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Obstetrics: Framework For Maternal & Child Nursing NCM 107

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FRAMEWORK FOR MATERNAL & CHILD NURSING

NCM 107

childbirth, sometimes termed the


fourth trimester of pregnancy)
OBSTETRICS
3. Care of infants during the perinatal
 The care of women during period (the time span beginning at
childbirth, is derived from the 20 weeks of pregnancy to 4 weeks
Greek word obstare, which [28 days] after birth)
means “to keep watch” 4. Care of children from birth through
 A branch of medical science that late adolescent
deals with pregnancy, childbirth 5. Care in a variety of hospital and
and the postpartum period. home care settings
 Combined with GYNECOLOGY FRAMEWORK FOR MCHN
under the discipline known as
OBSTETRICS & GYNECOLOGY Maternal and child health nursing can be
(OB-GYN) which is a surgical visualized within a framework in which
field. nurses use NURSING PROCESS,
NURSING THEORIES, NURSING
PEDIATRICS RESEARCH and QUALITY AND
 A word derived from the Greek SAFETY EDUCATION FOR
word pais, meaning “child”. NURSES(QSEN) competencies to care
 Branch of medicine concerned for families during the childbearing and
with the development, care, childrearing years through the FOUR
diseases & development of PHASES of health care which are:
babies & children. HEALTH PROMOTION, HEALTH
MAINTENANCE, HEALTH
GOALS AND PHILOSOPHIES OF RESTORATION, AND HEALTH
MATERNAL AND CHILD HEALTH REHABILITATION.
NURSING
 The primary goal of both maternal
and child health nursing is the
promotion and maintenance of
optimal family health. Maternal
and child health nursing extends
from preconception to
menopause with an expansive
array of health issues and NURSING THEORISTS
healthcare providers.
 Florence Nightingale
Scope of practice include: Environmental Theory
1. Preconception health care  Hildegard Peplau
2. Care of women during three Psychodynamic Nursing
trimesters of pregnancy and the
puerperium (the 6 weeks after

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FRAMEWORK FOR MATERNAL & CHILD NURSING
NCM 107

 Virginia Henderson 14 Six competencies for quality care:


Components of Basic Nursing
 Patient-centered care
Care
 Teamwork and collaboration
 Joyce Travelbee  Quality improvement
Human to human relationship  Informatics
Model  Evidenced-based practice
 Betty Neuman  Safety
System Model FOUR PHASES OF HEALTH CARE
 Dorothy Johnson
 Health Promotion
Behavioral System Model
 Health Maintenance
 Imogene King- Goal  Health Restoration
Attainment Theory  Health Rehabilitation
 Dorothea Orem Self Measuring maternal and child health
Care Deficit Theory nursing population: statistical terms
 Faye Abdellah  Birth rate: the number of births
Typology of 21 Nursing Problems per 1,000 population
 Sr. Callista Roy
Adaptation Mode  Fertility rate: the number of
pregnancies per 1,000 women of
 Jean Watson childbearing age
Philosophy of Science and Caring
 Madeleine Leiniger  Neonatal death rate: the number
Transcultural Nursing of deaths per 1,000 live births
occurring at birth or in the first 28
 Patricia Benner days of life
Excellence and Power in Clinical
Nursing Practice  Perinatal death rate: the number
NURSING RESEARCH of deaths during the perinatal
time period (beginning when a
The controlled investigation of problems fetus reaches 500 grams, about
that have implications for nursing week 20 of pregnancy, and
practice, provides evidence for practice ending about 4 to 6 weeks after
and justification for implementing birth), it is the sum of the fetal
activities for outcome achievement, and neonatal rates
ultimately resulting in improved and
cost-effective patient care.
QSEN: Quality and Safety Education  Maternal mortality rate: the
for Nurses number of maternal deaths per
100,000 live births that occur as a

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FRAMEWORK FOR MATERNAL & CHILD NURSING
NCM 107

direct result of the reproductive  Demonstrates a high degree of


process independent nursing functions
 Infant mortality rate: the number because teaching and
of deaths per 1,000 live births counselling are major
occurring at birth or in the 1st 12 interventions.
months of life (the most  Promotes health and disease
meaningful and important prevention because these protect
measure of maternal and child the health of the next generation.
health)  Serves as an important resource
for families during childbearing
 Childhood mortality rate: the and childrearing as these can be
number of deaths per 1,000 extremely stressful times in a life
population in children aged 1 to cycle.
14 years  Respects personal, cultural, and
spiritual attitudes and beliefs as
these so strongly influence the
Major philosophies on maternal and
meaning and impact of
child health nursing:
childbearing and childrearing.
Maternal and child health nursing is:  Encourages developmental
stimulation during both health and
 Family centered
illness so children can reach their
 Community centered
ultimate capacity in adult life.
 Evidenced based practice (is the
 Assesses families for strengths
conscientious, explicit and
as well as specific needs or
judicious use of current best
challenges.
evidence to make decisions
 Encourages family bonding
about the care of the patients
through rooming-in and family
obtained from randomized
visiting in maternal and child
controlled trials to move
health care settings.
healthcare actions from ‘’just
 Encourages early hospital
tradition’’ to a more solid and
discharge options to reunite
safer, scientific basis)
families as soon as possible in
 A challenging role for nurses and
order to create a seamless,
a major factor in keeping families
helpful transition process.
well and optimally functioning
 Encourages families to reach out
 Considers the family as a whole
to their community so the family
and as a partner in care when
can develop a wealth of support
planning or implementing or
people they can call on in a time
evaluating the effectiveness of
of family crisis.
care.
 Serves as an advocate to protect MATERNAL AND CHILD HEALTH
the rights of all family members, GOALS & STANDARD
including the fetus.

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FRAMEWORK FOR MATERNAL & CHILD NURSING
NCM 107

NATIONAL HEALTH GOALS ARE; motherhood, umbilical cord


sampling, safety of new
1. To increase quality and years of
medicines to children) can lead to
healthy life.
legal actions, especially if
2. To eliminate health disparities
patients are uninformed about the
A new objective was added in 2010 reason or medical necessity.
which recommended that 100% of pre-  Understanding the scope of
licensure programs in nursing include practice and care based on a
core content on counseling for lesbian, state or country can help nurses
gay, bisexual, and transgender (LGBT) practice within appropriate legal
populations, evaluation of health parameters.
sciences literature, environmental  Documentation is essential for
health, public health systems and global justifying actions.
health.*  Nurses need to be conscientious
about obtaining informed consent
ROLES & RESPONSIBILITIES OF
for invasive procedures.
MATERNAL AND CHILD HEALTH
NURSE  ‘’Wrongful birth’’, ’’wrongful life’’,
’’wrongful conception’’
 Clinical Nurse Specialist  A nurse is legally responsible for
 Case manager reporting inappropriate or neglect
 Nurse Practitioner or breach of duty of other
 Women’s Health Nurse practitioner.
Practitioner
Ethical considerations of practice
 Pediatric Nurse Practitioner
 Neonatal Nurse Practitioner  Conception issues (in vitro
 Family Nurse Practitioner fertilization, embryo transfer,
 Certified Nurse-Midwife ownership of frozen oocytes or
sperm and surrogate
Legal considerations of maternal- motherhood)
child practice  Pregnancy termination
 Nurses are legally responsible for  Fetal rights versus rights of the
protecting the rights of their mother
patients, including confidentiality,  Stem cell research
and are accountable for the  Resuscitation and length of its
quality of their individual nursing continuation
care and that of other health care  Number of procedures or degree
team members. of pain a child should be asked to
 Reproductive healthcare rights endure to achieve a degree of
and laws are complex and vary better health
from each countries.  Balance between modern
 New technologies (assisted technology and quality of life
reproduction, surrogate

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FRAMEWORK FOR MATERNAL & CHILD NURSING
NCM 107

 Difficulty maintaining Maternal-child health nursing care


confidentiality of records when and the community
there are multiple caregivers
 A community is a group of
individuals interacting within a
limited geographical area
Diversity and maternal and child
 Knowing the individual aspects of
health nursing
a community helps us
 Diversity means there is a understands why some people
mixture or variety of reach the illness level they do
sociodemographic groups, before they seek health care,
experiences, and beliefs in the example: a woman living in a
population. rural area has no transportation
 Culture is a view of the world and to prenatal care until her partner
a set of traditions a specific social comes home from work, a 5-year
group uses and transmits to the old child develops measles
next generation. because there are no free
 Transcultural nursing is care immunization services in his
guided by cultural aspects and community.
respects individual differences.  The health of individuals and their
 Cultural values are preferred families are influenced by the
ways of acting based on cultural health of their community. It is
traditions. important to become acquainted
with the community in which a
Understanding cultural diversity in nurse practice or where a patient
maternal and child health nursing lives.
Cultural aspects that are important to
assess are:
 COMMUNICATION PATTERN;
 USE OF CONVERSATIONAL
SPACE;
 RESPONSE TO PAIN;
 TIME ORIENTATION;
 WORK AND SCHOOL
ORIENTATION;
 FAMILY ORIENTATION
 MALE & FEMALE ROLES
 RELIGION
 HEALTH BELIEFS
 NUTRITION PRACTICES

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FRAMEWORK FOR MATERNAL & CHILD NURSING
NCM 107

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