ARE OF MOTHER, CHILD

& ADOLESCENTS(WELL
CLIENTS)
NCM 107
Ms. FRITZIE NECITAS
A.DURAN,RN
LECTURER/CLINICAL INSTRUCTOR
OBSTETRICS
 Thecare of women during childbirth, is
derived from the Greek word obstare,
which means “ to keep watch”
A branch of medical science that deals
with pregnancy, childbirth and the
postpartum period.
 Combined with GYNECOLOGY under
the discipline known as OBSTETRICS &
GYNECOLOGY (OB-GYN) which is a
surgical field.
PEDIATRICS
A word derived from the
Greek word pais, meaning
“child”.
Branch of medicine
concerned with the
development, care,
diseases & development
of babies & children.
GOALS AND 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 extends from preconception to menopause with an expansive array of
health issues and healthcare providers.
 Scope of practice include:
1. Preconception health care
2. Care of women during three trimesters of pregnancy and the puerperium
(the 6 weeks after childbirth, sometimes termed the fourth trimester of
pregnancy)
3. Care of infants during the perinatal period (the time span beginning at 20
weeks of pregnancy to 4 weeks [28 days] after birth)
4. Care of children from birth through late adolescent
5. Care in a variety of hospital and home care settings
FRAMEWORK FOR MCHN
 Maternaland child health nursing
can be visualized within a
framework in which nurses use
NURSING PROCESS, NURSING
THEORIES , NURSING RESEARCH
and QUALITY AND SAFETY
EDUCATION FOR NURSES(QSEN)
competencies to care for families
during the childbearing and
childrearing years through the
FOUR PHASES of health care which
are: HEALTH PROMOTION,HEALTH
MAINTENANCE,HEALTH
NURSING THEORISTS
 Florence Nightingale Environmental Theory
 Hildegard Peplau Psychodynamic Nursing
 Virginia Henderson 14 Components of Basic Nursing Care
 Joyce Travelbee Human to human relationship Model
 Betty Neuman System Model
 Dorothy Johnson Behavioral System Model
 Imogene King- Goal Attainment Theory
 Dorothea Orem Self Care Deficit Theory
 Faye Abdellah Typology of 21 Nursing Problems
 Sr. Callista Roy Adaptation Mode
 Jean Watson Philosophy of Science and Caring
 Madeleine Leiniger Transcultural Nursing
 Patricia Benner Excellence and Power in Clinical Nursing Practice
NURSING RESEARCH

 The controlled investigation of

problems that have implications
for nursing practice, provides
evidence for practice and
justification for implementing
activities for outcome
achievement, ultimately resulting
in improved and cost-effective
patient care.
QSEN: Quality and Safety Education for
Nurses
 Six competencies for quality care:
 Patient-centered care
 Teamwork and collaboration
 Quality improvement
 Informatics
 Evidenced-based practice
 Safety
FOUR PHASES OF HEALTH CARE

 Health Promotion
 Health Maintenance
 Health Restoration
 Health Rehabilitation
Measuring maternal and child health nursing
population: statistical terms
 Birth rate: the number of births per 1,000 population
 Fertility rate: the number of pregnancies per 1,000 women of childbearing age
 Neonatal death rate: the number of deaths per 1,000 live births occurring at
birth or in the first 28 days of life
 Perinatal death rate: the number of deaths during the perinatal time period
(beginning when a fetus reaches 500 grams, about week 20 of pregnancy, and
ending about 4 to 6 weeks after birth),it is the sum of the fetal and neonatal
rates
 Maternal mortality rate: the number of maternal deaths per 100,000 live births
that occur as a direct result of the reproductive process
 Infant mortality rate: the number of deaths per 1,000 live births occurring at
birth or in the 1st 12 months of life (the most meaningful and important
measure of maternal and child health)
 Childhood mortality rate: the number of deaths per 1,000 population in
children aged 1 to 14 years
Major philosophies on maternal and child
health nursing:
 Maternal and child health nursing is:
 Family centered
 Community centered
 Evidenced based practice (is the conscientious, explicit and
judicious use of current best evidence to make decisions about the
care of the patients obtained from randomized controlled trials to
move healthcare actions from ‘’just tradition’’ to a more solid and
safer, scientific basis)
 A challenging role for nurses and a major factor in keeping families
well and optimally functioning
Major philosophies on maternal and child
health nursing:
 A maternal and child health nurse :
 Considers the family as a whole and as a partner in care when planning or
implementing or evaluating the effectiveness of care.
 Serves as an advocate to protect the rights of all family members, including
the fetus.
 Demonstrates a high degree of independent nursing functions because
teaching and counselling are major interventions.
 Promotes health and disease prevention because these protect the health
of the next generation.
 Serves as an important resource for families during childbearing and
childrearing as these can be extremely stressful times in a life cycle.
 Respects personal, cultural, and spiritual attitudes and beliefs as these so
strongly influence the meaning and impact of childbearing and
childrearing.
Major philosophies on maternal and child
health nursing:
 Encourages developmental stimulation during both health and
illness so children can reach their ultimate capacity in adult life.
 Assesses families for strengths as well as specific needs or
challenges.
 Encourages family bonding through rooming-in and family visiting
in maternal and child heath care settings.
 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.
 MATERNAL AND CHILD HEALTH GOALS &
STANDARD
 NATIONAL HEALTH GOALS ARE;

1. To increase quality and years of healthy life.

2. To eliminate health disparities

 A new objective was added in 2010 which

recommended that 100% of pre-licensure programs in
nursing include core content on counseling for lesbian,
gay, bisexual, and transgender (LGBT) populations,
evaluation of health sciences literature, environmental
health, public health systems and global health.*
ROLES & RESPONSIBILITIES OF
MATERNAL AND CHILD HEALTH
NURSE
 Clinical Nurse Specialist
 Case manager
 Nurse Practitioner
 Women’s Health Nurse Practitioner
 Pediatric Nurse Practitioner
 Neonatal Nurse Practitioner
 Family Nurse Practitioner
 Certified Nurse-Midwife
Legal considerations of maternal-child
practice
 Nurses are legally responsible for protecting the rights of their
patients, including confidentiality, and are accountable for the quality
of their individual nursing care and that of other health care team
members.
 Reproductive healthcare rights and laws are complex and vary from
each countries.
 New technologies(assisted reproduction, surrogate motherhood,
umbilical cord sampling, safety of new medicines to children)can lead
to legal actions, especially if patients are uninformed about the reason
or medical necessity.
 Understanding the scope of practice and care based on a state or
country can help nurses practice within appropriate legal parameters.
 Documentation is essential for justifying actions.
 Nurses need to be conscientious about obtaining
informed consent for invasive procedures.
 ‘’Wrongful birth’’, ’’wrongful life’’, ’’wrongful
conception’’
 A nurse is legally responsible for reporting
inappropriate or neglect or breach of duty of other
practitioner.
Ethical considerations of practice
 Conception issues (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
Diversity and maternal and child health
nursing
 Diversity means there is a mixture or variety of
sociodemographic groups, experiences, and beliefs in
the population.
 Culture is a view of the world and a set of traditions a
specific social group uses and transmits to the next
generation.
 Transcultural nursing is care guided by cultural aspects
and respects individual differences.
 Cultural values are preferred ways of acting based on
cultural traditions.
Understanding cultural diversity in maternal
and child health nursing
Cultural aspects that are important to assess are :
 COMMUNICATION PATTERN;
 USE OF CONVERSATIONAL SPACE;
 RESPONSE TO PAIN;
 TIME ORIENTATION;
 WORK AND SCHOOL ORIENTATION;
 FAMILY ORIENTATION
 MALE & FEMALE ROLES
 RELIGION
 HEALTH BELIEFS
 NUTRITION PRACTICES
Maternal-child health nursing care and the
community
 A community is a group of individuals interacting within a
limited geographical area
 Knowing the individual aspects of a community helps us
understands why some people reach the illness level they do
before they seek health care, example: a woman living in a
rural area has no transportation to prenatal care until her
partner comes home from work, a 5-year old child develops
measles because there are no free immunization services in his
community.
 The health of individuals and their families are influenced by
the health of their community. It is important to become
acquainted with the community in which a nurse practice or
where a patient lives.
ACTIVITY 1:

Reflective journaling on the roles and responsibilities of a Maternal Child

Nurse.