FRAMEWORK OF MATERNAL AND CHILD GOALS AND PHILOSOPHIES OF

HEALTH NURSING MATERNAL AND CHILD HEALTH NURSING

Obstetric The primary goal of maternal and child
health nursing:
- care of woman during child birth
- derived from the Greek word “obstare” The promotion and maintenance of optimal
which means “to keep watch” family health to ensure cycles of optimal
childbearing and childrearing.
Pediatrics
The goals of MCHN:
- Derived from the Greek word “pais”
meaning “child” 1. Preconceptual health care
2. Care of women during three trimesters
FRAMEWORK FOR MCHN
of pregnancy and the puerperium
MCHN can be visualized as a framework in
Puerperium- the 6 weeks after childbirth; fourth
which nurses use:
trimester of pregnancy
- Nursing process
3. Care of children during the perinatal
- Nursing theory
period
- Quality and Safety Education for Nurses
(QSEN) Perinatal period- 6 weeks before conception to
- Evidence-based practice 6 weeks after birth
- Nursing research
4. Care in settings as varied as the birthing
FOUR PHASES OF HEALTH CARE room, the pediatric intensive care unit, and
the home
- Health promotion
- Health maintenance PHILOSOPHY OF MATERNAL AND CHILD
- Health restoration HEALTH NURSING
- Health rehabilitation
- family centered; assessment data must
QSEN include a family and individual
assessment
- Robert Wood Johnson Foundation
- community centered; health of families
- Challenge nursing leaders to:
depends on and influences the health of
o Improved the quality nursing care
communities
by describing what constitutes - research-oriented because research is
good nursing care the means whereby critical knowledge
o To build into prelicensure and increases
graduate program in nursing that - both nursing theory and evidence-based
KSA necessary to help achieve practice provide a foundation for nursing
to level of care care
QSEN SIX COMPETENCIES - a maternal and child health nurse serves
as an advocate to protect the rights of all
1. Patient-centered care family members, including the fetus
2. Teamwork and collaborative - mchn includes a high degree of
3. Quality improvement independent nursing functions, because
4. Informatics teaching and counseling are so
5. Evidence-based practice frequently required
6. Safety
 - promoting health is an important nursing
role, because this protects the health of
the next generation
- pregnancy or childhood illness can be
stressful and can alter family in both
subtle and extensive ways
- personal, cultural, and religious attitudes
and beliefs influence the meaning of
illness and its impact on the family.
Circumstances such as illness or
pregnancy are meaningful only in the
context of a total life.
- MCHN is a challenging role for a nurse
and is a major factor in promoting high-
level wellness in families
MAIN OBJECTIVE OF MCHN
- Is to improve maternal and newborn
AMERICAN NURSES ASSOCIATION /
SOCIETY OF PEDIATRIC NURSES
STANDARDS OF CARE AND
PROFESSIONAL PERFORMANCE
Standards of Care:
Comprehensive pediatric nursing care focuses
on helping children and their families and
communities achieve their optimum health
potentials.
This is best achieved within the framework of
family-centered care and the nursing process,
including primary, secondary, and tertiary care
coordinated across health care and community
settings.
Association of Women’s Health, Obstetric,
and Neonatal Nurses Standards and
Guidelines
Standards of Professional Performance:
Standard I: Quality of Care
Standard II: Performance Appraisal
Standard III: Education
Standard V: Ethics
- The nurse’s decisions and actions on
behalf of patients are determined in an
ethical manner
Standard VI: Collaboration
- The nurse collaborates with the patient,
significant others, and health care
providers in providing patient care,
Standard VII: Research
- The nurse uses research findings in
practice
Standard VIII: Resource Utilization
- The nurse considers factors related to
safety, effectiveness, and cost in
planning and delivering patient care
Standard IX: Practice Environment
- The nurse contributes to the
environment of care delivery withing the
practice settings
Standard X: Accountability
- The nurse is professionally and legally
accountable for his/her practice. The
professional registered nurse may
delegate to and supervise qualified
personnel who provide patient care
THEORIES RELATED TO MATERNAL CHILD
NURSE
Theorist and Major Concepts of Theory
a. Patricia Benner - nursing is a caring
relationship; nurses grow from novice to
expert as they practice in clinical
settings
b. Dorothy Johnson – a person
comprises subsystems that must remain
in balance for optimal functioning; any
actual or potential threat to this system
balance is a nursing concern
c. Imogene King – nursing is a process of
action, reaction, interaction, and
transaction; needs are identified based
 on client’s social system, perceptions,
and health; the role of the nurse is to
help the client achieve goal attainment
d. Madeleine Leininger – the essence of
nursing is care; to provide transcultural
care, the nurse focuses on the study
and analysis of different cultures with
respect to caring behavior
e. Florence Nightingale – the role of the
nurse is viewed as changing or
structuring elements of the environment
such as ventilation, temperature, odors,
noise, and light to put the client into the
best opportunity for recovery
f. Betty Neuman – a person is an open
system that interacts with the
environment; nursing is aimed at
reducing stressors through primary,
secondary, and tertiary prevention
g. Dorothea Orem- The focus of nursing is
on the individual; clients are assessed in
terms of ability to complete self-care.
Care given may be wholly compensatory
(client has no role); partly compensatory
(client participates in care); or
supportive-educational (client performs
own care)
h. Ida Jean Orlando- Focus of the nurse is
interaction with the client; effectiveness
of care depends on the client’s behavior
and the nurse’s reaction to that
behavior. The client should define his or
her own needs
i. Rosemarie Rizzo Parse- Nursing is a
human science. Health is a lived
experience. Man-living-health as a
single unit guides practice
j. Hildegard Peplau- The promotion of
health is viewed as the forward
movement of the personality; this is
accomplished through an interpersonal
process that includes orientation,
identification, exploitation and resolution
k. Martha Rogers- The purpose of nursing
is to move the client toward optimal
health; the nurse should view the client
as whole and constantly changing and
help people to interact in the best way
possible with the environment
l. Sister Callista Roy- The role of the
nurse is to aid clients to adapt to the
challenge caused by illness; levels of
adaptation depend on the degree of
environmental change and state of
coping ability; full adaptation includes
physiologic interdependence
ROLES AND RESPONSIBILITIES OF MCH
NURSE
WHO’S 17 SUSTAINABLE DEVELOPMENT
GOALS
Introducing the SDGs
The SDGs Are:
- Set of goals for the world’s future,
through 2030
- Backed up by a set of 169 detailed
targets
- Negotiated over a two-year period at the
United Nations
- Agreed to be nearly all the world’s
nations on 25 September 2015
What is New and Different About the 17
SDGs?
1. Universality- First and most important,
these goals apply to every nation and every
sector. Cities, businesses, schools,
organizations, all are challenged to act
2. Integration- Second, it is recognized that
the goals are all inter-connected, in a system.
We cannot aim to achieve just one goal. We
must achieve them all
3. Transformation- And finally, it is widely
recognized that achieving these goals involves
making very big, fundamental changes in how
we live on earth
17 SUSTAINABLE DEVELOPMENT GOALS
1. End poverty in all its forms everywhere
2. End hunger, achieve food security and 1. Life came into existence
improved nutrition and promote sustainable 2. Primitive life evolved into more organisms
agriculture and eventually producing mankind
3. Ensure healthy lives and promote well-
being for all and at all ages
4. Ensure inclusive and quality education for HOW DID PROCREATION CAME ABOUT?
all and promote lifelong learning The Process of Reproduction
5. Achieve gender equality and empower
women and girls 1. Sexual intercourse
6. Ensure access to water and sanitation for 2. Conception
all 3. Pregnancy
7. Ensure access to affordable, reliable, 4. Birth
sustainable, and modern energy for all
8. Promote inclusive and sustainable TYPES OF REPRODUCTION
economic growth, employment and decent a) SEXUAL- Requires two parent organisms
work for all b) ASEXUAL- Requires one parent organism
9. Build resilient infrastructure, promote
sustainable industrialization and foster
innovation
10. Reduce inequality within and among
countries
11. Make cities inclusive, safe, resilient and
sustainable
12. Ensure sustainable consumption and
production patterns
13. Take urgent action to combat climate
change and its impacts
14. Conserve and sustainably use the oceans,
seas, and marine resources
15. Sustainably manage forests, combat
desertification, halt and reverse land
degradation, halt biodiversity loss HUMAN REPRODUCTION
16. Promote just, peaceful and inclusive - Sexual and Reproductive Development
societies - Human beings are sexual throughout
17. Revitalize the global partnership for life. Sexuality encompasses more than
sustainable development sexual behavior- it is not only physical,
but the mental and spiritual as well.
REPRODUCTIVE AND SEXUAL HEALTH
Sexuality is a core component of
Concept of Unitive and Procreative Health personality and a fundamental part of
human life. While the problems usually
- Procreation- Creation of a new human associated with sexual behavior are real
person by act of sexual intercourse, and need to be addressed, human
between a man and a woman sexuality also has significant meaning
- Creation- The making of all things from and value in each individual’s life
nothing, by an act of God, at some time in
the past. God’s action could have taken a Freud’s Psychosexual Theory (1856-1939)
second, or 6 days, or a million years
- The first three stages (Oral, anal and
- Evolutionary Theory- A theory explaining
phallic) are called pre-genital stage
that all things came about by the repeated
- The culminating stage is the genital
random actions of natural selection
stage
Charles Darwin Theory of Evolution
 - If the individual does not achieve a - Generally, occurs between the ages 9-
satisfactory progression of each stage, 13
the personality becomes fixated at that - Results in ovulation and menstruation,
stage which involve cyclic hormonal changes
- Preschooler (3 to 6 years)- Phallic in estrogen and progesterone
stage: child learns sexual identity - And the development of secondary
through awareness of the genital area sexual characteristics
REPRODUCTIVE BIOLOGY
- Reproductive physical maturity and the FEMALE AND MALE REPRODUCTIVE
capacity for human reproduction begin SYSTEM
during puberty, a period of rapid growth
and change experienced by both males - Vulva or pudenda refers to the entire
and females female genitalia
- During puberty, the hypothalamus (a - Mons pubis is a fold of fats above the
gland located at the base of the brain symphysis pubis that is an important
which regulates temperature, sleep,
obstetrical landmark and protects the
emotions, sexual function and behavior)
produces hormones symphysis pubis from trauma
- These hormones stimulate the gonads, o It is richly supplied with sebaceous
the reproductive glands (the testes in gland
male and ovaries in female) to produce o Escutcheon with curly hair
testosterone (males) and estrogen and
progesterone (females)
Male Puberty
- Generally, occurs between the ages of
13-15
- Characterized by the secretion of the
male hormone testosterone, which
stimulates spermatogenesis (production
of sperm through meiosis)
- And the development of secondary
sexual characteristics

- Labia majora are thick folds of adipose

tissues originating from the Mons and
terminating in the perineum
o Its functions is to provide covering
and protection to the external organs
located under it
- Labia minora are two thin folds of
connective tissues that joins anteriorly to
form the prepuce and posteriorly to form
the fourchette
Female Puberty
 o It is moist highly vascular, sensitive
and richly supplied with sebaceous
glands
- Skene’s gland- are pair of gland also known
as “paraurethral and minor vestibular gland”
- Vaginal orifice or introitus is the external
opening of the vagina located just below the
urethral meatus
- Grafenburg- or the G spot is a very
sensitive are located at the inner anterior
surface of the vagina
- Urethral meatus- is the external opening of
the female urethra is located just below the
clitoris Uterus “The Womb”
- Uterus- hallow muscular pear-shaped
The Hymen
organ with three layers. Endometrium,
myometrium, and perimetrium
- Located between the bladder and the
rectum and consisting of five parts;
fundus, corpus/body, cornua, isthmus,
and cervix

THE FEMALE REPRODUCTIVE SYSTEM

Functions:
INTERNAL STRUCTURE
1. Menstruation- sloughing away of the
endometrial layers with bleeding from torn
vessels
2. Pregnancy- development of embryo and
fetus after fertilization; it houses and
nourishes the growing baby
3. Labor- powerful contractions of muscular
uterine wall that propels the products of
conception into the vaginal canal

Fallopian Tube
Normal Tube: 2. Ovulation- monthly expulsion of the ovum
from the graafian follicle
3. Endocrine function- secretion of estrogen
and progesterone

ESTROGEN

- secreted by the maturing follicle

- Secreted by the ovaries, adrenal
cortex, and placenta during
pregnancy
- Develops female secondary sex
- Fallopian tubes- two muscular canals characteristic and assists in the
or tubes with the length of 8-14cm maturation of ovarian follicles
extending from the uterine corner to the
site near the ovaries
- The lumen is lined with cilias called
ciliated cubical epithelium that
facilitate movement of the tubes
In pregnancy:
Parts:
1. increases vascularity
1. Interstitial- embodied within the uterine wall 2. maintains the highly specialized
with a lumen that is 1mm in diameter endometrium called decidua
2. Isthmus- a narrow portion immediately after 3. stimulate uterine contraction
the uterus
3. Ampulla- site of fertilization, widest portion PROGESTERONE
4. Infundibulum- funnel-shaped passage that
has fringed end called fimbriae- fimbria - Secreted by corpus luteum and placenta
ovarica is connected to the ovary as early as 6th week of pregnancy until
parturition
Functions: - Inhibits secretion of lutenizing hormone
1. Site of normal fertilization - Helps maintain the endometrium by
2. Ducts through which ova travel from ovaries facilitating secretory phase of the
to the uterus; sperm from uterus to the menstrual cycle- preparation for
ovary implantation
- Relaxes smooth muscle including the
Ovary myometrial muscle of the uterus
- Ovaries- two almond shaped organ - Progesterone maintains pregnancy by
located at the upper part of the pelvic maintaining decidua
cavity - Decrease progesterone level may lead
to abortion
Functions: - Decrease progesterone level at term
1. Oogenesis- process of developing a mature causes onset labor
ovum in a graafian follicle - Increases basal body temperature
 - Has water-retaining antidiuretic action
- Increases fibrinogen level- increases
blood coagulability
- Decreases hemoglobin and hematocrit
level
- Responsible for infertile cervical mucus
- Thick, opaque
- Sticky, non-stretchable
- Produces non-fern pattern when dry

In Pregnancy:
1. Maintains pregnancy
2. Relaxes the uterus
3. And together with estrogen and human
placental lactogen (HPL) and cortisol-
antagonizes insulin