1
Maternal-Child Nursing Notes
Week 1
Prepare and Plan
● Weekly Objectives
○ Identify essential dietary needs for the pregnant woman.
○ Explore dietary needs that support religious and cultural requirements.
○ Explain the relevance of genetics in providing care to childbearing families.
○ Compare current settings for childbirth both within and outside the hospital
setting.
○ Discuss ethical, social, and legal concepts affecting the pregnant woman.
○ Describe the effect of cultural diversity on nursing practice.
○ Discuss the roles for nurses in maternity care and women's healthcare.
○ Review current maternal-newborn health outcomes and the implications of these
trends for expectant couples, parents, and healthcare providers.
● Concepts with Exemplars
○ Introduction to Maternal Child Nursing
■ Health Promotion and Pregnancy
■ Social Determinants of Health and Maternal-Child Nursing
■ Culture, Religion, and Pregnancy
■ Ethics, Legal, and Pregnancy
Textbook Notes
● Key Points
○ Chapter 1: Clinical Judgement and the Nursing Process
■ Programs to improve patient safety and the quality of care include:
● The Joint Commision
● Interprofessional Collaboration and Education
● Alliance for Innovation on Maternal Health
● Women’s Health and Perinatal Nursing Care Quality Measures
■ Families must make many decisions about childbirth, including:
● Choosing a birth attendant
● Choosing a birth setting
● A support person for labor
● Types of educational classes to attend
, 2
■ Family-centered maternity care is based on the principle that families can
make decisions about health care if they have adequate information
■ Technological advancements, increasing knowledge, government
involvement, cost containment efforts, and consumer demands have all
impacted maternity care in the United States
■ Reduced lengths of stay make it more difficult for the nurse to provide
information regarding self-care and infant care to the client who is
recovering from fatigue and discomfort of birth
■ Nurses provide care based on standards, guidelines, and evidence
● This is provided based on critical thinking, clinical judgement, and
the nursing process
○ Chapter 2: Social, Cultural, and Ethical Issues
■ Families vary in structures and patterns of functioning
● Nuclear family
● Single-parent family
● Extended family
■ Functional families are characterized by:
● Open communication
● Flexibility in role assignments
● Adult agreement on basic principles of parenting, resiliency, and
adaptability
■ Culture is the sum of beliefs and values that are learned, shared, and
transmitted from generation to generation in a specific group of people
■ Dominant Western cultural values may influence the thinking and actions
of nurses in the United States, but may not be shared by culturally diverse
childbearing clients and their families
■ Professional nurses are expected to provide culturally competent care,
which requires awareness of, sensitivity to, and respect for the diversity of
clients served
■ Health care disparity is a major social issue that underlines adequacy of
health care resources, access to prenatal care, government programs to
increase health care to indigent persons and children, and health care
rationing
■ Multiple factors are associated with intimate partner violence, which is
deliberate, severe, and generally repeated in a predictable cycle that often
causes severe physical harm or death to the client
■ Perinatal nurses should screen for intimate partner violence and provide
appropriate education and resources
■ Human trafficking, also called trafficking of persons, is the recruitment
and movement of individuals for the purpose of exploitation.
, 3
● Sex and labor trafficking are the most common forms
■ Persons and children of childbearing age make up the majority of reported
cases of human trafficking, with the average age of entry into sex
trafficking reported to be between 12 to 14 years of age
■ Ethical dilemmas are a difficult area of practice and are best solved by
applying common ethical methods and principles and the steps of the
nursing process
■ When ethical principles of beneficence, nonmaleficence, autonomy, and
justice result in ethical dilemmas, the nursing process may be used to
guide ethical decision-making
■ Punitive approaches to ethical and social problems may prevent clients
from seeking adequate prenatal care
■ Nurses are expected to perform in accordance with nurse practice acts,
standards of care, and agency policies
■ Nurses can help defend malpractice claims by following guidelines for
informed consent, refusal of care, and documentation and by maintaining
their levels of expertise
■ Complete and timely documentation is the best evidence that the standard
of care received by a client was met
■ Continuing pressures on optimal nursing practice include unlicensed
assistive personnel and shortened lengths of stay
○ Chapter 8: Nutrition for Childbearing
■ Nutritional education during the childbearing period may have long-term
positive effects on the client, infant, and the entire family
■ Weight gain during pregnancy is an important determinant of fetal growth.
● Poor weight gain in pregnancy is associated with low-birth-weight
and SGA infants.
● Excessive weight gain may lead to
○ Increased birth weight
○ Gestational diabetes
○ Labor complications
○ Postpartum weight retention
■ The recommended weight gain during pregnancy for clients of normal
prepregnancy weight is 11.5 to 16 kg (or 25 to 35 lbs)
● The amount is greater for clients who are underweight or who
carry more than one fetus
● The amount is less for those who are overweight or obese
■ The client should gain 0.5 to 2 kg (or 1.1 to 4.4 lbs) each week during the
first trimester
, 4
● The client should gain 0.35 to 0.5 kg (0.8 to 1 lb) per week during
the second and third trimester
■ The recommended increase in daily energy intake during pregnancy is
● 340 calories in the second trimester
● 452 calories in the third trimester
● Calorie increases should be attained by choosing foods high in
nutrient density to meet the other needs of pregnancy
○ Protein should be increased to 71 g daily during pregnancy
and lactation
○ This is 25 g more than nonpregnancy needs
■ Some clients may not eat enough foods high in vitamins and minerals to
meet recommendations
● Fat soluble vitamins are stored in the liver, adipose tissue, and
skeletal muscle
● Excess consumption of vitamins A, D, E, and K may result in toxic
effects
● Daily intake of water soluble vitamins and folic acid are necessary
because excess are not stored in the body
● Iron and calcium tend to not be consumed at recommended
amounts during pregnancy
○ Iron is often added as a supplement during pregnancy
○ Calcium is also added as a supplement for clients with low
intake
■ Vitamin and mineral supplements should be used carefully in order to
prevent toxicity
■ Pregnant and lactating clients should ingest approximately
● 8-10 cups of fluid each day
● 6-8 oz of whole grains
● 2.5-3 cups of vegetables
● 2 cups of fruit
● 3 cups of dairy
● 6-6.5 oz of protein
■ Culture can affect diet diet during pregnancy
● As nurses, it is important to ask clients if they follow any specific
dietary practices
■ Low income clients may not be able to afford to meet nutrient needs
during pregnancy
● Nurses should refer them for financial assistance and nutritional
counseling
Maternal-Child Nursing Notes
Week 1
Prepare and Plan
● Weekly Objectives
○ Identify essential dietary needs for the pregnant woman.
○ Explore dietary needs that support religious and cultural requirements.
○ Explain the relevance of genetics in providing care to childbearing families.
○ Compare current settings for childbirth both within and outside the hospital
setting.
○ Discuss ethical, social, and legal concepts affecting the pregnant woman.
○ Describe the effect of cultural diversity on nursing practice.
○ Discuss the roles for nurses in maternity care and women's healthcare.
○ Review current maternal-newborn health outcomes and the implications of these
trends for expectant couples, parents, and healthcare providers.
● Concepts with Exemplars
○ Introduction to Maternal Child Nursing
■ Health Promotion and Pregnancy
■ Social Determinants of Health and Maternal-Child Nursing
■ Culture, Religion, and Pregnancy
■ Ethics, Legal, and Pregnancy
Textbook Notes
● Key Points
○ Chapter 1: Clinical Judgement and the Nursing Process
■ Programs to improve patient safety and the quality of care include:
● The Joint Commision
● Interprofessional Collaboration and Education
● Alliance for Innovation on Maternal Health
● Women’s Health and Perinatal Nursing Care Quality Measures
■ Families must make many decisions about childbirth, including:
● Choosing a birth attendant
● Choosing a birth setting
● A support person for labor
● Types of educational classes to attend
, 2
■ Family-centered maternity care is based on the principle that families can
make decisions about health care if they have adequate information
■ Technological advancements, increasing knowledge, government
involvement, cost containment efforts, and consumer demands have all
impacted maternity care in the United States
■ Reduced lengths of stay make it more difficult for the nurse to provide
information regarding self-care and infant care to the client who is
recovering from fatigue and discomfort of birth
■ Nurses provide care based on standards, guidelines, and evidence
● This is provided based on critical thinking, clinical judgement, and
the nursing process
○ Chapter 2: Social, Cultural, and Ethical Issues
■ Families vary in structures and patterns of functioning
● Nuclear family
● Single-parent family
● Extended family
■ Functional families are characterized by:
● Open communication
● Flexibility in role assignments
● Adult agreement on basic principles of parenting, resiliency, and
adaptability
■ Culture is the sum of beliefs and values that are learned, shared, and
transmitted from generation to generation in a specific group of people
■ Dominant Western cultural values may influence the thinking and actions
of nurses in the United States, but may not be shared by culturally diverse
childbearing clients and their families
■ Professional nurses are expected to provide culturally competent care,
which requires awareness of, sensitivity to, and respect for the diversity of
clients served
■ Health care disparity is a major social issue that underlines adequacy of
health care resources, access to prenatal care, government programs to
increase health care to indigent persons and children, and health care
rationing
■ Multiple factors are associated with intimate partner violence, which is
deliberate, severe, and generally repeated in a predictable cycle that often
causes severe physical harm or death to the client
■ Perinatal nurses should screen for intimate partner violence and provide
appropriate education and resources
■ Human trafficking, also called trafficking of persons, is the recruitment
and movement of individuals for the purpose of exploitation.
, 3
● Sex and labor trafficking are the most common forms
■ Persons and children of childbearing age make up the majority of reported
cases of human trafficking, with the average age of entry into sex
trafficking reported to be between 12 to 14 years of age
■ Ethical dilemmas are a difficult area of practice and are best solved by
applying common ethical methods and principles and the steps of the
nursing process
■ When ethical principles of beneficence, nonmaleficence, autonomy, and
justice result in ethical dilemmas, the nursing process may be used to
guide ethical decision-making
■ Punitive approaches to ethical and social problems may prevent clients
from seeking adequate prenatal care
■ Nurses are expected to perform in accordance with nurse practice acts,
standards of care, and agency policies
■ Nurses can help defend malpractice claims by following guidelines for
informed consent, refusal of care, and documentation and by maintaining
their levels of expertise
■ Complete and timely documentation is the best evidence that the standard
of care received by a client was met
■ Continuing pressures on optimal nursing practice include unlicensed
assistive personnel and shortened lengths of stay
○ Chapter 8: Nutrition for Childbearing
■ Nutritional education during the childbearing period may have long-term
positive effects on the client, infant, and the entire family
■ Weight gain during pregnancy is an important determinant of fetal growth.
● Poor weight gain in pregnancy is associated with low-birth-weight
and SGA infants.
● Excessive weight gain may lead to
○ Increased birth weight
○ Gestational diabetes
○ Labor complications
○ Postpartum weight retention
■ The recommended weight gain during pregnancy for clients of normal
prepregnancy weight is 11.5 to 16 kg (or 25 to 35 lbs)
● The amount is greater for clients who are underweight or who
carry more than one fetus
● The amount is less for those who are overweight or obese
■ The client should gain 0.5 to 2 kg (or 1.1 to 4.4 lbs) each week during the
first trimester
, 4
● The client should gain 0.35 to 0.5 kg (0.8 to 1 lb) per week during
the second and third trimester
■ The recommended increase in daily energy intake during pregnancy is
● 340 calories in the second trimester
● 452 calories in the third trimester
● Calorie increases should be attained by choosing foods high in
nutrient density to meet the other needs of pregnancy
○ Protein should be increased to 71 g daily during pregnancy
and lactation
○ This is 25 g more than nonpregnancy needs
■ Some clients may not eat enough foods high in vitamins and minerals to
meet recommendations
● Fat soluble vitamins are stored in the liver, adipose tissue, and
skeletal muscle
● Excess consumption of vitamins A, D, E, and K may result in toxic
effects
● Daily intake of water soluble vitamins and folic acid are necessary
because excess are not stored in the body
● Iron and calcium tend to not be consumed at recommended
amounts during pregnancy
○ Iron is often added as a supplement during pregnancy
○ Calcium is also added as a supplement for clients with low
intake
■ Vitamin and mineral supplements should be used carefully in order to
prevent toxicity
■ Pregnant and lactating clients should ingest approximately
● 8-10 cups of fluid each day
● 6-8 oz of whole grains
● 2.5-3 cups of vegetables
● 2 cups of fruit
● 3 cups of dairy
● 6-6.5 oz of protein
■ Culture can affect diet diet during pregnancy
● As nurses, it is important to ask clients if they follow any specific
dietary practices
■ Low income clients may not be able to afford to meet nutrient needs
during pregnancy
● Nurses should refer them for financial assistance and nutritional
counseling
