OB1 Module 1.pdf

Care of Mother, Child and Adolescent (Well- Clients) INSTRUCTOR’S GUIDE...

Care of Mother, Child and Adolescent (Well- Clients) INSTRUCTOR’S GUIDE BS NURSING / SECOND YEAR Session # 1 Materials: Book, paper, pen, notebook, and LCD projector LESSON TITLE: FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING AND CONCEPTS OF UNITIVE AND PROCREATIVE HEALTH LEARNING OUTCOMES: At the end of the lesson, the student nurse can: References 1. Identify the Framework and Maternal and Child Health Goals and Standards Pilliteri, Adele and Silbert-Flagg, JoAnne (2018) 2. Describe the theories related to Maternal and Child Health th Maternal and Child Health Nursing, 8 Edition. Nursing USA: Lippincott Williams and Wilkins 3. Define the roles and responsibilities of a Maternal-Child nurse. Sustainable Developmental Goals launch in 2016. 4. Explain the ethico-legal considerations of maternal and child (2015, December 30). practice. https://www.un.org/sustainabledevelopment/blog/ 5. Define “family” in its different contexts. 2015/12/sustainable-development-goals-kick-off- 6. Identify the basic family types and structures with-start-of-new-year/ 7. Enumerate the functions characteristics and tasks of the family United Nations Millennium Developmental Goals. https://www.un.org/millenniumgoals/ SUBJECT ORIENTATION (10 minutes) Activity 1: Getting to Know Each Other The instructor will initiate the activity by greeting the class, saying his/her full name, his/her preferred nickname, statin g an object that best describes him/her, and why. Example: “Hello, everyone! I am (full name). You can call me Sir/Ma’am (nick name). The object that best describes me is a clock because time is so precious and we must mak e each moment count. ” The instructor will then tap the right shoulder of the next person to introduce himself/herself. The process will continue until every student is done. Activity 2: Course Orientation The instructor will introduce the course, Care of Mother, Child and Adolescent Well-Clients)-Lecture. Copies of the course outline will be distributed and discussed accordingly, with emphasis on: o Calendar of activities o Classroom rules and regulations o Computation of grades o Students will then be allowed to ask questions and voice out their expectations. o Election of officers will follow as needed. MAIN LESSON (40 minutes) The instructor should discuss the following topics. Instruct the students to tak e down notes and read their book about this lesson (Chapter 1: A Framework for Maternal and Child Health Nursing page 3). A Framework for Maternal and Child Health Nursing: 1. Primary Goal of Maternal and Child Health Nursing: The promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing. This document and the information thereon is the property of PHINMA Education (Department of Nursing) 1 of 11  Maternal and Child Health Nursing Practice Throughout the Childbearing‒Childrearing Continuum  Provision of preconception health care  Provision of nursing care of women throughout pregnancy, birth, and postpartum period  Provision of nursing care of children from birth through adolescence  Provision of nursing care to families in all settings 2. Philosophy of Maternal and Child Health Nursing: o Family-centered o Community-centered o Evidence-based 3. Maternal and Child Health Goals and Standards GLOBAL HEALTH GOALS: a. The United Nations (UN) and the World Health Organization established Millennium Health Goals in 2000 in an effort to improve health worldwide. b. These concentrate on improving the health of women and children because increasing the health in these two populations can have such long-ranging effects on general health. c. These Global Health Goals are: MILLENIUM DEVELOPMENT GOALS- These eight goals, set by the United Nations back in 2000 to eradicate poverty, hunger, illiteracy and disease, expire at 2015. SUSTAINABLE DEVELOPMENT GOALS:  are a collection of 17 global goals set by the United Nations General Assembly in 2015 for the year 2030.  part of a wider 2030 Agenda for Sustainable Development  built on the Millennium Development Goals (MDGs) as framework  In total, 5 million people from across 88 countries in all the world’s regions took part in the consultation, and shared their vision for the world in 2030.  It aims to transform our world and to improve people's lives and prosperity on a healthy planet. This document and the information thereon is the property of PHINMA Education (Department of Nursing) 2 of 11   It applies to all countries through partnerships and peace. Countries, regions, cities, the business sector and civil society are actively engaged in implementing the Agenda and the SDGs.  They are mobilizing efforts to end all forms of poverty, fighting inequalities and tackling climate change, while ensuring that no one is left behind. 4. Theories Related to Maternal and Child Health Nursing Nursing theories that are related in promoting healthy pregnancies and keeping the children well are designed to offer helpful ways to view patient so nursing activities can be created to best meet patients ’ needs. Examples: a. Callista Roy’s Adaptation Theory- nurse’s role is to help patients adapt to change caused by illnesses or other stressors b. Dorothea Orem’s Self-Care Theory- involves examining the patient’s ability for self-care c. Patricia Benner’s Novice-Expert Model- describes nurse’s move from novice to expert 5. Roles and responsibilities of a Maternal-Child nurse. 6 Competencies Necessary for Quality Care:  Patient-Centered Care  Teamwork & Collaboration  Evidence-Based Practice  Quality Improvement  Safety  Informatics 6. 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 healthcare team members  Proper documentation is essential for justifying actions. This document and the information thereon is the property of PHINMA Education (Department of Nursing) 3 of 11   Nurses need to be conscientious about obtaining informed consent about invasive procedures in children and determining if pregnant women are aware of any risk to the fetus associated with a procedure or test.  Nurses are legally responsible to report inappropriate or insufficient care provided by another practitioner. 7. Ethical Considerations of Practice  Nurses should provide factual, complete information, supportive listening and helping them in clarifying their values without imposing their own. (Chapter 3: Concepts of Unitive and Procreative Health). A. Definitions of Family: D. Family Theory 1. “A group of people related by blood, marriage,  a set of perspectives from the family’s point or adoption living together.” (US Census of view Bureau, 2009)  helps address important issues of 2. “Two or more people who live in the same childbearing and childrearing families. household (usually), share a common  Modern concept of MCN Nursing is based on a family and community standpoint emotional bond, and perform certain interrelated social tasks. (Allender & Spradley, E. Basic Family Types 2008) 1. Family of orientation: the family one is born B. Influence of Family on Its Members into (e.g., oneself, mother, father, and 1. Provides long-lasting emotional ties siblings, if any) 2. Provides a depth of support - refers to the family in which a person is 3. Determines how members relate to people RAISED. 4. Influences what moral values members follow 2. Family of procreation: the family one 5. Molds the members’ basic perspectives on establishes (e.g., oneself, a spouse or the present and future significant other, and children, if any) C. Family Nursing -the family that we CREATE by getting - focus of modern nursing practice married and having children - it is nursing care that considers the family, not the individual F. RECOGNIZED FAMILY STRUCTURES 1. Childfree or childless family 8. Binuclear family -2 people living together without children -A family that is created by divorce or separation when the child is raised in two families -Advantages: Companionship and shared resources 9. Communal Family - group of people who choose to live together as an 2. Cohabitation family extended family -Couples perhaps with children who live together but remain unmarried -motivated by social or religious values rather than kinship 3. Nuclear family -Composed of 2 parents and children. -freedom & free choice rather than those of a traditional family -Advantage: financial and emotional support, genuine affection for each other. -prefer complementary or alternative therapies 4. Extended (multigenerational) family 10. Gay or Lesbian (LGBT) Families -Nuclear family plus grandparents, uncles, aunties, cousins and grandchildren. - individuals of the same sex live together as partners for companionship, financial security and sexual fulfilment -Contains more people to serve as resources during crises and models for behavior and values. -some include children from previous heterosexual relationships, artificial insemination, adoption or surrogate 5. Single-parent family motherhood -PROS: family can offer the child a special parent-child relationship & increased opportunities for self-reliance & -Pros: advantages of a nuclear family independence. -CONS: discrimination -CONS: limited resources 11. Foster Family -foster parents may or may not have children of their own and receive remuneration for their care of the foster child; theoretically temporary until the kids can be returned to This document and the information thereon is the property of PHINMA Education (Department of Nursing) 4 of 11 6. Blended family/Remarriage/Reconstituted Family their own parents -a divorced or widowed person with children marries someone who also has children; -PROS: prevents kids from being raised in large orphanage settings -PROS: increased security and resources, exposure to different customs or culture; -CONS: insecurity & inability to establish meaningful relationships due to frequent moves -CONS: rivalry, each spouse may experience difficulty helping rear the other’s children, financial problems 12. Adoptive Family - type of family structure in which a person from 7. Dyad Family the family assumes the parenting of a child from -2 people living together, usually man & woman (e.g. his/her biological parents through adoption newly-married couple) agencies, international adoption and private adoption -single, young, same-sex adults who live together as a dyad for companionship & financial security 13. Polygamous Family -marriage with multiple spouses -polygyny- (1 man with several wives) -polyandry (1 woman with several husbands) G. 5 Universal Characteristics of a Family H. Characteristics of A Healthy Family 1. Small social system- interrelated; actions of 1 Members: affect the other  interact with each other repeatedly in many 2. Performs certain basic functions: provides for contexts. the physical, spiritual, mental health, socialization  encouraged to grow and develop as of members, provision of economic well-being individuals and members of the family 3. Has structure- who are the members?  enhanced and fulfilled by maintaining 4. Has its own cultural values and roles contacts with a wide range of community 5. Moves through stages in the life cycle groups and organizations  make efforts to master their lives by becoming members of groups, finding information and options, and making decisions. I. 8 Family Tasks: J. Family Life Cycles a. PHYSICAL MAINTENANCE- food, clothing & shelter Stage 1: Marriage Stage 2: The Early Child-bearing Family b. SOCIALIZATION OF FAMILY MEMBERS Stage 3: The Family with a Pre-school Child Stage 4: The Family with a School-age Child c. ALLOCATION OF RESOURCES Stage 5: The Family with an Adolescent Stage 6: The Launching Stage Family Stage7: The Family of Middle Years d. MAINTENANCE OF ORDER Stage 8: The Family in Retirement or Old Age e. DIVISION OF LABOR *BOOMERANG GENERATION- young adults return f. REPRODUCTION, RECRUITMENT AND RELEASE OF home to live with their family after college or a failed FAMILY MEMBERS relationship until they can afford their own apartment or form a new relationship g. PLACEMENT OF MEMBERS INTO THE LARGER SOCIETY * SANDWICH FAMILY- a family that is squeezed into taking care of both aging parents and a returning young h. MAINTENANCE OF MOTIVATION AND MORALE adult. *EMPTY NEST SYNDROME- is a feeling of boredom or grief and loneliness parents may feel when their children leave home for the first time, such as to live on their own or to form families of their own K. ASSESSMENT OF FAMILY STRUCTURE AND FUNCTION This document and the information thereon is the property of PHINMA Education (Department of Nursing) 5 of 11  Family assessment is best done when a family is doing well GENOGRAM- diagram that details family structure, provides info about the family’s history and the roles of various family members over time, usually through several generations; provides a basis for discussion and analysis of family interaction. ECOMAP- to document the fit of a family in their community; a diagram of family and community relationships FAMILY APGAR- a screening tool of the family environment -a Family APGAR form is administered to each family member and their scores are c ompared This document and the information thereon is the property of PHINMA Education (Department of Nursing) 6 of 11 CHECK FOR UNDERSTANDI NG (30 minutes) The instructor will prepare 10-15 questions that can enhance critical thinking skills. Students will work by themselves to answer these questions and write the rationale for each question. Multiple Choice (For 1-10 items, please refer to the questions in the Rationalization Activity) RATIONALIZATION ACTIVITY The instructor will now rationalize the answers to the students and will encourage them to ask questions and to discuss among their classmates. 1. These are primary goals of maternal and child health nursing except: A. Provision of nursing care of women throughout pregnancy, birth, and postpartum period B. Provision of nursing care of children from birth through adolescence C. Provision of quality education D. Provision of nursing care to families in all settings ANSWER: C RATIONALE: Option C is part of the 17 Sustainable Development Goals. A, B and D are goals of maternal and child Health Nursing 2. Maternal and child health nursing is: A. Patient-centered B. Family-centered C. Evidence-based D. All of the above E. None of the above ANSWER: D RATIONALE: A, B and C are part of the philosophy of Maternal and child health nursing. 3. Which of the following is not a Millennium Development Goal? A. Improve maternal health B. Enhance child mortality C. Eradicate extreme poverty and hunger D. Combat HIV, AIDS, malaria and other diseases ANSWER: B This document and the information thereon is the property of PHINMA Education (Department of Nursing) 7 of 11  RATIONALE: The correct statement of MDG number 4 is: Reduce child mortality 4. Which of the Millennium Development Goals does this graphic image represent? A. Eradicate extreme poverty and hunger B. Improve maternal health C. Combat HIV, AIDS, malaria and other diseases D. Achieve universal primary education ANSWER: A st RATIONALE: The graphic image represents the 1 MDG: Eradicate extreme poverty and hunger 5. Fill in the blank. MDG6 is to combat HIV-AIDS, __________ and other diseases A. Tuberculosis B. Malaria C. Diarrhea D. Cholera ANSWER: B RATIONALE: MDG 6 specifically states: Combat HIV/AIDS, MALARIA and other diseases. Tuberculosis, Diarrhea and Cholera are not specifically mentioned. 6. Sustainable Development Goal number 1 is about poverty. What is the aim of this goal? A. Cut poverty in half by 2030 B. Reduce poverty by 75% in 2030 C. End poverty in all its forms everywhere D. Help each nation make progress in ending poverty ANSWER: C RATIONALE: “Leave no one behind” is a k ey message throughout the 2030 Agenda for Sustainable Development. Goal 1 is about ending poverty, in all its forms, everywhere in the world. 7. Sustainable Development Goal 17 is about strengthening the “means of implementation” and revitalizing the “Global Partnership” for realizing all the other Goals. Which of the following is not part of Goal 17? A. Mobilizing the financial resources to achieve the goal B. Creating international sports tournaments and festivals to meet the goal. C. Helping developing countries build the capacities they need in areas such as technology, public policy and data for reporting on progress. D. Enhancing trade, especially to help developing countries increase their exports and grow their economies. ANSWER: B RATIONALE: Option B is not formally part of the sustainable development goals 8. Which of the following is not part of the Sustainable Development Goals? A. Access to sustainable energy for all B. Availability of water and sanitation for all. C. Provision of free internet services for all D. Promotion of decent jobs for all ANSWER: C RATIONALE: Provision of free internet services for all is not part of the SDGs. This document and the information thereon is the property of PHINMA Education (Department of Nursing) 8 of 11 9. The nurse’s role is to help patients adapt to change caused by illnesses or other stressors. This is a theory by: A. Florence Nightingale B. Dorothea Orem C. Callista Roy D. Patricia Benner ANSWER: C RATIONALE: Callista Roy’s Adaptation Model states that the nurse’s role is to help patients adapt to change caused by illness or other stressors. 10. These are all competencies necessary for quality care except: A. Patient-centered care B. Experience-based practice C. Safety D. Teamwork and collaboration ANSWER: B RATIONALE: A, C, and D are all competencies necessary for quality care. Evidence- based practice, NOT experience-based practice is part of the competencies. 11. Group of people who choose to live together as an extended family and their relationship is motivated by social or religious rather than kinship A. Nuclear family B. Communal Family C. Adoptive Family D. Multigenerational family ANSWER: B RATIONALE: A communal family is a group of people who choose to live together as an extended family motivated by social or religious values rather than k inship 12. The family that loosens ties to allow freedom and prepares the children to lead their own lives is in the life cycle stage of: A. Stage 8: The Family in Retirement or Old Age B. Stage 5: The Family with an Adolescent C. Stage 5: The Family of Middle Years D. Stage 6: The Launching Stage Family ANSWER: D RATIONALE: The launching stage family has children adult children who are ready to leave home in order to form families of their own or to live independently. Options A and C have children that usually have children that have already left home and are leading their own lives. Option B is a family that is still preparing their child to live independently. 13. The family task that helps maintain a sense of unity and pride in the family is: A. socialization of family members B. maintenance of order C. division of labor D. motivation and morale ANSWER: D RATIONALE: Motivation and boosting of morale brings the family together and cultivates a sense of unity and pride in being a part of the family. Socialization of family members prepares them for creating relationships outside the family and in the bigger community. Maintenance of order and division of labor instills a sense of responsibility and promotes equality. 14. “Empty Nest Syndrome” is: A. When young adults return home to live with their family after college or a failed relationship until they can afford their own apartment or form a new relationship. B. A family that is squeezed into taking care of both aging parents and a returning young adult. C. A feeling of boredom or grief and loneliness parents may feel when their children leave home for the first time, such as to live on their own or to form families of their own D. All of the above ANSWER: C RATIONALE: Option A refers to Boomerang Generation, while Option B refers to a Sandwich Family. This document and the information thereon is the property of PHINMA Education (Department of Nursing) 9 of 11 15. The family is: A. A group of people related by blood, marriage, or adoption living together. B. Two or more people who live in the same household (usually), share a common emotional bond, and perform certain interrelated social tasks C. A couple perhaps with children who live together but remain unmarried D. A and B E. All of the above ANSWER: E RATIONALE: Options A, B and C refer to the different definitions of family: Option A is the definition of family by the US Census Bureau, 2009. Option B is the definition of family by Allender & Spradley, 2008. Option C is the definition of a Cohabitation Family 16. What type of family does this image represent? A. Multigenerational Family B. Nuclear Family C. Single-Parent Family D. LGBT Family ANSWER: A RATIONALE: The graphic image represents a multigenerational family comprised of the Nuclear family plus grandparents and probably uncles, aunties, cousins and grandchildren. Option B is Composed of 2 parents and their children, Option C is composed of one parent and his/her child or children. Option C is composed of a couple of the same sex, with or without children. 17. The stage in the family life cycle wherein the nurse serves as a counsellor to a family with teenagers, a step in family growth: A. Family with an adolescent B. Family with young adult C. Family in the middle years D. Family with a Preschool child ANSWER: A RATIONALE: An adolescent is defined as someone between the ages of 10 to 19, inclusive of the teenage years. Options B and C are families with children with ages above the teens, from 20 years of age onwards. Option B describes a family with a child aged 3 to 6 years. 18. A Family assessment tool that consists of a Diagram of family history A. EcoMap B. Genogram C. Family APGAR D. A and B E. A and C ANSWER: B RATIONALE: A Genogram is a diagram that details family structure, provides info about the family’s history and the roles of various family members over time, usually through several generations. An EcoMap is a diagram of family and community relationships. A Family APGAR is a screening tool of the family environment which mak es use of a questionnaire as its tool. This document and the information thereon is the property of PHINMA Education (Department of Nursing) 10 of 11 19. The family task that establishes family rules and regulations: A. Physical maintenance B. Reproduction, recruitment and release of family members C. Allocation of resources D. Maintenance of order ANSWER: D RATIONALE: Option D, maintenance of order, is the family task that constitutes of establishing rules and regulations and instilling discipline among its members. Physical maintenance entails provision of basic needs such as food, water and shelter. Allocation of resources refers to the just division and distribution of resources to each family member. 20. It refers to the family one is born into (e.g., oneself, mother, father, and siblings, if any) A. Family of Orientation B. Family of Procreation C. Nuclear family D. Adoptive family ANSWER: A RATIONALE: Family of orientation refers to the family one is born into. Option B refers to the family one establishes or creates. Option C is type of family structure composed of 2 parents and children. Option D is a type of family structure in which a person from the family assumes the parenting of a child from his/her biological parents LESSON WRAP-UP (10 minutes) Teacher directs the student to mark (encircle) their place in the work tracker which is simply a visual to help students trac k how much work they have accomplished and how much work there is left to do. This tracker will be part of the student activity sheet. You are done with the session! Let’s track your progress. Period 1 Period 2 Period 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 AL Strategy: Minute Paper 1. Towards the end of the class, students are asked to use index cards or half-sheets of paper to provide written feedback to the following questions: a. What was the most useful or the most meaningful thing you have learned this session? b. What question(s) do you have as we end this session? 2. Collect the responses as or before the students leave. One way is to station yourself at the door and collecting “minute papers” as student file out. 3. Respond to students’ feedback during the next class meeting or as soon as possible This document and the information thereon is the property of PHINMA Education (Department of Nursing) 11 of 11