Maternal-Child Nursing Care: Optimizing Outcomes for Mothers, Children, & Families

1260 Pages·2009·54.87 MB·English

by  Susan L. Ward

Contents in Brief
unit one 17 Physiological Transition of the Newborn 541
Foundations in Maternal, Family, and Child 18 Caring for the Normal Newborn 563
Care 1
19 Caring for the Newborn at Risk 603
1 Traditional and Community Nursing Care for unit six
Women, Families, and Children 1
Caring for the Child and Family 639
2 Contemporary Issues in Women’s, Families’, and
Children’s Health Care 25 20 Caring for the Developing Child 641
3 The Evolving Family 46 21 Caring for the Child in the Hospital and in the
4 Caring for Women, Families, and Children in Community 664
Contemporary Society 71 22 Caring for the Family Across Care Settings 701
unit two unit seven
The Process of Human Reproduction 111 Ongoing Care of the Child in the Hospital
and in the Community 715
5 Reproductive Anatomy and Physiology 113
6 Human Sexuality and Fertility 137 23 Caring for the Child with a Psychosocial or
Cognitive Condition 717
7 Conception and Development of the Embryo and
Fetus 164 24 Caring for the Child with a Respiratory
Condition 750
unit three
25 Caring for the Child with a Gastrointestinal
The Prenatal Journey 191 Condition 785
26 Caring for the Child with an Immunological or
8 Physiological and Psychosocial Changes During
Infectious Condition 819
Pregnancy 193
27 Caring for the Child with a Cardiovascular
9 The Prenatal Assessment 215
Condition 853
10 Promoting a Healthy Pregnancy 256
28 Caring for the Child with an Endocrinological or
11 Caring for the Woman Experiencing Complications Metabolic Condition 885
During Pregnancy 291
29 Caring for the Child with a Neurological or
unit four Sensory Condition 921
The Birth Experience 353 30 Caring for the Child with a Musculoskeletal
Condition 962
12 The Process of Labor and Birth 355 31 Caring for the Child with an Integumentary
13 Promoting Patient Comfort During Labor and Condition 995
Birth 399 32 Caring for the Child with a Renal, Urinary Tract,
14 Caring for the Woman Experiencing Complications or Reproductive Condition 1033
During Labor and Birth 427 33 Caring for the Child with a Hematological
Condition 1071
unit fi ve
34 Caring for the Child with Cancer 1104
Care of the New Family 467
35 Caring for the Child with a Chronic Condition or
15 Caring for the Postpartal Woman and Her the Dying Child 1133
Family 469
16 Caring for the Woman Experiencing Complications
During the Postpartal Period 511
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Maternal-Child
Nursing Care
Optimizing Outcomes for Mothers, Children, and Families
Susan L. Ward, PhD, RN
Professor of Nursing
Nebraska Methodist College
Omaha, Nebraska
Shelton M. Hisley, PhD, RNC, WHNP-BC
Assistant Professor of Nursing (Retired)
University of North Carolina at Wilmington
Wilmington, North Carolina
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F.A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2009 by F.A. Davis Company
Copyright © 2009 by F.A. Davis Company. All rights reserved. This book is protected by copyright. No
part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,
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Printed in the United States of America
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Publisher, Nursing: Lisa Deitch
Developmental Editor: Shirley Kuhn
Content Development Manager: Darlene Pedersen
Senior Project Editor: Padraic Maroney
Manager of Art and Design: Carolyn O’Brien
Cover Illustration: Jose Ortega
As new scientifi c information becomes available through basic and clinical research, recommended
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Caution is especially urged when using new or infrequently ordered drugs.
Library of Congress Cataloging-in-Publication Data
Ward, Susan L.
Maternal-child nursing care: optimizing outcomes for mothers, children, and
families / Susan L. Ward, Shelton M. Hisley.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-8036-1486-4 (alk. paper)
ISBN-10: 0-8036-1486-1 (alk. paper)
1. Maternity nursing--Textbooks. I. Hisley, Shelton M. II. Title.
[DNLM: 1. Maternal-Child Nursing--methods. 2. Cultural Diversity. 3.
Evidence-Based Nursing--methods. 4. Holistic Nursing--methods. WY 157.3
W263m 2009]
RG951.W37 2009
618.2’0231--dc22 2008051815
Authorization to photocopy items for internal or personal use, or the internal or personal use of specifi c
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license by CCC, a separate system of payment has been arranged. The fee code for users of the
Transactional Reporting Service is: 8036-1486-4/09 0 (cid:2) $.25.
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In loving memory of my mother, Betty A. Tighe, who always said “it’s possible”.
With great love and appreciation to my family, particularly to my intelligent
children Kathleen, Frank, and William.
To my co-author, Shelton Hisley, who has amazing fortitude. To faculty,
administration, and staff at Nebraska Methodist College.
To the skilled and caring nurses at Children’s Memorial and Methodist Hospitals.
To my dear friend, Jeanne Snowden.
Susan Ward
To my husband, Jack, whose love and encouragement, especially during the dark
days of my cancer diagnosis and treatment, kept me aloft and convinced that I could
achieve this goal.
To my parents, Barbara and Hubert McLendon, for a lifetime of love and support.
Also to Susan, my co-author and friend, for whom I hold the greatest admiration
and respect.
Shelton Hisley
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Preface
Maternal–Child Nursing Care: Optimizing Outcomes for different outpatient settings. With this text, students learn
Mothers, Children, and Families springs from our passion- that community-based care can take place in a variety of
ate commitment to providing the best nursing care possi- ways at any time and in any place. It is our hope that the
ble to mothers and children and our desire to inspire oth- users of this textbook will acquire the essential knowledge
ers to make that same commitment. In this all-inclusive for professional nursing practice in the specialties of
source, we provide students with current, comprehensive maternal and child nursing and that they will gain insights
information about maternal–child nursing in creative, about providing nursing care in a myriad of settings and
dynamic ways and in a concise, accessible format. Building with diverse populations.
upon theoretical foundations in basic nursing care, com-
munication skills, and principles of health promotion, the
text challenges students to optimize outcomes for their Organization
maternal and pediatric patients using critical thinking as
they care for them in the hospital and community environ- Each chapter opens with a culturally or spiritually oriented
ments. We focus on aesthetics, cultural sensitivity, and a story, literary piece, caring element, or quotation that cre-
caring approach. The textbook also serves as an excellent atively expresses various dimensions of aesthetics in nurs-
resource for practicing nurses who work with women, ing. Because contemporary nursing is a dynamic profession
children, and families in a variety of settings. We believe with a rich past, present, and future, we emphasize and
that combining essential information about the two spe- promote the importance of innovative, state-of-the art tech-
cialties into a single textbook supports good educational nology balanced with compassionate, humanistic care.
practice while being economically practical. “Learning Targets” offer a guided approach to chapter con-
tent and provide a gauge for assessing outcomes.
Chapter introductions provide a preview of content and
Philosophy assist students in identifying essential information and
major concepts. Key words appear in boldface print accom-
The primary objective of this textbook is to identify the panied by brief defi nitions in the text and are grouped in
myriad of options for holistic, evidence-based practice in the glossary for easy, quick reference on the Electronic
maternal and child nursing care in this new millennium, Study Guide. Color illustrations and photos provide visual
based on a philosophy of physiological and developmental cues to enhance understanding. These features facilitate
normalcy and stressing safety and optimization of outcomes students’ learning and promote an understanding of the
for mother and child. In addition to comprehensive cover- relationship between classroom or textbook information
age of maternal and child nursing care in traditional set- and the delivery of nursing care in the clinical setting.
tings, essential elements for providing cost-effective, high- A short review of anatomy, physiology, and pathophysi-
quality, innovative nursing care in community settings are ology is provided in applicable chapters to foster under-
presented. Discussion of health care delivery in community standing of new applications of concepts previously
settings is crucial in contemporary nursing education and learned. Eye-catching display boxes draw students’ atten-
refl ects the present trend for women, families, and children tion to essential information about medications, critical
to obtain health care in the diverse settings in which they nursing actions, nursing procedures, related research stud-
live, grow, play, work, or go to school. ies, assessment tools, diagnostic modalities, safety issues,
This book is built upon a framework that views the therapeutic communication strategies, and family teaching
delivery of nursing care as a continuum spanning the tra- guidelines.
ditional hospital in-patient environment to the community Each chapter concludes with a concept map that visually
setting. Students are presented with information essential summarizes the relationships among the most important
to providing appropriate, culturally sensitive nursing care concepts presented. The map reinforces students’ learning,
to women, families, and children. A variety of creative promotes mastery of information, and assists students in
learning aids are used to assist students in subject mastery critical analysis. It is a useful tool for confi rming that stu-
and prompt the delivery of care that appropriately addresses dents have identifi ed the essential chapter elements and for
contemporary needs while incorporating innovative applying classroom information to the clinical setting.
approaches that integrate provider–patient partnerships A number of strategies designed to prompt and enhance
and alliances with coalitions that serve women, families, critical thinking weave through the text. Case studies, nurs-
and children across the lifespan. Because the traditional ing care plans, NCLEX-style review questions, and exer-
hospital experience constitutes an important component cises in clinical decision-making assist students in master-
of nursing education, content on hospital-based nursing ing content and in integrating new information. These
care for women, families, and children examines acute, creative learning activities help students to assimilate and
traumatic, chronic, and terminal conditions. Likewise, internalize information as they build upon previously
content that addresses community-based nursing care for learned nursing knowledge and prepare to apply newly
women, families, and children explores strategies and introduced concepts in various maternal–child clinical
resources for the provision of appropriate care in many practice areas.
ix
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x preface
Themes and Key Features actual patient situations. As students work through the
various case studies, they are challenged to apply criti-
The overarching theme of this comprehensive maternal– cal thinking and practice clinical decision-making.
child resource focuses on how to provide contemporary (cid:129) Nursing Diagnoses foster the development of new
nursing care to women, families, and children in the com- nursing knowledge where diagnoses are developed
munity as well as in the traditional hospital setting. In based on information obtained during a nursing
service to that goal are the broad themes of holistic care, assessment. A standardized statement about the health
critical thinking, validating practice, and tools for care. of a patient is created for the purpose of providing
We use the following key features throughout the chap- nursing care. The nursing diagnoses portray patients’
ters to creatively illustrate and emphasize information responses to their condition where the nurse can
essential for the delivery of safe, effective nursing care to address the problems independently.
diverse populations across care settings, thus ensuring an (cid:129) “Clinical Alerts” help students recognize emergent
educational experience rich with critical thinking activi- or critical situations and relate classroom or text-
ties and clinical application opportunities. book information as they deliver safe, effective
nursing care in the hospital and community-based
HOLISTIC CARE environments.
(cid:129) “Critical Nursing Actions” prompt students to assimi-
(cid:129) Each chapter begins with a culturally or spiritually ori-
late and internalize information as they prepare to
ented story, literary piece, caring element or quotation
apply important concepts in the clinical area.
that creatively expresses aesthetics in nursing.
(cid:129) NCLEX-style review questions located at the end of
(cid:129) “Nursing Insight” boxes show students how experi-
each chapter prompt and enhance critical thinking and
enced nurses use their fi ve senses to gain a deeper
help to prepare students for licensure examination.
understanding about the clinical situation or the
(cid:129) Concept Maps visually summarize the relationships
patient’s condition.
among the most important concepts presented in
(cid:129) “Collaboration in Caring” provides guidelines for
every chapter. The concept map can be used by stu-
working with other health care professionals to care
dents to think critically, to review, and to more clearly
for patients and families in in-patient and community-
see the application of classroom information to the
based environments.
clinical setting.
(cid:129) “Ethnocultural Considerations” emphasize cultural
humility in both the hospital and community settings.
VALIDATING PRACTICE
(cid:129) “What to Say” helps students develop and enhance
their communication skills by providing verbatim (cid:129) “Moving Toward Evidence-Based Practice” highlights
examples or helpful hints. current relevant research and encourages students to
(cid:129) Nursing Care Plans incorporating NANDA, NOC, incorporate evidence-based fi ndings into their every-
and NIC terminology relate classroom and textbook day practice.
knowledge to clinical practice, while evidence-based (cid:129) “Optimizing Outcomes” enhance critical thinking
rationales for interventions show how research sup- skills for clinical application and help establish the
ports practice. best possible outcomes and how to obtain them.
(cid:129) “Complementary Care” shows students the wide range (cid:129) “Where Research and Practice Meet” focus on investi-
of complementary options available for integration gative initiatives that may impact practice in the future,
with conventional approaches to provide safe, timely, underscoring the value of clinical inquiry in ensuring
and compassionate care. positive outcomes for patients and their families.
(cid:129) “Across Care Settings” foster students’ responsiveness (cid:129) “Be Sure To…” alert new nurses to important legal
to trends in health care by highlighting holistic health issues that impact the clinical environment and help
care in acute care and community-based settings in them recognize how to critically analyze potentially
which children and families live, grow, play, work, or litigious situations.
go to school. Sensitivity to diverse patient populations (cid:129) “Now Can You?” prepares students to assimilate and
is also underscored. internalize information presented throughout the
(cid:129) “Family Teaching Guidelines” help students teach chapter and serve as a mini check to ensure mastery of
families essential components about caring for them- material before proceeding to the next section.
selves and their children and are offered both in (cid:129) “Summary Points” bring together the information
English (in the text and on the Electronic Study students should be most careful to comprehend from
Guide) and Spanish (on the Electronic Study Guide). the chapter.
(cid:129) References provide current citations that validate prac-
CRITICAL THINKING tice and support the chapter content.
(cid:129) “Learning Targets” offer a guided approach to chapter
TOOLS FOR CARE
content and provide a gauge for assessing outcomes.
(cid:129) Key words appear in boldface type accompanied by (cid:129) “A & P Review” of chapter-specifi c anatomy, physiol-
brief defi nitions. Key words are also stored in the glos- ogy, and pathophysiology foster understanding of new
sary for easy, quick reference on the Electronic Study applications of previously learned concepts.
Guide and DavisPlus. (cid:129) “Labs” boxes present crucial information about labora-
(cid:129) “Case Studies” facilitate students’ practice in the tory testing and its relationship to the patient’s overall
assimilation of content from various chapters into health status.
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preface xi
(cid:129) Procedures provide step-by-step instructions for per- areas of strength and weakness and prepare for course
forming common procedures in maternal–child tests and the national licensure examination.
nursing and the rationales for why things are done a
particular way. Each procedure includes an example of PowerPoint Presentations
documentation to emphasize the critical nature of A collection of slides is provided that form the basis for a
proper, accurate documentation. lecture for each chapter, which can be modifi ed based on
(cid:129) “Medication” boxes present crucial information about the instructor’s preferences.
commonly prescribed medications and help students
in their care of mothers, children, and families. Media Ancillary
(cid:129) “Assessment Tools” facilitate understanding of clinical Electronic fi les of the images from the text are included
evaluation and help students make the connection for use in the classroom, as are audio selections of heart
between classroom or textbook knowledge and the sounds.
clinical setting.
(cid:129) “Diagnostic Tools” present crucial information about ELECTRONIC STUDY GUIDE
common diagnostic measures and their relationship to
A complimentary electronic study guide is included with
various disease entities.
the text. This is intended to assist and enhance students’
learning and offers creative ways to supplement and rein-
force the textbook information. It contains the following:
Teaching Ancillaries and Other
Related Products Interactive Exercises
These provide a creative and enjoyable way to enhance
INSTRUCTOR’S RESOURCE DISK students’ learning and include:
The components on the Instructor’s Resource Disk seam- (cid:129) Hangman
lessly guide faculty through the content and offer innovative (cid:129) Quiz Show
strategies for creatively supplementing the text. This com- (cid:129) Critical Thinking
plete and easy-to-use collection of teaching aids for mater- (cid:129) Drag and Drop Bucket
nal–child content includes the following components. (cid:129) Fill-in-the-Blank Clue
Instructor’s Guide Case Studies
The course syllabus includes a proposed class schedule for Thirty-one relevant case studies from selected chapters
a traditional 15-week semester and for an accelerated 8- facilitate students’ practice in the assimilation of content
week semester along with reading assignments and testing from various chapters into actual patient situations.
content. The syllabi provide a guide for using the text in
the most effi cient way. Nursing Care Plans
“Teaching Plans” provide a user-friendly lesson plan All care plans from the textbook are provided and are
for each chapter whether teaching in separate or com- printable. There are also twelve expanded care plans that
bined courses. The Teaching Plans integrate teaching are not included in the text (six for Obstetrics and six for
tips, PowerPoint presentations, and suggested students Pediatrics) to provide in-depth information and guidance
assignments. for planning and providing care to maternity and pediatric
“Tips for Teaching a Combined Maternal–Child patients with commonly encountered normal and patho-
Course” offer suggestions about how to effectively teach logical conditions.
these two specialties in one course.
Family Teaching Guidelines
Case Studies English and Spanish versions of the Family Teaching
The case studies provided to the instructor are more Guidelines from the text, as well as additional ones unique
extensive and detailed than those provided in the text or to the Electronic Study Guide, can be personalized and
on the Electronic Study Guide so they can be used for test- printed and used in actual patient care situations.
ing as well as post-conference discussions. Answers to the
case studies are provided to promote and enhance critical NCLEX-style Review Questions
thinking skills and facilitate the application of theoretical A collection of NCLEX-style questions and rationales can
concepts into the clinical setting. help students identify areas of strength and weakness,
and prepare for course tests and the national licensure
Concept Maps examination.
Concept maps are constructed to underscore the relation-
ships among the essential concepts in each chapter. They Sound Collection
prompt critical thinking and may be used as a guide for Heart sounds depicting various normal and abnormal heart
students assigned to create additional maps about other sounds are included to help students recognize when there
important theoretical elements. is a problem.
Electronic Test Bank Podcasts
The electronic test bank is a collection of NCLEX-style Podcasts directs students to key chapter concepts and
questions and rationales to enable students to identify reinforces essential information.
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xii preface
Concept Maps Thank you for choosing Maternal–Child Nursing Care:
For students’ convenience, all concept maps from the text Optimizing Outcomes for Mothers, Children, and Families. It
are included on the Electronic Study Guide. is our sincere hope that this textbook and ancillary package
will provide you with the tools needed to convey the essen-
Clinical Pathways tials of care for the childbearing/child-rearing family.
Clinical pathways display patient goals and corresponding We believe that providers of contemporary nursing
sequence nursing actions to achieve those goals. education are challenged to present timely, evidence-
based information grounded in a framework of holistic,
DavisPlus Website compassionate care. We appreciate that you will bring
your own unique approach as you guide students toward
In addition to all the Web-suitable content from the
providing competent, sensitive care for mothers, children,
Instructor’s Resource Disk and the Electronic Study Guide
and families. We share your passion for maternal–child
(instructor materials are password protected; students’
nursing and hope that this learning package may be
materials are not), the Web site contains Internet links
instrumental in sparking this same passion in others.
related to specifi c content areas presented throughout the
book; links to useful Web sites, links to the F.A. Davis
Web site and product page, and bonus material, including
interactive exercises for pediatric dosage calculations.
CLINICAL POCKET COMPANION
TO MATERNAL–CHILD NURSING
The separate, for-sale Clinical Pocket Companion contains
critical information to facilitate the delivery of safe, effec-
tive, compassionate care in maternity and pediatric clinical
settings. Information is extracted from the core text and is Susan L. Ward
presented in easy-to-access formats. In addition to nursing
skills and procedures, nursing tools and charts, and color
illustrations from the parent text, each chapter in the Clini-
cal Pocket Companion covers:
(cid:129) Key Terms
(cid:129) Focused Assessments
(cid:129) Clinical Alerts
(cid:129) Diagnostic Tests
(cid:129) Medications
(cid:129) Ethnocultural Considerations
(cid:129) Teaching the Family Shelton M. Hisley
(cid:129) Additional Information for the Clinical Setting
(cid:129) Resources
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