1. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Chapter 10 Promoting a Healthy Pregnancy Edited by Catherine Marin, MSN/Ed(c), WHCNP, RN

2. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Planning for Pregnancy  Preconception  Periconception  Interconception  Preconception counseling  Identify conditions that could adversely affect pregnancy

3. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley The Healthy Body  Menstrual and medical history  Exposure to childhood illnesses  Exposure to STIs (for example, chlymydia,gonorrhea, herpes)  Exposures related to lifestyle choices (for e.g., monagamous relationship or multiple partners)  Physical examination  Laboratory evaluation (for e.g., CBC, UA, Blood Type, Rubella, VDRL/RPR, Hepatitis, HIV  Genetic testing

4. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley The Healthy Mind  Readiness for motherhood  Psychological changes during pregnancy (Ambivalence, Acceptance, Preparation for motherhood)  The healthy relationship  Readiness for fatherhood  Support for life changes

5. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Nutrition and Weight Gain  Nutritional elements  Calories  Protein  Water  Minerals and vitamins  Iron  Folic acid

6. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Weight Gain  Affected by:  Physiological factors  Social influences  Inadequate diet  Inadequate physical activity  Management  Daily food and fluid intake

7. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Factors That Affect Nutrition  Eating disorders  PICA- associated with anemia  Anorexia nervosa, bulimia nervosa  Cultural factors  Vegetarian diets  Food cravings and food aversions

8. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Exercise, Work, and Rest  Exercise  Muscle strengthening  No rigorous aerobic activity  Work  Impact on pregnancy  Maternity leave  Rest

9. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Medications  Safe versus teratogenic  Always consult physician regarding ANY medication  Over-the-counter  Herbal and homeopathic preparations  Prescription  FDA pregnancy categories

10. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Common Discomforts  Nausea and vomiting  Ptyalism  Fatigue  Nasal congestion  Backache  Leukorrhea

11. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Common Discomforts (cont.)  Urinary frequency  Dyspepsia  Flatulence  Constipation/hemorrhoids  Dental problems  Leg cramps

12. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Common Discomforts (cont.)  Dependent edema  Varicosities  Dyspareunia  Nocturia  Insomnia  Round ligament pain

13. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Common Discomforts (cont.)  Hyperventilation, shortness of breath  Numbness/tingling in fingers  Supine Hypotensive Syndrome

14. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Signs and Symptoms of Danger

15. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley First Trimester  Severe, persistent vomiting  Abdominal pain and vaginal bleeding  Indicators of infection

16. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Second Trimester  Maternal complications  Preeclampsia  Premature rupture of the membranes  Preterm labor  Fetal complications  Decreased fundal height  Absence of fetal movement after quickening

17. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Third Trimester  Maternal complications  Gestational diabetes  Placenta previa  Abruptio placentae  Fetal complications  Hypoxia

18. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Pregnancy Map  Prenatal care map  Timetable

19. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Childbirth Education  Primary goal  To promote a positive childbearing experience  Topics  Anatomy and physiology  Comfort measures  Labor and birth process  Relaxation and pain management

20. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Childbirth Education—Methods  Lamaze  Empowerment  Dispelling myths  Controlled breathing, position, massage, relaxation  Bradley  Inward relaxation  Normal breathing

21. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Other Methods  Dick-Read  HypnoBirthing  LeBoyer method  Odent method  Birthing from within

22. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Finding Information on Childbirth Education  Primary source—health care provider  Online and at-home programs  Parents need to ask questions about the class to determine if it fits their needs  Factors related to personal values and beliefs

23. Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley The Birth Plan  Written information that identifies labor and birth preferences  The choices  Choosing a provider  Choosing a location