Contemporary Maternity Care, Family, and Cultural Considerations lecture notes

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