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 impt 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 HEALTH 1. NURSING PROCESS 2. NURSING RESEARCH 3. NURSING THEORY 1. A. B. C. D. E. NURSING PROCESS Assessment Diagnosis Planning Implementation 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 needs Patricia Benner- nurses grow from practice Dorothy Johnson- subsystems must remain on balance Imogene King- action, reaction, interaction, transaction Madeleine Leininger- transcultural care which focus on study and analysis of cultures with respect to caring behavior Florence Nightingale- changing or structuring the environment Betty Neuman- a person is an open system interacting with envt Dorothea Orem- focus on the individual in assessing self care Ida Jean Orlando- focus of the nurse is interaction with the client Rosemarie Rizzo Parse- man-living-health as a single unit Hildegard Peplau- promotion of health Martha Rogers- move the client toward optimum health Sister Callista Roy- aid the client to adopt to change brought by the illness PHASES OF HEALTH CARE I. Promotion, maintenance II. Prevention III. Cure, restoration IV. 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 Envtal quality Immunization Access to health care

MEASURING MATERNAL AND CHILD HEALTH 1. Birth rate Number of live births in a year/ average population x 100 2. Fertility rate Number of pregnancies in a year/ women of childbearing age x 100 3. Fetal mortality rate

Number of fetal deaths/ number of pregnancies x 100 4. Maternal mortality rate Maternal deaths as direct result of reproductive process/ total live births x 100 5. Infant mortality rate Deaths occurring after birth or in the first 12 mos 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 rate Number 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 PRACTICE 1. In-vitro fertilization, embryo transfer and surrogate mother 2. Abortion 3. Fetal rights versus maternal rights 4. Use of fetal tissue for research 5. Resuscitation 6. Procedures and pain of the child 7. Modern technology and quality of life

THE FAMILY
BASIC FAMILY STRUCTURES 1. FAMILY OF ORIGIN 2. 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 LIFE 1. Mobility patterns 2. Poverty 3. The homeless family 4. Increasing number of one-parent families 5. Increasing separation or annulment 6. Decreasing family size 7. Dual-parent employment 8. Increased family responsibility for health monitoring 9. Increased abuse in families COMMUNITY ASSESSMENT 1. Age span 2. Education 3. Finances, occupation 4. Health care delivery 5. Housing 6. Recreational 7. Religion 8. Safety. Protection 9. Socio-cultural 10.Transportation

COMMUNITY SUPPORT FAMILY 1. Health 2. Education 3. Leisure 4. Safety 5. Spirituality 6. 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 acting NORMS- usual values of group TABOOs- not acceptable actions TRANSCULTURAL NSG- nsg. with cultural aspects as a guide to care STEREOTYPING- expecting people to act in a manner without regard to individual characteristics ETHNICITY- cultural groups into which people were Born ASSIMILATION- trading cultures ETHNOCENTRISM- a belief that ones own culture is superior to all others

CULTURAL CONSIDERATIONS
1. 2. 3. 4. 5. 6. 7.

Communication Space & touch Time orientation Social organization Environmental control Nutrition Spiritual beliefs and practices

MCN PROGRAMS OF DEPARTMENT OF HEALTH

MOTHER CHILD Prenatal care Immunizations during pregnancy Proper nutrition and vitamins during pregnancy Evidenced-based care during labor and delivery Essential newborn care Breastfeeding programs Integrated management of childhood illnesses Infant daycare centers Newborn screenings Childhood immunizations