MATERNAL AND CHILD HEALTH NURSING (LEC1)

PRIMARY GOAL OF MCN-Promotion and maintenance of optimal family health to ensure optimal childbearing and childrearing.

PHILOSOPHIES IN MCN family- centered community- centered research- centered nsg. theory provides a basis for nsg. care serves as an advocate uses a high degree of independent nsg. function promoting health is a very imp’t nsg. role pregnancy and childhood illness are very stressful personal, cultural, and religious attitudes and beliefs influence a lot.. maternal and child nsg. is a very challenging role for the nurse

STANDARDS OF MCN PRACTICE nurse helps attain optimum health nurses assists the family in maintaining balance between personal growth needs and family functioning nurse intervenes with vulnerable families nurse promotes a healthy environment nurse detects changes and deviations nurse carries out interventions and treatments nurse assists in the coping period nurse actively pursues strategies nurse continuous to improve MCN practice

FRAMEWORK FOR MATERNAL AND CHILD HEALTH1. NURSING PROCESS2. NURSING RESEARCH3. NURSING THEORY

1. NURSING PROCESSA. AssessmentB. DiagnosisC. PlanningD. ImplementationE. Evaluation

2. NURSING RESEARCH-the controlled investigation of a problem using a scientific method that have implications for nursing practice by which the foundation of nursing grows, expands, and improves.

WHY RESEARCH??-Immortality

-Altruism-Status/prestige

-Utility-Economy

-Collaboration-Fun/Excitement

-Because!-Qualifications

3. NURSING THEORY

Faye Abdellah- identification- identify and correct needsPatricia Benner- nurses grow from practiceDorothy Johnson- subsystems must remain on balanceImogene King- action, reaction, interaction, transactionMadeleine Leininger- transcultural care which focus on study and analysis of cultures with respect to

caring behavior Florence Nightingale- changing or structuring the environmentBetty Neuman- a person is an open system interacting with env’tDorothea Orem- focus on the individual in assessing self careIda Jean Orlando- focus of the nurse is interaction with the clientRosemarie Rizzo Parse- man-living-health as a single unitHildegard Peplau- promotion of healthMartha Rogers- move the client toward optimum healthSister Callista Roy- aid the client to adopt to change brought by the illness

PHASES OF HEALTH CAREI. Promotion, maintenanceII. PreventionIII. Cure, restorationIV. Rehabilitation

TREND OF MATERNAL AND CHILD HEALTH TODAY Families are smaller Single parents are increasing Increasing number of working mothers Families are more mobile, increasing number of homeless families Families are more health conscious Health care must respect cost containment

LEADING HEALTH INDICATORS

Physical activity Overweight and obesity Tobacco use Substance abuse Responsible sexual behavior mental health Injury and balance Env’tal quality Immunization Access to health care

MEASURING MATERNAL AND CHILD HEALTH

1. Birth rateNumber of live births in a year/ average population x 100

2. Fertility rateNumber of pregnancies in a year/ women of childbearing age x 100

3. Fetal mortality rateNumber of fetal deaths/ number of pregnancies x 100

4. Maternal mortality rateMaternal deaths as direct result of reproductive process/ total live births x 100

5. Infant mortality rateDeaths occurring after birth or in the first 12 mo’s of life/ total live births x 100

6. Neonatal mortality rate Deaths occurring after birth/ in the 1st 28 days of life/ total live births x 100

7. Perinatal mortality rateNumber of fetal and neonatal deaths/ total live births x 100

LEGAL CONSIDERATIONS OF MCN PRACTICE

-A nursing note written today may need to be defended as many as 20 years in the future.

ETHICAL CONSIDERATIONS OF MCN PRACTICE1. In-vitro fertilization, embryo transfer and surrogate mother2. Abortion3. Fetal rights versus maternal rights4. Use of fetal tissue for research5. Resuscitation6. Procedures and pain of the child7. Modern technology and quality of life

THE FAMILY

BASIC FAMILY STRUCTURES1. FAMILY OF ORIGIN2. FAMILY OF PROCREATION

-The people who will be supportive of a woman throughout the childbearing year are her family.

Dyad- pair: husband & wife Nuclear- dad, mom & children Extended- near relatives + nuclear Single-parent Cohabitation- live-together Communal Blended- includes children of a

previous marriage of one spouse or both

Foster Gay or lesbian Single alliance

FAMILY TASKS Physical maintenance

Socialization Allocation of resources Maintenance of order Division of labor Reproduction, recruitment or release Placement of members into a larger society Maintenance of motivation for morale

CHANGING PATTERNS OF FAMILY LIFE1. Mobility patterns2. Poverty3. The homeless family4. Increasing number of one-parent families5. Increasing separation or annulment6. Decreasing family size7. Dual-parent employment8. Increased family responsibility for health monitoring9. Increased abuse in families

COMMUNITY ASSESSMENT1. Age span2. Education3. Finances, occupation4. Health care delivery5. Housing6. Recreational7. Religion8. Safety. Protection9. Socio-cultural10. Transportation

COMMUNITY SUPPORTFAMILY1. Health2. Education3. Leisure4. Safety5. Spirituality6. physical

THE WELL FAMILY and THE FAMILY IN CRISIS The well family

-making a genogram The family in Crisis

- APGAR scoring

SOCIAL AND CULTURAL ASPECTS

CULTURE- set of traditions that a specific social group Uses

CULTURAL VALUES- preferred ways of actingNORMS- usual values of groupTABOOs- not acceptable actionsTRANSCULTURAL NSG- nsg. with cultural aspects as a

guide to careSTEREOTYPING- expecting people to act in a manner without regard to individual characteristicsETHNICITY- cultural groups into which people were

BornASSIMILATION- trading culturesETHNOCENTRISM- a belief that one’s own culture is

superior to all othersCULTURAL CONSIDERATIONS

1. Communication2. Space & touch3. Time orientation4. Social organization5. Environmental control6. Nutrition7. Spiritual beliefs and practices

MCN PROGRAMS OF DEPARTMENT OF HEALTH

MOTHER…- Prenatal care- Immunizations during pregnancy- Proper nutrition and vitamins during pregnancy- Evidenced-based care during labor and delivery

CHILD…- Essential newborn care- Breastfeeding programs- Integrated management of childhood illnesses- Infant daycare centers- Newborn screenings- Childhood immunizations