MGGMORADACU2023 HEALTH NURSING Mary Grace Morada-Cu, MAN, RN Nursing Care Management 107 SPUM- CNAHS OBJECTIVES After interactive discussion, learners should be able to: 1. Identify the goals and philosophy of
MGGMORADACU2023 maternal and child health nursing. 2. Define common statistical terms used in the field, such as infant and maternal mortality 3. Integrate knowledge of trends in maternal and child health care with the nursing process to achieve quality maternal and child health nursing care. MATERNAL AND CHILD HEALTH NURSING ¢ Obstetrics, or the care of women during childbirth, is derived from the Greek word obstare, which
MGGMORADACU2023 2015-16 means “to keep watch.”
2021
¢ Pediatrics is a word derived from
the Greek word pais, meaning “child.”
2016 onwards 2022 onwards
MATERNAL AND CHILD HEALTH NURSING ¢ The care of childbearing and childrearing families is a major focus of nursing practice, because to have healthy adults you must have healthy children.
MGGMORADACU2023 ¢ To have healthy children, it is important to promote the health of the childbearing woman and her family from the time before children are born until they reach adulthood. ¢ That makes both preconceptual and prenatal care essential contributions to the health of a woman and fetus and to a family’s emotional preparation for childbearing and childrearing. MATERNAL AND CHILD HEALTH NURSING ¢ The nurse’s role in all these phases focuses on promoting healthy growth and development of the child and family in both health and illness
MGGMORADACU2023 ¢ MCN divides its concerns for families during childbearing and childrearing into two separate entities, maternity care and child health care, the full scope of nursing practice in this area is not two separate entities but rather a continuum: maternal and child health nursing (1 Unit) MATERNAL AND CHILD HEALTH NURSING SCOPE OF PRACTICE ¢ The goals of maternal and child health nursing care are necessarily broad because the scope of is so broad. The range of practice includes
MGGMORADACU2023 1. Preconceptual health care 2. Care of women during three trimesters of pregnancy and the puerperium (the 6 weeks after childbirth, sometimes termed the fourth trimester of pregnancy) 3. Care of infants during the perinatal period (6 weeks before conception to 6 weeks after birth) 4. Care of children from birth through adolescence 5. Care in settings as varied as the birthing room, the pediatric intensive care unit, and the home PHILOSOPHY OF MATERNAL AND CHILD HEALTH NURSING 1. Maternal and child health nursing is family centered; assessment must include both family and individual assessment data.
MGGMORADACU2023 2. Maternal and child health nursing is community centered; the health of families depends on and influences the health of communities. 3. Maternal and child health nursing is evidence based, because this is the means whereby critical knowledge increases. PHILOSOPHY OF MATERNAL AND CHILD HEALTH NURSING 4. A maternal and child health nurse serves as an advocate to protect the rights of all family members, including the fetus.
MGGMORADACU2023 5. Maternal and child health nursing includes a high degree of independent nursing functions, because teaching and counseling are major interventions.
6. Promoting health and disease prevention
are important nursing roles because these protect the health of the next generation. PHILOSOPHY OF MATERNAL AND CHILD HEALTH NURSING (CONT) 7. Maternal and child health nurses serve as important resources for families during childbearing and childrearing as these can be extremely stressful times in
MGGMORADACU2023 a life cycle. 8. Personal, cultural, and religious attitudes and beliefs influence the meaning and impact of childbearing and childrearing on families. 9. Circumstances such as illness or pregnancy are meaningful only in the context of a total life. 10. Maternal and child health nursing is a challenging role for nurses and a major factor in keeping families well and optimally functioning. MATERNAL AND CHILD HEALTH NURSING PRIMARY GOAL ¢ The primary goal of maternal and child health nursing care can be stated simply as the promotion and maintenance of optimal family health to ensure cycles of
MGGMORADACU2023 optimal childbearing and childrearing. FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING CARE ¢ Maternal and child health nursing can be visualized within a framework in which nurses, using: 1. Nursing Process, organized series of steps to ensure quality and consistency of care and serves as the basis for assessing, making a
MGGMORADACU2023 nursing diagnosis, planning, organizing, and evaluating care ü (Prenatal clinic/care to the Pediatric intensive care unit) FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING CARE 2. Nursing Theory, One requirements of a profession is that the concentration of a discipline’s knowledge flows from a base of established theory.
MGGMORADACU2023 ü seeing a pregnant woman not simply as a physical form but as a dynamic force with important psychosocial needs, or by viewing children as extensions or active members of a family as well as independent beings. ü health promotion as a major nursing goal, teaching, counseling, supporting, and advocacy FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING CARE 2. Nursing Theory ü Florence Nightingale: Environmental Theory Nola Pender’s Health Promotion
MGGMORADACU2023 ü
ü Sr Callista Roy’s Adaptation Model of
Nursing, innate and acquired mechanisms to adapt ü Hildegard Peplau: Psychodynamic and Interpersonal Relations Theory- Understanding of one's own behavior, Helping others identify felt needs or difficulties ü Imogene King: Theory of Goal Attainment, healthy mother-baby ü Ramona Mercer’s Maternal Role Attainment Theory, mother-baby developmental and interactional process. ü Cheryl Beck’s Postpartum Depression Theory, to change the perception of postpartum depression and to improve patient care FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING CARE (CONT) 3. Nursing Research, controlled investigation of problems that have implications for nursing practice, provides evidence for practice and justification for implementing activities for outcome achievement, ultimately
MGGMORADACU2023 resulting in improved and cost-effective patient care. ü Research carried out by Rubin (1963) on a mother’s approach to her newborn. Before the study, nurses assumed that a woman who did not immediately hold and cuddle her infant at birth was a “cold” or unfeeling mother. After observing a multitude of new mothers, concluded that attachment is not a spontaneous procedure; rather, it more commonly begins with only fingertip touching. Armed with the findings and integrating into practice, nurses became better able to differentiate healthy from unhealthy bonding behavior in postpartum women.
4. Evidence-based practice, conscientious, explicit, and judicious use of
current best evidence in making decisions about the care of patients. It is also combination of research, clinical expertise, and patient preferences. ü Unang Yakap Ø FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING CARE ¢ Care for families during childbearing and childrearing years through four phases of health care: 1. Health promotion -Educating clients
MGGMORADACU2023 2. Health maintenance- Intervening to maintain health when risk of illness is present 3. Health restoration-diagnosing and treating illness using interventions that will return client to wellness most rapidly 4. Health rehabilitation- Preventing further complications; bringing back to an optimal state of wellness or helping to accept inevitable death FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING CARE Health Health Health Health Promotion Maintenance Restoration Rehabilitation
• Teaching • Encouraging • Caring for a • Encouraging
women the women to woman a woman to
MGGMORADACU2023 importance of come for during a continue to rubella, prenatal care; complication take measles other • Encouraging of pregnancy medications immunization Mothers to • Caring for therapy/ HPV Vaccine continue BF Mother with procedure before for the complications necessary pregnancy. 1000days in BF • Encouraging • Teaching the mother to importance of continue to Breastfeeding BF, take for Mother, medications Child and therapy/ Family necessary and make sure the proper BF techniques MGGMORADACU2023 MGGMORADACU2023 MEASURING MATERNAL & CHILD HEALTH ¢ Birth Rate ¢ Fertility Rate
MGGMORADACU2023 ¢ Fetal Death Rate
¢ Neonatal Death Rate
¢ Perinatal Death Rate
¢ Maternal Mortality Rate
¢ Infant Mortality Rate
¢ Childhood Mortality Rate
¢ Childhood Morbity Rate
MEASURING MATERNAL & CHILD HEALTH ¢ Birth Rate- Number of births per 1000 population.
MGGMORADACU2023 ¢ Fertility Rate- reflects what proportion of women who could have babies are having them. Fertility rates may below in countries troubled by famine, war, or disease. Ø Number of pregnancies per 1000 women of childbearing age MEASURING MATERNAL & CHILD HEALTH ¢ Fetal Death Rate Ø defined as the death in utero of a child (fetus) weighing 500 g or more, roughly the weight of a fetus of 20 weeks’ or more pregnancy.
MGGMORADACU2023 Ø is important in evaluating the health of a nation because it reflects the overall quality of maternal health and prenatal care. Ø the emphasis on both preconceptual and prenatal care has helped to reduce this rate from a number as high as 18% in 1950 to 6.2% at present (Eldridge & Sutton, 2009). Ø CAUSES: • may occur because of maternal factors such as maternal disease, premature cervical dilation, or maternal malnutrition or fetal factors such as fetal disease, chromosome abnormality, or poor placental attachment. • many fetal deaths occur for reasons that are unknown. MEASURING MATERNAL & CHILD HEALTH ¢ Neonatal Death Rate Ø the first 28 days of life are known as the neonatal period, and an infant during this time is known as a neonate. Ø reflects not only the quality of care available to women during
MGGMORADACU2023 pregnancy and childbirth but also the quality of care available to infants during the first month of life. Ø CAUSES: • during the first 4 weeks of life are prematurity (early gestational age or low birth weight of less than 2500 g ([17%]) and congenital malformations (20%). • 80% of infants who die within 48 hours after birth weigh less than 2500 g (5.5 lb). • the proportion of infants born with low birth weight is about 12.5% of all births. This number rises slightly each year due to the increase in multiple births and better prenatal care that allows infants who would have died in utero (fetal death) to be born and survive (Hamilton et al., 2007). MEASURING MATERNAL & CHILD HEALTH ¢ Perinatal Death Rate Ø the perinatal period is the time period beginning when a fetus reaches 500 g (about week 20 of pregnancy) and
MGGMORADACU2023 ending about 4 to 6 weeks after birth. Ø the perinatal death rate is the sum of the fetal and neonatal rates. MEASURING MATERNAL & CHILD HEALTH ¢ Infant Mortality Rate- Ø The infant mortality rate of a country is an index of its general health because it measures the quality of pregnancy care,
MGGMORADACU2023 nutrition, and sanitation as well as infant health. Ø This rate is the traditional standard used to compare the health care of a nation with that of previous years or of other countries. Ø Number of deaths per 1000 live births occurring at birth or in the first 12 months of life. Ø CAUSES: Two factors: number of infants born to adolescent Mothers and the type of health insurance and care available. MEASURING MATERNAL & CHILD HEALTH ¢ Maternal Mortality Rate Ø Is the number of maternal deaths that occur as a direct result of the reproductive process per 100,000 live births.
MGGMORADACU2023 Ø dramatic decrease can be attributed to improved preconceptual, prenatal, labor and birth, and postpartum care such as: • Increased participation of women in prenatal care • Greater detection of disorders such as ectopic pregnancy or placenta previa and prevention of related complications through the use of ultrasound • Increased control of complications associated with hypertension of pregnancy • Decreased use of anesthesia with childbirth MEASURING MATERNAL & CHILD HEALTH ¢ Childhood Mortality Rate Ø Number of deaths per 1000 population in children, 1 to 14 years of age.
MGGMORADACU2023 MEASURING MATERNAL & CHILD HEALTH ¢ Childhood Morbidity Rate Ø Number of sick children per 1000 population, 1 to 14 years of age
MGGMORADACU2023 Ø Health problems commonly occurring in large proportions of children today include: • Respiratory disorders (including asthma and tuberculosis), • Gastrointestinal disturbances, and consequences of injuries. • Obesity become a health problem in some communities that more 20% of school- aged children are obese (National Vital Statistics Service). Obesity in school-aged children can lead to cardiovascular disorders, self-esteem issues, and type 2 diabetes . WHAT WOULD BE YOUR ROLE AS A NURSE?
MGGMORADACU2023 MATERNAL AND CHILD
MGGMORADACU2023 HEALTH NURSING Mary Grace Morada-Cu, MAN, RN Nursing Care Management 107 SPUM- CNAHS
