Transcript Maternal and infant health care - Home

Clinical Application for Community Health Nursing (NUR 417)
MATERNAL AND INFANT HEALTH CARE IN
PRIMARY HEALTH CARE SETTING
Lecture 5
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Objectives of maternal –infant and child health
care program:
 Ensure that every expected and nursing mother
maintains good health, has a normal delivery, bears
healthy children and learns the art of child care
 Conduct activities for the health promotion of
children from 0 to 6 years of age
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Services offered by primary health center to mothers
and infant:
1.
2.
3.
4.
5.
6.
Pre-marital care and counseling
Maternity care
Infant and preschool child care
Family planning
Health education
Social care
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PRE-MARTIAL CARE
Importance of pre-marital care:
1. Early detection of health problems, better chance to
treatment
2. Providing guidance, preparation for marriage , family
education , training in the art of children rearing and
family planning
3. Prevention of health problems for the couple and their
future children
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The goal of the premarital care is to:
1. Promote the health of the future parents
2. Prevent health hazards and to have healthy future generations.
3. Give education about health care before marriage
4. Implement medical consultation for those who are not of a
legal age to marry, or who have severe genetic diseases,
psychiatric diseases and certain infectious diseases
5. Perform physical exams, including radiological exams,
screening for diseases of the renal, reproductive, and
metabolic systems, and screening for sexually transmitted
diseases.
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Components of Premarital Care
A. Premarital Counseling
B. Premarital examination
C. Premarital immunization
D. Genetic counseling
E. Premarital education
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A. Premarital Counseling
 Is a communication process in which the counselor (nurse) tries
to provide a couple with complete and accurate information
about the responsibilities of marriage
 The counselor encourages the couple to explore and
communicate their individual’s needs, goals, values and
deficiencies. It is a chance for couple to verbalize their
expectations of marriage including any fears and anxieties they
may have
 Topics in counseling includes sexuality, sexual health and sexual
problems, the family planning concept, the befits of different
methods of family planning
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A. Premarital Counseling
The benefits of premarital counseling:
1. It can reduce the risk of divorce by up to thirty percent
2. It can lead to a significantly happier marriage
3. It can help reduce the stress of planning a wedding
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A. Premarital Counseling
The role of the nurse premarital counseling
1. Prepare a proper atmosphere for counseling
2. Ensures privacy of the client
3. Assess the health needs of the couple
4. Take a complete history of the couple
5. Helps them to understand several topics including family
planning, conception, etc.
6. Help the future couple to make decisions about their future lives
and their marriage
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B. Premarital Examination
1. History taking should include:
 Personal history ;as name, age, occupation, education & address, religion
 Menstrual history : menarche, dysmenorrheal, menstrual disturbances and last
menstrual cycles
 Medical history: cardiovascular disease, renal disease, infectious disease,
hypertension, tumors, surgical procedure and trauma, venereal diseases, DM and
TB
2. Premarital examination (physical examination):
 Complete physical examination including: heart and chest examination, pelvic
measurement to detect contracted of deformed pelvis
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B. Premarital Examination
3. Laboratory examination:
 Complete blood counts , hematocrit , hemoglobin and platelet counts .
 Antibody test to detect Human Immunodeficiency Virus (HIV).
 Urine analysis for sugar and albumin to exclude D.M or kidney diseases.
 Analysis of the man's seminal fluid to determine its speed , morphology
, volume and number of sperms for early detection and intervention in
case of infertility.
 Chest x-ray to exclude pulmonary T.B.
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C. Premarital Immunization
Such as:
 MMR
 Tetanus
 Hepatitis
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D. Genetic Counseling
Genetic counseling is the process of:
 Evaluating family history and medical records
 Ordering genetic tests
 Evaluating the results of this investigation
 Helping parents understand and reach decisions about what to do
next
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E. Premarital education
Premarital education used to guide and prepare couples for marriage
The following areas of health education should emphasize on:
Parent’s health
Nutrition
Safe environment
Role of father
Role of mother
Child rearing
Sex education
Family planning
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2. Antenatal Care in Primary Health Care Centers
Antenatal care is the care giving to pregnant women in primary
health centers to maintain their mental and physical fitness
Objectives of antenatal care:
 To maintain the mother and her fetus health
 To prepare the mother for labor and subsequent care of her child
 To early detect and appropriate treatment of high risk conditions
 To reduce of maternal and infant mortality, stillbirths and
prematurely
 Increase the number of breast fed babies
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2. Antenatal Care in Primary Health Care Centers
Schedule of antenatal visits:
The total visits during pregnancy are 12 to 15 visits in normal as
follows:
 One visit every month until the 6th months of pregnancy
 One visit every two weeks during 7th and 8th months of
pregnancy
 One visit every week during the 9th month of pregnancy
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2. Antenatal Care in Primary Health Care Centers
Anti natal care during initial visit:
A. History taken including
 Social history : family members
 Family history: any genetic diseases , hypertension DM TB, heart
disease
 Medical history : past illness HD, DM , TB venereal diseases
 Menstrual history :LMP,EDD, Menarche, any disorders or
irregularities
 Obstetric history : gravidity , parity , and complications for mother
of baby
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2. Antenatal Care in Primary Health Care Centers
B. General physical examination concentrated on
 Extremities are examined for varicose veins and edema
 Blood pressure: should be 120/80 or less and not above 140/90
 Body weight and height: weight should be recorded in the first
visit
 Obstetric examination: For breast and abdomen (fundal height,
fetal lie, presentation and fetal heart sound should be assessed
accurately)
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2. Antenatal Care in Primary Health Care Centers
C. Laboratory investigation :
Urine analysis for glucoses and albumin
Blood group is determined because of the risk of hemorrhage
Hemoglobin: if HB is below 12.9g: iron , folic acid and vitamins
B&C are prescribed .
Screening for AID’s and Hepatitis C
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3. Post Partum Care
 The first six weeks after birth – is critical to the health and
survival of a mother and her newborn.
 Lack of care in this time period may result in death or disability
as well as missed opportunities to promote healthy behaviors,
affecting women and newborn
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3. Post Partum Care
Schedule of home visits for post partum care by nurse or
midwife or community health nurse:
 1st day of post partum,
 3rd day of postpartum,
 7th day of post partum,
 40th day of post partum
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3. Post Partum Care
Objectives of post partum care:
1. To help women to resume physical and mental health
2. Detect and arrange proper management and follow up obstetric
injuries, heath problems, and pregnancy associated complication,
as well as treat reproductive tract infection
3. Examine the newborn for early detection of congenital
malformation, handicapping condition and jaundice.
4. Provide health education and guidance for the mother regarding
hygiene, nutrition, child-care, breast feeding, immunization, birth
spacing and family planning methods.
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