Study Guide for Maternal Child Nursing Care

321 Pages·2013·74.017 MB·English

by  Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, David Wilson

Study Guide for
Maternal Child
Nursing Care
Fifth Edition
Karen A. Piotrowski, RNC, MSN
Associate Professor of Nursing
D’Youville College
Buffalo, New York
David Wilson, MS, RNC, NIC
Staff & PALS Coordinator
Children’s Hospital at Saint Francis
Tulsa, Oklahoma
Study Guide for
Maternal Child Nursing Care, Fifth Edition ISBN: 978-0-323-09607-2
Copyright © 2014, 2011, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,
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without permission in writing from the publisher.
Notices
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Introduction
Maternal Child Nursing Care, fifth edition, is a comprehensive textbook of maternity and pediatric nursing. This Study
Guide is designed to help students use the textbook more effectively. In addition to reviewing content of the text, this
Study Guide encourages students to think critically in applying their knowledge.
ORGANIZATION
Each chapter in this Study Guide is designed to incorporate learning activities that will help students meet the objectives
of the corresponding textbook chapter. The content is organized as follows:
• Learning Key Terms—Matching or fill-in-the-blank questions give students the opportunity to test their ability to
define all key terms in the corresponding textbook chapter.
• Reviewing Key Concepts—A variety of questions (matching, fill-in-the-blank, true/false, short answer, and multiple
choice) are used to provide students with ample opportunity to assess their knowledge and comprehension of the in-
formation covered in the text. These activities are specifically designed to help students identify the important content
of the chapter and test their level of knowledge and understanding after reading the chapter.
• Thinking Critically—Students are required to apply concepts found in the chapter to solve problems, make decisions
concerning care management, and provide responses to patients’ questions and concerns.
• Answer Key—Answers to all questions are provided at the end of this Study Guide.
iii
Copyright © 2014, 2011, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. All rights reserved.
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Contents
PART 1: MATERNITY NURSING PART 2: PEDIATRIC NURSING
Unit 1 Introduction to Maternity Nursing Unit 7 Children, Their Families, and the Nurse
1. 21st Century Maternity Nursing 1 26. 21st Century Pediatric Nursing 167
2. Community Care: The Family and Culture 5 27. Family, Social, Cultural, and Religious Influences on
Child Health Promotion 171
Unit 2 Reproductive Years 28. Developmental and Genetic Influences on Child
Health Promotion 176
3. Assessment and Health Promotion 13
4. Reproductive System Concerns 24
Unit 8 Assessment of the Child and Family
5. Infertility, Contraception, and Abortion 35
29. Communication, History, and Physical Assessment 181
Unit 3 Pregnancy 30. Pain Assessment and Management 187
6. Genetics, Conception, and Fetal Development 42
Unit 9 Health Promotion and Special Health
7. Anatomy and Physiology of Pregnancy 48
Problems
8. Nursing Care of the Family During Pregnancy 53
9. Maternal and Fetal Nutrition 62 31. The Infant and Family 190
10. Assessment of High Risk Pregnancy 67 32. The Toddler and Family 194
11. High Risk Perinatal Care: Preexisting Conditions 72 33. The Preschooler and Family 197
12. High Risk Perinatal Care: Gestational Conditions 80 34. The School-Age Child and Family 200
35. The Adolescent and Family 203
Unit 4 Childbirth
Unit 10 Special Needs, Illness, and Hospitalization
13. Labor and Birth Processes 90
14. Pain Management 93 36. Chronic Illness, Disability, and End-of-Life Care 207
15. Fetal Assessment During Labor 99 37. Cognitive and Sensory Impairment 210
16. Nursing Care of the Family During Labor 38. Family-Centered Care of the Child During Illness
and Birth 104 and Hospitalization 214
17. Labor and Birth Complications 112 39. Pediatric Variations of Nursing Interventions 217
Unit 5 Postpartum Period Unit 11 Health Problems of Children
18. Maternal Physiologic Changes 121 40. Respiratory Dysfunction 221
19. Nursing Care of the Family During the Postpartum 41. Gastrointestinal Dysfunction 226
Period 124 42. Cardiovascular Dysfunction 231
20. Transition to Parenthood 130 43. Hematologic and Immunologic Dysfunction 237
21. Postpartum Complications 135 44. Genitourinary Dysfunction 240
45. Cerebral Dysfunction 244
Unit 6 Newborn 46. Endocrine Dysfunction 248
47. Integumentary Dysfunction 252
22. Physiologic and Behavioral Adaptations of the
48. Musculoskeletal or Articular Dysfunction 258
Newborn 143
49. Neuromuscular or Muscular Dysfunction 263
23. Nursing Care of the Newborn and Family 149
24. Newborn Nutrition and Feeding 155
Answer Key 266
25. The High Risk Newborn 160
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UNIT 1  INTRODUCTION TO MATERNITY NURSING
1
21st Century Maternity Nursing
I. LEARNING KEY TERMS
MATCHING: Match each term with its corresponding description.
1. Number of live births in 1 year per 1000 population. a. Fertility rate
2. All deaths during pregnancy and within 1 year following the end b. Infant mortality rate
of pregnancy.
c. Birth rate
3. Number of maternal deaths from births and complications of
pregnancy, childbirth, and puerperium (the first 42 days after d. Maternal mortality rate
termination of the pregnancy) per 100,000 live births.
e. Neonatal mortality rate
4. An infant who, at birth, demonstrates no signs of life, such as
breathing, heartbeat, or voluntary muscle movements. f. Perinatal mortality rate
5. Number of stillbirths and number of neonatal deaths per 1000 live g. Pregnancy-associated deaths
births.
h. Pregnancy-related deaths
6. Number of births per 1000 women between the ages of 15 and
44 years (inclusive), calculated on an annual basis. i. Stillbirth
7. An embryo or fetus that is removed or expelled from the uterus at j. Abortus
20 weeks of gestation or less, weighs 500 g or less, or measures
25 cm or less.
8. Number of deaths of infants younger than 1 year of age per
1000 live births.
9. Number of deaths of infants younger than 28 days of age per
1000 live births.
10. Deaths that are a complication of pregnancy, an aggravation of
an unrelated condition by the physiology of pregnancy, or a
chain of events initiated by the pregnancy.
FILL IN THE BLANKS: Insert the term that 12. A set of goals
corresponds to each of the following definitions based on assessments of major risks to health and
or descriptions. wellness, changes in public health priorities, and
issues related to the health preparedness and preven-
11. Specialty area tion of our nation.
of nursing practice that focuses on the care of child-
bearing women and their families through all stages 13. A set of eight
of pregnancy and childbirth, as well as the first goals to be achieved by 2015 that respond to the
4 weeks after birth. world’s main development challenges and are adopted
by 189 nations under the auspices of the United
Nations.
1
Copyright © 2014, 2011, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. All rights reserved.
2 Chapter 1 21st Century Maternity Nursing
14. Approach to II. REVIEWING KEY CONCEPTS
health care that encompasses complementary and
1. When assessing pregnant women, what factors would
alternative therapies in combination with conven-
you recognize as having the potential to contribute to
tional Western modalities of treatment.
the rate of infant mortality in the United States?
15. An umbrella
term for the use of communication technologies and
electronic information to provide or support health
care when the participants are separated by distance.
16. Trained and
experienced female labor attendants who provide a
continuous one-on-one caring presence throughout
the labor and birth process.
2. The number of high risk pregnancies occurring in the
17. Term that re-
United States is increasing. Briefly discuss several
fers to a spectrum of abilities, ranging from reading
factors that have been identified as contributing to this
an appointment slip to interpreting medication
increase in incidence of high risk pregnancies.
instructions.
18. Health care
that is based on information gained through research
and clinical trials.
19. Guidelines for
nursing practice that reflect current knowledge, rep-
resent levels of practice agreed on by leaders in the
specialty, and can be used for clinical benchmarking.
3. An integrative health care approach implies which of
20. An evolving the following? (Circle all that apply.)
process that is used to identify risks, establish pre- a. The focus is on the whole person.
ventive practices, develop reporting mechanisms, b. Conventional Western modalities of treatment are
and delineate procedures for managing lawsuits. not included.
c. The beliefs, values, and desires of the patient in
21. Term used by terms of health and health care are respected.
The Joint Commission to describe an unexpected d. Patient autonomy is limited in terms of choosing
occurrence involving death or serious physical or alternative therapies.
psychological injury, or risk thereof. e. The patient’s disease complex is the primary con-
sideration when choosing treatment approaches.
22. Failure to rec-
ognize or act on early signs of distress. Key compo- 4. A nurse manager of a prenatal clinic should recognize
nents include careful surveillance and identification that the most significant barrier encountered by preg-
of complications and quick action to initiate appro- nant women in accessing health care would be which
priate interventions and activate a team response. of the following?
a. Lack of transportation to the clinic
23. Level of prac- b. Child care responsibilities
tice that a reasonably prudent nurse would provide in c. Inability to pay
the same or similar circumstances. d. Deficient knowledge related to the benefits of pre-
natal care
24. An effort to
provide nurses with the competencies to improve the 5. In the United States, the leading cause of maternal
quality and safety of the systems of health care in mortality is which one of the following?
which they practice. They were delineated by the IOM. a. Unsafe abortion
b. Infection
25. A teamwork c. Gestational hypertension
system for health professionals to provide higher d. Diabetes
quality, safer patient care. It provides an evidence
base to improve communication and teamwork skills.
Copyright © 2014, 2011, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Chapter 1 21st Century Maternity Nursing 3
6. Pregnant women who are obese are more likely to b. Hemorrhage and hypertension associated with preg-
develop one or both of the two most frequently re- nancy
ported maternal risk factors. These factors include c. Infection and diabetes
which of the following combinations? d. Diabetes and hypertension associated with preg-
a. Premature labor and infection nancy
III. THINKING CRITICALLY
1. Imagine that you are the nursing director of an inner-city prenatal clinic that serves a large number of minority
women, many of whom are younger than 20 years of age. Describe five nursing services you would provide for these
women that would help reduce the potential for maternal and infant morbidity and mortality and low birth weight.
Use the statistical data and risk behaviors presented in Chapter 1 to support the types of services you propose.
2. Support the accuracy of the following statement: An emphasis on high-technology medical care and lifesaving tech-
niques will not reduce the rate of preterm and low-birth-weight infants in the United States.
3. Explain how a nurse could use social media to improve the health care provided to pregnant women and their families.
Identify the precautions the nurse must take to ensure that patient confidentiality and privacy are respected.
4. Many barriers interfere with a woman’s participation in early and ongoing prenatal care. Describe incentives and
services that you would offer to pregnant women to encourage their participation in prenatal care. State the rationale
for your proposals. Your answer should reflect an understanding of the barriers.
Copyright © 2014, 2011, 2010, 2006, 2002, 1998 by Mosby, an imprint of Elsevier Inc. All rights reserved.