Chapter 1- A Framework for Maternal and Child Health Nursing
unintentional injuries
what is the leading cause of death for all individuals 1-24 years of age?
infant mortality rate
what is the most meaningful and important measure of maternal and child health?
promotion and maintenance of optimal family health
what is the primary goal of both maternal and child health nursing?
nursing research, evidence-based practice
what methods are how maternal and child health nursing expands and improves? (2)
infant mortality rate
what rate is declining steadily, but in the United States is still higher than in 25 European countries?
perinatal death rate
what rate is the sum of the fetal and neonatal death rates?
20th week of pregnancy to 4-6 weeks after birth
when does the perinatal period take place?
role of fetus and child
why do maternal and child health care have both legal and ethical considerations and responsibilities over and above those in other areas of practice?
health restoration
1. caring for a woman during a complication of pregnancy such as gestation diabetes 2. caring for a child during an acute illness such as pneumonia (health promotion/health maintenance/health restoration/health rehabilitation)
health rehabilitation
1. encouraging a woman with gestational trophoblastic disease (abnormal placenta growth) to continue therapy 2. encouraging a child with a renal transplant to continue to take necessary medications (health promotion/health maintenance/health restoration/health rehabilitation)
health maintenance
1. encouraging women to be partners in prenatal care 2. teaching parents the importance of safeguarding their home by childproofing against poisoning (health promotion/health maintenance/health restoration/health rehabilitation)
health promotion
1. teaching women the importance of rubella immunization before pregnancy 2. providing preteens with information about safer sex practices well before they are likely to become sexually active (health promotion/health maintenance/health restoration/health rehabilitation)
a. Assess whether the father is willing to try skin-to-skin care
A growing body of knowledge suggests skin-to-skin contact between mother and baby immediately after birth provides numerous benefits, including regulating heartbeat and temperature for the baby and promoting feelings of calm and well-being in both mother and baby. To see if fathers were interested in participating in this form of care (often called kangaroo care), researchers interviewed seven new fathers who had spent time in skin-to-skin interaction with their newborn. Findings showed kangaroo care allowed fathers to feel more in control and also that they were doing something good for their infant. Based on the previous study, what action would the nurse take? a. Assess whether the father is willing to try skin-to-skin care b. Suggest neither parent use skin-to-skin care to prevent infection c. Encourage the father to praise his wife when she provides skin-to-skin care d. Apologize to his wife because men do skin-to-skin care more effectively than women
c. The hospital has met high standards for nursing competency
A nursing assistant informed the nurse that a patient asked why the hospital where his baby is being cared for is termed a "Magnet hospital." The nurse would want team members to know which rationale? a. Magnet hospitals are those who care for the most acutely ill patients b. The designation is one assigned by the American Medical Association c. The hospital has met high standards for nursing competency d. The term refers to hospitals that only admit a limited number of patients
b. No one can say for certain. You did all you could to ensure a healthy pregnancy
A patient waited until she was 42 years old to have her second baby. She asks the nurse if that is the reason her baby was born prematurely. Which statement would be the most reassuring for her? a. It's hard to say because so few women over 40 years are having babies today b. No one can say for certain. You did all you could to ensure a healthy pregnancy c. It's good to see you taking responsibility for your child's prematurity d. You should ideally have had your children as a teenager as that's the safest time
c. From the 20th week of pregnancy to 4 to 6 weeks after birth
A patient's doctor has told her that her baby's most dangerous time will be until the perinatal period ends. When does the perinatal period take place? a. From the day of brith until 1 month afterward b. During the time the infant will be on ventilator support c. From the 20th week of pregnancy to 4 to 6 weeks after birth d. Until the infant's body temperature stabilizes following birth
d. Consent is required: you can be contacted by telephone or e-mail for long distance consultation
A woman is concerned as to how she will give consent for procedures for her newborn baby because the baby is hospitalized so far away. Which statement would be best to reassure her? a. Informed consent is not needed for newborn care as newborns are underage b. Newborn care requires parental consent only for procedures that will involve pain c. Healthcare providers can omit informed consent if the parent is not present with the child d. Consent is required: you can be contacted by telephone or e-mail for long distance consultation
. The use of multiple technologies can make parents feel overwhelmed unless they receive nursing support
Nurses must always be aware of quality improvement because as society changes with new situations, nursing care must make responding adjustments. Which of the following is a trend that will influence the care that a family's new baby is likely to receive? a. More and more children are treated in ambulatory, not hospital settings, so nurses will be less significant in the future b. Immunizations are available for all childhood infectious diseases so the family's baby with never need treatment for these c. The use of multiple technologies can make parents feel overwhelmed unless they receive nursing support d. Prematurely born infants, assuming their mother received prenatal care, rarely need long-term or follow-up care
QSEN competencies, nursing process
___ combined with ___ provide a sound method of care for expanding areas of practice
practice roles
___ in maternal and child health nursing are expanding rapidly as nurses become more versed in evidence-based practice and technologic skills
magnet status
a credential furnished by the American Nurses Credentialing Center (ANCC), an affiliate of the American Nurses Association, the hospitals that meet a rigorous set of criteria designed to improve the strength and quality of nursing care
nursing process
a scientific form of problem solving that serves as the basis for assessing, making a nursing diagnosis, planning, implementing, and evaluating care that is applicable to all healthcare settings from the home to ambulatory clinics to intensive care units
decreasing
the infant mortality rate is ___ (increasing/decreasing) steadily
25 European countries
the infant mortality rate is still higher in the US than in:
among infants from birth-1 year of age per 1,000 live births
the infant mortality rate is the number of deaths:
health promotion
educating parents and children to follow sound health practices through teaching and role modeling
family-centered care
form of care that enables nurses to better understand individuals and their effect on others and, in turn, to provide more holistic care; it includes encouraging rooming-in with the mother by the mother's partner or support person and with the child by their caregiver
health rehabilitation
helping prevent complications from illness; helping a patient with residual effects achieve an optimal state of wellness and independence; helping a patient to accept inevitable death
health maintenance
intervening to maintain health when risk of illness is present
health promotion
involves education when no specific risk is present
health maintenance
involves intervening to maintain health when risk of disease is present
preconception, menopause
maternal and child health nursing extends from ___ to ___
teamwork and collaboration
nurses function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making as they achieve quality patient care; QSEN competency
evidence-based practice
nurses integrate the best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care; QSEN competency
safety
nurses minimize the risk of harm to patients and providers through both system effectiveness and individual performance; QSEN competency
quality improvement
nurses use date to monitor the outcomes of care and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems; QSEN competency
informatics
nurses use information and technology to communicate, manage knowledge, mitigate error, and support decision making; QSEN competency
expands, improves
nursing research and use of evidence-based practice are methods by which maternal and child health nursing: (2)
QSEN competencies
patient-centered care, teamwork and collaboration, quality improvement, informatics, evidence-based practice, safety
evidence-based practice, technologic skills
practice roles in maternal and child health nursing are expanding rapidly as nurses become more versed in ___ and ___
family-centered
regardless of the setting, a ___ approach is the preferred form of nursing care
patient advocacy
safeguarding and advancing the interests of patients and their families
American Nurses Association, guidelines for practice
standards of maternal and child heath nursing practice have been formulated by the ___ to serve as ___
standards of maternal and child health nursing
the American Nurses Association has formulated ___ to serve as guidelines for practice
decreased
the birth rate in the United States has continued to gradually (increase/decrease) in recent years
evidenced-based practice
the conscientious, explicit, and judicious use of current best evidence (combination of research, clinical expertise, and patient preferences or values) to make decisions about the care of patients
health promotion, health maintenance, health restoration, health rehabilitation
the framework for maternal and child health nursing care includes 4 phases:
birth rate
the number of births per 1,000 population
perinatal death rate
the number of deaths during the perinatal time period (beginning when a fetus reaches 500 g, about week 20 of pregnancy, and ending about 4 to 6 weeks after birth); sum of fetal and neonatal death rates
infant mortality rate
the number of deaths per 1,000 live births occurring at birth or in the first 12 months of life
neonatal death rate
the number of deaths per 1,000 live births occurring at birth or in the first 28 days of life
childhood mortality rate
the number of deaths per 1,000 population in children aged 1 to 14 years
fetal death rate
the number of fetal deaths (over 500 g), per 1,000 live births
maternal mortality rate
the number of maternal deaths per 100,000 live births that occur as a direct result of the reproductive process
fertility rate
the number of pregnancies per 1,000 women of childbearing age
patient-centered care
the patient or designee is thought of as the source of control and full partner in the provision of compassionate and coordinated care based on respect for the patient's preferences, values, and needs; QSEN competency
scope of practice
the range of services and care that may be provided by a nurse based on state requirements
nursing research
the systematic investigation of problems that have implications for nursing practice usually carried out by nurses
90
trends in maternal and child health care: __% of women in the United States work outside their home at least part time
increasing
trends in maternal and child health care: both child and intimate partner violence is (increasing/decreasing)
are not, fewer
trends in maternal and child health care: families (are/are not) as extended as in previous generations, so they contain (greater/fewer) members
more
trends in maternal and child health care: families are (more/less) health conscious than before
more, increase
trends in maternal and child health care: families are (more/less) mobile than previous and there is an (increase/decrease) in the number of homeless women and children
equals
trends in maternal and child health care: the number of single-parent families ___ the number of nuclear families in the United States
increasing
trends in maternal and child health care: the number of single-parent families is (increasing/decreasing) rapidly
changes in setting of care, family-centered care, improved preventative care, increased concern about health care costs
trends in maternal and child health nursing include: (4_
health restoration
using conscientious assessment to be certain that symptoms of illness are identified and interventions are begun to return patient to wellness most rapidly
