NCM 107-LECTURE: Care of Mother, Child, Adolescents (Well Clients)
Introduction:
The area of childbearing and childrearing families is a major focus
of nursing practice in promoting health for the next generation.
Comprehensive preconception and prenatal care is essential in ensuring
a healthy outcome for mother and child.
TOPICS:
I.Philosophies of Maternal and Child Health Nursing
The primary goal of both maternal and child health nursing is the
promotion and maintenance of optimal family health
Maternal and child health nursing is:
a. Family centered
b. Community centered
c. Evidence based , this is the means whereby critical knowledge is increased.
d. A challenging role for nurses and a major factor in keeping families well and
optimally functioning.
A maternal and Child Health Nurse:
a. Considers the family as a whole and as a partner in care when planning or
implementing or evaluating the effectiveness of care.
b. Serves as an advocate to protect the rights of all family members, including
the fetus.
c. Demonstrates a high degree of independent nursing functions because
teaching and counseling are major interventions
d. Promotes health and disease prevention because these protect the health of
the next generation.
e. Serves as an important resource for families during childbearing and
childrearing as these can be extremely stressful times in a life cycle.
f. Respects personal, cultural and spiritual attitudes and beliefs as these so
strongly influence the meaning and impact of childbearing and childrearing
g. Encourages developmental stimulation during both health and illness so
children can reach their ultimate capacity in adult life.
h. Assesses families for strengths as well as specific needs or challenges
i. Encourages family bonding through rooming-in and family visiting in maternal
and child healthcare settings.
j. Encourages early hospital discharge options to reunite families as soon as
possible in order to create a seamless, helpful transition process.
Encourages families to reach out to their community so the family can develop a
wealth of support people they can call on in a time of family crisis.
II. Maternal and Child Health Goals and Standards
The 2020 National Health Goals are intended to help citizens more easily
understand the importance of health promotion and disease prevention and to
encourage wide participation in improving health in the next decade.
It’s important for maternal and child health nurses to be familiar with these
goals because nurses play such a vital role in helping the nation achieve these
objectives through both practice and research
The goals also serve as the basis for funding and financing of evidence-based
practice
GLOBAL HEALTH GOALS
1. To end poverty and hunger.
2. To achieve universal primary education.
3. To promote gender equality and empower women.
4. To reduce child mortality.
5. To improve maternal health.
6.To combat HIV/AIDS, malaria, and other disease.
7.To ensure environmental sustainability.
8.To develop a global partnership for development.
> The establishment of global health goals is a major step forward in improving
the health of all people.
III. Framework for Maternal and Child Health Nursing Care
Maternal and child health nursing can be visualized within a framework
in which nurses use:
• Nursing process
• Nursing theory
• Quality and Safety Education for Nurses
To care for families during child bearing and child rearing years and
through the four phases of health care:
1.Health promotion – educating parents and children to follow sound
health practices through teaching and role modeling
2. Health maintenance - intervening to maintain health when risk of
illness is present
3. Health restoration – using conscientious assessment to be certain
that symptoms of illness are identified and interventions are begun to
return patient to well ness most rapidly
4. Health rehabilitation – helping prevent complications from illness
helping a patient with residual effects achieve an optimal state of
wellness and independence; helping a patient to accept inevitable death.
Discussion:
a. Nursing Process – a scientific form of problem solving, serves as the
basis for assessing, making a nursing diagnosis, planning, implementing
and evaluating care.
It is a process broad enough to serve as the basis for modern nursing
care because it is applicable to all healthcare settings, from the home to
ambulatory clinics to intensive care units.
b. Nursing Theory
> Nursing theories are designed to offer helpful ways to view patients so
nursing activities can be created to best meet patients needs
c. QSEN – Quality and Safety Education for Nurses
Created 6 competencies necessary for quality care
a. patient-centered care
b. Teamwork and collaboration
c. Quality improvement
d. Informatics
e. Evidence based practice
f. Safety
Over all goal of QSEN: to prepare future nurses with the abilities
necessary to continuously improve the quality and safety of the
healthcare systems in which they work.
IV. Legal Considerations of Maternal –Child Practice:
Legal concerns arise in all areas of health care
Maternal and child health nursing carries some legal concerns above
and beyond other areas of nursing because care is often given to
patients who are not of legal age for giving consent.
Reproductive healthcare rights and laws are complex and vary from
state to state.
Nurses are legally responsible for protecting the rights of their patient,
including confidentiality and are accountable for the quality of their
individual nursing care and that of other healthcare team members.
Understanding the scope of practice (the range of services and care
that may be provided by a nurse based on state requirements) and
standards of care can help nurses practice within appropriate legal
parameters.
Documentation is essential for justifying actions
A nursing note written today may need to be defended as many as 21 years
into the future
Nurses should be careful enough in obtaining informed consent for invasive
procedures
ETHICAL CONSIDERATIONS OF PRACTICE
Some of the most difficult ethical quandaries in health care today are
those that involve children and their families.
Examples:
Conception issues, especially those related to in vitro fertilization, embryo
transfer, ownership of frozen oocytes or sperm and surrogate motherhood
Pregnancy termination
Fetal rights versus rights of the mother
Stem cell research
Resuscitation (and length of its continuation)
Number of procedures or degree of pain a child should be asked to endure to
achieve a degree of better health
Balance between modern technology and quality of life
Difficulty maintaining confidentiality of records when there are multiple
caregivers.