o 50% chance of passing altered gene to offspring o Can be from
mutation o Examples: Huntington’s disease, achondroplasia,
neurofibromatosis, Marfan’s syndrome
• Autosomal Recessive o Each parent has the
altered gene (carrier o 25% chance of passing
trait
o 50% chance of passing altered gene (carrier)
o Examples: PKU, maple syrup disease, sickle cell anemia, cystic fibrosis,
tay-sach’s disease)
o Greater chance of occurrence in this population
• X-Linked Dominant o Altered gene on X
chromosome o If the father has the dominant
gene (Xy):o
➢ All of daughters will inherit gene
➢ None of sons will inherit gene o If the mother has the
dominant gene (Xx):
➢ 50% chance of inheriting the gene
➢ Some chance for son or daughter
• X-Liked Recessive o More common than Xlinked dominant disorders o Trait occurs more
frequently in males r/t X
Male with trait will pass gene to all daughters o Female with
gene (carrier) has 50% chance of passing on the gene o Examples:
Hemophilia A, Duchenne muscular dystrophy
• Process of fertilization o Ovulation – cervical
mucus changes o Deposit of 200 – 600 million
sperm o Approximately 200 sperm reach
fertilization site o Oocyte (female) and sperm
(male) meet in fallopian tube
• Cellular Multiplication o Cleavage (mitotic cell
division of the zygote)
o 3 to 4 days after fertilization, there are approximately 16 cells and the
zygote is called a morula and enters the uterus
o Once the morula enters the uterus, fluid passes into the intercellular
spaces of the inner cell mass and forms a large fluid-filled cavity
o The morula is now called a blastocyst and contains an inner mass of
cells called the embryoblast
o The embryo develops from the embryoblast and contains an outer cell
layer called the trophoblast.
o The chorion and placenta develop from the trophoblast
• Implantation
o The zygote is propelled by cilia and peristalsis o Reaches uterine cavity
in 3-4 days
o Nidation (implantation into the endometrium) occurs by the 10th day
after fertilizationo
• Placenta o Provides oxygenation, nutrition,
waste elimination, and hormones o Protects the
fetus [Show Less]