1. Copyright © 2008 Delmar. All rights reserved. Chapter 22 Maternal and Child Populations

2. Copyright © 2008 Delmar. All rights reserved. 2 Maternal Deaths Healthy People 2010 objectives See figures 16-4 and 16-5 Reduce maternal deaths

3. Copyright © 2008 Delmar. All rights reserved. 3 Maternal Deaths Causes of maternal deaths: –Hemorrhage –Ectopic pregnancy –Pregnancy induced hypertension –Infection and other complications

4. Copyright © 2008 Delmar. All rights reserved. 4 Maternal Deaths Those at risk: –Women in rural areas –African Americans –Women who live near Indian reservations Public health nurse should assess for: –Factors indicating high risk pregnancy –Biophysical risk assessment

5. Copyright © 2008 Delmar. All rights reserved. 5 Maternal Deaths Public health nurse should assess for: –Factors indicating high risk pregnancy –Biophysical risk assessment –Psychosocial assessment –Client perception –Immigration problems –Ethnicity and culture –Health behaviors

6. Copyright © 2008 Delmar. All rights reserved. 6 Maternal Deaths Morbidity related to complications of pregnancy –Uterine prolapse –Fistulae –Incontinence –Pain during intercourse –Infertility Postpartum depression checklist

7. Copyright © 2008 Delmar. All rights reserved. 7 Reduce Rate of Fetal and Infant Deaths Low birth weight leading cause of death in infants Factors contributing to low birth weight: –Preterm delivery –Inadequate prenatal care –Alcohol and tobacco use –Drug use, poor nutrition, STDs

8. Copyright © 2008 Delmar. All rights reserved. 8 Reduce Rate of Fetal and Infant Deaths Low birth rate may cause the following: –Respiratory distress –Infection –Intracranial hemorrhage –Blindness –Developmental delay –Feeding problems

9. Copyright © 2008 Delmar. All rights reserved. 9 Reduce Rate of Fetal and Infant Deaths Other factors contributing to infant morbidity –Neural tube defects and fetal alcohol syndrome

10. Copyright © 2008 Delmar. All rights reserved. 10 Reduce Rate of Fetal and Infant Deaths Anticipatory guidance Reduce rate of child death –Motor vehicle accidents and unintentional injuries

11. Copyright © 2008 Delmar. All rights reserved. 11 Reduce Rate of Fetal and Infant Deaths Reduce rate of child death –Leading cause of death in children ages 1-4 years Bright Futures guidelines Immunizations Assess for iron-deficient anemia and child abuse

12. Copyright © 2008 Delmar. All rights reserved. 12 Reduce Rate of Adolescent and Young Adult Deaths Leading cause of death due to unintentional injuries –Motor vehicle accidents, falls, drowning –Poisonings, homicides, suicides

13. Copyright © 2008 Delmar. All rights reserved. 13 Reduce Rate of Adolescent and Young Adult Deaths Health issues facing adolescents today: –Dietary and exercise habits –Problem solving and coping strategies –Alcohol, drug, tobacco use –Early and unprotected sex, unsafe driving –Participation in delinquent activities

14. Copyright © 2008 Delmar. All rights reserved. 14 Teen Pregnancy Contributing factors to teen pregnancy: –Early onset of puberty –Early age of intercourse –Increased sexual activity –No contraceptive use –Decreased knowledge about sex

15. Copyright © 2008 Delmar. All rights reserved. 15 Teen Pregnancy Three goals of comprehensive programs that address teen pregnancy: 1.Delay or halt sexual activity 2.Provide access to contraception 3.Strengthen life goals

16. Copyright © 2008 Delmar. All rights reserved. 16 Teen Pregnancy Care coordination –Healthy Families American Initiative Criteria Service initiation Service content Staff characteristics

17. Copyright © 2008 Delmar. All rights reserved. 17 Reduce Obesity and Improve Nutrition in Children and Adolescents Overweight and obesity are risk factors for: –Asthma, type II diabetes, cardiovascular risk, sleep apnea, psychosocial consequences Two areas identified: 1.Food consumption 2.Physical activity

18. Copyright © 2008 Delmar. All rights reserved. 18 Healthy Eating Guidelines for school lunch program –Provide more nutritious food and beverages for foods sold a la carte –Increase number and variety of healthy food choices –Encourage moderation rather than over- consumption

19. Copyright © 2008 Delmar. All rights reserved. 19 Physical Activity Comprehensive school health model –Separate, female only physical education class –Focus on physical activities selected by students –Instruction on health benefits of physical activity

20. Copyright © 2008 Delmar. All rights reserved. 20 Physical Activity Comprehensive school health model –Use of stairs versus elevator and walking instead of driving –Fun, interactive, weight control programs –Gradual increase in activity level –Use of program leaders who have been overweight in the past or currently managing their weight

21. Copyright © 2008 Delmar. All rights reserved. 21 Education and Community Based Programs Overall goal is to increase quality, availability, effectiveness of educational and community based programs such as: –Programs designed to prevent disease –Programs designed to improve health and quality of life for children and adolescents

22. Copyright © 2008 Delmar. All rights reserved. 22 Healthy People 2010 School health education should address: –Injury prevention, tobacco use –Alcohol and illicit drug use –Sexual behaviors that result in pregnancy and STDs –Dietary patterns that cause disease –Inadequate physical inactivity

23. Copyright © 2008 Delmar. All rights reserved. 23 Coordinated School Health Program Eight components: 1.Physical education 2.Health services 3.Counseling 4.Psychological services 5.Social services 6.Healthy school environment 7.Health promotion for staff 8.Family/community involvement

24. Copyright © 2008 Delmar. All rights reserved. 24 National Association of School Nurses Comprehensive school health education curriculum addresses the following: –Personal, family, community, environmental health, sexuality, emotional and mental health –Injury prevention, nutrition –Prevention and control of disease –Substance use and abuse

25. Copyright © 2008 Delmar. All rights reserved. 25 Maternal and Child Health Services and Public Health Nursing Primary goal for public health nursing: –Attain, regain, or maintain health of mothers, children and families Public health nursing practice –Promote normal growth and development –Facilitate health promotion and wellness

26. Copyright © 2008 Delmar. All rights reserved. 26 Maternal and Child Health Services and Public Health Nursing Enhance nutritional and immunologic status –Promote safe environment –Improve health behaviors –Advocate healthy public policy –Monitor services