Maternal and Child Health Nursing: Lecture

Our preliminary lecture in MCN talks about the High-Risk Pregnancy that could cause complications and
put the fetus on risk. Last semester, our discussion was all about normal pregnancy. Moving on to the
abnormalities that happening before, during and after pregnancy taught me that it is crucial to master the normal
pregnancy as it helps me to identify the possible cause of the deviation in achieving normal and well pregnancy.

To be honest, when someone say “abortion”, the only thing that comes into my mind is that someone
intentionally killed the baby. I was thankful in our discussion regarding it. There are different kinds of abortion
and miscarriage that happens due to complication arising during pregnancy. I also learned that abortion is the
medical term for any interruption of a pregnancy before a fetus is viable while miscarriage was defined as
interruption that occurs spontaneously—both of them can be a “natural loss”. We also discussed the different
diseases that could contribute to the overall health of the fetus. First, the cardiovascular disease that has two
classifications: 1. Left Sided Heart Failure that arise due to mitral problem. Example, mitral stenosis, mitral
deficiency and aortic coarctation. Since the heart does not pump effectively, the delivery of the blood in the
placenta is also affected that will result to miscarriage and preterm labor. 2. Right Sided Heart Failure wherein
the pulmonary valve is not functional. The blood that flows in the right ventricle keeps on going back
(backflow) to the right atrium and vena cava that can cause congestion of the jugular veins, spleen and liver.
The fluid will now accumulate to this organs and travels to the interstitial spaces of lower extremities that will
result in peripheral edema. Another problems that we discussed are: Iron Deficiency Anemia, Folic Acid
Deficiency, Sickle Cell Anemia, Thalassemia, Urinary Tract Infection and Sexually Transmitted Diseases.

Learning this concepts plays an important role in our profession. Since we are assigned in taking care
and providing sufficient information to our patients, learning this concepts will be our guide to provide reliable
information and educate the patients to prevent the complications to occur. Maternal and Child health nursing is
correlated to our anatomy and physiology. Mastery of the anaphy that was discussed last year will be our strong
foundation of knowledge. We are dealing with the lives of our patients and having the skills are not enough to
help our patients. We have to be skillful and knowledgeable at the same so we can help the client to achieve
optimum level of functioning during and after the pregnancy. Maternal and Child Health Nursing is one of the
hardest subject and we have to put our souls into it so we can digest the information that was introduced to us
wholeheartedly. Learning is a choice and we have to keep it in our mind.
 Maternal and Child Health Nursing:
Skills Lecture
To be honest, basic life support specifically cardiopulmonary resuscitation (CPR) was one of my favorite
topic in our preliminary discussion. I’ve learned that there are guidelines that should be follow when reviving
our patient. There are differences in performing a CPR with the infant, child and adult and I should be mindful
about it since it can fracture the sternum and ribs if not applied properly. I also learned that as health care
provider, I must also know what are the things that I’m supposed to remember before performing the CPR like:
Assessing the breath and pulse as well as the scene to promote safety. If there’s an absence of breathing and
pulse, I must proceed to the CPR immediately. But when there’s a normal breathing, the only thing that I will
do is to monitor the victim and deliver a rescue breath if needed. During CPR, when the emergency respond
system arrives, I have to stop the CPR and use the AED to provide controlled electric shock and bring back the
normal rhythm of the heart.
I also learned in this subject the importance of differentiating the physiologic and pathologic jaundice
that is common in newborns. I’ve learned that when jaundice appeared less than 24 hours after birth, it is
classified as Pathologic Jaundice and phototherapy is required to cure the baby. There are only 2 reasons why
jaundice occurs: First, there are destruction of RBC. Second, the newborn has a liver problem wherein
unconjugated RBC cannot be conjugated. I also enjoyed the discussion of oxygenation that merely focus on the
masks and nebule. In this discussion, I have learned that the mask has different levels of providing oxygen and
as a student nurse, I must remember that I should consider the level of oxygen that the mask could provide so it
will not cause unnecessary rupture of airway passages. Example, when the doctor ordered a nasal cannula with
5L. I will clarify the order regarding it and recommend that we have to change the nasal cannula to facemask.
Oxygenation is a dependent nursing action so I must inform the assigned physician before doing a certain
action.
The learnings that I received to this subject is helpful in our clinical duty. Last semester, in delivery
room, some of the mothers has an oxygen and as a student, I was doubting if I would take responsibility of the
oxygen administered to the mother since I know nothing about it. However, I have to be aware that not
everything will be discussed by our instructor and we have to learn on our own. If we know nothing, read.
Reading will be our guide to provide appropriate to our patient and “not being discuss” is not an excuse. Lack
of knowledge or absence of knowledge is an ignorance and this behavior is inappropriate in nursing profession.
 Maternal and Child Health Nursing: Return
Demonstration
Our revalida is the application of our overall learnings in return demonstration and skills lecture. This

reflection was all about our revalida and the problems that arise as we perform the skills necessary to the scene

that we have chosen.

Before everything start, our group started to assign the skills that we have to performed in order to

organize the flow and sequence of the revalida. I was assigned to administer oxygen and nebule to our patient.

During the actual scene, all of us are already anxious and nervous that most of the members are only marketing

the materials needed and there are only few students attending the needs of the client. Every minute, there’s an

additional problem that we have to deal with. I was a little bit hesitant to perform a certain skill because I’m

afraid that someone will get mad at me because we already assigned to a specific skill and I’m not supposed to

interfere with it. “Lack of communication,” was the problem that we encountered as group. We are all shy to

give commands to our fellow group and ask for something that was needed in the scene. Because of the delay,

we were not able to finish the skill that we need to perform.

In this experience, I have learned that communication is important to function effectively especially in

the clinical area. There are cases of emergency and we have to work faster in order to provide the care needed

by the client. We can’t perform a several number of skills without the help of the other health care personnel.

Teamwork has an important role in clinical area because it makes the job easier and allows good

communication within staff members of the ward. Our group will be together for five months and we need to

learn that we need each other to survive those five months of duty. We have to be more comfortable to each

other and learn to respect the opinion on each of us. We are different in our own ways but we need to respect

those differences in order to be united.

 Nursing Informatics:
Laboratory and Lecture
I don’t really appreciate the essence of informatics in our profession because I believe that technology
was really easy to take control and learn. But as the time passes by, I have learned that there are things that I
can’t understand without the guidance of an expert user of technologies. In our discussion, I have learned how
to search effectively in finding a reliable source of information to support the research I want to prove. Before
searching for a reliable journal or article, I have to come up with a question I want to be answered. This is the
moment wherein P.I.C.O.T (Population <Patient, Public>, Intervention, Comparison, Outcome, Time) become
useful. PICO is a structured format the helps to ask health uncertainties. This is functional when finding an
information that will guide our decision making. The website that we used as a search engine is EBSCOHOST
—this the one that most of us encountered difficulties. Before searching, we have to use the Medical Subject
Heading in order to find the synonym suitable for the terms that we used because there are researches that use
other medical terms. Example, neonates. Some researcher uses newborns or infant instead of neonates. We have
to develop our own searching strategies which is the most difficult phase of searching. We have to familiarize
ourselves in the Boolean phrase which is difficult to do. We have to watch several tutorial videos about
EBSCOHOST and up until now, we’re still trying to learn everything.
In this subject, we also discussed the different theories but among all of it, CHANGE THEORY was
the one that I was interested on. It is truly applicable in the clinical area wherein continuous innovation is
rampant. I have learned that in change theory, there are two forces involve. The driving forces that push us to
initiate a change and the restraining forces that hinders that change. We have 3 stages of change theory: The
Unfreezing, Change and Refreezing. This is useful when trying to implement a certain rule or inventing another
technology that could help to make the job easier for nurses. For example, electronic charting. The driving force
of this is the nurses want to lessen their burden and to implement a paperless community. However, the
restraining force for this change are lack of sustainability and the lack of resources. I believe that this theory is a
guide for the nurses and other health care professionals to come up with a good idea that could benefit
everyone. This will give them the opportunity to decide what they want and what they perceived to be right and
useful.
 Health Ethics: Reflection
This subject offers a lot of opportunities especially that it was assigned to discuss the concept

comprehensively. I learned how the family influences the development of the children. I also learned that each

individual has rights regarding to their treatment and stay in the hospital and as a nurse, we should know their

rights so we can act accordingly and appropriately. Learning the delivery system in the Philippines, l learned

what are the difference between public and private hospital and how their policy works. Learning the different

acts, we could help the patients as well as the individuals residing in the Philippines to raise their advocacy and

awareness of their rights as citizens.

I think my strength in this subject is my interest to learn the principles that could help me to avoid

violations that could affect my profession. I was active during our class and participates in our group activities. I

was able to cooperate and share my ideas that can help our group to attain good grades. Being an active listener

in class, I can also retain the topics so during our surprise quiz, I was able to answer it easily. Being good in

numbers is also an advantage because I can easily identify the date and the article number of a certain act which

is common during this term.

Besides my strengths, I also have areas that I would like to improve on. I believe my weakness lies in

appropriate time management. Since our instructor always give us an activity, I’m having a hard time to do it

because we also have other things to do. I can’t easily identify what are the things I need to do first. Also, my

mobile phone interrupts on the things that I have to do. I spent almost three hours on my phone rather than on

my activities that needs to be finish. These weaknesses should be improved in order to manifest a skillful nurse

especially that I’m holding the title of Louisian Student Nurse. This subject is important in our profession

especially that it tackles the behavior that a professional nurse should manifest.

Overall, this subject seems to be boring for the others but for me, it is subject that will guide me to

decide the things I have to do with my patient. As a student nurse, I know my rights and limitation of practice.
 Integrated Management of Child
Illnesses
Honestly, IMCI is an integration of our maternal and child health nursing but the discussion is

merely specific. In our discussion and class activities, I have learned that IMCI was established to determine

whether the child needs an immediate care or not. I also learned that health education will benefit both the

mother and child in providing care for their illness. Through the help of this subject, I can now classify the

illness of the child based on their symptoms and severity.

I have also learned that The IMCI clinical guidelines target children up to five years of age - the age

group that bears the greatest burden of death from common childhood diseases. These guidelines are derived

from an evidence-based, syndromic approach to case management and emphasize rational, effective, and

affordable use of drugs and diagnostic tools. With well-formulated guidelines and proper training of health care

workers, it would be possible to systematically assess common symptoms and clinical signs, ultimately leading

to rational and effective actions. Such an approach can help in diagnosing the clinical condition, assessing the

severity of the condition, and implementing actions that can be taken to care for the child (e.g. refer the child

immediately, manage within available resources, manage at home). Initially, IMCI referred to case management

of children. It later became a vehicle for WHO and UNICEF child survival strategies at household, community,

health facility, and referral levels. Thus it incorporated health service strengthening on the one hand and, on the

other hand, face-to-face nutrition and health advice provided through home visits and active involvement of

family members and the community in the health care process.

In our overall discussion, I have learned that IMCI was created to guide the health professionals to be

able to identify severity of the illness and to provide appropriate care. In this case, the intervention that will be

applied will help the child to achieve optimum level of functioning.