Nursing Interventions in Maternal Child Care

Stressful situations can slow down the flow of feel-good oxytocin hormones, which are essential for the nursing process (Smith, 2014). The stressful environment brought on by conflict in Juanita’s home means that she always mitigates or attends to conflict situations and is, therefore, less stimulated to produce breast milk. Breaking down in front of the nurse indicates a highly stressed-out psychological state, caused by the relationships that should otherwise support her in the post-delivery period (Smith, 2014).

Juanita and her family could have avoided this problem by reducing the number of significant changes made in the postnatal period (Perry et al., 2014). In this case, it would involve not inviting her mother over, which would have caused her stress and guilt. Another option is to get the mother a place of her own to reduce the conflicts between her, Juanita and her husband. This separation would decrease the number of possible confrontations and establish boundaries, leading to a better and more hospitable breastfeeding environment for Juanita (Smith, 2014).

One of the safest solutions is to allow the fecal matter to pass naturally, with little intervention from the nurse. Postnatal constipation is often the result of slowed digestion during labor or iron tablets taken during the pregnancy period (Kerber, et al., 2007). In fact, if possible, Juanita’s breastfeeding scenario proposes the use of little or no chemical interventions. The nurse should suggest that Juanita simulates a natural and relaxed bowel movement and does not strain herself, to reduce the risk of tearing her stitches. If this does not work, the nurse could prescribe a dose of Glycerol, which could complete its task in 5 – 30 minutes (Kerber, et al., 2007).

The first test would be to check whether Juanita positions the baby in the right place for breastfeeding by tucking the baby close to her body. The nurse would then check whether the baby attaches properly to the breast and maintains this attachment until it finishes feeding. The baby should also have an effective sucking pattern, with a slow and rhythmic being the preferred option. The baby should also have a regular swallowing pattern. Failing any of these checks indicates that Juanita may have a breastfeeding problem that requires further intervention (Kerber, et al., 2007).

There are several community resources that could benefit the family, depending on their location and access to internet services. One example is the Holistic Moms Network based in New Jersey, which connects mothers who then share information on creating the best psychological, physical and spiritual environments for their children (Smith, 2014). This network would be especially useful for Juanita since it would emphasize the need for a hospitable home environment for both her and her infant.

The RhoGAM injection reduces the chances that her Rhesus negative immune system will create antibodies to counter her baby’s Rhesus positive blood (Perry et al., 2014). Since she has already received the shot, she should have no complications the next time she conceives, regardless of the baby’s Rhesus factor. The Rhesus incompatibility between her and her husband, however, places Juanita in a position where she has to repeat the injection any time she has a delivery, abortion or miscarriage that is Rhesus positive in nature.

Juanita’s mother’s cultural knowledge prevents her from understanding that medically, there are very few restrictions placed on the mother post-delivery movements. Once her stitches have healed adequately, Juanita can venture out and resume her daily activities (Perry et al., 2014). A two-week period is sufficient enough to allow for proper healing, provided she does not take part in strenuous activities. The nurse should emphasize the need for Juanita to communicate this information to her mother and reduce the conflicts between their differing viewpoints.

This finding indicates that the parenting methods proposed by Juanita’s mother take precedence over Juanita’s. Safety pins are considered unsafe for use on infants’ clothes and by allowing her baby to wear one, Juanita indicates her subservience to her mother’s beliefs. Subservience in turn means that the baby’s upbringing will align itself more with the cultural beliefs held by Juanita’s mom as opposed to the information that Juanita herself possesses (Dulzura, 2008). It also indicates that in the absence of external interventions, these cultural expectations will continue dictating the lives of Juanita and her baby at the expense of Juanita’s psychological well-being.

The string is another indication of Juanita’s mother’s cultural inclinations and their effect on the baby’s life. It connects to superstition in Juanita’s community, where the string supposedly keeps the child safe from evil (Dulzura, 2008). Juanita looks embarrassed because she does not place the same significance as her mother does on these superstitions. Although she may have adverse connotations towards her mother’s superstitions, she allows them all the same and in turn, her mother’s decisions take precedence over her own when caring for the infant.

The nurse should offer Juanita real information concerning the allowable postnatal activities. Such information includes the fact that a post-delivery shower is highly recommended in medical circles. It allows the mother to soothe her stitches while also easing any hemorrhoid-related complications that may have arisen during the birth (Perry et al., 2014). To maximize the positive effects of this process, Juanita should ensure that she takes her bath in a sanitary manner to avoid infecting her stitches. In fact, the nurse should encourage Juanita to go take the shower for both its hygienic and therapeutic properties.

References

Dulzura. (2008). Mexican Folk Beliefs Regarding Pregancy, Eclipse and Other Natural and Supernatural Things. Web.

Kerber, K. J., de Graft-Johnson, J. E., Bhutta, Z. A., Okong, P., Starrs, A., & Lawn, J. E. (2007). Continuum of Care for Maternal, Newborn and Child Health: From Slogan to Service Delivery. Lancet, 1358-1369.

Perry, S. E., Hockenberry, M. J., Lowdermilk, D. L., & Wilson, D. (2014). Maternal Child Nursing Care (5th ed.). Mosby.

Smith, S. S. (2014). Postpartum Tranquility. Savor the Moments. Wait…what? Web.