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- Traditional Nuclear- two parents and children
- Single Parent Family- one parent and children
- Step or blended family- step parents and kids
- extended family- grandparents, aunts
- same sex family (homosexual family/lesbian family)
families have change not necessarily related
- binuclear- divorced parents- remarried, get along (two sets of families)
- Communal- takes a village- group living together (sister wives)
- Grandparents- as parents
- Adolescent- pregnant teens (at risk nutritional)
- cohabiting- me and ricky
- assess family for the strengths- to help build interventions
- assess their ability to do the skill (ie can mom/dad give baby insulin with DM)
Family centered Care
- Childbirth is considered a normal part of life of a family
- childbirth effect the entire family and the family relationship will change
- families are capable of making family decision about their care if given
- adequate or professional support
Family- centered care
Partnerships between- families of children, nurses and providers- inwhich the families and children benefit
respect culture diversity- in plan of care
understanding growth and development needs of children and families
treating children and families as clients
Family- centered Care
- working with all types of families
- work together with families regarding hospitalization, home, community resources
allowing families to experts in their care b/c they may know what is best to treat their child
- encourage families strength and competencies
- assess family's abilities and skills
- educate familes on new abilities and skills to maintain a sense of control meeting the needs of pt
- important to encourage family empowerment, strengthing, and security
development task of families (Duvall, 1977)
- Family Stage
- - couple and family with children- stressors- potty training, not listening, safe,
- - family with adolescents and young adults- safe,
- - family with middle-aged adults- sandwich u have your kids and your parents caring for both parties- preparing for retirement
- - family with older adults- retirement
pg 42- review
- Physical- shelter, safe
- Economic- Finance
- Reproductive- procreate
- Affective and coping- nurturing/emotional comfort
- Socialization- beliefs/values, coping mechanisms
family members all have different roles, and can have more than one role.
- Dictatorial or Authoritarian- never allowed to watch tv on school night
- Democratic or Authoritative- take a vote, if children are good and homework done- setting rules and explain why and why able to change
- permissive- little or no control- child decides what they will do regardless of what u say
- Passive- uninvoled, rejecting
what family like
- who is considered family?
- who is in control?
- who has the most influence on pt?
- what are the ages and sex of the families members?
- what are their occupations?
- what is the health status of family PMH?
- are their any physical limitations that would affect how their help the child
What resources are available to the family?
- can the fam provide pt's physical needs?
- what is the pt's home like? safety? comfort?
- what is the pt's ability to perform self care?
- What neighborhood or community resources available?
- what connections does the family have with friends neighbors, church, community, organizations?
What is the fam educational background, lifestyles, and beliefs?
- What is level of education?
- teach at 5th grade level..
- can someone understand how to take care of fam?
- langauge barries? deaf?
- conflicts between culture belief and plan of care?
- normal dietary pattern?
- able to take in new information? teaching back
- do they feel overwhelm? to learn a new skill
How does family seem to function
- Do they seem sensitive to each other?
- can they communicate?
- do the accept help?
- can they make decision?
- who is the leader?
- how do they react to crisis? f
What is the family's understanding of the current health care problems?
- What do they think cause this?
- How severe do they think the illness is?
- are they in denial
- what is the major problem this illness has caused? financial?
- what doe they fear most about the situation
- Cognitive level?
- pt perception of what they need to do?
- do they understand and agree with treatment
fam assessment- risk factor
- Identify risk factors
- Lifestyles- alcohol abuse, safety, nutrition
- pyschosocial- families not getting along, iadequate resources
- enviromental risk- pollution, food
- developmental risk- brand new baby and no support, older people living alone
- biological- PFH, genetic, poor nutrition, birth defects, mental retardation
Cultural beliefs- maternal and children health
- African america
- Asian American
- Arab americans- only women, male dominanted
- Native american
- Ethnicity- nationality
- Culture- values and beliefs
- Gap in nursing education identified
- - culture sensitivy
- - Sexual minority
- Assessment of sexual identity along with gender identity: best for providing appropriate care
- unique health needs
- increase health disparities
Why is LGBT Health important?
- Reduction in disease transmission and progression
- increase mental and physical well being
- reduction of health care costs
- increased longevity
LBGTQ at risk for
- heart disease- stress from their lifestyle
- HIV, STD
- youth are 2-3x more likely to attempt suicide
- elderly (increase isolation)
- Lesbian and bisexual female- higher incidence of overweight
- higher incidence of mental and physical health issues
- Social Roles- Influence person values and beliefs
- Socioeconomic status
- - feminzation of poverty- single moms
- Vunerable population
- undocumented immigrants and refugees
- persons living in rural areas
- abused/neglected children
- victims of intimate partner violence
- incarcerated women
- persons who are substance abuser
Family Response to Pregnancy
- Maternal age
- Cultural beliefs
- was the pregnancy plan
- family dynamic
- social and economic resources
- age and health status of other family members
- mother's medical and OB history
Impaired parenting relating to premature birth, multiple births, not desired gender as evidenced by
compromised family coping related to lack of mutual decision making as evidence by
interrupted family process related to developmental transition of additional family member as evidence by
Nursing Plan/referrals Interventions
Nursing plan will be based on family stage
- safety in the home
- support group
health Status: maternal/child
- leading cause of death for;
- Infant- congenital anomalies
- children- motor vehicle accident
- pregnancy- related to embolism
- women- CVD
Roles of nurse in Maternal/child health
- Certified nurse mid wife
- registered nurse
- case management
- doula (does not have to be a nurse)
- Certified Pediatric NP