Chapter 1
A Framework for Maternal and
Child Health Nursing
Primary Goal of Maternal and Child Health
Nursing:
The promotion and maintenance of optimal family
health to ensure cycles of optimal childbearing
and childrearing.
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Maternal and Child Health Nursing Practice
Throughout the Childbearing‒Childrearing
Continuum
Provision of preconception health care
Provision of nursing care of women throughout
pregnancy, birth, and postpartum period
Provision of nursing care of children from birth
through adolescence
Provision of nursing care to families in all settings
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A Philosophy of Maternal and
Child Health Nursing
Includes the following concepts:
o Family-centered
o Community-centered
o Evidence-based
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Two Pillars of the 2020 National Health
Goals
 Increase quality and years of healthy life
 Eliminate health disparities
 New objective recommends that all prelicensure programs in
nursing include core content on
 Counseling for health promotion and disease prevention
 Cultural diversity
 Evaluation of health sciences literature
 Environmental health
 Public health systems
 Global health
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Framework for Maternal and Child Health
Nursing Care #1
Phases of health care
o Health promotion
o Health maintenance
o Health restoration
o Health rehabilitation
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Framework for Maternal and Child Health
Nursing Care #2
The steps of the nursing process
o Assessment
o Nursing diagnosis
o Planning
o Implementation
o Evaluation
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Quality & Safety Education for Nurses
(QSEN)
Patient-Centered Care
Teamwork & Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics
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Legal Considerations Specific to
Maternal–Child Nursing Practice
Informed consent related to fetal well-being
Informed consent and legal guardianship for
procedures performed on children
Length of time between healthcare incident and
child’s ability to bring lawsuit
Identifying and reporting suspected child abuse
Concepts of “wrongful birth,” “wrongful life,” and
“wrongful conception”
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Alternative Healthcare Practices
Commonly Used
Acupuncture
Homeopathy
Therapeutic touch
Chiropractic care
Herbalism
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Statistics Related to the Measurement of
Maternal and Child Health #1
Birth rate
Fertility rate
Fetal death rate
Neonatal death rate
Perinatal death rate
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Statistics Related to the Measurement of
Maternal and Child Health #2
Maternal mortality rate
Infant mortality rate
Childhood mortality rate
Childhood morbidity rate
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Trends Impacting Maternal and Child
Health Nursing
 Families contain fewer members.
 The number of single parents is increasing.
 Ninety percent of women work outside the home; many
are the primary wage earner.
 The number of homeless women and children is
increasing.
 Families are becoming more mobile.
 Families are more informed.
 Child and intimate partner violence is increasing.
 Balancing quality and cost containment in health care is
an increasing initiative.
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Question #1
Which of these actions would be most likely to
promote family-centered care?
A.Restrict hospital visiting hours so patients can rest.
B.Place a limit on the number of visitors per patient to improve
patient security.
C.Solicit parent’s preferences about the way education is
delivered.
D.Restrict the pediatric play area to specific times.
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Answer #1
C. Solicit parent’s preferences about the way
education is delivered.
Rationale: All of the other choices restrict choices that
families can make about healthcare services, access to
family, and their child’s developmental needs.
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Question #2
Which of the QSEN competencies is best reflected by
the act of a nurse promoting the use of electronic
health records (EHRs) to track the health histories of
families who are mobile because of seasonal
employment?
A. Informatics
B. Quality improvement
C. Evidence-based practice
D. Safety
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Answer #2
A. Informatics
Rationale: Although use of EHRs would make the monitoring
of outcomes easier (quality improvement), minimize risk
through system effectiveness (safety), and allow local data
to be collected to better guide practice (evidence-based
practice), the competency of informatics, which is the use of
information and technology to manage knowledge, prevent
error, and support decision making, is the competency most
relevant to this example.
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Question #3
The primary focus of which of these phases of health
care is that of education related to preventing
complications?
A. Health promotion
B. Health maintenance
C. Health restoration
D. Health rehabilitation
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Answer #3
D. Health rehabilitation
Rationale: The goal of health rehabilitation is to prevent
complications related to existing illness and to allow clients
to achieve an optimum state of wellness. Health promotion is
concerned with prevention of disease/illness and promotion
of continued good health, health maintenance occurs when
the client is at risk for disease/injury, and health restoration
is concerned with intervention when disease/injury has
occurred.
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