Week 1 Chapter 1 and 2 Flashcards
Women anxious about pregnancy and feared death of newborn during what time ERA?
Colonial America
What happened in the early 1900s
Physician Assisted Births
Midwives who could not afford doctors
When were natural childbirths introduced?
1950s
Current practices of maternal and newborn health include
Return of midwives and doulas, childbirth choices that works best for mothers, families, and the child
Many births in the old days were where and by who?
Home and by midwives
Affluent people cold afford doctors and pain to have pain management
Historical Development of Child Health and Care from the 20th to 21st century include?
Urban Public Health improvements- safer cities
Decreased threat of childhood diseases
Unintentional injuries leading causes of death in children greater than 1
Technologic advances increased survival rates but with chronic disabilities
National and international organizations for children’s rights
Nonmedical birth companion who provides continuous emotional, physical, and educational support to the woman and family during childbirth.
Doula
Number of people who have died over a specific period of time
Mortality
Evolution in the definition of health from the absence of disease, measured by monitoring mortality and morbidity, to a state of complete physical, mental, and social well-being.
True
Annual number of deaths from any cause during pregnancy or within 42 days of termination/100,000 live births
Maternal Mortality Rate
African Americans higher than any group
US ranks 46th
Healthy People of 2030 emphasizes on
Health promotion and disease prevention
GOALS:
Healthy; thriving lives
Health Equity
Health Literacy
Health development and behaviors
Engage leaders to develop policies that will improve the health and well being of all
Fetal Mortality Rate # 2 Includes
Maternal Factors: Malnutrition, disease, preterm cervical dilation
Fetal Factors: Chromosomal abnormalities, poor placental attachment
Major but not overlooked health problem
Neonatal Mortality Rate # 3 includes
Number of infant deaths in first 28 days/ 1,00 live births
Infant mortality rate: deaths within first 12 months /1,000 live births
Congenital anomalies #1
Low Birth Weight and Prematurity : Significant indicators
Factors Affecting Maternal and Child Health
Family
Genetics
Society
Global Society
Culture
Health Status and Lifestyle
Access to Health Care
Improvement and a Treatments
Empowerment of Health Consumers
Factors affecting Maternal and Child Health
Developmental level impacts, disease contribution and variable with age
Nutrition deficiencies or excess, childhood obesity
Lifestyle choices: eating patterns, exercise, tobacco use, drugs, alcohol, methods of stress coping
Environmental Exposures
Stress and Coping: Disasters, crises, inadequate finances, inadequate support systems, violence, normal problems with growth and development
What are barriers to health care?
Finances
Sociocultural
Nurses need to assess for financial and sociocultural barriers to health care and beware of resources available to families
Legal and Ethical issues in Maternal and Child Health Care
Abortion: legal, social, and political issue, nurses struggling with personal beliefs and duty
Substance Abuse: Fetal Injury; possible charges negligence and child endangerment
Intrauterine Therapy: Medical Technology versus Nature ; better quality of life
Maternal- Fetal Conflict: Beneficence and autonomy; complex issue
Legal and Ethical issues in Maternal and Child Health Care #3
Informed Consent
Age of majority: 18 years
Parent or legal guardian for minors
Nurse’s Responsibility
- Ensuring form completed with signatures
- Serving as witness to signature process
- Determining client and family understanding what they are signing for with right questions
Legal and Ethical Issues in Maternal and Child Health Care: Informed Consent #1
Special Situations with informed consent
- Parent unavailable, person in charge with written permission from parent for emergency tx
- Verbal consent via telephone for emergency
- Emergency or urgent situations
Legal and Ethical Issues in Maternal and Child Health Care: Informed Consent # 2
Exceptions of parental consent vary by state
- Mature minor over 14
Emancipated Minor - Armed Services Member
- Marriage or college attendance
- Court Determined
- Financial Independent
- Pregnancy mother under 18
Legal and Ethical Issues in Maternal and Child Health Care: Informed Consent #5
Refusal of Medical Treatment
- All clients with the right to refuse medical treatment
- Parental Autonomy- Fundamental; Parents acting best interest for child
- Possible conflicts related to religious or cultural beliefs, child’s quality of life
- Sometimes form of child abuse, use of judicial system to advocate for child- parens patriae
Use of research or evidence in establishing a plan of care and implementing it
Clinical decision making approach integrating best scientific evidence , client values and preferences, clinical circumstances, and clinical expertise for best outcomes
Evidence Based Care
Interdisciplinary plan of care to meet physical, developmental, educational, spiritual, and psychosocial needs
Collaborative Care
- Case Management
- Advocacy, communication, resources management
- Client focused comprehensive care across continuum
- Coordinated care with interdisciplinary approach
Collaborative partnership, mutual trust, sensitivity to client and family’s belief and those of their culture
Family as constant
Support for uniqueness and diversity, encouragement and enhancement of family strengths and competencies
Family Centered Care
Greater family self- determination, decision making, control and self efficacy
