CMCA PRELIMS.pdf

CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ M1L1: OVERVIEW OF MATERNAL PHILOSOPHY OF MCN AND CHILD NURSING...

CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ M1L1: OVERVIEW OF MATERNAL PHILOSOPHY OF MCN AND CHILD NURSING 1. Family centered; assessment should Maternal and Child Nursing: Definition always include the family as well as an individual Has 3 subordinate terms in the CINAHL 2. Community centered; the health of subject headings hierarchy families is both affected by and influences the health of communities. 1. Obstetric nursing (care of normal, 3. Evidence based; critical knowledge uncomplicated pregnancies only) increases 2. Perinatal nursing (nursing care of 4. A challenging role for nurses and a childbearing families who are at risk major factor in keeping families well for increased maternal, fetal, or and optimally functioning neonatal mortality) 3. Pediatric nursing An MCN Nurse: ROLES PRIMARY GOAL 1. Considers the family as a whole and as a partner in care - The promotion and maintenance of 2. Serves as an advocate to protect the optimal family health to ensure cycles of right of all family members, including optimal childbearing and childrearing the fetus 3. Demonstrate a high degree of SCOPE OF PRACTICE independent nursing functions because teaching and counseling 1. Preconception health care are major interventions 2. Care of women during the trimesters of 4. Promotes health and disease pregnancy and the puerperium (6 weeks prevention because these protect the after childbirth) health of the next generation 3. Care of infants during the perinatal 5. Serves as important resource for period (the time span beginning at 20 families during childbearing and weeks of pregnancy to 4 weeks after childrearing as these can be birth) extremely stressful times in a life 4. Care of children from birth through late cycle adolescence 6. Respects personal, cultural, and 5. Care in a variety of hospital and home spiritual attitudes and beliefs care settings influence the meaning  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ 7. Encourages developmental mortality ratio. stimulation during both health and Target 5.B: Achieve, by 2015, illness so children can reach their universal access to reproductive health. ultimate capacity in adult life 8. Assess families for strengths as well Goal 6: Combat HIV/AIDS, malaria as specific needs or challenges and other diseases 9. Encourages family bonding through Target 6.A: Have halted by 2015 and rooming-in and family visiting in begun to reverse the spread of maternal and child healthcare facility HIV/AIDS. 10. Encourages early hospital discharge options to reunite families as soon as Target 6.B: Achieve, by 2010, possible in order to create a universal access to treatment for seamless helpful transition process HIV/AIDS for all those who need it. 11. Encourages families to reach out to Target 6.C: Have halted by 2015 and their community so the family can begun to reverse the incidence of develop a wealth of support people malaria and other major diseases. GLOBAL HEALTH GOALS Goal 7: Ensure environmental sustainability Health-related Millennium Target 7.C: Halve, by 2015, the Development Goals and Targets proportion of people without sustainable access to safe drinking water and basic Goal 1: Eradicate poverty and sanitation. hunger Target 1.C: Halve, between 1990 and Goal 8: Develop a global partnership 2015, the proportion of people who for development suffer from hunger Target 8.E: In cooperation with pharmaceutical companies, provide Goal 4: Reduce child mortality access to affordable essential drugs in Target 4.A: Reduce by two-thirds, developing countries. between 1990 and 2015, the under-five mortality rate. SUSTAINABLE DEVELOPMENT GOALS (SDGs) Goal 5: Improve maternal health Target 5.A: Reduce by three quarters, The Sustainable Development between 1990 and 2015, the maternal Goals (SDGs) are a collection of 17  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ global goals set by the United Nations prevention and treatment and promote General Assembly in 2015 for the year mental health and well-being. 2030. The SDGs are part of Resolution 70/1 of the United Nations General 3.5 Strengthen the prevention and Assembly, the 2030 Agenda treatment of substance abuse, including narcotic drug abuse and harmful use of The 17 SDGs are broader and more alcohol. ambitious than the MDGs, presenting 3.6 By 2020, halve the number of global an agenda that is relevant to all people deaths and injuries from road traffic in all countries to ensure that "no one is accidents. left behind." 3.7 By 2030, ensure universal access The new agenda requires that all 3 to sexual and reproductive health-care dimensions of sustainable development services, including for family planning, – economic, social and environmental – information and education, and the are addressed in an integrated manner. integration of reproductive health into national strategies and programmes. 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 3.8 Achieve universal health coverage, per 100 000 live births. including financial risk protection, 3.2 By 2030, end preventable deaths of access to quality essential health-care newborns and children under 5 years of services and access to safe, effective, age, with all countries aiming to reduce quality and affordable essential neonatal mortality to at least as low as medicines and vaccines for all. 12 per 1000 live births and under-5 mortality to at least as low as 25 per 3.9 By 2030, substantially reduce the 1000 live births. number of deaths and illnesses from hazardous chemicals and air, water and 3.3 By 2030, end the epidemics of soil pollution and contamination. AIDS, tuberculosis, malaria and 3.a Strengthen the implementation of neglected tropical diseases and combat the WHO Framework Convention on hepatitis, water-borne diseases and Tobacco Control in all countries, as other communicable diseases. appropriate. 3.4 By 2030, reduce by one third premature mortality from non- communicable diseases through  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ 3.b Support the research and Universal Health Care Frame, the National development of vaccines and Safe Motherhood Program is committed to medicines for the communicable and provide rational and responsive policy non-communicable diseases that direction to its local government partners in primarily affect developing countries, the delivery of quality maternal and provide access to affordable essential newborn health services with integrity and medicines and vaccines, to protect accountability using proven and innovative public health, and, in particular, provide approaches access to medicines for all. Objectives 3.c Substantially increase health The Program contributes to the national financing and the recruitment, goal development, training and retention of of improving women’s health and well-being the health workforce in developing by: countries, especially in least developed countries and small island developing Collaborating with Local Government Units States. in establishing sustainable, cost-effective 3.d Strengthen the capacity of all approach of delivering health services that countries, in particular developing ensure access of disadvantaged women to countries, for early warning, risk acceptable and high quality maternal and reduction and management of national newborn health services and enable them and global health risks. to safely give birth in health facilities near their homes PHILIPPINE HEALTH GOALS 2. Establishing core knowledge base and National Safe Motherhood Program support systems that facilitate the delivery of quality maternal and newborn health Vision services in the country. For Filipino women to have full access to health services towards making their pregnancy and delivery safer Mission Guided by the Department of Health FOURmula One Plus thrust and the  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ M1L2: MATERNAL AND CHILD a. Establishment of Safe Blood Supply NURSING INITIATIVES Network with support from the National Voluntary Blood Program NATIONAL SAFE MOTHERHOOD b. Behavior Change Interventions in PROGRAM collaboration with the Health Promotion and Communication Service Program Components c. Sustainable financing of maternal - Component A: Local Delivery of the newborn services and commodities Maternal–Newborn Service Package through locally initiated revenue generation and retention activities This component supports LGUs in including PhilHealth accreditation and establishing and mobilizing the service enrolment. delivery network of public and private providers to enable them to deliver the Component B: National Capacity to integrated maternal-newborn service Sustain Maternal-Newborn Services package. In each province and city, the following shall continue to be undertaken: 1. Operational and Regulatory Guidelines 1. Establishment of critical capacities to a. Identification and profiling of current FP provide quality maternal-newborn users and identification of potential FP services through the organization and clients and those with unmet need for operation of a network of Service FP (permanent or temporary methods) Delivery Teams consisting of: b. Mainstreaming FP in the regions with high unmet need for FP a. Barangay Health Workers c. Development and dissemination of b. BEmONC Teams composed of Doctors, Information, Education Communication Nurses and Midwives materials d. Advocacy and social mobilization for FP 2. In collaboration with the Centers for health development and relevant 2. Network of Training Providers national offices: Establishment of a. 31 Training Centers that provide Reliable Sustainable Support Systems BEmONC Skills Training for Maternal-Newborn Service Delivery through such initiatives as: 3. Monitoring, Evaluation, Research, and Dissemination with support from the Epidemiology Bureau and Health  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ Policy Development and Planning 4. Administrative Order 2015-0020: Bureau Guidelines in the Administration of Life a. Monitoring and Supervision of Private Saving Drugs During Maternal Care Midwife Clinics in cooperation with PRC Emergencies by Nurses and Midwives Board of Midwifery and Professional in Birthing Centers Midwifery Organizations b. Maternal Death Reporting and Review 5. Administrative Order 2016-0035: System in collaboration with Provincial Guidelines on the Provision of Quality and City Review Teams Antenatal Care in All Birthing Centers c. Annual Program Implementation and Health Facilities Providing Reviews with Provincial Health Officers Maternity Care Services and Regional Coordinators 6. Administrative Order 2018-0003: POLICIES AND LAW National Policy on the Prevention of Illegal and Unsafe Abortion and Republic Act No. 10354: Responsible Management of Post-Abortion Parenthood and Reproductive Health Complications Law (RPRH Act of 2012) Section 2. Declaration of Policy. 1. Administrative Order 2008-0029: The State recognizes and guarantees the Implementing Health Reforms to human rights of all persons including their Rapidly Reduce Maternal and right to equality and non-discrimination of Neonatal Mortality these rights, the right to sustainable human 2. Department Order 2009-0084: development, the right to health which Guidelines Governing the Payment of includes reproductive health, the right to Training Fees relative to the education and information, and the right to Attendance of Health Workers to choose and make decisions for themselves Basic Emergency Obstetric and in accordance with their religious Newborn Care Skills Training Course convictions, ethics, cultural beliefs, and the at Duly Designated Training Centers demands of responsible parenthood 3. Administrative Order 2011-0011: Establishment of Basic Emergency Section 3. Guiding Principles for Obstetric and Newborn Care Training Implementation. – This Act declares the Centers in Regional Hospitals and following as guiding principles: Medical Centers a. The right to make free and informed  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ decisions, which is central to the exercise of which have been proven medically safe, any right, shall not be subjected to any form legal, non-abortifacient, and effective in of coercion and must be fully guaranteed by accordance with scientific and evidence- the State, like the right itself; based medical research standards b. Respect for protection and fulfillment of f. The State shall promote programs that: reproductive health and rights which seek (1) enable individuals and couples to to promote the rights and welfare of every have the number of children they desire person particularly couples, adult with due consideration to the health, individuals, women and adolescents particularly of women, and the resources available and affordable to them and in c. Since human resource is among the accordance with existing laws, public principal assets of the country, effective and morals and their religious convictions: quality reproductive health care services Provided, That no one shall be deprived, for must be given primacy to ensure maternal economic reasons, of the rights to have and child health, the health of the children; unborn, safe delivery and birth of healthy children, and sound replacement g. The provision of reproductive health rate, in line with the State’s duty to promote care, information and supplies giving the right to health, responsible parenthood, priority to poor beneficiaries as identified social justice and full human development; h. The State shall respect individuals’ d. The provision of ethical and medically preferences and choice of family planning safe, legal, accessible, affordable, non- methods that are in accordance with their abortifacient, effective and quality religious convictions and cultural beliefs, reproductive health care services and supplies is essential in the promotion of i. Active participation by nongovernment people’s right to health, especially those of organizations (NGOs), women’s and women, the poor, and the marginalized, people’s organizations, civil society, faith- and shall be incorporated as a component based organizations, the religious sector of basic health care; and communities is crucial e. The State shall promote and provide j. While this Act recognizes that abortion information and access, without bias, to is illegal and punishable by law, the all methods of family planning, including government shall ensure that all effective natural and modern methods women needing care for post-  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ abortive complications and all other programs and projects that seek to uplift the complications arising from quality of life of the people, more pregnancy, labor and delivery and particularly the poor, the needy and the related issues shall be treated and marginalized; and counseled in a humane, nonjudgmental and compassionate p. That a comprehensive reproductive manner in accordance with law and health program addresses the needs of medical ethics; people throughout their life cycle. k. Each family shall have the right to Administrative Order 2008-0029: determine its ideal family size: Provided, Implementing Health Reforms to Rapidly however, That the State shall equip each Reduce Maternal and Neonatal Mortality parent with the necessary information on all aspects of family life, including reproductive This policy issuance provides the health and responsible parenthood, in order strategy for rapidly reducing maternal and to make that determination; neonatal deaths through the provision of a package of maternal, newborn, child health l. There shall be no demographic or and nutrition (MNCHN) services. The goal population targets and the mitigation, of rapidly reducing maternal and neonatal promotion and/or stabilization of the mortality shall be achieved through effective population growth rate is incidental to the population-wide provision and use of advancement of reproductive health; integrated MNCHN services as appropriate to any locality in the country. m. Gender equality and women empowerment are central elements of The strategy aims to achieve the reproductive health and population and following intermediate results: development; 1. Every pregnancy is wanted, planned n. The resources of the country must be and supported; made to serve the entire population, 2. Every pregnancy is adequately especially the poor, and allocations thereof managed throughout its course; must be adequate and effective: Provided, 3. Every delivery is facility-based and That the life of the unborn is protected; managed by skilled birth attendants/skilled o. Development is a multi-faceted health professionals; and process that calls for the harmonization 4. Every mother and newborn pair secures and integration of policies, plans, proper post-partum and newborn care with  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ smooth transitions to the women’s health 2. blood banking and transfusion services, care package for the mother and child 3. other highly specialized obstetric survival package for the newborn. interventions. Administrative Order 2011-0011: It is also capable of providing neonatal Establishment of Basic Emergency emergency interventions, which include at Obstetric and Newborn Care Training the minimum, the following: Centers in Regional Hospitals and Medical Centers 1. newborn resuscitation; 2. treatment of neonatal sepsis/infection; Basic Emergency Obstetric and 3. oxygen support for neonates; Newborn Care (BEmONC)-Capable 4. management of low birth weight or network of facilities and providers that preterm newborn; and can perform the following six signal 5. other specialized newborn services. obstetric functions: These facilities can also serve as high 1. parenteral administration of oxytocin in volume providers for Intrauterine device the third stage of labor; (IUD) and Voluntary Surgical Contraception 2. parenteral administration of loading (VSC) services, especially tubal ligations. dose of anti-convulsants; 3. parenteral administration of initial dose It should also provide an itinerant team that of antibiotics; will conduct out-reach services to remote 4. performance of assisted deliveries communities. (Imminent Breech Delivery); 5. removal of retained products of The itinerant team is typically composed of conception; and 1 physician (surgeon), 1 nurse and 1 6. manual removal of retained placenta. midwife. Comprehensive Emergency Obstetric Administrative Order 2016-0035: and Newborn Care (CEmONC) Guidelines on the Provision of Quality Antenatal Care in All Birthing Centers Capable facility or network of facilities that and Health Facilities Providing Maternity can perform the six signal obstetric Care Services functions for BEmONC, as well as provide The order seeks to improve the quality of 1. caesarean delivery services, antenatal care through the provision of  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ technical guidance in the shift in ANC 3. While on skin-to skin contact (up to 3 concept from the high risk approach to the minutes post-delivery) four-visit model of focused ANC and 3.1 Reduce the incidence of anemia in term consequent service delivery scheme of the newborns and intraventricular hemorrhage ANC package in preterm newborns by delaying or non- immediate cord clamping (clamp and cut The four –visit model the cord after cord pulsations have stopped, First visit : 8-12 weeks typically 1-3 minutes.) Second visit : 24-26 weeks Third visit : 32 weeks 4. Within 90 minutes of age Fourth visit: 36-38 weeks 4.1 Facilitate the newborn’s early intiation to breastfeeding and transfer of colostrum Essential Newborn Care Protocol (AO through support and initiation of 2009-0025) breasfeeding. 4.2 To prevent opthalmia neonatorum The policy ensures the provision of globally through proper eye care ( administer accepted evidence-based essential erythromycin or tetracycline ointment or newborn care focusing on the first week of 2.5% povidone-iodine drops) life. b. Non-immediate Interventions -usually Emphasis is given to care interventions given within 6 hours that should be provided to the newborn After birth from birth until the first 6hours of life. 1. Give Vitamin K Prophylaxis a. Ensure Quality Provision of Time- 2. Inject Hepatitis B and BCG vaccinations Bound Interventions 3. Examine the newborn. Check for birth injuries, malforamations or defects 1. Within the first 30 seconds 4. Cord care 1.1 Dry and provide warmth to the newborn and prevent hypothermia Essential Intrapartum and Newborn Care 2. After thorough drying (EINC) Evidence-based Standard 2.1 Facilitate bonding between the mother Practices and her newborn through skin-to-skin contact to reduce likelihood of infection and The EINC practices are evidenced-based hypoglycaemia standards for safe and quality care of birthing mothers and their newborns, within  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ the 48 hours of Intrapartum period (labor 1. Immediate and thorough drying of the and delivery) and a week of life for the newborn newborn. 2. Early skin-to-skin contact between In December 2009, the Secretary of the mother and the newborn Department of Health Francisco Duque 3. Properly-timed cord clamping and cutting signed Administrative Order 2009-0025, 4. Unang Yakap (First Embrace) of the which mandates implementation of the mother and her newborn for early EINC Protocol in both public and private breastfeeding initiation hospitals. Likewise, the Unang Yakap campaign was launched. Unnecessary interventions eliminated The unnecessary interventions during labor The EINC practices during Intrapartum and delivery, which do not improve the period health of mother and child, are eliminated. These are: 1. Continuous maternal support, by a 1. enemas and shavings, companion of her choice, during labor and 2. fluid and food intake restriction, and delivery 3. routine insertion of intravenous fluids. 2. Mobility during labor – the mother is still 4. Fundal pressure to facilitate second mobile, within reason, during this stage stage of labor is no longer practiced, 3. Position of choice during labor and because it resulted to maternal and delivery newborn injuries and death. 4. Non-drug pain relief, before offering labor anesthesia Unnecessary interventions eliminated 5. Spontaneous pushing in a semi-upright Likewise, the unnecessary interventions in position newborn care which include 6. Episiotomy will not be done, unless necessary 1. routine suctioning, 7. Active management of third stage of 2. early bathing, labor (AMTSL) 3. routine separation from the mother, 8. Monitoring the progress of labor with the 4. foot printing, use of partograph 5. application of various substances to the cord, Recommended EINC practices for 6. and giving pre-lacteals or artificial infant newborn care are time-bound milk formula or other breast-milk interventions at the time of birth substitutes.  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ ANNUAL REPORT 2017 DEPARTMENT OF HEALTH PHILIPPINES Come Back to Bakuna The Department of Health, in partnership with the World Health Organization launched a communication campaign during the National Immunization week celebration last April 2017. The Come Back to Bakuna campaign aims to improve the  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ childhood vaccination coverage of the Feeding Package targeting 420 pre-school Philippines. It utilized an edutainment children aged 6-71 months in the region. (education entertainment) approach that The program aimed to improve the was rolled out in national TV, radio, social nutritional status from underweight or media, and communities. It used music severely underweight to normal in a span of videos with catchy jingles and engaging 90 days. The program provided a full meal dance moves to highlight easy-to-recall amounting to PHP 80 per day, including information on vaccination schedule, morning snacks, to preschoolers with preventable diseases, and safety. weight and height that are lower for their age. Medical Assistance Program: Kawasaki Disease Maternal and Neonatal Tetanus Elimination (MNTE) The Kawasaki Diseases also known as Kawasaki Syndrome is an illness with no On November 29, 2017 the Philippines definite cause that primarily affects children through the Department of Health younger than 5 years of age. Through the celebrated the achievement of eliminating passage of the Rare Disease Act of the maternal and neonatal tetanus. Such efforts Philippines (RA 10747), the Department of were made possible through immunization, Health is embarking on the provision of antenatal care and safe delivery practices, services to patients with rare diseases. That and enhanced neonatal tetanus is, providing patients and their families surveillance. The country now has less than better access to adequate healthcare one case of neonatal tetanus per 1,000 live service to treat their condition. This includes births in all its cities and provinces. the Kawasaki syndrome which is supported Moreover, it now joins 43 other countries through the Medical Assistance for Indigent which have achieved this global public Patients Program. As of December 2017, health goal. there were 59 patients served with the Medical Assistance for Kawasaki Disease The Buntis Summit 2017 which was attended by more than 100 pregnant Nutritional Feeding Program for Pre- women, aimed to reduce maternal and child school Children mortality through increased awareness on the importance of the 3-Delay: 1) seeking Department of Health (DOH) – MIMAROPA appropriate medical care, 2) reaching an under its Oplan Kain Sigla Program started appropriate medical facility, and 3) another round of Eat to Nourish Approach receiving adequate care when a facility is  CARE OF MOTHER, CHILD, AND ADOLESCENTS NCM107 – LBBUENVIAJE S.Y. 2024-2025, FIRST SEMESTER, PRELIMS ___________________________________________________________________ reached. This year, it was held in 12 different Municipalities/Cities in the Cagayan Valley Region from March – October 2017 with the theme “Kalusugan Mo Inay, Ingatan Mo: Kinabukasan Ninyo ni Baby, Nakasalalay Sa’yo” January 9, 2017: Executive Order No. 12: Attaining and and Sustaining Zero Unmet Need for Modern Family Planning through the Strict Implementation of the Responsible Parenthood and Reproductive Health Act, Providing Funds Therefor and for Other Purposes which identifies fund sources and mechanisms to accelerate attainment of the targets for modern Family Planning.