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Family Nursing with Childbearing Families

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Family Nursing with Childbearing Families By Nataliya Haliyash, MD,PhD,MSN Lecture Objectives: Upon completion the lecture students will be able to: Give definition ... – PowerPoint PPT presentation

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Title: Family Nursing with Childbearing Families


1
Family Nursing with Childbearing Families
  • By Nataliya Haliyash,
  • MD,PhD,MSN

2
Lecture Objectives
  • Upon completion the lecture students will be able
    to
  • Give definition to childbearing family nursing
    and differentiate it from obstetrical nursing.
  • Discuss nursing theories that contribute to
    nurses understanding of families growth,
    development, functioning, and changes during
    childbearing.
  • Understand the developmental tasks for
    childbearing families.
  • Guide health promotion activities in the
    childbearing families.
  • Recognize possible threats to health during
    childbearing and plan activities for maintaining
    and preserving family health.

3
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4
HISTORICAL PERSPECTIVE
  • Late 1800s Industrialization
  • Families moved to more urban areas household
    size and functions diminished.
  • Traditional networks of women were not always
    available, and mothers needed to replace care
    previously carried out in the home.
  • Childbearing still occurred at home for many
    middle-class families (Leavitt, 1986 Wertz
    Wertz, 1989).

5
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6
HISTORICAL PERSPECTIVE
  • First Third of the 20th Century
  • The hospital became the place for labor, birth,
    and early postpartum recovery for middle-class
    families.
  • Many immigrant and working-class urban families
    continued to have babies at home with their
    traditional care providers.
  • An impetus to the development of public health
    nursing was concern for the health of urban
    mothers and babies.
  • Realizing that the health needs of all the family
    members were intertwined, early public health
    nurses considered families, not individuals, as
    their clients.

7
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8
HISTORICAL PERSPECTIVE
  • 1930s through the Baby Boom of the 1950s
  • With the dramatic shift of births to hospitals,
    family involvement with childbearing diminished
    (Leavitt,
  • 1986).
  • Concerns about infection control contributed to
    separation of family members.
  • Family members were forbidden to be with women
    in the hospital.
  • Babies were segregated into nurseries and
    brought out to their mothers only for brief
    feeding sessions.
  • Nurses focused on the smooth operation of
    postpartum wards and nurseries through the use of
    routine
  • and orderliness.
  • Despite these inflexible conditions, families
    tolerated them because they believed that
    hospital births
  • were safer for mothers and babies.

9
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10
Birth in America
  • 1900 95 of all births took place at home
  • 1939 50 of all births at home
  • 1955 95 of all births in the hospital
  • Wolf, 2009

11
HISTORICAL PERSPECTIVE
  • 1980s to the Present
  • The research of Klaus and Kennell (1976) served
    as the impetus for the growth of family-centered
    care (American College of Obstetricians and
    Gynecologists Interprofessional Task Force on
    Health Care of Women and Children, 1978).
  • Today promotion of family contact is becoming the
    hallmark of childbearing care.
  • Many hospitals have renamed their obstetrical
    services, using names such as Family Birth Center
    to convey the importance of family members in
    childbearing health care even though obstetrical
    care is becoming more dependent on technology.
  • With the trend for shorter hospital stays after
    birth, postpartum care is becoming family-based
    with nursing guidance.

12
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13
Childbearing Family Nursing
  • Childbearing family nursing considers the family
    as client and/or the family as context for the
    care of its members.
  • Family nursing with childbearing families covers
    the period before conception, pregnancy, labor,
    birth, and the postpartum period.
  • It focuses on health and wellness rather than on
    procedures and medical treatment.

14
Theories applicable to childbearing family
nursing
  • General Systems Theory
  • is especially effective for childbearing family
    nurses when they consider that a family, while in
    a state of change and readjustment, has
    more-permeable boundaries or is more open to the
    outside environment because the family becomes
    aware of resources beyond itself.
  • Duvalls Developmental Theory
  • In this theory, the family childbearing stage is
    defined as the period from the beginning of the
    first pregnancy until the oldest child reaches 18
    months of age.

15
Prenatal Care
Education
Treatment for medical conditions or risk
reduction
Risk Assessment
Each component can contribute to reductions
in perinatal illness, disability and death by
identifying and mitigating potential complications
16
Frequency of Prenatal Visits
Every 4 weeks until 28 weeks gestation Every 2
weeks until 36 weeks gestation Weekly until
delivery
17
Antepartal Nursing Interventions
  • Being knowledgeable in the normal changes of
    pregnancy
  • Instructing in signs symptoms that indicate a
    problem may be developing
  • Providing appropriate information for self care
    measures
  • Referring when necessary

18
Nursing in a Home Care Setting
  • Can be used for women who have difficulty in
    accessing the healthcare system
  • Most often used for women with prenatal
    complications that can be managed without
    hospitalization.

19

Attitude about pregnancy
Exercise Rest
Smoking
Traveling
First Trimester Topics
Danger signs of spontaneous abortion
Employment
Fetal growth development
Early pregnancy classes
20
Infants tend to have lower birth weights
Infants have a higher incidence of preterm birth
21
The Faces of Fetal Alcohol Syndrome
Growth Retardation Facial Anomalies Major Cause
of mental retardation
22
Even moderate alcohol intake is contraindicated
  • Increased incidence of lowered birth weight
  • Some neurologic effects such as Attention Deficit
    Disorder
  • No Safe level of drinking during
  • pregnancy has been identified

23
  • Live Viruses (like rubella) should not be given
    to pregnant women
  • Vaccines using killed viruses may be used

24
Exercise during pregnancy
  • 30 minutes daily and stop when fatigued
  • No balance activities
  • No exercising in supine position
  • Pulse rates lt 140/min

25
Nursing Pearls of Wisdom
  • At each prenatal visit, focus your teaching on
    changes or possible discomforts the woman might
    encounter during the coming month and the next
    trimester.

26
The importance of support during labor---having a
doula
  • http//www.youtube.com/watch?v16uFf02NYb4
  • http//www.youtube.com/watch?vHfOBVPZg94Y

27
We Are Family
28
Types of Families
  • Nuclear Cohabiting parent
  • Married-parent Single-Parent
  • Childless Married blended
  • Extended Gay Lesbian

The primary institution in society that preserves
transmits culture.
29
  • What basic information should be included in
    a Family Assessment?

30
Family Assessment
  • Name, age, sex and family relationship of all
    people residing in the household
  • Family type, structure roles and values
  • Cultural associations
  • Religious affiliations
  • Language
  • Support network

31
Friedman Family Assessment Model
  • Identifying data
  • History of family
  • Environmental data
  • Family structure
  • Family functions
  • Family stress coping

32
  • Culture is not just something the client
    possesses it is something that all humans
    possess.

It is learned.
33
Are there cultural influences on
childbearing and rearing?
34
Taboos
Refers to behaviors or things that are avoided
What is avoided in your family?
35
Ask not what disease the person has, but
rather, what person the disease has.
36
  • Develop cultural competence by becoming
    knowledgeable about the cultural practices of
    local groups where you work and live.

37
Cultural Humility Lifelong process of self
reflection and awareness with a respectful
attitude toward diverse points of view.
38
Its all about relationships..
39
And Respectwhich comes full circle
40
Questions to ask.
What do you think you should do to remain healthy
during pregnancy?
What healing methods have you tried?
What do you think will help?
41
  • Who do you want with you during your labor?
  • How will family members participate in your
    pregnancy, childbirth parenting?
  • What do you and your family expect from the
    nurses caring for you?

42
  • L Listen
  • EExplain
  • AAcknowledge
  • RRecommend
  • NNegotiate

43
Thanks for attention!
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