Nursing Goals for Family Planning: Care, Planning, and Evaluation

This report delves into the nursing goals for family planning, beginning with a family assessment using a genogram to visually represent the William family's structure and relationships. It then identifies and discusses two key challenges: breastfeeding and the transition to parenthood. The report outlines nursing care plans, interventions, and evaluations to address issues such as improper latching and support for mothers and infants. The report also explores the importance of parental bonding and provides strategies for nurses to assist families in navigating the transition to parenthood. The report emphasizes the significance of emotional support, proper positioning during breastfeeding, and understanding the emotional dynamics of both parents and infants during the transition period.

Running head: NURSING GOALS FOR FAMILY PLANNING
Nursing goals for family planning
Name of the Student
Name of the University
Author Note

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Part 1: Nursing care of the family
a. The genogram of the William family to visually depict the structure of the
family
= Female
= Male
= Death with year
= Divorce
= Female focus
= Male focus
= Marriage with year
Key:
Steven Hannah Barry Jane
EmilyRonan
n
Billy
SamAriel
MavisHenry
Marion
M 2014
M 1978
2016

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b. The structure of the William family according to the genogram provided above is
explained here. Hannah Williams and Steven Williams are married to each other for 3 years
since 2014. Before Steven, Hannah was married to Barry but their relationship ended followed
by divorce. Billy 5 years old is the only son of Hannah and Barry and shares their joint custody.
Recently, Hannah gave birth to a premature girl child conceived with Steven. Barry is in
relationship with Jane and lives with Emily and Ronan, children of Jane from her previous
relationship. Hannah’s mother Marion lives with her and Hannah’s father Sam lives with his new
wife Ariel in Philippines. Steven’s father, Henry died on last year, 2016. Henry was married to
Mavis on 1978.
c. According to The Australian Family Strengths Nursing Assessment Guide (AFSNAG),
the two strengths that were found in the William family were sharing activities in order to
support each other and acceptance of the situation (Gbur, 2013). These guides help the families
to identify and develop their subsequent strengths to bring out positive changes in family
functioning. These strengths were observed by the nurses by watching their behaviour or by
asking questions to them. One of the strength in the William family was sharing the activities.
This strength was evident from the behaviour of Steven as Hannah recently gave birth to a
premature baby and she required some time to recover from the caesarean delivery. Therefore in
order to provide a healthy orientation he planned to take his family to the local golf club for
lunch because that would help them to meet new people as due to commitments in work place
and moving to a new place they hardly met new friends. But he was bit concerned about the
financial management in the coming six months as due to Hannah’s pregnancy they hired a paid
manager to look after her boutique business and thus he wanted Hannah to get back to her work
as soon as possible. When Steven was asked about handling the crying baby in the morning, he

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replied that he got golf rounds in the morning and Hannah was accustomed to sort this problem
as she experienced it earlier when her son Billy was a baby. Although he planned to help her in
cooking after getting back home. The second strength was the acceptance of not resuming back
into their sexual relationship. He anticipated the decision of not involving into any sexual
relationship at that very moment as Hannah underwent a caesarean delivery recently. He
believed that they will resume back to their sexual relationship within two week and things will
be normalised. He even added up to the fact that as her wife was on leave from work, she would
be able to take proper rest and relaxed. This would help them to get back to their normal sexual
relationship.
Part 2: Nursing Care of the Family: Planning, Implementing and Evaluating
The two challenges or issues faced by the William family were breastfeeding and
transition to parenthood. The first issue is breastfeeding faced by both the baby and the mother.
Several challenges are faced by the mother while breastfeeding (Rollins et al., 2016). The most
common is latching the baby properly and improper latching leads to sore nipples in mother and
insufficient milk to the baby (Holmes, 2013). Pinching pain in the nipple area if persists after
four days implies improper latching of the baby. Another issue is the formation of tender lump in
the breast area which suggests that the duct that connects the glands producing milk to the nipple
is clogged. The concerned issue in case of Hannah in this study was taking extra help to
breastfeed her baby as she underwent a caesarean delivery and needed time to recover her heal. It
takes longer time for the milk to secrete in caesarean cases with problem in latching due to
improper position of the other (Dahl, 2015). Postoperative pain is common in this cases which
challenges the mothers from enjoying the first few days of motherhood.

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a. One of the issues faced in breastfeeding is the improper latching of the baby that can
lead to soreness of the nipple and insufficient intake of the milk by the baby (Kent et al., 2015).
Providing proper nursing management can solve the problem. The nurse in charge should
recommend the mother to position her body properly in a relaxed state as this helps better flow
of milk. A proper nursing station should be provided with a comforting chair having sufficient
pillows to support and a peaceful environment. Secondly, the position of the baby should be
maintained by holding the baby under the arm and closer to breast by supporting the baby’s neck
with hand. In case of mother lying sideways, the baby should face towards the breast keeping the
mouth at the nipple level. Then cupping the breast with fingers along with palm below and on
top with thumb should be done. It should be ascertained that the baby sucks the milk from the
areola inspite of the nipple. In order to avoid painful feeding from the breast, baby’s gum should
grab a radius of one inch surrounding the nipple at the time of latching. Compressing the areola
region of the breast successfully provides sufficient milk to the baby as the sinuses for milk are
situated below the areola of the breasts (Simpson, 2017).
One of the interventions related to successful breastfeeding in nursing health care is by
supporting the mothers to breastfeed their babies (Renfrew et al., 2012). The initiation of the
breastfeeding starts with proper skin contact between the mother and the baby. The
encouragement of having unhurried contact of the mothers’ skin to their babies immediately after
birth is one of the possible strategies. During this procedure, the physiological along with the
emotional benefits about the skin contact should be made aware to the mothers. Making direct
contact ok skin makes both the mother and the newborn baby calm by keeping the baby warm.
The breathing rate and the heart rate are stabilised with facilitating increased hormonal release
that initiates a new bond in the mother with the baby. The first breastfeeding starts immediately

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after the baby is born by initiating skin contact (Moore et al., 2012). With this procedure, both
the mother and the newborn baby get alert towards each other. In some cases the baby develops
an attachment with the breast with any assistance. During the first breastfeeding time, the care
giver supports the mother in proper positioning of the body and helping in proper attachment.
Successful breastfeeding can be obtained in three steps. With proper assistance and support
breastfeeding occurs naturally and works fine with 99% mothers with their babies (Guyer, J
Millward & Berger, 2012). However, when the mother grows surrounding the bottle feeding,
certain things about the breastfeeding should be known. Breastfeeding should be started early to
starts early milk production so that if the baby is born immature, the mother will have to express
breast milk (Meier et al., 2013). Secondly, the mothers should know that breastfeeding should
not cause pinching sensation in their nipple or cause pain producing sore nipple. Lastly
breastfeeding should be done whenever required in order to comfort the baby and assuring
sufficient supply of milk (Bealafeld, 2015). Breastfeeding is always surrounded with strong
emotions both in the mother and the baby. Thus it is essential to encourage the mothers and the
caregivers to understand how the baby can feel while breastfeeding. Both breast feeding and
bottle feeding are accomplished by eye contact thereby increasing the emotional bond and
intimate sensation between the mother and the infant (Brookes, Harvey & Mullany, 2016).
b. Another major challenge in family planning is the transition to parenthood. Mental
satisfaction sometimes declines following the birth of a chid due to stresses in looking after the
infant (Lutz et al., 2012). Apart from enjoying the parenthood, certain challenges impact the
development of the child. Births occurring immediately after marriage play negative impact on
the couple relationship leading to separation followed by divorce (Gottman, 2014). According to
some research studies it has been found that women become more unsatisfied during the

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transition of motherhood in comparison to men (Mortensen et al., 2012). Women are found to be
more vulnerable towards the challenges of parenthood as the workload increases with giving
primary care to the baby along with other household works. Socioeconomic status also affects
the women who left their jobs to experience motherhood struggle more in the transition period
(Goldenberg & Goldenberg, 2012). A little is known about the impact on parenting due to
disturbed sleep. The factor challenge that the couples face is the marital satisfaction such as
thoughts about how their partner feels, affection, conflict in prenatal stage and withdrawal.
Factors related to child such as child with temperament and always crying challenges the
wellbeing in parenthood transition especially in fathers.
One of the nursing goal to prevent the challenges in transition to parenthood is the
supporting the parents for forming a parental bond with the new born (Cockcroft, 2012). The
process through which the parents develop love and acceptance towards the child is called
attachment. The bonding should be accomplished immediately by forming close contact with the
baby in the few first hours of the birth both from mothers and fathers side (Dermott, 2014).
Attachment is established by maintain a close proximity with the infant by whom the parents
become acquainted with the baby and starts accepting the baby as the new member of the family.
This process develops through positive feedbacks such as through socially, verbally with non
verbal responses (Schaffer, 2013). The attachment is perceived by mutuality through the
behaviour of the infant eliciting the behaviours of the parents. When the infant expresses signals
such as through crying, cooing and sometimes smiling, these initiates the parents close to them.
Following this behavioural signals other signals such as grasping with postural adjustments also
maintains the attachment. Care givers are more attracted towards the infants who are alert and

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responsive but if the infant becomes irritable, the care givers repel themselves from the
attachment process.
Among many interventions in transition to parenthood, implementing the role of the
parents after the birth of the newborn is one of them. The transition to parenthood is considered
as a period of disequilibrium and sometimes a period of satisfaction in the mothers and their
partners (Wolkoff, 2014). Some parents, specially the men think their spouse to be their only
support and this transition brings a feeling of deprivation when their spouses are unable to
provide that support. Emotions like feeling helpless, inadequate and anger when dealing with a
crying infant makes many parents not ready to accept the transition. Fathers can undergo
interventions in order to improve their relationship with their infants (Alio et al., 2013). Nurses
can make arrangements to teach them about the infant care and provide necessary guidance
regarding the acceptance of the transition to parenthood. Separate sessions of prenatal along with
parenting classes and the groups that provide parenting support for the fathers can give them a
chance to discuss about their concerns by meeting some of their demands. Making home visits
by the nursing staffs includes assessment time to help adjust the need of the fathers. This
intervention can successfully fulfil the gap between the fathers and the infant as they gets less
time to spend with their new born baby to meet other demands. The effectiveness of this
intervention is to build up a strong communication between the two and thereby granting delights
by the response of the infants. It builds a sense of feeling proud and matured with increased self
esteem (Liang, 2017). From the following study, it can be said that implementing this strategy
towards Steven who recently became father can bring a positive inclination in his parenthood.
When the nurse asked him how he would manage if woken up in the morning by the baby, he
replied that as he got his golf session his wife would better handle the situation as she had

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experienced early parenthood. He even confirmed to spend with his family in the weekends if the
baby does not cry. Interventions with thorough knowledge about parenthood would effectively
build a positive response in Steven towards his infant.

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References:
Alio, A. P., Lewis, C. A., Scarborough, K., Harris, K., & Fiscella, K. (2013). A community
perspective on the role of fathers during pregnancy: a qualitative study. BMC pregnancy
and childbirth, 13(1), 60.
Bealafeld, L. (2015). Initiating skin-to-skin in the operating room: program planning,
implementation, and evaluation (Doctoral dissertation, University of Pittsburgh).
Brookes, G., Harvey, K., & Mullany, L. (2016). 'Off to the best start'? A multimodal critique of
breast and formula feeding health promotional discourse. Gender & Language, 10(3).
Cockcroft, S. (2012). How can family centred care be improved to meet the needs of parents
with a premature baby in neonatal intensive care?. Journal of Neonatal Nursing, 18(3),
105-110.
Dahl, L. (2015). Clinician’s Guide to Breastfeeding.
Dermott, E. (2014). Intimate fatherhood: A sociological analysis. Routledge.
Gbur, M. (2013). Effects of Blackboard on the work-life balance of students and
lecturers (Bachelor's thesis, University of Twente).
Goldenberg, H., & Goldenberg, I. (2012). Family therapy: An overview. Cengage Learning.
Gottman, J. M. (2014). What predicts divorce?: The relationship between marital processes and
marital outcomes. Psychology Press.
Guyer, J., J Millward, L., & Berger, I. (2012). Mothers' breastfeeding experiences and
implications for professionals. British journal of midwifery, 20(10).

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Holmes, A. V. (2013). Establishing successful breastfeeding in the newborn period. Pediatric
Clinics, 60(1), 147-168.
Kent, J. C., Ashton, E., Hardwick, C. M., Rowan, M. K., Chia, E. S., Fairclough, K. A., ... &
Geddes, D. T. (2015). Nipple pain in breastfeeding mothers: incidence, causes and
treatments. International journal of environmental research and public health, 12(10),
12247-12263.
Liang, H. (2017). Inside Out Parenting: How to Build Strong Children from a Core of Self-
Esteem. Pan Macmillan.
Lutz, K. F., Burnson, C., Hane, A., Samuelson, A., Maleck, S., & Poehlmann, J. (2012).
Parenting Stress, Social Support, and Mother‐Child Interactions in Families of Multiple
and Singleton Preterm Toddlers. Family relations, 61(4), 642-656.
Meier, P. P., Patel, A. L., Bigger, H. R., Rossman, B., & Engstrom, J. L. (2013). Supporting
breastfeeding in the neonatal intensive care unit. Pediatric Clinics, 60(1), 209-226.
Moore, E. R., Anderson, G. C., Bergman, N., & Dowswell, T. (2012). Early skin-to-skin contact
for mothers and their healthy newborn infants. Cochrane Database Syst Rev, 5(5).
Mortensen, Ø., Torsheim, T., Melkevik, O., & Thuen, F. (2012). Adding a baby to the equation.
Married and cohabiting women's relationship satisfaction in the transition to
parenthood. Family process, 51(1), 122-139.
Renfrew, M. J., McCormick, F. M., Wade, A., Quinn, B., & Dowswell, T. (2012). Support for
healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst
Rev, 5(5).

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Rollins, N. C., Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C. K., Martines, J. C., ... &
Group, T. L. B. S. (2016). Why invest, and what it will take to improve breastfeeding
practices?. The Lancet, 387(10017), 491-504.
Schaffer, R. (2013). Early social development. Becoming a Person, 1(5).
Simpson, A. C. (2017). Boost Your Breast Milk: An All-in-one Guide for Nursing Mothers to
Build a Healthy Milk Supply. Workman Publishing.
Wolkoff, S. R. (2014). Paternal Empathy: A Moderating Effect on Maternal Mood and Marital
Satisfaction in the Transition to New Parenthood. Adelphi University, School of Social
Work.