NR 327 EDAPT- INTRODUCTION TO MATERNAL CHILD NURSING

INTRODUCTION TO MATERNAL CHILD NURSING Maternity care has changed over the years to increase the emphasis on safety and quality of care. Many expectant mothers have other health concerns such as obesity, high blood pressure, and even substance abuse. Their socioeconomic status can have an impact on their pregnancy, along with their cultural preferences. Abuse and human trafficking may be other risks that these women face during this period of their lives. When planning maternal childcare for a client, nurses and providers must take into consideration the specific needs of the client. A client should be cared for at a facility that promotes safety and bases their care on the latest evidence. The client should be involved in their care and discussing options with their provider. In maternal care, Level III provides the highest level of care, whereas a home birth or birthing center typically has fewer interventions and less care for lower-risk clients. Level I, II, III are designations given to inpatient hospital facilities. Evidence-based practice The care is provided based on the latest research and recommendations to promote safety and positive health outcomes. Level I facility Low-risk clients, in a hospital setting LDR room Mom labors, delivers and recovers in the same room, but is transferred to a post partum unit. Birth centers Tub births and births may not require as much medical monitoring. Home births Specialized physicians and midwives deliver within a client’s residence. Level II facility Typically, care is provided for clients 32 weeks gestation in a hospital setting. LRDP room Mom labors, delivers, and recovers in the same room and stays for 2-4 days. Level III facility Highest-risk moms and their infant(s), in a hospital setting Most families now recognize that they have choices in the childbirth experience. What are the basic principles of family-centered care? Nurses must support their clients and provide family-centered care. Nurses should involve the clients whenever possible. The health and safety of the client and baby are the top priority. If there are no health risks or financial barriers, clients should have the opportunity to have family/support persons present at the birth, select the type of provider and decide on the birth setting. Usually, childbirth is considered a normal, healthy process. Family dynamics will be impacted by childbirth. Which factors will help to reduce maternal mortality in the United States? Select all that apply.  Availability of high-risk, maternal-infant care centers  Use of a specialized antepartum maternity clinic  Increased use of hospitals and specialized health care personnel, such as a certified nurse midwife (CNM) Home deliveries can provide a safe birthing experience, but have not improved the mortality rate. Birthing plans have provided client involvement in their care, but they have not been a factor in decreasing maternal mortality. CJANGES IN MATERNITY CARE OVER TIME Prior to the twentieth century (before 1901)  Deliveries happened at home; “granny midwives” were in attendance  High rates of maternal and infant death, both at home and in hospitals  Postpartum hemorrhage, postpartum infection, toxemia, prematurity, dehydration r/t diarrhea, contagious diseases 20th century developments  Increase in physician assisted births in hospitals  By 1960, 90% of all births in the U.S. were in hospitals  Lay midwifery became increasingly illegal  Women’s role in delivery became passive; doctors delivered  Twilight sleep; narcotic and scopolamine  Continued problems with poor maternal nutrition, infection, inadequate prenatal care & cost issues When reviewing nursing history, which factors led to increased mortality rates and negative pregnancy outcomes? Select all that apply. All of these factors increased the mortality rates and increased the risk for mothers and their newborns.  Short hospital stays sent women home before they were physically and emotionally stable.  Women were passive in the delivery process, often medicated and not able to have any voice in the process.  Maternal nutrition resources were not always accessible and women sometimes didn’t know the importance of their nutrition or didn’t have the financial means to buy it.  Risk of hemorrhaging post-delivery and communicable diseases were caused by factors such as untrained delivery support personnel and unclean equipment.