Maternal and Child Health Nursing Practice

1 UNIT ONEM aternal and Child HealthNursing PracticeAFramework for Maternal and ChildHealth NursingObjectivesAfter mastering the contents of this chapter, you should be able to:Key Termsclinical nurse specialistevidence-based practicefamily nurse practitionerfertility ratematernal and Child healthnursingmortality rateneonatal nurse practitionerneonatenurse-midwifenursing researchpediatric nurse practitionerpuerperiumscope of practicewomen s Health the goals and philosophyof Maternal and Child the evolution, scope,and professional roles fornurses in Maternal and Child Health common statistical termsused in the field, such as infantand Maternal the implications of thecommon standards of maternaland Child Health Nursing and thehealth goals for the nation for ma-ternal and Child Health the interplay of nursingprocess, evidence-basedpractice.

2 And Nursing theory asthey relate to the future ofmaternal and Child healthnursing critical thinking to identifyareas of care that could benefitfrom additional research orapplication of concepts of family-centered care to Maternal andchild Health knowledge of trends inmaternal and Child Health carewith the Nursing process toachieve quality Maternal andchild Health Nursing Chung is a premature neonate who must be transported to a regional center for care about 30 milesfrom your local hospital. Her parents, Melissa and Robert, have many concerns. They don t want to be sofar from their daughter, and they don t know how they will pay for her special care . Also, Melissa, 37 years old, believes she is too old to leave the hospital so soon after having a cesarean birth. She recalls staying in the hospital much longer after having her first Child , Micko, now 6 years chapter discusses standards and philosophies of Maternal - Child Health care and howthese standards and philosophies affect are some Health care issues evident in this scenario?

3 How has modern cost containment changedthis scenario?What is the Nursing role here?After you ve studied this chapter, access the accompanying website. Read thepatient scenario and answer the questions to further sharpen your skills, growmore familiar with RN-CLEX types of questions, and reward yourself with howmuch you have 1he care of childbearing and childrearing families isa major focus of Nursing Practice , because to havehealthy adults you must have healthy children. Tohave healthy children, it is important to promote the healthof the childbearing woman and her family from the timebefore children are born until they reach adulthood. Bothpreconceptual and prenatal care are essential contributionsto the Health of a woman and fetus and to a family s emo-tional preparation for childbearing and childrearing. As chil-dren grow, families need continued Health supervision andsupport.

4 As children reach maturity and plan for their fam-ilies, a new cycle begins and new support becomes nec-essary. The nurse s role in all these phases focuses onpromoting healthy growth and development of the childand family in Health and in the field of Nursing typically divides its con-cerns for families during childbearing and childrearinginto two separate entities, maternity care and Child healthcare, the full scope of Nursing Practice in this area is nottwo separate entities, but one: Maternal and Child healthnursing (Fig. ).GOALS AND PHILOSOPHIES OF Maternal AND Child Health NURSINGThe primary goal of Maternal and Child Health nursingcare can be stated simply as the promotion and mainte-nance of optimal family Health to ensure cycles of optimalchildbearing and childrearing. Major philosophical assump-tions about Maternal and Child Health Nursing are listed inBox The goals of Maternal and Child Health nursingcare are necessarily broad because the scope of Practice isso broad.

5 The range of Practice includes Preconceptual Health care care of women during three trimesters of pregnancyand the puerperium(the 6 weeks after childbirth,sometimes termed the fourth trimester of pregnancy) care of children during the perinatal period (6 weeksbefore conception to 6 weeks after birth) care of children from birth through adolescence care in settings as varied as the birthing room, the pediat-ric intensive care unit, and the homeIn all settings and types of care , keeping the family atthe center of care delivery is an essential goal. Maternal andUNIT 1 Maternal and Child Health Nursing Practice4 TTFIGURE and Child Health Nursing includescare of the pregnant woman, Child , and family. (A) Duringa prenatal visit, a Maternal Child Health nurse assessesthat a pregnant woman s uterus is expanding normally.

6 (B) During a Health maintenance visit, a Maternal childhealth nurse assesses a Child s growth and development.( Barbara Proud.)ABBOX of Maternal and Child Health Nursing Maternal and Child Health Nursing is family-centered; assessment data must include a familyand individual assessment. Maternal and Child Health Nursing is community-centered; the Health of families depends on andinfluences the Health of communities. Maternal and Child Health Nursing is research-oriented, because research is the means wherebycritical knowledge increases. Both Nursing theory and evidence-based practiceprovide a foundation for Nursing care . A Maternal and Child Health nurse serves as anadvocate to protect the rights of all familymembers, including the fetus. Maternal and Child Health Nursing includes a highdegree of independent Nursing functions, becauseteaching and counseling are so frequently required.

7 Promoting Health is an important Nursing role,because this protects the Health of the nextgeneration. Pregnancy or childhood illness can be stressfuland can alter family life in both subtle andextensive ways. Personal, cultural, and religious attitudes and be-liefs influence the meaning of illness and its im-pact on the family. Circumstances such as illnessor pregnancy are meaningful only in the contextof a total life. Maternal and Child Health Nursing is a challengingrole for a nurse and is a major factor in promotinghigh-level wellness in Health Nursing is always family-centered; the familyis considered the primary unit of care . The level of familyfunctioning affects the Health status of individuals, becauseif the family s level of functioning is low, the emotional,physical, and social Health and potential of individuals inthat family can be adversely affected.

8 A healthy family, onthe other hand, establishes an environment conducive togrowth and Health -promoting behaviors that sustain familymembers during crises. Similarly, the Health of an individ-ual and his or her ability to function strongly influencesthe Health of family members and overall family function-ing. For these reasons, a family-centered approach enablesnurses to better understand individuals and, in turn, to pro-vide holistic care . Box provides a summary of key mea-sures for the delivery of family-centered Maternal and childhealth OF Maternal AND Child Health Nursing PRACTICEThe importance a society places on human life can bestbe measured by the concern it places on its most vulner-able members its elderly, disadvantaged, and youngestcitizens. To promote consistency and ensure quality nurs-ing care and outcomes in these areas, specialty organiza-tions develop guidelines for care in their specific areas ofnursing Practice .

9 In Maternal - Child Health , standards havebeen developed by the Division of Maternal - Child HealthNursing Practice of the American Nurses Association incollaboration with the Society of pediatric Nurses. Theseare shown in Box Association of Women s Health , Obstetric, and Neo-natal Nurses (AWHONN) has developed similar standardsfor the Nursing care of women and newborns. These aresummarized in Box FRAMEWORK FOR MATERNALAND Child Health Nursing CAREM aternal and Child Health Nursing can be visualized withina framework in which nurses, using Nursing process, nurs-ing theory, and evidence-based Practice , care for familiesduring childbearing and childrearing years through fourphases of Health care : Health promotion Health maintenance Health restoration Health rehabilitationExamples of these phases of Health care as they relate tomaternal and Child Health are shown in Table Nursing ProcessNursing care , at its best, is designed and implemented ina thorough manner, using an organized series of steps, toensure quality and consistency of care (Carpenito, 2004).

10 The Nursing process, a proven form of problem solvingbased on the scientific method, serves as the basis for as-sessing, making a Nursing diagnosis, planning, organizing,and evaluating care . That the Nursing process is applica-ble to all Health care settings, from the prenatal clinic tothe pediatric intensive care unit, is proof that the methodis broad enough to serve as the basis for all Nursing nurses rarely work in isolation, but rather as amember of a Health care team or unit, MultidisciplinaryCare Maps are included throughout the text to demon-strate the use of the Nursing process for selected clients,provide examples of critical thinking, and clarify nursingcare for specific client needs. Multidisciplinary care mapsrather than Nursing care plans are shown, because theynot only demonstrate the Nursing process but accentuatethe increasingly important role of the nurse as a coordi-nator of client addition, selected chapters also identify specificnursing outcomes using the terminology presented in theNursing Outcomes Classification (NOC) and Nursing ac-tivities using the terminology presented in the Nursing In-terventions Classification (NIC) developed by the IowaIntervention Project ( Johnson et al.)