NCM 102

CARE OF CLIENTS A CROSS THE LIFESPAN WITH THE MOTHER, CHILD, AND
FAMILIES AT RISK OR WITH PROBLEMS

CONTENT:
1. INTRODUCTION:
A. National Health situation focusing on Maternal and Child Health
B. Statistics on Maternal and Child Health
C. Maternal mortality and morbidity rates
D. Other Important Statistics
II. Nursing Care of the High Risk Pregnant Clients
A. Assessment of clients at risk begins with the first prenatal visit and
continues through the puerperium
B. Risk factors includes physiological, socio demographic , psychological,
environmental
C. Vulnerable pregnant women with:
1. Physiologic problems such as concurrent illness with malnutrition
2. Mother who are too old, too young, pregnant too frequently
3. Presence of frequent deformity
4. Psychological mental illness or mental retardation
5. Marginalized because of:
* Poverty
* Unemployment
* Lack of education
* Exposure to terratogens due to occupation
* Victims or abuse or domestic violence, rape, incest
* Single or separated mothers
D. Medical conditions affecting pregnancy outcomes such as:
(PRE-GESTATIONAL)
* Rheumatic heart dse. * Diabetes Mellitus
* Substance abuse * HIV/AIDS
* RH sensitization * Anemia
* Hepatitis
( GESTATIONAL)
* Hyperemesis gravidarum * Ectopic pregnancy
* H. mole * Incompetent cervix
* Abortion * Placenta previa
* Abruptio placenta
* Premature rupture of membranes
* Pregnancy Induced Hypertension
III. NURSING CARE OF THE HIGH RISK PREGNANT CLIENT DURING LABOR AND
DELIVERY
A. High risk factor related to:
* Passenger or Fetus * Passageway or pelvic bone structure
 * Power or uterine contraction * Psyche or psychological state
B. Specific problem of the passenger:
* Fetal malposition/ malpresentation
* Fetal distress
* Cord prolapsed
C. Others:
* Premature labor * Precipitate labor and birth
* Uterine prolapsed * Uterine rupture
IV. Nursing care of the high risk postpartal clients
A. Postpartum hemorrhage
* Early postpartal hemorrhage * Late postpartal hemorrhage
* Subinvolution
B. Postpartal Infection
* Endometritis * Wound infection
* UTI
C. Thromboembolic disorder
V. Nursing care to client with general disturbances in reproduction and sexuality
A. Infertility B. Sexual disturbances
C. Cancer D. Infection
VI. Nursing care to client with specific health problems related to reproduction
And sexuality
1. Infant and child
* Altered reproductive development
* Phimosis * Hypospadia
* Epyspadia * Cryptorchidism
* Hydrocele
2. Adolescents and young adult
* STD * Infertility
* Varicocele
3. Adult Woman
* Breast and Uterine cancer
* Fibrocystic dse. of the breast
* Fibroadenoma
* Hypoplasia/ Hyperplasia of the breast
* Mastitis
* Infectious disorder of the female genital area
- vaginal infection
- ovarian cysts
* Pre- menstrual dysmorphic disorder
* Vaginal fistula
* Imperforate hymen
* Pre-menstrual syndrome
* Menopausal syndrome