Chapter 1

Introduction to Maternal and

Child Health Nursing

Maternal and Child Health Nursing

Maternal and Child Health Nursing

Includes the care of the pregnant woman, child and 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

Primary Goal

Primary Goal
Promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing

Major Philosophical Assumptions

about Maternal and Child Health Nursing

Major Philosophical Assumptions about MCN:

1. Family-centered

2. Community-centered
3. Research-oriented

4. 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.

Major Philosophical Assumptions about MCN:

6. Includes a high degree of independent nursing functions. 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 and beliefs influence the meaning of illness and its impact on the family.

Major Philosophical Assumptions about MCN:

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

Standards of Care

Standards of care
Promote consistency and ensure the quality of care in specific area of nursing practice Help the nurse stay within legal parameters

Standards of practice Provide guidelines for planning care and identifying outcome criteria for evaluation of nursing care

Sample Nursing Practice Standards

and Guidelines Related to Maternal-Newborn Care

Standard Standard I Quality of care

Standard II Performance appraisal Standard III Education Standard IV Collegiality

Interpretation The nurse systematically evaluates the effectiveness of nursing practice. The nurse evaluates his or her own nursing practice in relation to professional practice standards and regulations. The nurse acquires and maintains current knowledge in nursing practice. The nurse contributes to the professional development of peers, colleagues, and others.

Standard
Standard V Ethics Standard VI Collaboration Standard VII Research Standard VIII Resource utilization

Interpretation The nurses decisions and actions on behalf of patients are determined in an ethical manner. The nurse collaborates with the patient, significant others, and health care providers in providing patient care. The nurse uses research findings in practice. The nurse considers factors related to safety, effectiveness, and cost in planning and delivering patient care.

Standard Standard IX Practice environment

Standard X Accountability

Interpretation The nurse contributes to the environment of care delivery within the practice setting. 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.

Maternal Newborn Health

Statistical terms used to report maternalnewborn nursing Birth rate - number of births per 1,000 population Fertility rate - number of pregnancies per 1,000 women of childbearing age Fetal death rate - number of fetal deaths occurring in infants weighing over 500g per 1,000 live births Perinatal death rate - number of deaths per 1,000 live births occurring between birth and the first 28 days of life

Statistical terms used to report maternalnewborn nursing Neonatal mortality - number of deaths per 1,000 live births of fetuses weighing more than 500g and in the first 28 days of life Maternal mortality - number of maternal deaths per 100,000 live births that occur as a direct result of the childbearing process Infant mortality - number of deaths per 1,000 live births occurring at birth or in the first 12 months of life

Statistical terms used to report maternalnewborn nursing Child mortality - number of deaths per 1,000 population in children from 1 to 14 years of age

Advanced Practice Roles in Maternal-Newborn Nursing

Advanced Practice Roles in MaternalNewborn Nursing 1. Womens health nurse practitioner 2. Family nurse practitioner (FNP) 3. Pediatric nurse practitioner (PNP) and a neonatal practitioner (NNP) 4. Certified nurse-midwife 5. Clinical nurse specialist 6. Certified registered nurse (RNC)

Advanced Practice Roles in MaternalNewborn 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 to clients across the life span

Advanced Practice Roles in MaternalNewborn 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

Advanced Practice Roles in MaternalNewborn 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 field of nursing, such as labor and delivery, by taking and passing a national certification examination.

Ethical and Legal Issues in Maternal-Newborn Nursing

Ethical and Legal Issues in Maternal-Newborn Nursing Ethics determining the best course of action
Bioethics application of ethics to health care situations

Ethical and Legal Issues in Maternal-Newborn Nursing Ethical issues: maternal vs fetal rights abortion length of time resuscitation should be continued

Ethical and Legal Issues in Maternal-Newborn Nursing Professional liability

Nurses are legally responsible and accountable for the quality of nursing care they give

Documentation is the best evidence of the quality of care received by the client

Ethical and Legal Issues in Maternal-Newborn Nursing Malpractice

Nurses are expected to provide care within the context of nurse practice acts, standards of care and policies developed by the agency

Documentation is essential to protecting the nurse an justifying her actions

Nursing Process for Maternal-Newborn Nursing

Nursing Process Maternal-Newborn Nursing

Assessment Three levels of nursing assessment: 1. Comprehensive assessment 2. Focused assessment 3. Emergency assessment

Data gathered are either: - subjective data - objective data

Nursing Process Maternal-Newborn Nursing

Nursing Diagnoses Anxiety Breast- feeding: Effective, Ineffective or Interrupted Body Image Disturbance Constipation Decisional Conflict Altered Family Process Fatigue

Nursing Process Maternal-Newborn Nursing

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

Nursing Process Maternal-Newborn Nursing

Planning and outcome identification Nurse determines priorities and develops goals

Implementation Interventions are developed and implemented to accomplish the goals or outcomes that have been identified
Evaluation Determines the effectiveness of the plan