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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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 #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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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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