Sie sind auf Seite 1von 18


 Obstetrics – Care of woman during childbirth; derived from Greek
word “obstare” (to keep watch)
 Pediatrics – derived from Greek word, “pais” (child)
 Focus of MCN – Care of childbearing and childrearing families.
 Primary Goal of MCN – Promotion and maintenance of Optimal Family
 Goals of MCN are broad b/c the scope of practice or range of
practice includes the ff:
 Preconceptual Health Care
 Care of women during 3 trimesters of pregnancy
 1st trimester (1st – 3rd month)
 2nd trimester (4th – 6th month)
 3rd trimester (7th – 9th month)
 Care of women during Puerperium or 4th Trimester (6 weeks after childbirth)
 Care of infants during Perinatal Period (6 weeks before conception and 6
weeks after birth)
 Care of children from birth to adolescence
 Neonatal (28 days of life); Infancy (1 – 12 months); Adolescence (after 18 y/o)
6. Care in settings as varied as the birthing room, the PICU, and the home.
Philosophies of MCN

1. MCN is Family Centered; assessment must include both family and individual assessment.
2. MCN is Community Centered; health of families depends on & influences the health of
3. MCN is Evidence Based because critical knowledge increases
4. MCN includes independent nursing functions because teaching & counselling are major
5. MCN Nurse, Advocate (protects the rights of family members, including fetus)
6. Health Promotion and Disease Prevention to protect health of new generation.
7. MCN is a challenging role for nurses
Family – basic unit of society

 Framework for MCN

1. Nursing Process (ADPIE)
2. Evidence Based Practice
3. Nursing Research
4. Nursing Theory
4 Phases of Health Care

1. Health Promotion
 Educating clients to be aware of good health through teaching and role modelling

 Ex. Family planning, teach the importance of safe sex practice, importance of immunizations

1. Health Maintenance
 Intervening to maintain health when risk of illness is present

 Ex. Encourage prenatal care, importance of safeguarding homes by childproofing it against

1. Health Restoration

 Diagnosing and treating illness using interventions that will return client to wellness fast
Ex. Care of child during illness, care of woman during pregnancy complications
1. Health Rehabilitation
 Preventing further complications from an illness
 Bringing client back to an optimal state of wellness
 Helping client accept inevitable death

 Ex. Encourage continuous therapies and medications

Trends in Maternal and Child
Health Nursing Population
Client Advocacy – safeguarding
and advancing the interests of
clients and their families.

Trends Nursing Implications

Families are smaller in size Fewer family members are present as support people in
times of crisis
Role of Nurse: Fullfill the role
Increased Single Parents Fewer financial resources esp. woman
(most common type of parent in US) Role of Nurse: Inform parents of care options and back –
up opinion
Increased mothers working outside home Healthcare must be scheduled at times a working parent
at least part – time (90%) can care for her own self or bring a child for care.
Role of Nurse: Discuss selection of child care centers
Families are more mobile; Increased no. of Good interviewing & health monitoring are necessary so
homeless women & children health database can be established and continuity of care.
Child and Intimate Partner Abuse Screening for child or intimate partner abuse; Nurses must
be aware of legal responsibilities for reporting abuse.
Families are more health conscious Provide Health Education
Health care should respect cost Comprehensive care is necessary in primary care settings
containment because referral to specialists may no longer be an option;
Health insurance is not available in all families.
 Ex. Care of child during illness, care of woman during pregnancy
Measuring Maternal and Child
Health / Statistical Terms Used
to Report Maternal and Child
1. Birth Rate – no. of births per 1000 population
2. Fertility Rate – no. of pregnancies per 1000 women of childbearing age
3. Fetal Death Rate –no. of fetal deaths weighing more than 500 g or more per 1000
live births
4. Neonatal Death Rate
 Neonatal Period – 1st 28 days of life; Infant is called Neonate

 No. of deaths per 1000 live births occurring in the 1st 28 days of life
1. Perinatal Death Rate
 Perinatal Period – 6 weeks before conception and 6 weeks after childbirth
 No. of deaths of fetuses weighing > 500g and within the first 28 days of life per 1000 birth.
1. Infant Mortality Rate – no. of deaths per 1000 live births in the first 12 months of life.
2. Childhood Mortality rate – no. of deaths per 1000 population in children; 1 – 14 y/o
3. Maternal Mortality Rate – no. of maternal deaths per 100,000 live births that occur as
direct result of reproductive process.
Legal Considerations of MCN

1. Identifying and Reporting Child Abuse

2. Child can bring a lawsuit when they reach legal age
3. Informed Consent for invasive procedure and any risk that may harm the fetus
4. In divorced or blended families, nurse has the right to give consent.
Ethical Considerations of

1. Conception Issues
 In Vitro Fertilization
 Embryo Transfer
 Cloning
 Stem Cell Research
 Surrogate Mothers
1. Abortion
2. Fetal Rights vs Rights of the Mother
1. Use of Fetal Tissue for Research
2. Resuscitation
3. No. of procedures or degree of pain that a child should asked to achieve better health
4. Balance between modern technology and quality of life.