MCN LAB - M1 - Framework for Maternal & Child Health Nrsg Care

Maternal & Child Health Nrsg ` Planning - dvloping a plan of care;

- can be visualized w/in a framework in w/c Ns. use:
1. Nrsg process
2. Nrsg theory
3. Evidence-based practice, care for fams
during childbearing & childrearing yrs
thru 4 phases of H. C.:
i. Health promotion - educates Clients to be aware of good health
thru teaching and role modelling
ii. Health maintenance - when ✓risk of illness = present.
intervenes to maintain health
iii. Health restoration - promptly Dx-ing & Tx-ing illness
using interventions; to return Client’s wellness most rapidly
iv Health rehabilitation
- prevents further complications from an illness;
brings ill Client back to optimal state of wellness/ helps Client to accept
GOALS, PHILOSOPHIES, & STANDARDS of
MATERNAL & CHILD NRSG
prescribe interventions to obtain the Expected Outcomes
` Implementation – implementing interventions identified in the plan of care
` Evaluation – N. evaluates the Child’s & family’s progress
towards attainment of outcomes
□ III.ii Standards of PROFESSIONAL PERFORMANCE
` Quality of Care - evaluating the quality & effectiveness of nrsg practice
` Performance Appraisal
- evaluation of nrsg practice in relation to professional standards
` Education
- acquisition & maintenance of current knowledge in nrsg practice
` Collegiality
- contributing to professional dvlopment of peers, colleagues & others
` Ethics - decisions & actions on behalf of the Pt.
are determined in an ethical manner.
` Collaboration – collaborating w/ the Pt, significant others, & H. C. providers.
` Research Utilization – considering fxs r/t safety, effectivity & cost
in planning & delivering Pt. care
` Practice Environment – contributing to the Environment of care delivery
w/in the practice setting
` Accountability – N. = professionally & legally accountable for her practice

🍏 I.Goals of Maternal & Child Health Nrsg

○PRIMARY GOAL of both maternal & child health nrsg: 🖸 FXS AFFECTING MATERNAL & HEALTH
✓promotion & ✓maintenance of optimal family health 1. SYSTEMIC LVL
to ensure cycles of optimal childbearing & child rearing Poverty
Religious beliefs
Cultural beliefs
SCOPE of PRACTICE in MChNrsg CARE includes the ff: Traditional practices
1. Preconceptual health care Societal stigma
2. Care of women [ during 3 trimesters of pregnancy 2. ORGANIZATIONAL LVL
& the puerperium = 6 wks after childbirth Availability of services
3. Care of children [ during perinatal period =6 wks b4 conception Quality of H. C. providers
& to 6 wks after birth Accessibility of health services
4. Care of children from BIRTH to ADOLESCENT
5. Care in settings as varied as the Birthing room, 3. INTERPERSONAL LVL
Pediatric intensive care unit & Home Family tradition
Husband’s knowledge & perception
🍏 II.Philosophies of Maternal & Child Health Nrsg Peer influence
◦ FAMILY- CENTERED APPROACH Influence of other members of the family
enables N. to better understand Indivs & in turn to provide holistic care Family support for home delivery
◦MChNrsg → COMMUNITY-CENTERED;
4. INDIVIDUAL LVL
health of fams depends on & influences the health of communities
Age & education
◦ MChNrsg → RESEARCH ORIENTED, Knowledge & perceived need of maternal H. C.
bc research is the means whereby it ↑s CRITICAL KNOWLEDGE Afraid of disclosure of pregnancy
◦Both Nrsg theory & EBP - provides a FOUNDATION for Nrsg CARE Financial burden/ income
◦MCh N. ↓Low decision-making autonomy
- advocate to protect the rights of ALL family members, (+) fetus
◦ MChNrsg includes a H↑GH degree of INDEPENDENT nrsg fnxns,
bc frequently required: teaching & counselling ◦EVIDENCE BASED JOURNAL ARTICLE REVIEW:
MChNrsg = multidimensional.
◦!!Promoting health - !mportant nrsg role, - affected by many fxs & as future Ns., it is vital to understand & identify how
bc it protects the health of the next generation. these fxs can affect the health of the mother & child.
◦Pregnancy/ childhood illness - Knowing these fxs can help in ↓reducing pregnancy related complications
can be stressful & can alter family life in both subtle & extensive ways
◦Personal, cultural & religious attitudes & beliefs
influence the meaning of illness & its impact on the family ◦Birth rate - # of births per 1,000 population
◦ MChNrsg → challenging role for a N. ◦Fertility rate
& is a major fx in promoting H↑GH-lvl wellness in families - # of PREGNANCIES per 1,000 women of childbearing age.
- tends to be ↓low in countries where
🍏 III. Standards of Maternal & Child Nrsg ✓ ↓fewer nutritional resources bc poor nutrition makes conceiving
◦To promote consistency & ensure quality nrsg care & outcomes in these difficult,
areas, specialty organizations dvlop standards for care in their specific areas as well as in countries where
of nrsg practice. Proportion of Young Adult MEN = ↓low bc of WAR/ DISEASE
◦Association of Women’s Health, Obstetric, & Neonatal Ns. (AWHONN) has
developed similar standards for the nrsg care of women & newborns
◦Fetal death rate
□ III.i Standards of CARE - # of FETAL DEATHS (over 500g) per 1,000 live births.
`Assessment- COLLECTION Pt. data. - It is important in evaluating the health of a nation bc it reflects the
`Diagnosis- assessment of data to determining the Dx overall quality of maternal health & whether common services
` Outcome identification - identifies Expected Outcomes individualized such as prenatal care are available
to the child & family Sir! – di pa napanganak
◦Neonatal death rate
- # of deaths per 1,000 live births occurring @ birth or
74 in the first 28 days of life
- This rate reflects ✗ot only the quality of care available to women
during pregnancy & childbirth but also the quality of care available to
infants during the 1st month of life.
◦Perinatal death rate
- # of deaths during the perinatal time period
(beginning when a fetus reaches 500g, abt week 20 of pregnancy,
& ends about 4 to 6 weeks after birth);
- sum of FETAL & NEONATAL RATES
◦Maternal mortality rate
- # of maternal deaths per 100,000 live births that occur as a
direct result of the reproductive process
◦Infant mortality rate
- # of deaths per 1,000 live births occurring @ birth/ in the first 12
months of life
- infant mortality rate of a country
= good index of its general health bc it measures the quality of
pregnancy care, overall nutrition, & sanitation,
as well as infant health & available care.
This rate = the traditional standard used to compare the health of a
nation w/ previous yrs or w/ other countries
◦Childhood mortality rate
- # of deaths per 1,000 population in children aged 1 to 14 yrs
🍏 ROLES & RESPONSIBILITIES of a M&CH N.
M&C N.:
1. considers the Family as a whole & a partner to achieve optimal care,
2. Serves an advocate to protect the rights of the family, including the fetus.
3. Demonstrates a H↑GH degree of nrsg fnxns.
4. Promotes health & disease prevention
5. Respects personal, & cultural & spiritual attitudes & beliefs
6. Assesses Family’s strengths as well as specific needs & challenges
7. Encourages family bonding thru rooming-in & visits in MCN settings
8. Encourages early hospital discharge options to reunite family ASAP
9. Encourages family to reach out their community
Concept map - diagram/ graphical tool;
visually represents relationships b/w concepts & ideas
- Most c. maps depict ideas as boxes/ circles AKA “NODES”,
w/c
MCNareLAB
structured hierarchically & connected
- M 2 - REPRODUCTIVE & SEXUALw/HEALTH
lines/ arrows AKA “ARCS”
Unitive & Procreative Health; and Human Sexuality (Part 1)
` Addressed in diff religious & societal norms,
ppl are uncomfortable to disclose abt the concept on sex & sexuality
` @ wilder perspective, it is sex = makes the world go around
` Idea of evolution, procreation & expression of sexuality
can be as old as the earliest date of mankind.
CONCEPTS on UNITIVE & PROCREATIVE HEALTH;
& HUMAN SEXUALITY
Understanding the purpose of a union of two (2) individuals for the purpose
of procreation is a prerequisite in discerning sexuality as a form of human
expression. Engaging in an erotic activity, as what is implied in sex, is
different when one talks about the concept related to human expression of
sexuality that may encompass kissing, hugging and comforting.
🍏Trends in Maternal & Child Health Care & Implications for Ns.
Maternal & child population - constantly changing bc of changes in social
structure, variations in fam lifestyle & changing patterns of illness
Today, client advocacy, a philosophy of cost containment, an ↑d focus on
Health education, & new!nrsg roles = ways in w/c Ns. have adapted
to these changes.
Here are some of the social changes that occur in the past yrs that have
altered H. C. priorities for Maternal & Child health Ns.
` Families are smaller than in previous decades.
↓Fewer family members are present as support in a time of crisis.
Ns. must fulfill this role more than ever before.
` Single parents are ↑ing in #.
A single parent may have ↓fewer financial resources
` ↑ing # of women work outside the home.
!H. C. must be scheduled @ times a working parent can bring a child for care
`Families are more mobile than previously; there is an ↑ in the # of homeless
women & children.
Good interviewing
= necessary w/ mobile families so a health database can be established;
Education for health monitoring = !mportant.
` Abuse is more common than ever before.
! Screening for child/ intimate partner abuse
should be included in family contacts.
` Families = more health-conscious than previously.
! Families = ripe for HEALTH EDUCATION;
providing this can be a MAJOR NRSG ROLE.
` H. C. must respect cost containment.
! Comprehensive care = necessary in primary care settings bc
referral to specialists may ✗longer be an option
🍏NRSG THEORIES:
1 of the requirements of a profession is that the concentration of a
discipline’s knowledge flows from a base of established theory.
Nursing theorist
- offer helpful ways to view clients so that nursing activities can best meet
client’s needs
- Only with this broad theoretical focus can nurses appreciate the significant
effect on a family of a child’s illness/ of the introduction of a new!member
Another issue most nrsg theorist’s address
◦is how Ns. should be viewed/ what the goals of nrsg care should be.
◦Extensive changes in the scope of MChNrsg have occurred as health
promotion,/ keeping parents & children well, has become a greater priority
The concept on unitive health is associated with the root word unity that
implies a union of a man and a woman in the sole purpose of procreation-
procreative health. The term procreation - the need for individuals to
voluntary engage in a sexual activity with the purpose of producing an
offspring, an individual similar to their kind.
Various viewpoints on the word sex and sexuality often lead to
interchangeably referring one to the other. Referring to biological assignment
to being male or female according to genital nature, the word sex is implied.
Other than assignment to male or female, sex - also refers to the specific
sexual act/ behavior. Meanwhile, sexuality refers to 1’s human character- an
expression of feelings, emotions and thoughts related to being human
irrespective of genital nature.
Male and female refer to biologically determined sex, as determined by a
number of factors. Gender goes beyond just one's biologically determined
sex, although in most cases that forms the cornerstone of one's gender
identity. Gender encompasses one's perceptions of gender identity. Gender
also entails subsequently learning society's expectations for a particular
gender, what is referred to as gender role. So a number of additional
psychosocial perceptions, expectations, and meanings are attached to being
either of the male or female sex by the concept of gender.
Sigmund Freud (1856-1939)
- based his PSYCHOLOGICAL THEORIES on the influence of sexuality on
personality

Root words
Unity = implies a union of man & a woman in the sole purpose of pre
Havelock Ellis (1858-1939)
- pioneer in SCIENTIFIC than theoretical, investigation of human sexuality

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 CHN LAB – M1

Community Health Nrsg

- service rendered by a professional N. w/ communities, grps, fams, indivs @
home, in health centers, in clinics, in schools, in places of work for the II. 2ndary Prevention
promotion of health, prevention of illness, care if the sick @ home & in ○Promptness = ○early Dx
rehabilitation
–implemented, when health probs have dvloped,/ Sxs have occurred
○Community – PRIMARY Client in CHN - Ex. Early case findings followed by appropriate referrals
○Family – also a Client
& an Indiv member who is sick is usually the entry point to the fam
Entry = 1st person that we are able to talk w/ III. Tertiary Prevention
○ Rehabilitation
Public Health Nrsg - strategies to assist Client in Rehabilitation
- special field of nrsg; combines Knowledge & Skills in nrsg & public health, - provides for re-adaptation & re-education & is initiated after Tx
primarily for the promotion of health & prevention of illness
Sir! - Pt. = cured thru surgery, then 2nd week = therapy
Health – state of complete Physical, Mental & Social well-being,
✗t merely the absence of disease/ infirmity [WHO]

COMPONENTS of H. C. DELIVERY SYSTEM

1. formulation & dvlopment of national health policies, guidelines, standards
& manual of operations for health services & programs;
2. issuance of rules & regulations, licenses & accreditations;
3. promulgation of national health standards, goals, priorities & indicators;
Sir! Ex. DOH
4. dvlopment of special health programs & projects & advocacy for legislation
on health policies & programs

Department of Health,DOH
- country’s principal health agency
- responsible for ensuring access to basic public health services thru the
provision of quality h.c. & the regulation of providers of health goods &
services

Universal Health Care, UHC “Kalusugan Pangkalahatan (KP)”

- “provision to every Filo of the HIGHEST possible quality of h. c. that is
accessible, efficient, equitably distributed, adequately funded, fairly financed
& appropriately used by an informed & empowered public.””

PH Health Agenda 2016-2020

- aspires to create a society in w/c Filos have the means to lead healthy &
productive lives, & have a health system where Filos feel respected, valued,
& empowered in ALL of their interactions w/ the system

LVLS of PREVENTIONS
I. Primary Prevention
○ Specific Protection
○ Health Promotion
- involves IMPLEMENTATION of strategies to strengthen (+) coping
strategies & provides Health educ programs

Sir! to TEACH Clients