FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING |34 QUESTIONS AND ANSWERS

STANDARDS OF M/C HEALTH NURSING PRACTICE Health Promotion Health Maintenance Health Restoration Health Rehabilitation Health Promotion Educating clients to be aware of good health through teaching and role modeling. Health Maintenance Intervening to maintain health when risk of illness is present. Health Restoration Promptly diagnosing and treating illness using interventions that will return client to wellness most rapidly Health Rehabilitation Preventing further complications from an illness; bringing an ill client back to an optimal state of wellness or helping a client to accept inevitable death. HOW MANY STANDARDS OF CARE AND MEASURES OF QUALITY (WHO) 8 Standard 1 Every woman and newborn receive routine, evidence-based care and management of complications during labor, childbirth and the early postnatal period, according to WHO guidelines. Standard 2 The health information system enables use of data to ensure early, appropriate action. Standard 3 Every woman and newborn with condition(s) that cannot be dealt with effectively with the available resources is appropriately referred. Standard 4 Communication with women and their families is effective and responds to their needs and preferences. Standard 5 Women and newborns receive care with respect and preservation of their dignity. Standard 6 Every woman and her family are provided with emotional support that is sensitive to their needs and strengthens the woman's capability. Standard 7 For every woman and newborn, competent, motivated staff are consistently available to provide routine care and manage complications. Standard 8 The health facility has an appropriate physical environment, with adequate water, sanitation and energy supplies, medicines, supplies and equipment for routine maternal and newborn care and management of complications. ADVANCED-PRACTICE ROLES FOR NURSES IN MATERNAL AND CHILD HEALTH ARE AS FOLLOWS Clinical nurse specialists Are nurses prepared at the master's or doctorate degree level who are capable of acting as consultants in their area of expertise Neonatal Nurse Specialists Manage the care of infants at birth and in intensive care settings; ensure the newborn remains well. Childbirth Educators Teach families about normal birth and how to prepare for labor and birth. Lactation Consultants Educate women about breastfeeding and support them while they learn how to do this. Genetic Nurse Counselors Consult with families about patterns of inheritance and offer support to families with a child who has inherited a genetic disorder. Case Manager A graduate level nurse who supervises a group of patients from the time they enter a health care setting until they are discharged from the setting. Case management can be a vastly satisfying nursing role, because if the healthcare setting is "seamless," or one that follows people both during an illness and on their return to the community. Nurse Practitioners Are educated at the master's or doctoral level. Play pivotal roles in today's health care system. Recent advances in technology, research, and knowledge have amplified the need for longer and more in-depth education for nurse practitioners as they play pivotal roles in today's health care system. Women's Health Nurse Practitioner Has advanced study in the promotion of health and prevention of illness in women. Such a nurse plays a vital role in educating women about their bodies and sharing with them methods to prevent illness; in addition, they care for women with illnesses such as sexually transmitted infections, and offer information and counsel them about reproductive life planning. Pediatric Nurse Practitioner (PNP) A nurse prepared with extensive skills in physical assessment, interviewing, and well-child counseling and care. In this role, a nurse interviews parents as part of an extensive health history and performs a physical assessment of the child. Neonatal Nurse Practitioner is an advanced-practice role for nurses who are skilled in the care of newborns, both well and ill. NNPs may work in level 1, level 2, or level 3 newborn nurseries, neonatal follow-up clinics, or physician groups. Family Nurse Practitioner (FNP) provides health care not only to women and children but also to the family as a whole. In conjunction with a physician, an FNP can provide prenatal care for a woman with an uncomplicated pregnancy Certified Nurse Midwife an individual educated in the two disciplines of nursing and midwifery and licensed. Plays an important role in assisting women with pregnancy and childbearing. Either independently or in association with a physician, the nurse-midwife assumes full responsibility for the care and management of women with uncomplicated pregnancies. LEGAL CONSIDERATIONS Maternal and child health nursing carries some legal concerns that extend above and beyond other areas of nursing, care is often given to an "unseen client"—the fetus—or to clients who are not of legal age for giving consent for medical procedures. In addition, labor and birth of a neonate are considered "normal" events, so the risks for a lawsuit are greater when problems arise (O'Grady et al., 2007) Nurses are legally responsible for protecting the rights of their clients, including confidentiality, and are accountable for the quality of nursing care. Understanding the scope of practice and standards of care can help nurses practice within appropriate legal parameters. Nurses need to be conscientious about obtaining informed consent for invasive procedures and determining that pregnant woman are aware of any risk to the fetus Documentation is essential for protecting a nurse and justifying his or her actions. Adolescents who support themselves or who are pregnant are termed ---- and have the right to sign for their own health care. "emancipated minors" or "mature minors" Some of the most difficult ethical quandaries in health care today are those that involve children and their families. Examples are ● Conception issues related to in vitro fertilization, embryo transfer, ownership of frozen oocytes or sperm, cloning, stem cell research, and surrogate mothers ● Abortion, particularly partial-birth abortions ● Fetal rights versus rights of the mother ● Use of fetal tissue for research ● Resuscitation (for how long should it be continued?)