1_chapter 1-introduction to maternal and child health nursingqweqe

7/29/2019 1_chapter 1-Introduction to Maternal and Child Health Nursingqweqe

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Chapter 1

Introduction to Maternal and

Child Health Nursing


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Maternal and Child Health Nursing


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Maternal and Child Health Nursing

Includes the care of the pregnant woman, childand family

Family-centered Maternal-Newborn Nursing

Describes the provision of safe, quality nursing

care that recognizes, focuses on, and adapts to

the physical and psychosocial needs of the

pregnant woman, her family and the newborn


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Primary Goal


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Primary Goal

Promotion and maintenance of optimal familyhealth to ensure cycles of optimal childbearing

and childrearing


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Major Philosophical Assumptions

about Maternal and Child

Health Nursing


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Major Philosophical Assumptions about MCN:

1. Family-centered

2. Community-centered

3. Research-oriented4. Both nursing theory and evidence-based

practice provide a foundation for nursing care.

5. A maternal and child health nurse serves as an

advocate to protect the rights of all family

members, including the fetus.


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6. Includes a high degree of independent nursingfunctions.

7. Promoting health is an important nursing role

8. Pregnancy or childhood illness can be stressful

and can alter family life.

9. Personal, cultural and religious attitudes andbeliefs influence the meaning of illness and its

impact on the family.


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10. Is a challenging role for a nurse and is amajor factor in promoting high-level wellness in

families.


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Standards of Care


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Standards of care

Promote consistency and ensure the quality ofcare in specific area of nursing practice

Help the nurse stay within legal parameters

Standards of practice

Provide guidelines for planning care andidentifying outcome criteria for evaluation of

nursing care


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Sample Nursing Practice Standards

and Guidelines Related to

Maternal-Newborn Care


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Standard Interpretation

Standard IQuality of care

The nurse systematically evaluates the

effectiveness of nursing practice.

Standard IIPerformance

appraisal

The nurse evaluates his or her own

nursing practice in relation to

professional practice standards andregulations.

Standard IIIEducation

The nurse acquires and maintains

current knowledge in nursing

practice.

Standard IVCollegiality

The nurse contributes to the

professional development of peers,

colleagues, and others.


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Standard VEthics

The nurses decisions and actions on

behalf of patients are determined inan ethical manner.

Standard VICollaboration

The nurse collaborates with the patient,

significant others, and health careproviders in providing patient care.

Standard VIIResearch

The nurse uses research findings in

practice.

Standard VIIIResource

utilization

The nurse considers factors related to

safety, effectiveness, and cost in

planning and delivering patient care.


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Standard IXPractice

environment

The nurse contributes to the

environment of care delivery withinthe practice setting.

Standard X

Accountability

The nurse is professionally and legally

accountable for his or her practice.The professional registered nurse

may delegate to and supervise

qualified personnel who provide

patient care.


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Maternal Newborn Health


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Statistical terms used to report maternal-

newborn nursing

Birth rate - number of births per 1,000 population

Fertility rate - number of pregnancies per 1,000

women of childbearing ageFetal death rate - number of fetal deaths

occurring in infants weighing over 500g

per 1,000 live birthsPerinatal death rate - number of deaths per 1,000

live births occurring between birth and

the first 28 days of life


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newborn nursing

Neonatal mortality - number of deaths per 1,000

live births of fetuses weighing more

than 500g and in the first 28 days of lifeMaternal mortality - number of maternal deaths

per 100,000 live births that occur as a

direct result of the childbearing processInfant mortality - number of deaths per 1,000 live

births occurring at birth or in the first 12

months of life


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newborn nursing

Child mortality - number of deaths per 1,000

population in children from 1 to 14

years of age


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Advanced Practice Roles in

Maternal-Newborn Nursing


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Advanced Practice Roles in Maternal-

Newborn Nursing

1. Womens health nurse practitioner

2. Family nurse practitioner (FNP)

3. Pediatric nurse practitioner (PNP) and aneonatal practitioner (NNP)

4. Certified nurse-midwife

5. Clinical nurse specialist6. Certified registered nurse (RNC)


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Newborn Nursing

1. Womens health nurse practitioner- a nurse

with advanced study in health promotion and

health maintenance of women

2. Family nurse practitioner (FNP) a nurse

who provides care not only to women but toclients across the life span


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Newborn Nursing

3. Pediatric nurse practitioner (PNP) and a

neonatal practitioner (NNP) - nurses who

provide skilled care to children and infants

4. Certified nurse-midwife - provides complete

care during an uncomplicated pregnancy,labor and birth


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Newborn Nursing

5. Clinical nurse specialist - a role model,

researcher and teacher of quality nursing

care

6. Certified registered nurse (RNC) - a nurse

who has shown expertise in a particular fieldof nursing, such as labor and delivery, by

taking and passing a national certification

examination.


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Ethical and Legal Issues in



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Ethical and Legal Issues in Maternal-Newborn

Nursing

Ethics determining the best course of action

Bioethics application of ethics to health caresituations


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Nursing

Ethical issues:

maternal vs fetal rights

abortion length of time resuscitation should be

continued


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Nursing

Professional liability

Nurses are legally responsible andaccountable for the quality of nursing care they

give

Documentation is the best evidence of the

quality of care received by the client


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Nursing

Malpractice

Nurses are expected to provide care within thecontext of nurse practice acts, standards of

care and policies developed by the agency

Documentation is essential to protecting the

nurse an justifying her actions


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Nursing Process for



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Nursing Process Maternal-Newborn Nursing

Assessment

Three levels of nursing assessment:

1. Comprehensive assessment2. Focused assessment

3. Emergency assessment

Data gathered are either:

- subjective data

- objective data


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Nursing Diagnoses

Anxiety

Breast- feeding: Effective, Ineffective orInterrupted

Body Image Disturbance

Constipation Decisional Conflict

Altered Family Process

Fatigue


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Nursing Diagnoses

Risk of Infection

Pain Altered Parent/ Infant Attachment

Altered Role Performance

Situational Low Self- esteem Sleep Pattern Disturbance

Ineffective Thermoregulation

Altered Urinary Elimination


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Planning and outcome identification Nurse determines priorities and develops

goals

Implementation

Interventions are developed and

implemented to accomplish the goals oroutcomes that have been identified

Evaluation

D t i th ff ti f th l

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