Introduction to Maternal & Children's Health

Question 1

A person’s ability to lead a fulfilling life & to participate fully in society depends largely on…

Answer 1

…his or her health status

Question 2

What is a nurse’s role in women’s & children’s health?

Answer 2

Advocate in various issues

Draw attention to the importance of health care for children

Encouraging focus on education & prevention

Assisting families who lack resources or access to health care

Legal issues related to care of children

Question 3

What services are integrated in maternity care?

Answer 3

Prenatal, intranatal, & postnatal

Question 4

What type of care is encompassed in maternal & newborn nursing?

Answer 4

Care of the woman before pregnancy

Care of the woman and her fetus during pregnancy

Care of the woman & newborn after pregnancy (usually the first 6 weeks after birth)

Question 5

What is the overall goal of maternal & newborn nursing?

Answer 5

Promote & maintain optimal health of the woman & her family

Question 6

Providing quality maternity care includes…

Answer 6

…client satisfaction and achieving the best evidence-based outcomes w/ the fewest interventions

Question 7

What does child/pediatric nursing involve?

Answer 7

It involves the care of the child from infancy to adolescence

Question 8

What is the percentage of children under the age of 18 in the United States?

Answer 8

Accounts for 23% of the population (~73.7 million)

Question 9

What was the overall trend of the percentage of children in the population?

Answer 9

Since the 1960s, children have decreased as a percentage of the U.S. population & are expected slowly decline through 2050

Question 10

What is the overall goal of pediatric nursing practice?

Answer 10

Promote & assist the child in maintaining optimal levels of health, while recognizing the influence of the family on the child’s well-being
- Involves health promotion
- Disease & injury prevention
- Assist w/care during illness

Question 11

What is the common thread of both maternity and pediatric nursing?

Answer 11

The care of the family

Question 12

What were the common causes of death in women after childbirth during the 17th & 18th century?

Answer 12

Exhaustion, dehydration, infection, hemorrhage,
& seizures

Question 13

What are the death rates of children before the age of 5 during the colonial period versus today?

Answer 13

Colonial Period: ~43% of all children before the age of 5

Today: 5.8 infant deaths per 1,000 live births

Question 14

Granny Midwives

Answer 14

Role: Handle the normal birthing process for most women

Learned their skills via apprenticeship from more experienced midwife

All births were done at home (physicians only called in extreme cases)

Obstetrics rose in the 1800s & midwifery went to the periphery; however, it has re-emerged as an organized profession

Question 15

What is the effect of continuous companionship during labor on patient outcomes?

Answer 15

Improves patient outcomes

Question 16

Children & Women Health in Late 19th Century & Early 20th Century

Answer 16

Root causes of illness were becoming better understood-> fuel public efforts for safer milk supply
- Pasteurizing milk & dispense free milk in some cities

Compulsory vaccination programs began at this time
- Mandated smallpox vaccine for school admittance
-> Decrease in infant & child deaths

Diseases such as diphtheria, cholera, polio, & yellow fever began to take less of a toll on children

Penicillin, corticosteroids, & increased number of vaccines (developed during this time) assisted w/the fight against communicable diseases
- Unintended injuries surpassed death caused by disease

Question 16

Maternity Care in 1900’s

Answer 16

Physicians attended about half of the births in the U.S.

Midwives often cared for patients who could not afford a physician

Women were attracted to the hospitals to show affluence & receive pain management (unavailable in home births)

1950’s: “Natural Childbirth” practices, advocating birth w/out pain meds, & focus on relaxation methods were introduced
- Opened the door for childbirth education classes & reintroduce the father to the childbirth process

Question 17

What is the number one cause of death among people between the ages of 1-44 year olds?

Answer 17

Unintentional injuries

Question 18

The Effect of Technological Advances on Child Health Care?

Answer 18

Increased survival rates in children but, those that survived previously fatal diseases are left w/ chronic disabilities
Ex) Before the 1960s, premature infants died due to lung immaturity. Newer ventilation methods & med use to foster lung development -> chronic lung disease, retinopathy, etc

Increased survivability has resulted in a significant increase in chronic illness relative to acute illness as a cause of hospitalization and mortality

Question 19

Chronic Diseases

Answer 19

Illnesses that last more than 3 months & cannot be prevented by vaccination, cured by medicine, & do not disappear

Question 20

What is the current percentage of American children suffering from one or more chronic illnesses today?

Answer 20

More than 54% of American children are suffering from one or more chronic illnesses today

Question 21

Recent Advances in Biomedicine Effect on Trends

Answer 21

Created a trend toward earlier diagnosis & treatment

Genetics have been linked w/ pathophysiological processes
Ex) Female fetuses diagnosed w/ congenital adrenal hyperplasia leading to disfiguring anatomic abnormalities of sexual characteristics are able to receive treatment before birth
- Early genetic defect identification allows for appropriate counseling

Also, a number of organizations have been formed to protect children’s rights
- Focus on violence and abuse, child soldiering and labor, juvenile justice, child immigrants, homeless, abandoned children

Question 22

Certain health concerns, such as poor nutrition, obesity, infections, lead poisoning, digestive issues, & asthma affect ___ children at higher rates & w/greater severity than _____ & ____ class children

Answer 22

Poor children are affected at higher rates & severity than affluent & middle-class children

~ 1 in 5 children today live in families w/incomes below the poverty line

Question 23

Certified Nurse Midwife (CNM)

Answer 23

They have postgraduate training in the care of normal pregnancy & delivery

Certified by the American College of Nurse-Midwives (ACNM)

Question 24

Midwife

Answer 24

Primary care provider for women w/a special emphasis on pregnancy, childbirth, & reproductive health

Committed to providing ethical, individualized, evidence-based care for all women throughout their life-cycle

Question 25

Doula

Answer 25

Non-medical birth companion who provides continuous emotional, physical, & educational support to the woman & family during childbirth & postpartum period

They do NOT perform clinical or medical tasks
-They are there to support the mother & enhance communication between the mother and medical staff

Question 26

Mortality

Answer 26

Incidence or number of people who have died over a specific period

Presented as rates over 100,000 & is calculated from a sample of death certificates

Question 27

Maternal Mortality Ratio

Answer 27

Annual number of deaths from any cause related to or aggravated by pregnancy or its management

Question 28

Fetal Mortality Rate

Answer 28

AKA Fetal Death Rate

Spontaneous intrauterine death of a fetus at any time during pregnancy prior to birth/ 100,000 live births