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Mother & child health

الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 4
أستاذ المادة سلمى كاظم جهاد الابراهيمي       3/30/2011 8:58:03 AM

Mother & child health:

Mothers & children constitute about 70% of the total population they are special risk groups.
 Most of work of the nurses focuses on the primary prevention.
 Mother & child considered as one unit of care because:
Fetus receives the building materials from the mother’s blood.

Many of the community health nurse’s clients are pregnant teens and women, along with the infants and young children.
Certain segments of the maternal and infant populations such as adolescent mothers and those who economically disadvantaged remain at high risk for disease, disability, and even death.
Preconception care seeks to improve the health of the woman.

Needs of pregnant woman and infants:

Community health nurses involved in the care in both planning and the actual delivery of the services to the mothers and the babies.
Global overview
In 2005, an estimated half million woman died of maternal causes in Africa. In these areas maternal mortality rate exceeds 1,000 per 100,000 live births.
Infant mortality
Globally 3.5-4 million deaths and 3.3-4 still births occur each year. Caused by the same factors of the mothers

Causes include poor maternal health, inadequate care, poor hygiene, and insufficient management
Teenage pregnancy
About 10% of all births worldwide are to adolescent mothers. Teenage mothers have a higher rate of pregnancy-related complications. And their infants are more likely to have LBW or to be premature, injured at birth, or stillborn. This may result from their educational and employment limitations. 

HIV/AIDS:
In 2005 it is rising faster among than men, about 17.5 million woman were estimated to have HIV. In poor areas of the world the death of a mother often means that her child especially those under 5 will die.
Violence:
It is the cause of injuries and death for pregnant and postpartum woman, as well as their unborn and their infant, and homicide is the leading cause of injury for woman who are pregnant.

Risk factors for pregnant woman and infants:
1. Lifestyle: smoking, inadequate nutrition and…..
2. Sociodemograhpic: low maternal age, low educational level………..
3. Medical and gestational history: primiparity, multiple gestations……………
Drug use, alcohol use and tobacco use.  
 
? A healthy mother gives birth to a healthy child.

? Certain diseases are likely to have effect on the baby.

? Child depends on the mother & any loss will affect the growth & development.

? Postpartum period is inseparable.

? The mother is the first teacher to the child.
Physiological status

? The vulnerability is due to the physiological changes that take place; they are normal but can convert to abnormal conditions.
Objectives
1. For the mother:
? Maintain good health during pregnancy & lactation.
? Learn the motherhood.
? Enjoy normal child birth. 
? Born healthy child.
? Reduce the morbidity & mortality.

2. For the child:

? Being within the family.
? Enjoy love & security.
? Obtain adequate medical care.
? Reduce morbidity & mortality.

? Factors influencing the health of pregnant & infant
? Genetic, socioeconomic, life- style.

? Risk before birth:
 That leads to infant, maternal morbidity & mortality.
That includes low socioeconomic state, maternal age, and weight.
 Past pregnancy history, gestational age, abnormal delivery, delivery of pre-term.

? Past or present medical history, hypertension, hereditary disease.
? Additional obstetrical conditions such toxemia, anemia, maternal emotional crisis.
? Risk factors after birth. 
? Problems of early age that related to gestational age & birth weight.
? Problems after one month that related to environment factors.

? Role of the nurse

? Services start from infanthood to promote her health, safety, & prepare her for successful motherhood.
? Care given affects the health of the baby. & reflects the health of the family.
As phases care divided in to:
? Pre-natal, pre-conception care.

? Teaching of the importance of the case finding of some diseases especially hereditary.
?  Examination & investigations including chest x-ray, blood investigation & others. Health education & counseling.
Antenatal care:
? General history, obstetrical history, presents pregnancy, nutritional & social history. Medical examination, health education, frequent ante-natal visits, pregnancy warning signs & routine referral.
Natal care: assist the midwife & support the mother during the labor.
Post-natal care:
?  Through the home visit. Depends on the needs. Using the nursing process to give the care.
?  The nurses uses the nursing process to assess the mother checking all the vital signs & others, observe for breast problems, uterine involution & after pain, observing lochia for colour, amount & smell. Intervention including the post natal care, Hygiene & diet, care of new born, health education.

 Evaluation:
 Including the health status of the mother & child.  Evolution of the uterus, regular visiting to the clinic & recording. 

Health Care Indicators:

• Healthy People 2010-Examine areas of health care that need improvement.
• Infant mortality- deaths per 1000 births
• Maternal mortality- deaths per 100,000
• Most cause are preventable
• Rank 21st in maternal mortality
• Rank 27th in fetal mortality

Levels of Care:

• Primary- Prevention. Example: Neural Tubal Defects
• Secondary- Treatment of condition, promote wellness Example: HIV
• Tertiary-Limit disease process, live with disability. Example: Spinal cord injury, Violence



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