Maternal, Neonatal, and Women's Health Nursing (Maternal, Neonatal, & Women's Health Nursing)

1388 Pages·2001·21.71 MB·English

by  Lynna Y. Littleton

Maternal, Neonatal, and
Women’s Health
Nursing
Lynna Y. Littleton, RNC, PhD
and
Joan C. Engebretson, RN,
DrPH, HNC
Delmar / Thompson Learning
BRIEF CONTENTS
UNIT I: FOUNDATIONS OF CHAPTER 21: ENVIRONMENTAL RISKS AFFECTING
NURSING CARE 1 FETAL WELL-BEING 605
CHAPTER 1: NURSING IN THE CONTEMPORARY
CHAPTER 22: EVALUATION OF FETAL WELL-BEING643
HEALTH CARE SYSTEM 3
UNIT VI: CHILDBIRTH 675
CHAPTER 2: ISSUES IN MATERNAL, NEONATAL,
AND WOMEN’S HEALTH 29 CHAPTER 23: PROCESSES OF LABOR AND
DELIVERY 677
CHAPTER 3: THEORETICAL PERSPECTIVES
ON THE FAMILY 49 CHAPTER 24: ANALGESIA AND ANESTHESIA IN
LABOR AND DELIVERY 709
CHAPTER 4: COMPLEMENTARY AND ALTERNATIVE
THERAPIES 77 CHAPTER 25: INTRAPARTUM NURSING CARE 739
CHAPTER 5: ETHICS, LAWS, AND STANDARDS CHAPTER 26: HIGH-RISK BIRTHS
OF CARE 113 AND OBSTETRIC EMERGENCIES 811
CHAPTER 6: HOME VISITING PROGRAMS CHAPTER 27: BIRTH AND THE FAMILY 851
AND PERINATAL NURSING 139
UNIT VII: POSTPARTUM HEALTH
UNIT II: HEALTH CARE AND NURSING CARE 875
OF WOMEN 163 CHAPTER 28: NORMAL POSTPARTUM
CHAPTER 7: DEVELOPMENT OF WOMEN NURSING CARE 877
ACROSS THE LIFE SPAN 165
CHAPTER 29: POSTPARTUM FAMILY ADJUSTMENT 929
CHAPTER 8: NUTRITION FOR WOMEN
CHAPTER 30: LACTATION AND NURSING
ACROSS THE LIFE SPAN 185
SUPPORT 955
CHAPTER 9: HEALTH CARE ISSUES
UNIT VIII: NEWBORN DEVELOPMENT
FOR WOMEN ACROSS THE LIFE SPAN 221
AND NURSING CARE 1009
CHAPTER 10: COMMON CONDITIONS CHAPTER 31: PHYSIOLOGIC AND BEHAVIORAL
OF THE REPRODUCTIVE SYSTEM 257 TRANSITION TO EXTRAUTERINE LIFE 1011
CHAPTER 11: VIOLENCE AND ABUSE 297 CHAPTER 32: ASSESSMENT AND CARE
OF THE NORMAL NEWBORN 1039
UNIT III: HUMAN SEXUALITY
ACROSS THE LIFE SPAN 327 CHAPTER 33: NEWBORN NUTRITION 1099
CHAPTER 12: SEXUAL AND REPRODUCTIVE
CHAPTER 34: NEWBORNS AT RISK RELATED TO
FUNCTION 329
BIRTH WEIGHT AND PREMATURE DELIVERY 1121
CHAPTER 13: GENETICS AND GENETIC
CHAPTER 35: NEWBORNS AT RISK RELATED TO
COUNSELING 355
CONGENITAL AND ACQUIRED CONDITIONS 1167
CHAPTER 14: FAMILY PLANNING 383
CHAPTER 36: DEVELOPMENTAL CARE
OF THE INFANT AT RISK 1197
UNIT IV: PREGNANCY 411
CHAPTER 15: NORMAL PREGNANCY 413 UNIT IX: SPECIAL
CONSIDERATIONS 1237
CHAPTER 16: MANAGEMENT AND NURSING
CARE OF THE PREGNANT WOMAN 453 CHAPTER 37: GRIEF AND THE FAMILY
IN THE PERINATAL EXPERIENCE 1239
CHAPTER 17: CHILDBIRTH PREPARATION
AND PERINATAL EDUCATION 477 CHAPTER 38: COMMUNITY AND HOME HEALTH
CARE NURSING FOR THE HIGH-RISK INFANT 1269
CHAPTER 18: MANAGEMENT AND NURSING
CARE OF THE HIGH-RISK CLIENT 507 APPENDIX A: STANDARDS OF HOLISTIC NURSING
PRACTICE 1291
CHAPTER 19: PREGNANCY IN SPECIAL
POPULATIONS 541 APPENDIX B: ABBREVIATIONS, ACRONYMS,
AND SYMBOLS 1296
UNIT V: ASSESSMENT
GLOSSARY 1301
OF FETAL WELL-BEING 581
CHAPTER 20: FETAL DEVELOPMENT 583 INDEX 1313

Maternal, Neonatal, and
Women’s Health Nursing

Maternal, Neonatal, and
Women’s Health Nursing
Lynna Y. Littleton, RNC, PhD
Director of the Women’s Health Care Nurse Practitioner Program
Women’s Health Nurse Practitioner
Associate Professor of Clinical Nursing
University of Texas Health Science Center at Houston
Houston, Texas
and
Joan C. Engebretson, RN, DrPH, HNC
Associate Professor
Nursing for Target Populations/Head of Division of Women and Childbearing Families
University of Texas Health Science Center at Houston
Houston, Texas
Australia Canada Mexico Singapore Spain United Kingdom United States
Maternal, Neonatal, and
Women’s Health Nursing
Lynna Y. Littleton, RNC, PhD
Joan C. Engebretson, RN, DrPH, HNC
Health Care Publishing Director: Executive Marketing Manager: Art/Design Coordinator:
William Brottmiller Dawn F. Gerrain Jay Purcell
Executive Editor: Production Editor: Editorial Assistant:
Cathy L. Esperti James Zayicek Shelly Esposito
Acquisitions Editor: Project Editor:
Matthew Kane Maureen M. E. Grealish
Senior Developmental Editor:
Elisabeth F. Williams
COPYRIGHT © 2002 by Delmar, a division of Thomson Learning, Inc. For permission to use material from this text or product, contact us by
Thomson Learning ™ is a trademark used herein under license. Tel [phone]
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Printed in the United States of America www.thomsonrights.com
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Library of Congress Cataloging-in-Publication Data
For more information contact Delmar, Littleton, Lynna.
3 Columbia Circle, PO Box 15015, Maternal, neonatal, and women’s health nursing/Lynna Littleton and
Albany, NY 12212-5015 Joan Engebretson.
p. cm.
Or find us on the World Wide Web at http://www.delmar.com Includes bibliographical references and index.
ISBN 0-7668-0121-7 (alk. paper)
ALL RIGHTS RESERVED. No part of this work covered by the copyright 1. Maternity nursing. 2. Infants (Newborn)—Diseases—Nursing.
hereon may be reproduced or used in any form or by any means— 3. Infants (Newborn)—Care. 4. Gynecologic nursing. I. Engebretson,
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CONTENTS
CONTRIBUTORS xvi Complementary and Alternative Therapies 17
Contemporary Challenges in Health Care
REVIEWERS xx
Delivery 17
Rapidly Changing Technology 17
PREFACE xxi
Changing Demographics 18
ACKNOWLEDGMENTS xxiv Balancing Cost with Best Practice 19
Nursing Implications 19
ABOUT THE AUTHORS xxv Nursing Skills for Professional Practice 20
Cognitive Skills 20
HOW TO USE THIS TEXT xxvi
Technical Skills 21
Communication Skills 22
HOW TO USE THE STUDENT ACTIVITY
Collaborative Skills 23
SOFTWARE xxix
Cultural Competency 23
Economic Expertise 23
UNIT I: FOUNDATIONS OF Self-Awareness and Reflective Practice 24
NURSING CARE 1 Development of Intuition 24
CHAPTER 1: NURSING IN THE CONTEMPORARY
HEALTH CARE SYSTEM 3 CHAPTER 2: ISSUES IN MATERNAL, NEONATAL,
Current State of Health Care Delivery 4 AND WOMEN’S HEALTH 29
Technologic Advancement for Diagnosis and Changes in Maternal, Neonatal, and Women’s
Treatment 4 Health Care 30
Health Care Expansion 5 Advances in Diagnosis and Treatment 30
Movement of Health Care to the Community 6 Health Indicators 31
Change in Philosophy 7 Risk Assessment and Management 33
Cost Containment 7 Cost 33
Activities to Improve Health 8 Goals and Guidelines 33
Identify Health Indicators 8 Trends in Maternal, Neonatal, and Women’s
Establish Health Goals 8 Health Care 34
Address Health Disparities 8 Medicalization and Demedicalization 34
Institute Evidence-Based Practice or Best Practice 9 Decreased Hospital Stay 35
Develop and Publish Guidelines 10 Reduction in Intervention 35
Work Toward Cost Containment 11 Family-Centered Care 35
Develop Collaboration with Multidisciplinary Community-Centered Care 36
Teams 12 Evidence-Based Practice 36
Changing Views in Understanding Health, Illness, Understanding Women’s Health 37
and Disease 13 Biologic Health 37
Biologic Science 13 Behavioral Health 37
Environmental Medicine 14 Environmental Health 37
Behavioral Medicine 15 Social Health 37
Social Aspects of Health 15 Cultural Health 38
Cultural Issues and Health 16 Complementary and Alternative Therapies 39
VI CONTENTS
Issues Related to Maternal, Neonatal, Ingested and Applied Substances 87
and Women’s Health Care 39 Energy-Based Therapies 99
Cost Containment 39 Psychologic or Mind-Body Therapies 101
Access to Care 40 Spiritual Healing 102
Reduction of Medical Errors 40 Nursing Implications 103
Ethical Issues 40 Implications for Women’s Health 103
Medical-Legal Issues 40 Implications for Research 103
Philosophy of Care 42 Implications for Practice 103
Nursing Implications 43 Nursing Process 105
Nursing Practice 43 Assessment 105
Nursing Education 44 Nursing Diagnoses 105
Nursing Research 44 Outcome Identification 105
Planning 105
Nursing Intervention 105
CHAPTER 3: THEORETICAL PERSPECTIVES
Evaluation 107
ON THE FAMILY 49
Family System of Structure and Function 51
Traditional or Nuclear Family 51 CHAPTER 5: ETHICS, LAWS, AND STANDARDS
Childless Dyads 52 OF CARE 113
Extended Family 52 Ethical Issues 115
Communal Family 53 Basic Ethical Perspectives 115
Unmarried Heterosexual (Cohabitation) Family 53 Ethical Principles 119
Homosexual Family 53 Code for Nurses 120
Single-Parent Family 54 Ethical Decision-Making Model 121
Theoretical Frameworks 61 Selected Dilemmas in Maternal-Child Practice 123
Developmental Theories 61 Legal Issues 130
Interactional or Structural-Functional Theory 62 Basic Legal Concepts 130
Role Theory 63 Standards of Care 131
Systems Theory 63 Practicing Safely in Perinatal Settings 131
Cultural Issues that Influence Families 64 Legal Issues in Maternal-Child Practice 134
Lower Birth Rate and Longer Life Span 64 Practice Implications for Maternal-Child Nursing 135
Economics 64
Cultural Diversity 66
CHAPTER 6: HOME VISITING PROGRAMS
Choice of Marriage Partner 66
AND PERINATAL NURSING 139
Changing Role of Women 67
Historical Background 140
Provider Models 68
Community Health Concepts 141
Family Dynamics 68
Defining Home Visitation 142
Biopsychosocial Model 70
Site of Service Delivery 142
Resiliency Model of Family Stress, Adjustment,
Relationship Building 142
and Adaptation 70
Indications for Home Visitation 143
Proactive Model for Enabling and Empowering
Provision of Acute Care 143
Families 71
Health Promotion 144
Nursing Implications 74
Principles of Home Visitation 144
Efficacy of Home Visitation 147
CHAPTER 4: COMPLEMENTARY AND ALTERNATIVE Essential Skills for Home Visiting 148
THERAPIES 77 Nursing Process 150
Contemporary Use of Complementary Therapies 79 Assessment 150
Differentiating Alternative from Complementary Nursing Diagnoses 150
Therapies 81 Outcome Identification 150
Background and Classification of Modalities 82 Planning 150
Systems of Healing 82 Nursing Interventions 151
Healing Approaches Congruent with Self-Healing 85 Evaluation 151
Complementary Modalities 86 Case Management 152
Physical Manipulation 86 Making the Home Visit 152
CONTENTS VII
Previsit Preparation 152 Obesity 211
Visiting the Home 155 Heart Disease 211
Postvisit Activities 157 Osteoporosis 213
Challenges of Home Visitation 158 Cancer 213
Meeting Multiple Needs 158 Nursing Implications 214
Fostering Self-sufficiency 158
Physical and Emotional Overload 158
CHAPTER 9: HEALTH CARE ISSUES
Responding to Client Diversity 159
FOR WOMEN ACROSS THE LIFE SPAN 221
Cost and Reimbursement 159
Historical Perspective of Women’s Health 222
Terminating the Home Visiting Relationship 159
History of Reproductive Health Care in the U.S. 222
Current View of Women’s Health Care 223
Sociocultural Influences 224
UNIT II: HEALTH CARE Women’s Health as a National Priority 225
OF WOMEN 163 National Response to Women’s Health Issues 225
Demographic Data for American Women 227
CHAPTER 7: DEVELOPMENT OF WOMEN Life Expectancy 227
ACROSS THE LIFE SPAN 165 Race and Ethnicity 228
Prenatal through Early Adolescent Years 166 Population Shift 228
Adolescence 167 Employment 228
Physiologic Changes 167 Education 229
Psychosocial Changes 171 Marital Status 229
Cultural Influences 173 Fertility and Birth Rates 229
Self-Care Considerations 173 Birth Rates for Adolescent Mothers 230
Young Adulthood to Perimenopausal Years 174 Birth Rates for Unmarried Women 230
Physiologic Changes 174 Mortality and Morbidity 231
Psychosocial Changes 174 Leading Causes of Death 231
Cultural Influences 175 Cardiovascular Disease 231
Self-Care Considerations 175 Cancer 232
Perimenopausal to Mature Years 175 Chronic Conditions 244
Physiologic Changes 176 Age-Specific Issues 246
Psychosocial Changes 178 Infancy to Young Adulthood 246
Cultural Influences 178 Young Adulthood to Perimenopausal Years 247
Self-Care Considerations 178 Perimenopausal to Mature Years 248
Mature Years 179 Mature Years 249
Physiologic Changes 179 Health Promotion and Disease Prevention 250
Psychosocial Changes 180 Delivery of Preventive Services 251
Cultural Influences 181 Types of Preventive Services 251
Self-Care Considerations 181
Nursing Implications 181
CHAPTER 10: COMMON CONDITIONS OF THE
REPRODUCTIVE SYSTEM 257
CHAPTER 8: NUTRITION FOR WOMEN Menstrual Cycle Abnormalities 258
ACROSS THE LIFE SPAN 185 Amenorrhea 258
Nutritional Guidelines 187 Dysfunctional Uterine Bleeding 261
Dietary Guidelines 187 Dysmenorrhea 262
Food Guide Pyramid 187 Endometriosis 262
Culturally Adapted Food Guides 187 Premenstrual Syndrome 263
Nutrition Facts Food Label 190 Nursing Implications 264
Nutritional Needs Across the Life Span 192 Breast Conditions 266
Adolescence 192 Benign Breast Conditions 266
Adulthood and Childbearing Years 194 Malignant Breast Conditions 272
Mature Years 210 Nursing Implications 274
Nutrition-Related Health Concerns 211 Pelvic Conditions 277
Physicial Activity 211 Infectious Conditions 277