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The primary goal of maternal and child health nursing care can be stated
simply as the promotion and maintenance of optimal family health to ensure cycles
of optimal childbearing and childrearing. Major philosophical assumptions about
maternal and child health.
The goals of maternal and child health nursing care are necessarily broad because
the scope of practice is so broad. The range of practice includes
Care of women during three trimesters of pregnancy and the puerperium (the 6
weeks after childbirth, sometimes termed the fourth trimester of pregnancy
Care in settings as varied as the birthing room, the pediatric intensive care unit,
and the home child health nursing is always family-centered; the family is
considered the primary unit of care. The level of family functioning affects the
health status of individuals, because if the familys level of functioning is low, the
emotional, physical, and social health and potential of individuals in that family can
be adversely affected. A healthy family, on the other hand, establishes an
environment conducive to growth and health-promoting behaviors that sustain
family members during crises. Similarly, the health of an individual and his or her
ability to function strongly influences the health of family members and overall
family functioning. For these reasons, a family-centered approach enables nurses to
better understand individuals and, in turn, to provide holistic care.
Both nursing theory and evidence-based practice provide a foundation for nursing
care.
A maternal and child health nurse serves as an advocate to protect the rights of
all family members, including the fetus.
Maternal and child health nursing includes a high degree of independent nursing
functions, because teaching and counseling are so frequently required.
Promoting health is an important nursing role, because this protects the health of
the next generation. Pregnancy or childhood illness can be stressful and can alter
family life in both subtle and extensive ways.
Personal, cultural, and religious attitudes and beliefs influence the meaning of
illness and its impact on the family. Circumstances such as illness or pregnancy are
meaningful only in the context of a total life.
Maternal and child health nursing is a challenging role for a nurse and is a major
factor in promoting high-level wellness in families.
Encourage family bonding through rooming-in in both maternal and child health
hospital settings.
Share or initiate information on health planning with family members so that care
is familyoriented.
Health promotion
Health maintenance
Health restoration
Health rehabilitation
MATERNAL AND CHILD HEALTH NURSING TODAY At the beginning of the 20th
century, the infant mortality rate in the United States (i.e., the number of infants
per 1,000 births who die during the first year of life) was greater than 100 per
1,000. In response to efforts to lower this rate, health care shifted from a treatment
focus to a preventive one, dramatically changing the scope of maternal and child
health nursing. Research on the benefits of early prenatal care led to the first major
national effort to provide prenatal care to all pregnant women through prenatal
nursing services (home visits) and clinics. Today, thanks to these and other
community health measures (such as efforts to encourage breast-feeding, increased
immunization, and injury prevention), as well as many technological advances, the
U.S. infant mortality rate has fallen to 6.9 per 1,000 (National Center for Health
Statistics [NCHS], 2005). Medical technology has contributed to a number of
important advances in maternal and child health: childhood diseases such as
measles and poliomyelitis are almost eradicated through immunization; specific
genes responsible for many inherited diseases have been identified; stem cell
therapy may make it possible in the next few years to replace diseased cells with
new growth cells; new fertility drugs and techniques allow more couples than ever
before to conceive; and the ability to delay preterm birth and improve life for
premature infants has grown dramatically. In addition, a growing trend toward
health care consumerism, or self-care, has made many childbearing and
childrearing families active participants in their own health monitoring and care.
Health care consumerism has also moved care from hospitals to community sites
and from long-term hospital stays to overnight surgical and ambulatory settings.
Even in light of these changes, much more still needs to be done. National health
care goals established in 2000 for the year 2010 continue to stress the importance
of maternal and child health to overall community health (Department of Health and
Human Services [DHHS], 2000). Although health care may be more advanced, it is
still not accessible to everyone. These and other social changes and trends have
expanded the roles of nurses in maternal and child health care and, at the same
time, have made the delivery of quality maternal and child health nursing care a
continuing challenge.
a.
pad of fats which lies over the symphysis pubis covered by skin and at puberty, by
short hairs, protects the surrounding delicate tissues from trauma. b.
Labia Majora
Two folds of skin with fat underneath: contain Bartholin glands (believed to secrete
a yellowish mucus which acts as a lubricant during sexual intercourse). The
openings of
Labia Minora
two thin folds of delicate tissues: for an upper fold encircling the clitoris (called
forchette, which is highly sensitive to manipulation and trauma that is why it is
often torn during
womens delivery).
d.
Glans Clitoris
small, erectile structure at the anterior junction of the labia minora, which is
comparable to the penis in its being extremely sensitive. e.
Vestibule
Urethral Meatus
external opening of the urethra: slightly behind and to the side are the openings of
the Skene glands (which are often involved in infections of the external genitalia). g.
Vaginal orifice/Introitus
Perineus
area from the lower border of the vaginal orifice to the anus; contains the muscles
(e.g., pubococcygels and levator ani) which support the pelvic organs, the arteries
that supply blood and the pudendal nerves which are important during delivery
under anesthesia.
a 3-4 inch long dilatable canal located between the bladder and the rectum;
contains rogue, (which permit considerable stretching without tearing): passageway
for menstrual discharges, copulation and fetus.
b. Uterus
hollow pear-shaped fibromuscular organ. 3 inches long, 2 inches wide, 1 inch thick,
and weighing 50
area between corpus and cervix which forms part of the lower uterine segment;
and cervix
lower cylindrical portion. (1) Organ of menstruation, (2) site of implantation and (3)
retainment and nourishment of the products of conception.
c. Fallopian Tubes
4 inches long from side of the fundus; widest part (called empala) spreads into
fingerlike projections (called pimbrige). Responsible for transport of mature ovum
from ovary to uterus; fertilization takes place in its outer third or outer half.
d. Ovaries
almond-shaped, dull white sex glands near the fimbriae, kept in place by ligaments.
Produce, mature and expel ova and manufacture estrogen and progesterone.
although not a part of the female reproductive organs but of the skeletal system. Is
the very important body part of pregnant woman. A. Structure 1.
Os Coxae/Innominate
bones
made up of a.
Ilium
b. Ischium
under part; when sitting, the body rests on the ischial tuberositis: ischial spines are
important landmarks.
c. Pubis
front part; join to form an articulation of the pelvis called the symphysis pubis.
2. Sacrum
wedge-shaped, forms at the back part of the pelvis. Consists of 5 fuse vertebrae,
the first having a prominent upper margin called the sacral promontory. Articulates
the ilium, the sacroiliac joint.
3. Coccyx
lowest part of the spine; degree of movement between sacrum and coccyx, made
possible by the third articulation of the pelvis called
sacroccygeal joint
Divisions
set apart by the linea terminalis, an imaginary line from the sacral promontory to
the iliac on both sides to the superior portion of the symphysis pubis.
1. False pelvis
inferior half formed by the pubis in front, the iliac and the ischium on the sides, and
the sacrum and coccyx behind. Made up of three parts:
a. inlet
entranceway to the true pelvis. Its transverse diameter id wider than its
12.75 cm.
b. Cavity
c. Types/variations
1.
Gynecoid
Platypelloid
Android
d. Measurements 1. External
a. Intercristal
28 cm.
b. Interspincus
25 cm.
c. Intertrochanteric
31 cm.
d.
External conjugate/baudelocques
the distance between the anterior aspect of the symphysis pubis and depression
below Ls. Average
18-20 cm.
2. Internal
a. Diagonal conjugate
distance between sacral promontory and inferior margin of the symphysis pubis.
Average
12.5 cm.
distance between the anterior surface of the sacral promontory and the superior
margin of the symphysis pubis. Very important measurement because it is the
diameter of the pelvic inlet. Average
10.5-11 cm.
c. Bi-schial diameter/tuberishii
transverse diameter of the pelvic outlet. Is measured at the level of the anus.
Average
11 cm.
1. 300,000
4000,000 immature cocytes per ovary are present at birth (where formed during
the first 5 months of intrauterine life), many, however, degenerate and atrophy
(process called atresia). About 300
6 days; menstrual cycle from first day of menstrual period to the first day next
menstrual period. Average menstrual cycle
c.
5. Associated terms:
a. Amenorrhea
b.Oligomenorrhea
c.Menorrhagia
d.Metrorrhagia
e.Polymenorrhea