FAMILY HEALTH NURSING CARE–syllabus as per INC
a) Family as a unit of health
b) Concept, goals, objectives
c) Family health care services
d) Family health care plan and nursing process. e) Family health services – Maternal, child care and family welfare services.
f) Roles and function of a community health nurse in family health service.
g) Family health records.
Definition of Family :
Family means a group that is personally biologically related and lives together and eats in a common kitchen is called family.
A mature group of people living together and bound by marriage, sharing information with each other, inter-communication is called family.
Classification according to family structure.
Nuclear family.
Parents, dependent children.
Separate residence No spouse of origin/orientation shared with family members –
Financially independent.
Extended family
unilaterally extended
Expanded bilaterally
Consists of 3 generations
Stay together as a group
A kinship network provides work for all members
Single parent family – children under 17 years of age living in a family unit with one parent, other related or unrelated – may result from death by death of spouse, divorce, separation, abandonment,
Blended family – consisting of step-parents and step-children – families formed due to divorce, remarriage with annulment and separation
Communal family – a group of individuals formed for a specific ideological or social purpose – considered as an alternative way of life for people who feel economically isolated Privileged society – changes in social contacts
The Filipino family
closely connected
Expanded bilaterally
-Authority based on seniority/age
Outwardly patriarchal, inwardly matriarchal
High value of members’ education
Mainly Catholic
Family as a Unit of Health:
Reasons for considering family as a unit in Community Health Nursing :-
Community health nursing practices depend on the type of family that can be identified by family members or family need perceptions. This depends on how the family is represented as a unit in community health nursing services.
(1) Family is a natural and basic unit of society.
(2) resolves problems arising between members as a family group and
solves it. A person’s health depends on his family’s health
(3) Family health problems are interrelated. Family members are interdependent and interdependent.
(4) Family size (Family size), structure, income, educational standard, environment etc. the standard of family members affects health. Family supports in times of crisis.
(5) Family has limitations for health decisions and personal care. Illness of one family member affects the overall health of the family
(6) The family is an effective and available channel for many genuine community health nursing efforts.
(7) One’s health problem can be solved easily.
(8) Health risks, illness related customs, traditions, habits and socio-cultural aspects
(1) Biological
(2) Socialization
(3) Maintenance
(4) Status function
(5) Love affection
(6) Cultural function
(7) Economic function
(8) Protection.
Characteristics of Family:
(1) Smallest Group:
When male and female join each other through marriage and mating relationship, selection of partner by parents takes place, when son marries, the relationship changes.
(2) Compact Group :
More than one person has more than one role and status. Children grow up and separate and form another family. Relationships change. Sometimes relationships also reverse, change. When the father gets old, the children become dependent. Each is known by a family name.
AIMS of Family Health Service OR Objectives of Family Health
(1) Maternal and Child Mortality (Reduction in IMR,MMR) – To bring down the mortality rate.
(2) Family planning to distance the two children and prepare the parents for Planned Parenthood.
(4) To improve nutritional status of family members.
(5) Providing health education regarding preventive, promotional, curative and rehabilitative aspects in the family.
The following points are emphasized to cover family health.
(1) Maternal and Child Health Services,
(2) Family Welfare Services
(3) Nutrition
(4) Health Education
Factors affecting the health of the family:
For any family, maintaining the standard of health or well-being of the family depends on the capacity of the family. Health depends on the interplay between many outside and inside factors that will have a beneficial or detrimental effect on the family. Its full effect can be thought of in terms of positive and negative attitudes over a period of time. Many elements come together and create a family environment.
(A) Environmental Factors:
(1) Climate, Water Supply, air, soil etc.,
(2) Biological environment including animals & all living things
(3) Men made physical environment, character of building, noise, spacé, sewage disposal etc….
(B) Family factors affecting physical & mental health:
(1) Family structure, type, members, relationship, age etc.
(2) Genetic, prenatal, nutritional, physical and mental health status.
(3) Cultural patterns and behavioral patterns of the family
(4) Social Class, religious beliefs, skill & social habits.
(5) Economic Status,
(6) Geographical whole environment system can be prepared to determine the need of both nuclear & extent-family and support system can be determined and work can be done in the network of the family. Neglecting these factors leads to misunderstanding. Due to which there is a breakdown in communication between the nurse and the family.
E.g. Knowledge about anemia in pregnant women
And it can be helpful to give advice on what the family can buy. So with the knowledge of such things, the plan for family care can be done better.
Health Tasks of the Family:
(1) To identify the factors hindering the development of health,
(2) To make efforts to improve health. If any member of the family gets sick, it is first reported to the family members. And based on that family members decide to seek health services.
(3) A change in health to get out of any situation eg emergency or difficult situation like severe illness, death, birth of a child etc. which affects the health of the entire family.
(4) Caring for the dependent person of the family. Caring for a sick person in a hospital or at home is an important task of family members and this task has to be done with the help of health team members.
(5) Environment should be kept healthy. It should be protected from things like fire, accident etc. There should be facilities for sports and recreation. Emotional and social environment should be provided for the development of a person.
Objective Family Health & Nursing Care Process :
To provide family’s comprehensive nursing care, we as nurses need to understand its objectives which are as follows.
Objectives to provide comprehensive nursing care to the family. As follows. :
(1) Identifying and valuing health problems through the efforts of community health nurses and involving other professional workers who serve the family.
(2) Counseling the family to explain the health problem and adopt the treatment offered.
(3) To provide necessary nursing care to the family and also to himself
Explain as possible.
(4) To make each member of the family competent to solve their problems.
(6) To contribute to the personal and social development of the family.
(7) Making wise use of all useful facilities like medical care, health promotion, illness and related social as well as educational facilities.
(8) To give an understanding of the function of non-nursing agencies or health services within or outside the family, for which CHN. The nurse must skillfully and thoroughly provide the necessary information and education to the practitioner and family.
Principles of Family Health Care Nursing services:
In the planning and implementation of Family Health Care, Community Health Nurses should keep the following principles in mind.
(1) Family health nursing is a part of family health care services, so the community health nurse should know the family. Establish a professional relationship with the family, in which the roles of the nurse and each member of the family should be clear for the development of health. Earn the trust of the family. So that we can know the health need and do the assessment
(2) Prepare the family to help themselves and guide them to identify and meet their health needs. Health care policies, goals, objectives, and nature of family health care services to provide family health care. etc. as she needs to plan and deliver family health nursing services with active participation of family members.
(3) While taking family history obtain information about Family Size, Occupation, Education, Customs, Religious & traditional or customary customs.
(4) Identify family health problems and prioritize them.
(5) Provide care as needed rather than routine services.
(7) Treat every member of the family equally without giving importance to age, sex, earning capacity or any other matter.
(7) Family is cared for by different health agencies. This includes government, non-government and various voluntary agencies. Providing proper cooperation in such organizations and preventing overlapping of organizations so that time, energy, manpower and money can be saved.
(8) Providing preventive health services to maintain the health of family members and thereby reduce the need for curative services.
(9) At every contact with the family to communicate the necessary and important health messages for them to know and put into practice in their daily life.
Advantages of Family Health Care Or Objective of Family Health Care ;;
A CHN Nurse who is comprehensively taxed in the community is beneficial to the family. So that family base care can be planned.
(1) If there is knowledge of family background, then the health needs of each family member can be understood.
(2) Each member of the family can help in making a plan for a member of the family who needs special health care.
(3) Family base care provides an opportunity to provide care according to the individual needs of each member of the family.
(4) It is very economical. By which time, energy, money, material and
Resources for health services can be better utilized. Hong
(5) Overplanning of services can be prevented.
(6) It increases the self-confidence of the family and improves the health, well-being and nutrition standard of the family members.
Nursing Process in Family Services:
For a CHN Nurse, working in a family is very welcome and it is also important to consider the family as a unit. The tools which are selected for the beneficiary apart from neglecting it is called the nursing process. Which is applied to provide care at primary, secondary and tertiary level. Working with family is a long term process. The steps for the nursing process are as follows.
(1) Identification of Need,
(2) Assessment of Family
(3) Nursing Intervention
(4) Evaluation
Family Health Assessment :-
Nursing Assessment continuous, Systematically Orderly
The method is given precisely, this is an ongoing process. Including physical, psychological and social needs of the individual, the type of self-care, difficulty and other factors that affect the situation. is for him.
As a community health nurse, you must identify the health needs of the family in the assessment. Establishing a working relationship. Prioritize needs. Planning and implementation and evaluation of care. Family assessment includes many skills and data, which CHN uses. As required for individual clients. Eg: Family assessment includes individual health needs of family members like seeker, antenatal women who require special care. Planning and implementation of interventions is based on assessment data
. Family Assessment’s Contraindication ::
(1) Not to experience family breakdown or separation when there is any illness, injury or death in the family.
(2) Family sentiments are hurt like, there are some incidents in the family e.g. Leaving the home of a small child etc. or there is any event in the home like, not doing assessment even when there is a marriage,
(3) Family considers certain situations as problems. For example, if there is someone with chronic illness in the house, the child is very seriously ill. (4) Assessment should not be done when there is dysfunction in the family, such as psychiatric disorder or when family members do not want to allow family assessment.
Guidelines for Assessment.
While deciding to do Family Assessment, you should decide when, who and how to do the assessment, who should be present during the assessment from among the family members. It is not reasonable to have only one member present during the assessment. Each household member must be interviewed once so that an understanding of each member can be obtained. More information can be obtained if every member of the household is present. Also any specific matter can be discussed. Assessment can be done anywhere religiously, doing assessment at home gives an opportunity to meet every member of the family. Social as well as physical environment can also be seen. Through which the relationship between the family members can be known and in this way the assessment can be done from every aspect of the assessment like Structural, Developmental & Functional task.
It is also very important to determine a system for recording the data collected after a complete assessment is done.
Categories for Family Assessment
The following categories are defined for family assessment.
(1) Structural Internal Structure External Structure
(2) Developmental
(3) Functional
(1) Structure Assessment:
In which the nurse can know who is in the family, what kind of relationship they have with the family and with everyone outside the family. Structurally there are also 2 types.
In which the structure of the family in the internal structural i.e. what is the love and affection between the members of the family, how many children are there in the family. Their age and sex, husband-wife relationship, mother-child relationship, their role in the family, who contributes in what way to the family. etc. matters are included in the internal structural.
External structural includes family culture, religion, social status, sense of togetherness, social status and environmental factors such as privacy, schooling arrangements, retrieval theory, public transport etc.
(2) Development Assessment:
In which it is very important to know how the family reached the specific stage of development. We should be aware in terms of child development. Also the pursuit of work should be mixed with the family members.
(3) Functional Assessment:
It looks at how family members behave with each other while doing their work. Each member’s beliefs, feelings, sadness, anger, and happiness are included. While belit includes perceptions during the family process, • Maternal & Child Health Services ::
W.H.O. The expert committee of 1976 has defined maternal and child health services as promoting, preventive, curative and rehabilitative care to improve and enhance the health of both mother and child.
Why more to both mother and child for health services
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These are the main reasons why importance is given. 4 (1) Children and mothers between the ages of 0 and 5 years are more frequent in every country. 65% of the total population in the world is made up of this group, and in India it is 64%. Due to such a large number of them, it is natural that their health requirements are high.
(2) Mothers and children who are in special risk groups and morbidity and mortality rates are particularly associated with mothers such as infant mortality and child birth. While things like growth and development are associated with children. (3) Family and society to improve maternal and child health
Health also improves,
(4) It is especially important that the child is in good health. Because it is the future capital of the family and society. Today’s child is tomorrow’s citizen.
. Objectives of providing M.C.H, Care ::
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(1) To reduce maternal, perinatal, intent & child mortality & morbidity rule, (2) To increase reproductive health during reproductive age,
(3) Adulation and physical and psychological development of the children in the family.
(4) The purpose of M.C. Care is to maintain the health of the family throughout life.
Child Care Services ::
In developing countries, the mortality rate of children under 5 years is 35 to 60%. The main causes of death in this age group include the following,
Causes of I.M.R.:
(1) Highly infectious dissent like,
(2) Child TB, Polio, Diphtheria, Puliasis, Measles etc. Thick Udh
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(3) Death due to lack of treatment of Diarrhoeae Disease including, Diarrhoea, Pneumonia and Malaria,
Dysentery, infection..
(4) Malnutrition
Diseases like low birth weight, kwashiorkor, marasmus due to lack of nutrition.
All these causes are preventable. Infancy is also a time of rapid growth and development and it is for this reason that special care is required between the ages of 0 to 5 years. To solve this problem Under 5 Clinic which was earlier known as Wellbaby Clinic. has been started in its place. Under 5 Clinic provides high quality curative, preventive and promotive care. This clinic is run along with the antenatal clinic.
‘Under Five C!inic’s aim & objectives are shot in its symbols.
(1) Care of illness ::
This is part of the apex of the triangle. Caring for young children
and prescribes treatment in Illness. Learn through a study
It has been found that 70 to 90% of sick children are cared for by nurses
is coming. So nurses should have proper training and knowledge of responsibility.
So that nurses can work well even in the absence of qualified doctors and specialists in rural areas.
(2) Preventive Care ::
(A) Immunization :
It is the birthright of every child. Health for all by 2000 A.D. This is a very important thing to achieve. Health is also an important goal to prevent every child from 6 killer diseases like,
To protect against Diphtheria, Palus, Tetanus, Polio, TB and Mals.Ministry of Health Family. The Immunization Schedule suggested by Welfare is as follows.
(1) At birth = B.C.G & ‘O’Polio. Single Close. May Tie04_3
(2) 1.5 months Pal02
= First dose of D.PT & O.PV IM – Close Pavit62-
(3) 2.5 months = second dose of D.P.T CO.P.V I/M ← Close P247622
(4) 3.5 months = 3rd dose of D.P.T & O.P.V I/M – Close,
(5) 9 months = Measles & Vitamin A solution subcutaneous/oral Pura (6.5 = booster dose of DPT & O.P.V ‘I/M – Oral, Vs
(7) 5 to 6 years = D.PVaccine and second dose of DT after 1 month, (8) 10 to 16 years – TT and second dose after 1 month
(9) To antenatal mother – TT. Two doses of A period of 1 month.
(B) Prevention and Control of VjLA Deficiency in Children ::
All children below 5 years of age are given doses of Vitramin A. In which the first dose of 1 Lakh U is recommended to be given at the age of nine months with measles. And the second dose is given with a booster dose of $2Lakh f/U DPT/Polio. Then in the sequence every 6 months (February – August) round all the children up to 5 years of Vitamin.A. Doses of are provided. A total of 9 doses or 17 lakh [/U of vitamin A are given by 5 years. There should be a gap of at least 4 months between 2 doses.
(C) Prevention & Control of Anemia in Children ::
Tab containing 20 mg of elemental Iron & 0.1 Mg of Folic Acid, iron folic acid tablets are given to children under every 5 years. For this every sub center PHC. is provided on which protects children against anemia. Bhalgutrishan – Matin
(D) Nutritional Surveillance ::
Especially in children especially P.E.M. For, Patin Angel Anaemia and Vitamin A. Cases of deficiency are detected. And more attention is given to such children to find out the causes of deficiency and treatment is given and if necessary referred. For Dali Bhalpurima
Mothers are advised to ensure that children receive appropriate supplementary food. And for that LC.D.S Program is implemented in India.
Under this scheme, supplementary food is given to all children from 0 to 6 years. Antegrade Thield Typrinth Me (1.c.25)• Naat sharana = 2 0cle, 1015,100 v
(E) Health Check-Up ::
In health checkup every month health checkup of children is done, height weight is done and child health card is filled. This card is used under the project of C.D.S program. In which physical exam, laboratory tests are done for the children who are required.
(F) Oral Rehydration Therapy ::
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The average proportion of children in poor communities is higher due to which there is a possibility of diarrhea 2 to 6 times a year. Growth and development slow down due to diarrhea and nutritional deficiency. It often leads to death. Oral rehydration therapy can reduce mortality in children. And children can be protected from malnutrition. For which mother O.RS. Explain how to use and take care of children.
(G) Health Teaching ::
Health education is an essential part of child care services. Through health teaching, malnutrition leads to infections and stunted growth. which can be saved from the condition.
(3) Growth Monitoring = Reading from front
(4) Writing against Health Education.
(5) Family Planning :: Providing special education and guidance for the parents of the children. Explain F.P’s Method in detail and explain to them keeping in mind the following, which is an important role of the nurse. (I) Education & Counseling ::
To transmit ideas for health hygiene and family welfare.
(II) To Assist the Physcian ::
These are the functions of a nurse. In which the nurse should keep in her mind important goals for family planning like, (a) To promote the idea of small family. (b) All Eligible Couples should be given information about the method of F.P.
P is an important issue for family and child welfare first introduced in 1952 in our country.
Also, health education should be given about minor and major weaning of babies and also about breast feeding.
Dis-order
Maternal Health Services ::
Skilled Nurses at Every Stage in Maternal Health Services
provides services. Maternal health services include the following services.
(1) Antenatal Or Pre-natal Care. Catre of the during prugnency,
(2) Intranatal Care. -care of the woman time of young delivery. (3) Postnatal Care. (are of the woman after 3 Arintel – Koi
(4) Care of the new born. –
(5) Family Planning Services etc…
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(1) Antenatal Care ::
Antenatal or prenatal care taken during pregnancy
Care is coming. Which is given from the beginning of the pregnancy till the end.
AIMS of Antenatal Care ::
(1) To maintain and develop the health and nutritional status of the mother during pregnancy
(2) Identifying at-risk pregnant mothers and providing special supervision. bear,
(3) To provide adequate care to the mother during pregnancy
(4) To prepare the mother physically, mentally and materially for delivery.
(5) To reduce maternal morbidity and mortality.
(6) Mother safely delivers a mature and healthy baby through safe delivery
To be able to give birth.
(7) To educate the mother to care for her child and herself.
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Health Teaching ::
Surrounding the entire symbol is a border that covers each area or part of the under five clinic. Which shows health education. Which is very necessary for every area of under five clinic. It also suggests binding each part of the symbol together.
(3) Growth Monitoring ::
This is a basic activity of Under Five Clinic. In which the growth of the child is periodically monitored every month for the first year of his life. Every month in the second year, every three months in the third year and so on till the child is 5 to 6 years old. And this weight is recorded as a graph in the growth chart or road to health card. And thus the line resulting from it is known as growth curve.
The Road to Health card usually has two lines, with the top line or lines indicating that the child is vulnerable. And the line below it or the second line indicates that the child is average. When the child is growing normally, the growth line passes between the two lines shown above, the degree of malnutrition is also indicated in this chart. Children whose growth chart is shown above. Children whose growth chart falls below both the above-mentioned lines indicate malnutrition. Such children do not develop properly. So it is necessary to improve their nutrition. Hence it is necessary to give nutrition education to mothers.
(4) Health Education ::
Mothers of children coming to the Under Five Clinic should be given special health education for the following
(1) Personal Hygiene
(2) Nutrition
(3) Immunization
(4) House cleanliness,
(5) Waste disposal
(6) Health education should be given about waste water disposal etc.
History Talking ::
(1) General Health History::
A complete prenatal examination including general history of the mother including tuberculous chlorosis, anemia and malnutrition, heart diseases, diabetes, sexually transmitted diseases, kidney diseases or any other complications.
(2) Family History ::
Asking about husband’s occupation, his health, age of future children and his health, whether there is any illness in the family or close relatives.
(3) Environmental & Social History ::
In which the type of house, how many rooms, where drinking water is brought from.
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How to dispose of excreta and waste, personal hygiene, domestic hygiene, what kind of food to eat etc.
(4) Past Obstetric History::
Previous gynecological eg delivery including previous pregnancy, caesarean section, abortion blood transfusion, ectopic pregnancy, toxemia of pregnancy etc.
(5) History of Present Pregnancy ::
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(i) Identifying Data – to collect data?
In which mother’s name, address, age, number of living children, age of minor child, date of last menstrual period cycle, from that
E.D.D (Expected Date of Delivery)
(ii) Whether the pregnancy is unwanted or not.
(iii) Whether the mother has persistent vomiting, headache, vaginal bleeding or discharge?
Is the mother currently breast feeding the child? (iv) What she takes in food. (4) What does daily work.
(vi) Whether the mother can feel the movement of the baby etc. Antenatal
Take the hospitality and record it in the Mamta card.
(2) Prenatal Examination ::
After taking the mother’s history, do prenatal examination in which,
(1) Routine Examination :-
Including Record of TP.R., B.P, Height, Weight, Urine Sugar, Albumin, Blood Group, II,B, RH Factor, Stool Examination VDRL Test, > For Benereal Disease, Syphilis Garnaria.
(2) Physical Examination :-
In this * Heart, Lungs offer Body System, lead to foot examination is done. E.g. Facial puffiness (swelling), pallor (ficas), pitting edema on foot examination are very important to look for during the facial exam.
(3) Obstetric Examination :-
The exact duration of Bhujantida Bhama pregnancy is determined by the position of the baby in the uterus, the present import, whether there are one or more babies, more fluid (in the uterus), and if there is any other abnormality.
This examination also includes a pelvimetry exam. Also of abdominal exam in which inspection, palpation and auscultation are done for fetal heart sound. Inspection of the vulva and vaginal examination are performed.
Calculation of Expedite Delivery Date. (E.D.D) :-
During the first visit, after taking the mother’s total history, the first day of the last menstrual cycle and the number of days of the period should be asked, usually the period of pregnancy is 280 days.
It is counted from the first day of the last menstruation. So the date which comes after counting 280 days or 9 months and 7 days is called Expected Dclivery Date.
Antenatal Clinic A.N.C.::
A.N.C. Clinic provides antenatu cire.
1 time in this clinical week in urban area, P.H.C. and organized into sub-centres. Also that Maternity Hospital and MCH. Also arranged in Centre. The antenatal clinic should have two forms in which, – one room can prepare the mother’s height, weight and antenatal card and the other room can do the physical exam of the mother. Auctions of Antenatal Clinic
Factions (-1.
(1) Registration of antenatal cases – Registration of ANC Cases,
(2) Preparation of Antenatal Case Card – Preparations of ANC Curds,
(3) Conducting antenatal examination – ANC Examination
(4) Identification and detection of high risk mothers – Identification of high risk cases.
(5) Giving pre-natal advice – Prenatal Advice,
(5) Mental Preparation –
(7) Health Education & Mother Care Classes
(8) Referral Services (Referral)
(9) Home Visit.
(10) Maintenance of Records.
Some of the above functions must be performed precisely. It is recommended that there should be a Gynecologist in the antenatal clinic, but this is not always possible, so every case in the clinic a PHC Medical Officer, Qulified ANM, FIW.HLV or Midwife can do the examination and provide all the care. Only critical cases are referred to district hospitals. Where expert services can be found. Antenatal clinics are not only sufficient to detect ubnormality, but also run for the supervision of normal pregnant mother’s health.
High Risk Pregnancy ::
The main purpose of Antenatal Care is to find high risk cases and provide them with skilled care. Which is known as M.H, Care High Risk approach. A mother with the following symptoms is said to be at risk. Approximately 15% of all expectant mothers are at high risk.
(1) Elderly Primipura (30 years & over)
(2) Mal presentations (improper position of the baby in the uterus)
(3) Antepartum haemorrhage (A.P.II)
(4) Pre-eclampsia and eclampsia
(5) Arnaemia (Haemoglobin 50% and bellow) (6) Twins Pregnancy
(7) Hydramnios (large head of child).
(8) Any unwanted child due to previous stillbirth or intrauterine deaths
By all means
(9) Elderly grandmultiparas (more than four births)
(10) Past History of Caesarean (caesarean) (11) Pregnancy associated with general disease Ex. heart disease, kidney disease, diabetes, tuberculosis,
(12) Prolonged Pregnancy (14 days after E.D.D)
(13) Structure Height less than 140cm/4feet 10 inches,
(14) Age less than 18 years or more than 35 years.
High Risk Child :-
(1) Underweight (less than 2.5 kg)
(2) Paired children
(3) Congenital deformity
(4) Breast feeding ot estblished
(5) More children.
(6) Either Parent is chronically ill
(7) Working Mother
Re 1 Child Survival & Safe Motherhood (C.S.S.M 1992) ;
(Child Safety and Safe Moderation)
(1) The child should be 100% immunized by the age of 1 year and should receive ORS. have been included in .
(2) The newborn receives warmth and food at home.
(3) Vitamin A Solution 5 doses completed from 9 months to 3 years.
(4) Pneumonia is accessible to health services and appropriate treatment and care at centres.
(5) Door-to-door service and ORS in diarrhea. Packets are easily accessible to everyone. Such children can be called safe children.
When is a safe mother called?
(1) Immunization against tetanus covered 100%,
(2) Separate treatment for anemia including diet, health education and 100 tablets of iron during pregnancy.
(3) Antenatal exam must be done at least 4 times.
(4) Referral treatment for high risk mother.
(5) At the time of delivery, the delivery is done with cleaninly ness to a trained person.
(6) Planned childbearing at appropriate intervals and at appropriate times between two children.
Antenatal Visit
Generally, ideally every expectant mother should visit the antenatal clinic once a month for the first 7 months and every 15 days during the last 8 months. 9 Month Every Week, if everything is normal then many times mothers cannot come to antenatal clinic. In such a situation at least 3 visit workers must take his home. Which is shown below.
(1) First Visit : 20 Weeks of Pregnancy or Before 5 months of Pregnancy.
(2) Second Visit : 32 Weeks. (During 8 Months)
(3) Third Visit : 36 Week (During & Month)
(4) Fourth Visit : During 9th month. Further visits should be taken according to the mother’s condition.
Pre-natal Advice
(1) Diet :-
Malnutrition is common in the mother during the antenatal period. If the mother is healthy and well-nourished, her weight increases by 10 to 12 kg during pregnancy, while many women gain 7 to 9 kg. Therefore, a pregnant woman should take an extra 300 calories in addition to her normal requirement and get an extra 14 grams of protein so that the growth and development of the child can take place well. The mother should take a balanced diet containing 3300 calories, 1 gram of protein, 1 gram of calcium and 30 to 40 mg/day of iron. She should be advised to eat foods rich in protein, vitamins and minerals because milk A good amount of protein and calcium is available. Apart from this, it is necessary to take green vegetables, seasonal fruits, eggs, meat etc. to fulfill the daily requirement.
2) Personally-
In which the mother should bathe daily, wear clean and loose clothes, bladder and bowel activity should be regular. Sufficient rest and sleep should be taken. Antenatal exercise should also be done. Avoid weight gain during the last three months of pregnancy. Advise not to smoke. Ask to maintain oral hygiene. Ask to avoid intercourse for the last three months.
(3) Care of Nipples :-
If the nipple is not properly taken care of during the antenatal period, the baby has difficulty in taking feeding. Hence, ask to massage the breast daily from the ribs to the nipple and ask to pull the nipple slightly outward while taking a bath.
(4) Immunization :-
2 doses of TT should be administered during the antenatal period. There should be a gap of at least 1 month between the two doses. The first dose should be given as soon as the pregnancy is known or if the mother wants to get pregnant again within three years, the first dose of TT is 16-20 weeks, the second dose is 20-24 weeks, one dose is equal to two doses.
(5) Others :-
Pregnant women should not undergo necessary abdominal x-ray, because fetal malformation occurs due to x-rays during the first 4 months. Necessary medicines should also not be taken.
(6) Family Planning :-
The mother is counseled about family planning methods during the antenatal period. During this time he is ready to follow the advice given.
(7) Warning Signs :-
A mother is told to see a doctor immediately if she notices the following symptoms.
(1) Swelling on feet
(2) Fits
(3) Headache
(4) Blurring of vision
(5) Bleeding or discharge per vagina.
(6) Any other unusual symptoms.
(8) Mental Preparation :-
Mental preparation in antenatal care is as important as physical preparation. The expectant mother should be given adequate time and opportunity to discuss with the CCH.Nurse or visitor. So that the health worker can understand the mother well and remove her fear of delivery.
Home Visit
Home visits are the crux of MCH Services.
Home visits should also be done to the mother who goes to the regular clinic. A.N.Mor Public health nurse should visit home at least in 1 week and provide antenatal service. So that the social situnki of the mother can also be known. Also, if there is planning for home delivery, it can be understood for that and if there is a need to give advice to the mother, that can also be given.
Antenatal card is prepared at the first visit itself.
In which every detail should be asked and filled correctly. Writing investigation report and past and present history about health. The record of card thus prepared M.C.H. Keep in the center.
(2) Intranatal Care –
Intranatal care i.e. care given at the time of delivery begins with the onset of labor pains and ends when the third stage is over. The main purpose of providing these services is to provide good quality service to the mother at the time of delivery, as well as to make the delivery less traumatic for the mother and the baby and to be prepared to take measures against complications. E.g. Haemorrhage, Mal presentation, Card Prolepse,
The nurse should be aware of the events that occur during the three stages of delivery, she should also know what to do in an emergency.
Objectives:
(1) Best Available Care doing Labour.
(2) To Prevent Maternal & Child Mortality & Morbility.
Normal Labor *
About 95% of deliveries are normal.Giving the mother a warm welcome at the time of a donation provides emotional support to the mother. A nurse’s face should always be smiling. So at the time of delivery it stays fixed and its tension is removed.
The saving of Maghar’s valla is given in it. Then giving bath to the mother. By giving enema the bowels are emptied. Not only that but it also simulates labor pain. After that, admit the mother to the labor ward and do TPR, B.P and abdominal exam if necessary and record P.V.examination. To mark this paltograph in which T.P.R, B.P, Urine Sugar albumin, T.HS (Fetal heart Sound) etc. to mark 120 160 Normal, then mother’s heart, limbs and other systemic exam is done.
First Stage
The first stage begins with the onset of labor pain. From then on, the cervix’s full dilation takes place. The stage up to that stage is called the First Stage. Bhavna 0Yu vahi nakale This starts with the show, in which blood stained from the vagina.
S Discharge comes in small amounts. Painful rhythmic contractions, back pain etc. occur in the first stage. First stage is usually 12 to 16 hours in primipara and 6 to 8 hours in multipara. In the first stage, the main goal is to relieve pain and prevent maternal and fetal stress.
If prologue occurs in the first stage, analgesic drugs are given to the mother to provide pain relief so that the pain and discomfort are reduced and also injections are given to the mother to reduce fatigue if the doctor orders. If fetal distress is prolonged then .V.Glucose is given. During this time FI.S. Should be 120 to 140 per minute. 30 As an early sign of fetal distress, the main sign is that the fetal heart sound is more or less than 20 beats normal.
(2) Cord Prolapse.
(3) Signs of toxemia (increased BP, swelling, urine albumin)
(4) Malpresentation (behind the baby’s part outside) Gamli (5) Meconium Strained, Vaginal discharge. First all Inteiton School p
(6) Non – engagement of head.
(7) Abdominal girth more than 1 meter.
(8) Fetal distress.
(9) Dehydration
(10) Prolonged Labor (Over 24 hours in a Primi or over 12 hours in a multi)
(11) A rising Pulse rate in the Woman (Over 90 Per/Min)
Second Sage
The stage from the time Cervx’s full phyllodes to the birth of the baby is called the second stage.
In Primipara this is 1 to 2 hours. While in multipara it is not more than half an hour, in the second stage the mother is terrified. This time it is the nurse’s duty to give mental support to the mother. Every 5 minutes FH.S.
Take if F..S. If it is more than 160 per minute and less than 100 per minute, it suggests fetal distress. At this time to report immediately to the Medical Officer.
The following Zardes are commonly seen during the second stage.
(1) Survicle, Vaginal and Perinium tare,
(2) Rupture of uterus,
(3) Birth Injuries to Felons; Úm) Tham Sat It is mostly found in Primipara. So Yadama in Primipara Episiotomy is given. During the exvention of the head, valva stress is given to support the delivery, if the umbilical cord is wrapped around the baby’s neck, it is removed by sliding it over the neck and shoulders.
Third Stage
The stage from the birth of the baby till the placenta is delivered is called the third stage. In this stage, immediately after the placenta is delivered, give an injection of Methazyl 0.5 mg intra muscular, when the placenta is secreted, forcefully blood comes out. Which is usually 60 to 80 cc. have And with this the length of the cord is slightly lengthened. Third Tu || P.P.H (Post Partum Haemorrhage) is common among the 5 stage complications.
Retained Placenta
After the baby is delivered, the placenta is not delivered. It is called retained placenta. When this happens it is removed manually (by hand).
Asphyxia Neonatorum occurs in babies. The nurse should be especially alert for this complication. To cover this asphyxia, the air passage should be cleared and the baby crying should be done immediately. After the mother is delivered, give abdominal binder and plus and BP for two hours. Take half hourly.
Domiciliarv Midwiferv (Home Delivery) :
If the obstetric history of the mother is normal then she should be given permission for home delivery. But for this the home environment should be satisfactory. As a rule, the second and third deliveries can be made at home. But if there is a high risk mother, delivery should be done in the hospital itself, home delivery can always be done by a trained obstetrician, ANM or FHW.
Home delivery has both advantages and disadvantages.
Advantages of Home Deliverv ::-
(1) The mother feels better mentally as the delivery takes place in her home, as there is a family environment. Also the rush for delivery is reduced. And the fear of delivery seems less than hospital.
(r) Cos infection is less likely to occur in a properly prepared home than in a hospital.
(3) A mother can give enough attention to her other children and family members and can also attend to household affairs. So her mental tension is reduced.
Disadvantages of Home Deliver :: –
(1) Medical health, oxygen etc. cannot be obtained in case of emergency if the house is far away.
(2) If the house or room is small and poorly lit, it is difficult to keep the mother and child separate from other family members. (3) If any family member has an infectious disease, the newborn baby also gets infected very quickly; Data: T.B.
An important issue of Intranatal Care in India is Doiniciliary Midwifery. 80% of India’s people live in rural areas. So that they can get treatment at the time of their need and maximum home delivery is done in the community. According to a survey, 90% of deliveries are made through local delivery to the home in rural areas. At present as per rule there should be 1 trained ani for every 1000 population and one ANM/FHW for every 2500 population or 100 home deliveries can be done in 1 year, if good home delivery care is available then the workload in the hospital is reduced.
Hospita| Cofinement ::-
(time of delivery) Hospital delivery is recommended for every high-risk case and accordingly women now believe that hospital delivery is safer for both the mother and the baby.
Postnatal Care ::
Post natal period is also called periural period, which refers to the time of 6 weeks after delivery, ‘During this period, each reproductive organ comes to its original state, which is called involution of the uterus. Mother needs special care during this period. In the last period of labor, the weight of the uterus becomes 1000 grams. which is then reduced. Maximum involution occurs at 1 week after delivery. And after 6 weeks the complete back to normal,
Uterine discharge continues for 3 to 4 weeks. This period of 3 to 4 weeks is called Puerperium period or Lochia. The discharge of bright red color in the first 3 to 4 days is called “Lochia Rubra”. From the fourth day, brown or pale discharge is called Lochin Serasa. And then the white like discharge is called Lochia Alba,
(1) Pulse :: –
Keeping a record of plus for 2 hours after delivery, taking pulse every half hour, then keeping it twice a day, after that the plus rate usually becomes normal in 24 to 48 hours. Plus fast is seen in conditions like fever, shock or haemorrhage.
(2) Temperature :: –
A temperature of 100 ‘F’ is usually observed for 24 hours after delivery. Which becomes normal after 24 hours. Temperature should be taken 2 hourly for first 24 hours and recorded. After that, it should be taken 4 hourly for 1 week.
(3) Fundal Height ::-
Fundal height is measured especially after the bladder and rectum are empty. After delivery, fundul flight is usually 12 cm or 5 (inches) above the symphysis pubis. Which lasts for 24 hours. After the second day of delivery, the Fundal Height decreases by half an inch or 1 cm daily and gradually becomes normal. If the fundal height does not decrease, then immediately inform the doctor.
(4) Lochia ::
Discharge from the uterus in postnatal period is called Lochia. Which usually lasts for 10 to 15 days. Its reaction is alkaline. Its color, smell and clotted part should be observed. Inform the doctor if necessary, (5) Perineal
Care ::-
It is very important to take care of the area between the rectum and the vagina in the postnatal period. The area should be cleaned with antiseptic lotion daily and · dried. Taking care of this part can prevent sepsis. Mother as well as relatives should also be taught to take care of this part. After cleaning give autoclave pad and give T bandage and ask mother to wear clean clothes. But if inflammation is reported, stitches should not be removed immediately, but stitches should be removed after 6 days.
(6) Breast Care ::-
After delivery, breast should be rinsed with warm water before each feed. If a crack is found in the nipple, take care of it. Explain to the mother the technique of feeding the baby, the position and benefits of breast feeding and the importance of giving colostrum.
7) Care of bowel & bladder ::-
Perineal tears often occur during the mother’s delivery.
It needs to be refined. Because of this, the bowel and bladder are often unable to empty properly. Simple catheterization is also done if urine does not pass for a long time. For bowel care, if the mother has constipation, ask to give more liquids by mouth and ask to give light and fiber food that can be digested. If constipation persists for a long time, anema is also given.
(8) Early Ambulation :; –
After delivery, the mother can gradually do daily household work, as well as general housework. But giving health education for how and how much to work and how much rest to take and what kind of diet to take.
(9) Blood Examination ::-
If the mother appears anemic, her blood should be examined, especially HB.
(10) Other advice to mother :: –
(A) Diet :: –
Give liquid and semi-solid diet to the mother for the first 24 hours after delivery and after 24 hours, give the mother diet as soon as possible. say to take Advise to take a diet which contains more protein, iron, calcium and vitamins.
(B) Family Planning :: –
Convince the mother about family planning, if it is the first child, then explain about the temporary method like, copper-tea, oral pills, condoms, etc., if there is more than one child, tell her about the permanent method. In which to explain about laparoscopy and tubectomy and vagectomy. Tubectomy operation is best done within 4 to 7 days after delivery.
(C) Postnatal Exercise :: –
Explaining the importance of postnatal exercise to the mother and doing daily housework helps her abdominal and pelvic muscles return to their original state. Also ask the mother to do deep breathing exercises.
Minor Elements during the puerperium:-
The female health worker should know how to handle such minor elements in the puerperium period. Following are the common problems that occur during the per puerperium period.
(1) After Pains (2) Constipation (3) Inability to urinate within 24 Hours After Delivery. (4) Piles (5) Painful Episiotomy. (6) Creckel Nipples.
Compliations during the puerperium :: –
During the Puerperium Period it becomes necessary to check for the following complications, Mu 25).
(1) Puerperal Sepsis (2) Mastitis (3) Secondary Post Partum Haemorrhage,
(4) Thrombophebitis – (Blood clots in veins)
(5) Incontinence of urine and retention of urine
(6) Mental Disorders.
PostNatal Visits t –
Postnatal nursing care by A.N.M or FHEW should be provided for 10 days, which avoids the risk of secondary infection. If home delivery is done, visit the mother twice a day for 3 days and after the umbilical cord is removed. A health visitor or public health nurse should visit the mother after 24 hours after delivery and on the fourth and tenth day to take information about the mother herself and the infant. First, check-up for complete involution of the uterus by a lady doctor, if you come to the postnatal clinic.
• Care of the Children :–
According to the age period of the child, the parts of his childhood are divided.
(1) Infancy (up to 1 year of age)
(a) Neonatal Period (First 28 days of Tile)
(b) Post Neonatal Period (28 days to 1 year)
(2) Preschool Age (1 to 4 years) HA (3) School Age (5 to 14 years)
In General Mch Services, the child is taken care of till he reaches 5 years of age.
Infancy :: –
Almost half of all deaths in developing countries occur in the first 28 days of life. (In Neonatal Period) If we look at the main causes of neonatal death,
(1) Low Birth Weight.
(2) Infection Exp. Respiratory infections and diarrhea and
(3) Sequelae of birth injuries.
(4) Prolonged Labour.
(5) Congenital abnormality.
(6) Haemorrhagic diseases.
Jan) after Pel
Resuscitation :: – ( Resuscitation ) Sriresuscitation – Gently wipe the respiratory material from the mouth and nose with a clean cloth.
As soon as it is born from the head, if the liquid and vaginal are sucked, clean it immediately after birth with a mucus extractor, so that the baby can breathe through its lungs and cry. A normal newborn, if the section has been successful, keep the head to the side to clear the airway. Clean the nose and ears with a sterile gauze pad on the finger. Clears by turning round.
When natural breathing fails, resuscitation is started immediately within a few minutes, if necessary, rapid suction and oxygen mask are applied. It becomes necessary to take inoculation and resuscitation. Resuscitation equipment with oxygen should be kept ready in every labor room in the ward. If the heart stops within 5 minutes, the baby dies.
It is a common method to check the physical condition of a newborn baby. In which 5 clinical signs are carefully observed. Apgar score to be observed one minute and checked up to 5 minutes after birth (written from Apgar Score’ Table Book)
A baby’s physical condition can be instantly predicted by the Apgar score. It has a perfect screw 9 or 10. While a score of 7 to 3 shows that the baby is severely depressed. These five indicators prompt action.
(3) Care of the Cord :: –
Do not rush to cut the umbilical cord after delivery. Wait till the pulsation stops. Also doing the milking process which gives the baby 10 ml of extra blood, – then the cord on both sides about 6 cm and 9 cm from the umbilical cord. Cut the cord from the clamped part in between to tie. Tetanus can be prevented in newborns by taking proper care of sterilized instruments and cord tie material. Use an antiseptic solution (eg alcoholic solution or betadine) to apply if necessary to the cord, stump and surrounding skin area. is
(4) Care of the Eyes :-
Before the baby opens his eyes, clean the edges of his eyelids with a sterile wet swab. First 1 (one) eye then the other eye. Then prepare drops of silver nitrate solution (1%) facially and instill in the eye, to prevent ophthalmia neonatorum, apply tetracycline 1% ointment in the eye. Water should not go into the eyes while bathing. If there is any kind of discharge from the eye, get immediate treatment
(5) Care of the Skin :: –
Babies are not bathed to prevent hypothermia. So explain to the mother how to keep her nappy (baby diaper) changed, how to keep her lower part especially clean and how to keep it clean.
(6) Maintenance of bov Temperatures:-
Cold is a danger to every newborn infant, especially in winter, and should be dried immediately and covered well to prevent heat loss. For this honey should be given dry breast feeding. The first 12 to 24 hours of life are very happy.
(1) First Examination ::.
The first examination should be done in the delivery room immediately after birth, and the general condition should be noted. In which color, congenital abnormality temperature etc., the following conditions should be looked for during examination. If they are found, the medical office should be notified immediately.
(1) Cyanosis of the Lips and Skin.
(2) Birth Injuries.
(3) Bleeding from the cord.
(4) Pallor
(5) Any difficulty in breathing.
(6) Persistent vomiting
(7) Jnuüntice.
(8) Imperforate Anus.
(9) Signs of cerebral irritation such as Twitchings, Convulsions, Rolling of eyes, Neck Rigidity & Bulging of Anterior Cavity The front of the medicine should be up in Pasha).
(2) Second Examination ::-
Refer to pediatrician within 24 hours as needed during this examination. Also send the details of the baby systemically examined from head to foot.
Measuring the Baby. healthy leaky onl? heroic five.
(1) Birth Weight :–
Birth weight is an important indicator of health. Which is a reflector of intrauterine growth. It indicates how his growth and development will be in the first few years of life. A baby of a well-nursed mother is healthy and weighs around 3.5 kg at birth. The birth weight of most children in India is between 2700 to 2900 grams.
The weight of the baby should be done within the first hour after birth. Then it starts losing weight, so there are two types of weighing scales.
(1) Beam Balance Scale.
(2) Spring Scale.
Beam balance scale is more accurate. A clean towel is placed on a scale pan to weigh the baby. If the home delivery is done, then a yoke or a bag is used to weigh it and it is hung in Salter Spring Balance. If the baby is overweight, use the standard method of weight measurement.
If the birth weight of the baby is 2.5 kg. If it is less than, it is called Low Birth Weight Babies. Most babies lose about 10% of their weight in the first five to two days after birth, but after 10 days they start gaining weight. In the first three months, he gains one and a half kg of weight every month, at the end of five months, his weight doubles the weight at the time of birth. It is 3 times the birth weight of a baby who completes the first year. His weight growth. Charts are recorded monthly.
(2) Length (Height) ;; –
Children under two years of age are measured for height. Measure its tecumbent length. A wooden measuring board (infantometer) can be used to measure it accurately. In which there is a fixed wooden part at the head. The baby should be placed in an upright position with both legs straight. This requires two people to measure his height accurately. After measuring the height, the wooden board should be moved to the front of the slate and the reading taken. Length should be taken closer to 0.1 cm. Normal Indian baby’s height at birth is 48 to 50 cm. 8 / = 2 ) Narta 50 com via measurement there may be a slight change 2305 in the first 3 days. By measuring after delivery,
This is measured by a measuring tape. Maximum circumference is measured by placing a tape measure around the occipito-funtal diameter.
A baby’s birth weight – height and head circumference are common measures of health. Through which its health and maturity is measured at national and international level. It can be evaluated. A normal baby’s head circumference at birth is 33 to 35.
Breast Feeding ::-
Breast feed should be given to the baby within half an hour after birth. Which should be given every 2 hours or when the baby needs it. Explain to mother about breast feed and its importance and procedure.
(A) Maintenance of body temperature :: –
Hypothermia (preventing hypothermia) after birth is very important. BT To maintain, wipe with a clean cloth immediately after birth and transfer to another clean cloth. In which the head part should be specially covered. Then wrap the baby according to the season. If the child has severe hypothermia, give Kangaroo Mother Care (Kinc Care).
(B) Prevention of Infection :: –
Handle newborn baby only after washing hands, do not handle by person with cold, cough and other infection.
Definition New Born Baby’s activity is observed. This is a very common way of looking at physical condition. In which immediate & careful observation of the child is done to see 5 clinical signs. It is called Apgur score. It should be taken from 1 minute to 5 minutes after the birth of the child.
Aar Score :: –
Preparation of mother :: –
The period to prepare the mother for preparation is the antenatal mother. In which the mother can sit and discuss individually or in a group. So that he can feed and take care of the child well, so as to say about the things mentioned below.
(1) Nutrition :: –
Ask the mother to take a well-balanced diet and extra protein, calcium, vitamins and more fluid in the post-natal period.
(2) Work (Less heavy work) :: –
Avoiding work that puts too much heavy strain on the mother. Because it causes energy loss. Pay special attention to this matter especially in Malnaresh Maghar. Asking not to do work with psychological stress or keeping in mind that there should be no mild stress or tension.
: (3) Traditional Customs :-
Avoiding some rituals like fasting etc.
(4) Care of Nipple :: –
If the nipple is flat or introverted or small, then the father has difficulty in feeding. Stretching out the flat and introverted nipple through massage
(5) Room & Privacy :: –
Keeping the mother with the baby as much as possible will stimulate the production of milk due to the psychological feeling. Special attention should also be paid to maintaining privacy for breast feeding, so that the mother remains relaxed, and milk flow is good as well as convincing the mother not to worry.
Importance of Breast Feeding OR Advantages of Breast Feed :: –
(1) It is an excellent nutrient for the baby. Also there is a good natural pool in Sara.
(2) It fulfills the nutritional requirement of the child. Growth and development is improved.
(3) Protects the baby against infection. Because colostrum contains enough Antibodies, which protect the baby against infection.
(4) It is always Clean & Sterile. (5) It is available 24 hours.
(6) No preparation is required for it.
(7) No cost is payable.
(8) It is digestible and at the right temperature.
(9) An emotional bridge is built between mother and child.
(10) It helps the mother to keep a gap between two children, i.e. Natural Family Planning.
(11) Sucking is good for baby.
(12) It greatly reduces the child mortality rate.
(13) Helpful in involution of uterus. (Helps in bringing the uterus back to its original position)
(1) Begins immediately after birth within half an hour. So baby immediately
should be given
(R) Early breast milk i.e. colostrum is very essential for the baby. Because it contains a lot of antibody protein and other nutrients. So colostrum should be given specially.
(3) At each feeding, feed the baby on both breasts. Start by filling both breasts for 3 to 5 minutes and gradually increase until the breast is completely empty.
(4) It is imperative to feed the baby when it needs as well as when it wants. It increases the baby’s weight. It is not necessary to feed the baby according to time
(5) The interval between two feeds should vary from 1 to 4 hours. Babies have different feeding habits. Keeping that in mind,
(6) Keep a time of 6 hours between two feeds during the night. This rest is necessary for both mother and child.
(7) Persuading the mother and the child to give sufficient feed every time i.e. to give the feed so that the breast is well emptied.
(8) Persuading the mother to feed the child even when it is sick.
(9) Feed as long as the child takes the feed. At least till the age of 2 years.
(10) After the child reaches 4 to 6 months, only breast feed is not enough for the growth of the child, another supplementary diet should be given along with breast feed. Like rab, soup, mung water, foot juice to give as long as the child wants. Boiled potato, chikuni chir, khichdi, shiro etc. should be given 8 to 10 times during 24 hours till mother gets feed.
(11) Weigh the child every month and note it in the growth chart. Which is known as growth monitoring. By providing adequate nutrition, the growth and development of the child continues well and continuously.
Problem in Breastfeeding :: –
If the mother is worried, bereaved, etc., due to emotional problems, less milk is produced. This is common for women who have their first child i.e. flat nipple, retracted nipple etc. problematic are common in primipara mother. For this during the antenatal period, while taking a bath and also 2 to 3 times a day, massage the nipple and make it pull outwards. Hence there will be no feeding problems in flat nipples. Many times, because the mother’s breast is too enlarged, that means more milk is produced than the baby needs. At such times, give regular feed and ask to empty the breast. Cracked nipples also cause the nipple to become sore and the baby and the mother have difficulty in feeding. To prevent this, ask to massage antiseptic cream on the nipple and areola as well.
Painful and tender breasts also cause difficulty in feeding. For which persuading the mother to give antibiotic treatment as per the doctor’s advice, even when the baby’s nose is blocked, it could not suck properly. Baby having Respiratory Infection or Premature baby or Congenital Deformity like hare lip & cleft palate FIGGINS. Even when there is, the baby cannot take feed. Mother Bean – Even when experienced, cannot breast feed properly. Problems like these are seen in breast feed.
• Artificial Feeling :: –
It needs to be given in the following conditions. In which breast feed takes time to start, the mother may not breast feed.
(1) Mother has chronic illness (AIDS, hepatitis, cancer, TB).
(2) If the mother has died and someone can be found who can feed the child immediately, efforts should be made to do so.
(3) If such a person is not found, water milk, especially cow’s milk should be given.
Immunization’:: –
Immunization is a very simple and inexpensive way to maintain the health of children. Launch of National Immunization Program
Launched in India in 1978 under the auspices of the Expanded Program of Immunization, then known as the Universal Immunization Program since 1985, by the year 2000 every child was immunized against seven common communicable diseases, including diphtheria, poliomyelitis, tetanus. , including polio, tuber culosis, measles and typhoid.
These vaccines are given as per the immunization schedule. The schedule is approved by the Health Department of the Government of India.
(5) “Family Planning Services” :: –
Family Planning Services are provided on a wide base. which includes the following,
– Maternal & Child Health Care,
• Treatment of sterility,
A Marriage Counseling & Guidance.
– Premarital Education.
– Sex Education.
– Nutrition & Home Economics.
Currently more attention is given to MCL & FP Activities to reduce Birth Rate. Services provided in pursuance of family planning activities. It is as follows.
: (1) Clinical Services :: –
Following are the services available to the beneficiary visiting the family planning clinic.
(A) MCI Services :: –
Which includes Antenatal, PostNatal, Infant & Talar Care. These services are provided through regular clinic sessions etc. This session provides education and promotion about family planning. 1-4f n fit-sco02
(B) People who have completed their family size F.P. To encourage adoption of terminal method,
(C) Convincing people who do not want another child soon for Spacing Method like Oral Pills, Copper T’ etc. Indrao, Va
(D) Daily I.U.D in Clinic Insertion should be done. TU S D
(E) Vasectomy should be done in a clinic attached to the District Hospital & Primary Health Centre.
(2) Domiciliary Services :: –
Home visit is a very important part of Family Welfare Programme. This operation is done by multipurpose worker male and female.
Services provided pursuant to this. In it
(1) Individual Educntion and Encouragement of Oriented Couple.
(2) Follow-up of beneficiaries using IUD & Copper T Also Vasectomy, Tubectomy & MT.P. Follow-up of the case.
(3) Providing antenatal, natal, postnatal, infant and toddler domiciliary services.
(4) Providing referral services to people who have special problems or post-operative complications,’
(3) Community Services :: –
(a) Family Planning Services ::-
This includes gathering information (Denogralic Cultural Socio-Economical). It includes location, people villages, map preparation, list of household information, identity of target couple, pregnant mother, Infant & Pre-School children & information of other institutions providing family planning services etc. (b) Identification of Community ::-
The implementation of the Family Planning Program is a success of the program with the help of male and female leaders and other dedicated people who offer their services and support. They should be recognized. (c) Educational Activities :: –
The nurse has a very important part to play in popularizing and teaching the principle of small family adoption. Nurses should explain to people that population growth does not affect any one thing, so there should be a wide perspective to see it. It is directly related to the health of mother and child, it is also for the good of the country and society. Through which people’s standard of living is high. can be brought
Education activities, family planning and that method and
It is intended to promote adoption and create awareness of special information. Also the issue of small family is an important point of family planning program to be adopted by common people. For this the activity has to be done. It involves organizing film shows, exhibitions, mass meetings, group discussions etc. in the community. (d) Motivational Efforts ::-
Increase in Educational Activities is done only by encouraging. For this, information from the ineligible couples register should be used and encouraged to adopt individual and group family planning.
(e) Maintaining Adequate Supplies :: –
Contraceptive distribution depots should be located in every village where contraceptives can be obtained when needed.
() Organization OR Organizing Special Compains :: – Organizing a Special Compain creates a strong desire in a person to get it. So to organize IUD Camp, Vasetormy, & Tubectomy Camp for this. Planning can accomplish the target well in some time. To do so
Setting up Targets; –
In order to achieve the desired goal of bringing down the Birth Rate, for physical happiness, the proportion of people using different methods of contraception in 10 years is determined by each state on the basis of population. This target is given by the state government depending on different local factors. Achieving state targets is based on targets at each level. Every PNC Their annual targets are given according to their level of education and motivation.
The total target of the primary health center is divided into each center and subcenter area for achievement. Targets for SAFE during the year depend on the performances of certain villages. B.E… (Block_ Extended Education), checks at the beginning of every year with the help of Female Health Assistant & Female Health Worker. Target achievement is reduced during the harvest season. This difference is made up in the slack season.
(4) Supervisory Responsibilities of the Nurse :: –
The Community Health Nurse is supposed to supervise the FHWs and the staff. They have to observe his clinical work, camp and field work etc. And how to do the right thing should be taught. And to give her a chance to show that work to them. She should discuss the problem with them and observe the work plan and report during the visit to the subcentre. She discusses matters of common interest in staff meetings.
P.H.C. The staff should definitely meet once in a regular month to review the progress of the work, which is very important and to discuss ways to improve the work and make a plan for the next month, a specific day should be fixed for the meeting.
Each worker should present his new month’s workplan and discuss it. And to decide for those who have to take action for any special program for that month, giving them specific targets and responsibilities for education and service programs.
Family Planning Organization :: –
(a) At the Central Level ::-
Harm waste-si Union Ministry of health & Family welfare has a separate department, Family Welfare. The Secretary to the Government of India has overall charge of the Ministry of Health and Family Welfare. He is assisted by an Assistant Secretary, who supervises the implementation of each type of program in the country. Special Secretary, Joint Secretary and Advisor (Mass Media Communication) whose rank is Additional Secretary. It has to help. National Institute of Health & Family Welfare functions as an apex technical institute for health and family welfare through health education, training research and evaluation. We have constituted a Central Health and Family Welfare Council for each state minister to review the health programs from time to time.
(b) At the State Level :: –
‘, the Director of Health and Family Welfare Department of each State shall furnish the Department of Health and Family Welfare with sufficient accuracy. Currently 27 states family welfare bureaus are functioning in our country.
(c) At the District Level :: –
At the district level, the Family Welfare Bureau has been constituted with officials and technical staff. At present 4/4 (414) district family welfare bureaus are functioning in the country. Government of India has formed 960 rural health and 14 urban family welfare bureaus.
(d) At the Periphery :: –
Each program is extended to the Periphery through a network of subcentres PHCs and CHCs. Multipurpose Health Workers and Village Guides etc. of the subcentres have put in a lot of effort and are advancing every health programme.
FAMILY PLANNING :-
It is definitely called family planning.” –
Family Planning means “in which the couple decides when and how many children they want according to their wishes and responsibly. Accordingly, the size of the family Bet
Family Planning Program has been implemented with several objectives. It was first introduced in 1952 by the Central Health Government in the first five-year plan in the country. In which the second five-year plan was specially emphasized
(1) Family Planning Education (2) Family Planning Services.
(3) Family Planning Training (4) Family Planning Research,
Below are the main purposes of family planning
Purposes oLE.P ::
(1) Unwanted child birth can be prevented.
(2) Desired birth can be obtained.
(3) A fixed period can be kept between two children.
(4) Birth of a child in relation to the age of the mother,
(5) To maintain the health of mothers and children.
(6) To impart premarital education
(7) To carry out genetic counselling,
(8) To impart knowledge about physiology and pathology of reproductive system.
(9) To enlighten unmarried men and women.
(10) To give proper advice in sterility
(11) Sex Education,
Family Welfare :-
The term family welfare is very broad. The basic idea of family welfare is related to standard of living, but it also includes important things like education nutrition, health employment, women’s welfare and rights, housing, safe drinking water supply etc.
In 1977, the Government of India gave a new form to the National Family Welfare and called it the National Family Welfare Programme. The name of Ministry of Health & Family Planning was changed to Ministry of Health & Family Welfare. To promote family planning program to Government of India. Which was a response for the welfare of the whole family. His aim was very vast and lofty to improve the standard of living of the people.
Post Partam Programme: c d&: After delivery or abortion, the mother has a strong desire not to conceive early. Also they want to follow family planning program. So Government of India has opened such post partum centers in every district. It is known as India Post-participation Programme. Which is a part of National Family Welfare. The main objective of this 194+th Raburavataga program is to accelerate family planning programs in maternity hospitals. In which the service has to be provided according to this program when the mother comes for delivery, in which the mother is fully informed about the method of F.P, and fully encouraged to adopt it, in which Tubectomy Operation should be done 20%. And Vnsectomy operation should be done 10%.
4 Fertility ::-
Fertility is the quality that men and women possess to strengthen the action found with Ovem & Sprum.
Infertility :: k
Being powerless to stay pregnant. The inability of a woman to conceive a second time is called sterility.
Types of Sterility :-
(1) Primary Sterility :: Husband & Wife are together after marriage and fn. Primary sterility is when a couple who do not adopt any method of infertility do not have children even after one year of marriage.
(2) Secondary Sterility :: – If a woman does not have another pregnancy after having one child, it is called secondary sterility. Both husband and wife are investigated to find out the causes of sterility.
In Male
(1) Absence of spermatozoa
(2) Spermatozoa are less abundant
(3) Operation or injury of reproductive organ
(4) Mumps’s history or infection or history.
(5) Congenital malformation,
In Female
Uterine displacement.
Tumor:
Congenital Abnormalities
{inte{mation,
Overian Factor Tubal factor
Cervical factor uterine condition,
(A) Preventing Ovem & Sperm union,
(B) Suppressing Ovulation.
(C) Interfering with implantation of the fertilized ovum in the uterus. Preventing the fertilized ovum from implanting in the uterus, different
Contraceptive method is based on the above principles.
Eg : Condon = Prevents fertilization of Ovum & Sperm. Oral Pills = Interferes with Ovulation.
IUD = Fertilized ovu prevents implantation in the uterus.
An ideal contraceptive is defined as one that is safe, side-effect free, reversible, and readily available, and no single method meets the above requirements. known as
Classification of Contraceptive Method :: –
(1) Spacing Method : Temporary Method
(A) For Men
= Condom Withdrawal
(B) For Women
= (1) Intra uterine devices. ±ty),
Copper-T
(2) Hormonal contraceptives
Injectables (D.M.P.A. Net E N.)
Oral Pills.
Sub dermal implant (norplant)
(3) Diaphragm.
(4) Foani Tablets (Jelly and Cream)
(5) Rhythm Method (Safe Period)
(1) Natural Methods ::-
(a) Withdrawal or coitus interruptus :- Int
This is a very old method of family planning. This may prevent simen from growing into the vegeamal after intercourse. So the pregnancy cannot remain. Many people can use this method well. Jya Dhana finds this method dangerous. The failure rate of this method is 18%. So it can be said that the chances of pregnancy are maximum. Because inejaculation during coit has a lot of sperm in it. After coi, a little seaman’s wage goes into Kunal, which most of the time neither partner knows about it.
Advantages:
There is no need to use any tools for Farhily Planning.
. Disadvantages:
If there is a delay in the expulsion of the penis after coitus, there is a possibility of pregnancy remaining if even a little semen remains in the veg.canal.
(b) Self Control :: –
This is an effective method of family planning. In which the couple has control over the sexual relationship. This is a simple and natural way. But putting it into practice is very difficult.
The disadvantage of this method is that the person may have psychiatric problems. Nerve breakdown is also seen.
(c) Rhythm Method (Safe Period) ::-
This method is also called calendar method. Described by O.G. in 1930. Ovulation occurs 12 to 16 days before the second menstrual cycle. (13 to 17 days from the onset of maturation cycle) Sperm can survive for 2 to 3 days. The week before and after the menstrual cycle is considered safe period. Pregnancy does not occur during this time. Because there is no ovulation during that time. If the menstruation cycle is regular then the calculation of sale period is easy. If irregular, calculation becomes difficult. The failure rate of this method is 24%.
Advantages: –
Sexual relaxation must be avoided on half days of the month. Hence understanding between husband and wife is necessary.
This method cannot be used in the post-mortem period. Complications like ectopic pregnancy & fetal abnormality have been observed using this method.
(d) Basal Body Temperature Or Cervical Mucus Method ::-
This is based on identifying certain psychological changes. On the day of ovulation, the body temperature of the female increases by 0.5 centigrade. Taking the temperature every morning, on the day on which this increase is observed, intercourse should not be done for at least 10 days after ovulation.
This cervical method is also known as billing method. In this method there is a characteristic change of Cervical Mucus. Which is observed. At the time of ovulation, Cervical Mucus is watery, egg white, stooth & slippray in color and is produced in excess, after ovulation the mucus’s thickness and proportion decreases due to the effect of Progestrom. A woman should be trained to recognize this change. By adjusting this method and the rhythm method, the day of ovulation can be more accurate.
(e) Breast Feeding :: –
Lactation continues in Post Partum Period due to which contraceptive effect is also seen. Due to B.. testicles or female genitalia are not ready. Pregnancy does not occur during this period as sperm is not released. Hence due to B.F, naturally there is a gap between the two children.
But once monthly this method works