Maternal Health Nursing PDF

MATERNAL 2. Serves as an advocate to protect rights of all family members; including fetus. (Nurses are always advocate for...

MATERNAL 2. Serves as an advocate to protect rights of all family members; including fetus. (Nurses are always advocate for everybody!) MODULE 1 3. Demonstrates high degree of independent nursing functions. (Health teaching & counseling are major FRAMEWORKS OF MATERNAL interventions) 4. Promote health & disease prevention. (Our & CHILD HEALTH NURSING role is to prevent) 5. Serves as an important resource for Primary goal of MCHN is the promotion families during childbearing & childrearing. and maintenance of optimal family 6. Respects personal, cultural, & spiritual health to ensure cycles of optimal attitudes & beliefs. childbearing and childrearing. 7. Encourages developmental stimulation Healthy pregnancy → healthy infants → during both health & illness. healthy children → healthy adolescents → 8. Assess families for strengths & specific 🎉 healthy families → healthy community needs or challenges. (yehey ) 9. Encourages family bonding through rooming-in & family visiting in MCH care RANGE IF PRACTICE THROUGHOUT settings. CHIDLBEARING & CHILDREARING 10. Encourages early hospital discharge options to reunite families as soon as 1. Preconception health care. possible. (NSD: 24 hrs; CS: 3 days) 2. Nursing care of women throughout 11. Encourages families to reach out to their pregnancy, birth, & postpartum period. community. (Health center) 3. Nursing care of infants during perinatal period (time span beginning at 20 weeks of FRAMEWORK pregnancy to 4 weeks (28 weeks) after birth). MCHNC can be visualized within a 4. Nursing care of children from birth through framework which nurses use nursing adolescence. process, nursing theory, & Quality and 5. Nursing care to families in all settings Safety Education for Nurses competencies (home & hospital). to care for families and through 4 phases of health care: PHILOSOPHY OF MCHN 1. HEALTH PROMOTION 1. FAMILY-CENTERED - Health education, immunization. - Assessment should always include - healthy pa family as well as an individual. 2. COMMUNITY-CENTERED 2. HEALTH MAINTENANCE - Health of families is both affected by - Maintain health when risk of illness is and influences the health of present. communities. (Families are part of the - healthy but high-risk community) 3. EVIDENCED-BASED 3. HEALTH RESTORATION - This is where critical knowledge - Caring during complications. increases. - may sakit na!!! - There are practices before that are not practiced now due to lack of 4. HEALTH REHABILITATION evidence. - Helping pt with residual effects achieve an optimal state of wellness & independence. MATERNAL & CHILD NURSE - naka recover na (yey) 1. Consider the family as a whole & as a Nursing process partner care. - Scientific form or problem solving. - Basis for ADPIE  Nursing theory - Government-owned & controlled - Discpline’s knowledge flows from a corporation tasked with mandate base of established theory. of implementing National Health Quality & Safety Education for Nurses Insurance Program. (QSEN) c. RA 11223 (tandaan nio si doc jo, 1100 - 6 competencies deemed necessary basta may connect) for quality care. - Universal Health Care Act in - Goal is to address challenge of 2019 preparing future nurses with the - Under Pres. Noynoy Aquino. abilities necessary to continuously - Kalusugan Pangkalahatan improve quality & safety of healthcare - Better & equitable health systems. outcomes. a. Patient-centered care - Improved financial risk protection. - Patient as the source of control & - Responsive health system by full partner in provision of care. ensuring that all Filipinos, b. Teamwork & Collaboration especially disadvantaged group - Nurses function effectively within (DOPES - deprived, oppressed, nursing & inter professional poor, exploited, struggling) have teams. equitable access to affordable - Nurses cannot work alone, healthcare. nurses & other healthcare d. Health Sector Reform Agenda of 2021 providers work hand in hand. thru Executive Order 128 series of c. Evidenced-based practice 2021 - Intergate best evidence with - Implemented during pandemic clinical expertise & patient/family which focuses on full devolution preferences. of certain executive & local d. Quality improvement government functions. - Nurses use data to monitor - Provided opportunities to sustain outcomes of care & improve UHC through additional financing quality & safety of health care of health programs & services on system. the ground. e. Safety e. Health sector strategy for 2023-2028 - Nurses minimize risk of harm to - Define country’s vision to PTs. accelerate UHC. - Priority natin ‘to - Enable Filipinos to be healthy. f. Informatics - Protect Filipinos from health - Nurses use information & risks. technology to communicate, - Care for Filipinos’ health & manage knowledge, mitigate wellness. error, & support decision making. - Strengthen health institutions & - If it is not written, it is not done. workforce. - Everything you do, MILLENNIUM DEVELOPMENT write/document it. GOALS 2015 UNIVERSAL HEALTH CARE 1. Eradicate extreme poverty & hunger. 2. Achieve universal primary education. Sabi ni DOH (kasi feeling siya) they vision 3. Promote gender equality & empower that Filipinos are among the healthiest women. people in Asia by 2040 (‘di mo syur!). 4. Reduced child mortality. 5. Improve maternal health. a. RA 7160 6. Combat HIV/AIDS, malaria, & other - Decentralized health governance diseases. thru Local Government Code of 7. Ensure environmental sustainability. 1991 8. Develop global partnership. b. RA 7875 - Social health insurance program or PhilHealth in 1995.  17 SUSTAINABLE DEVELOPMENT - Healthy diet GOALS - Regular exercise - Moderate alcohol intake c. Family planning - To be achieved by 2030. - To avoid unwanted pregnancies. (All pregnancy has to be planned) 1. No Poverty (baligtarin mo yung NO tsaka d. Prevention & management of lagay ng E!) lifestyle-related diseases 2. Zero Hunger - Diabetes & cardiovascular 3. Good Health and Well-being (mukhang 3 diseases. yung W) e. Prevention & management of 4. Quality Education (QUAtro) infection 5. Gender Equality (LGBTQ = 5) - Deworming to reduce causes of 6. Clean Water and Sanitation (C mukhang iron deficiency or anemia. 6!) - Parasitism increase risk of 7. Affordable and Clean Energy (E mukhang anemia 7!) f. Counseling on STIs 8. Descent work and Economic growth - Including nutrition, personal (Dollar) (8 mukhang dollar sign!) hygiene, & consequences of 9. Industry, Innovation, and Infrastructure abortion. (INine!!, triple I) g. Provision of oral health services 10. Reduced Inequalities (mag asawa isang - Calcium demineralization payat isang may laman hehe = 10) 11. Sustainable Cities and Communities 2. Prenatal Package (buildings mukhang 11 diba!) - Pregnant na, 4 visits 12. Responsible Consumption and a. Prenatal visits Prodiction (tag 12 petot daw yung itlog - At least 4 visits sabi ni Ma’am Mel) - 1st semester (3 months): 1 13. Climate Action (malas = 13!) - 2nd semester (4-6 months): 1 14. Life below Water (yung 4 muhang fish - 3rd trimester (7-9 months): 2 hehe) b. Prenatal assessments 15. Life on Land (5 mukhang bundok!) - Weight & BP monitoring 16. Peace, Justice , and Strong Institution - Measurement of fundic height (yung peace sign hanapin mo 6 doon against AOG (size/height of bahala ka na ☮) abdomen) 17. Partnership for the Goals (alanganaman ➔ Xiphoid = 36 wks ‘di mo pa ‘to alalahanin) ➔ Lightening = 40 wks (ready) PACKAGES ➔ Umbilicus = 20 wks ➔ Between umbi & pubis = 1. Pre Pregnancy Package 16 wks - Before pregnancy. ➔ Pubis = 12 wks a. Nutrition - Fetal heartbeat & fetal movement - Nutritional counseling ➔ Maririnig sa FETAL - Micronutrient supplementation BACK ➔ Iron 60 mg/ 1 tab per day ➔ Normal FHR = 120-160 (take w/ vit C to increase ➔ LM1 = Fundus absorption, before meals) ❖ Firm = head ➔ Folic Acid 400 mcg/ 1 tab ❖ Soft - buttocks per day for 3-6 months ➔ LM2 = Sides (for ovulation) ❖ Smooth = Back ➔ Vitamin A 5,000 IU every ❖ Nodules/Irregular week = Front ➔ Use of iodized salt ➔ LM3 = Engaged / floating ➔ Calcium (for bones) (malapit na siya b. Healthy lifestyle manganak!) - Smoking cessation (to quit ➔ LM4 = Fetal’s attitude smoking) (degree of flexion ng head = well flexed)  - CBC, blood typing, urinalysis, comprehensive emergency obstetric screening for STIs, blood sugar & newborn care (CEmOnc) services screening, pregnancy test, - BEmOnc cervical cancer screening (acetic ➔ RHU, BHS, lying in, acid wash & Papanicolaou birthing home, stand-alone smear) facility c. Micronutrient supplementation ➔ Midwife / nurse - Iron & folate (60mg/400mcg) ➔ 1 BEmOnc per 125,000 once a day for 6 months or 180 population tablets. Oxytocin in 3rd Removal of retained - Vitamin A 10,000 IU twice a stage of labor products of week from 4th month of conception/IUD pregnancy. ➔ Binibigay for Loading dose of Manual removal of anticonvulsant retained placenta organogenesis (organ formation) (happens in 8th Initial dose of Newborn weeks, 1st tri) antibiotics resuscitation - Iodine 200 mg once during (treatment of pregnancy neonatal d. Tetanus toxoid sepsis/oxygen support) - Prevents tetanus in both mother & newborn. Assisted deliveries Blood transfusion if - Through IgG (imminent breech there is storage - Lock jaw, muscle spasms, delivery) facility no more than convulsion 2 km away e. Counseling on healthy lifestyle f. Early detection & management of - CEmOnc complications of pregnancy ➔ Can perform din yung sa g. Birth planning & promotion of BEmOnc facility-based delivery ➔ Tertiary or general - Lying in hospitals - Birthing home ➔ 500,000 population - Hospital CS delivery Neonatal h. Utilizing HBMR emergency - Home-Based Mother’s Record intervention (low - Record of hx of present & past birth weight, preterm pregnancies. newborn, fetal alcohol syndrome, pathologic jaundice, 3. Childbirth Package birth defects) a. Skilled birth attendance/skilled professional-assisted delivery & Blood banking Transfusion services facility-based deliveries Preterm labor - Use of partograph ❖ Active phase of labor ❖ Monitor and detect 4. Postpartum Package complications which - Menganak ne usually occur during labor a. Postpartum visits & 24 hrs postpartum - Within 72 hours ❖ Ito yung nasa LR room - 7th day postpartum yung maingay bwiset n ➔ Check for bleeding or yan, ems infections b. Proper management of pregnancy & b. Micronutrient supplementation delivery complications & newborn - Iron & folate (60mg/400 mcg) complications OD for 3 months or 90 tablets - Essential Intrapartum & Newborn - Vitamin A 200,000 IU within 4 Care (EINC) or Unang Yakap weeks after delivery c. Access to basic emergency obstetric c. Counseling on nutrition, childcare, & newborn care (BEmOnc) or family planning, & other available services.  5. Newborn (first week of life) Care Package - Recommended EINC practices in the care of newborn are evidenced-based 3. Maternal Mortality # of deaths of Rate (MMR) female from any measures that are vital for the survival cause related or & the quality care of newborn. # of deaths due to aggravated by - UNANG YAKAP! (sana all) pregnancy, delivery, pregnancy & puerperium in a childbirth or 6. Childcare Package calendar yr / # of life within 42 days of a. Immunization births in same yr x 1,000 termination of b. Nutrition pregnancy. Measure of - Exclusive breastfeeding up to 6 obstetric risk & months affected by - Sustained breastfeeding up to 24 maternal health months w/ complementary practices, feeding (w/ solid food) diagnostic - Micronutrient supplementation ascertainment, & completeness of c. Integrated management of childhood registration of illnesses births. d. Injury prevention e. Oral health 4. Infant Mortality # of deaths of f. Insecticide-treated nets Rate (IMR) infants under 1 - For mothers & children in year of age in a 𝑑𝑒𝑎𝑡ℎ𝑠 𝑢𝑛𝑑𝑒𝑟 1 𝑦.𝑜/𝑦𝑟 𝑥 1, 000 calendar year per malaria-endemic areas (Palawan # 𝑜𝑓 𝑙𝑏 𝑖𝑛 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟 1 thousand live teh) births in same MEASURING MCH period. Approximation of the risk of dying 1. Crude Birth Rate Measures how within the 1st year (CBR) fast people are of life. added to ↑ IMR = ↓ levels # 𝑜𝑓 𝑟𝑒𝑔. 𝑙𝑏 𝑖𝑛 𝑎 𝑦𝑟 population of health 𝑥 1, 000 𝑀𝑖𝑑𝑦𝑒𝑎𝑟 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 through births. standards (poor Affected by maternal health fertility, marriage & child health pattern, practices care) of place, sex, age 60-150/1,000 = composition of poor population population, birth >/= 200/1,000 = registration. very severe >/= 45/1,000 live environmental births = high conditions fertility (not good) 5. Neonatal Mortality # of deaths of