Contemporary Maternity Care, Family, and Cultural Considerations
Maternity Care
• Definition and goals
Maternity care: the care, support, instruction, and health promotion given by the nurse to the woman, partner, and family during pregnancy, labor & after birth.
Goals: for the pregnancy, labor, & birth to be as normal as possible with the additional goal of having a healthy newborn
Current Trends
• Birth settings
LDR
LDRP
Freestanding birth centers
• Technology & Maternity Care
Much more advanced: intrauterine fetal surgery, NICUs
• Gender Selection
Now able to select sex of fetus by sperm separation
Current Trends
• Providers of Maternity Care/Collaborative care
Certified Nurse Midwives (CNM)
Nurse practitioners
Obstetricians/gynecologists
Pediatricians
Neonatologists –MDs who specialize in the care of newborns from birth to 28 days
Geneticists
Social workers
Lactations specialists
Maternity Care
(…Cont’d)
• Health care delivery systems
Managed care (HMOs, PPOs)
Clinical pathways – maps of collaborative care given by the interdisciplinary health care team
• Government influences
Healthy People 2010
Statistics
Standards of care (communication, documentation, patient privacy, and HIPAA)
Nursing Process
• Problem-solving approach using clinical judgment to provide individualized, comprehensive nursing care
• Steps:
Assessment
Diagnosis
Planning
Implementation
Evaluation
NIC, NOC, NANDA
• NIC: Nursing Intervention Classification
Nursing actions or interventions
• NOC: Nursing Outcome Criteria
Measurable outcomes reflecting patient responses to interventions
• NANDA: Nursing diagnoses
• RN is responsible for identification and coding of NIC and NOC
• LPN is responsible for working with and understanding these classifications
Culture
• Socially inherited characteristics handed down from generation to generation, shaped by values, beliefs, norms, and practices shared by members of the same background
• Cultural competence: the skills and knowledge needed to understand and appreciate cultural differences in order to adapt clinical skills and practices as necessary
Culture
• To provide culturally sensitive care, nurses should:
Examine their own cultural beliefs
Identify biases, attitudes, and prejudices
Learn the practices of major cultures
Recognize a woman’s right to make her own health care choices
Family Types
• U.S. Census Bureau definition: “a group of people related by blood, marriage, or adoption, living together”
more modern definition is: “ 2 or more people who live in the same household, share a common emotional bond, & perform certain interrelated social tasks.”
• Family types
Nuclear
Blended or reconstituted
Cohabitating
Communal
Extended
Same-sex
Single-parent
Stepparent
Complementary and Alternative
Therapies (CAM)
• Alternative: therapies not traditionally recommended by health care providers; differ from conventional remedies
• Complementary: nontraditional methods used in conjunction with conventional therapy
• Integrated: using both CAM and traditional medicine to meet individual needs
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