BOOK
Foundations of Maternal-Newborn and Women's Health Nursing - E-Book
Sharon Smith Murray | Emily Slone McKinney
(2014)
Additional Information
Book Details
Abstract
With easy-to-read coverage of nursing care for women and newborns, Foundations of Maternal-Newborn & Women's Health Nursing, 6th Edition shows how to provide safe, competent care in the clinical setting. Evidence-based guidelines and step-by-step instructions for assessments and interventions help you quickly master key skills and techniques. Also emphasized is the importance of understanding family, communication, culture, client teaching, and clinical decision making. Written by specialists in maternity nursing, Sharon Smith Murray and Emily Slone McKinney, this text reflects the latest QSEN competencies, and the accompanying Evolve website includes review questions to prepare you for the NCLEX® exam!
- Nursing Care Plans help you apply the nursing process to clinical situations.
- Procedure boxes provide clear instructions for performing common maternity skills, with rationales for each step.
- UNIQUE! Therapeutic Communications boxes present realistic nurse-patient dialogues, identifying communication techniques and showing to respond when encountering communication blocks.
- Communication Cues offer tips for interpreting patients’ and families’ verbal and nonverbal communication.
- Critical Thinking exercises focus on clinical situations designed to test your skills in prioritizing and critical thinking.
- Updated drug guides list important indications, adverse reactions, and nursing considerations for the most commonly used medications.
- Check Your Reading helps you assess your mastery of key content.
- Critical to Remember boxes highlight and summarize need-to-know information.
- Want to Know boxes provide guidelines for successful client education.
- Glossary provides definitions of all key terms.
- NEW! Safety Alerts help you develop competencies related to QSEN and safe nursing practice.
- NEW! Unfolding case studies help you apply what you’ve learned to practice.
- UPDATED Evidence-Based Practice boxes highlight the latest research and the most current QSEN (Quality and Safety Education for Nurses) practice guidelines for quality care.
- UPDATED content includes the late preterm infant, fetal heart rate pattern identification, obesity in the pregnant woman, and the QSEN competencies.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Half title page | i | ||
| Brife Table Of Contents | ii | ||
| Foundations of Maternal-Newborn and Women's Health Nursing, 6/e | iii | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Reviewers | vii | ||
| Dedication | ix | ||
| Preface | xi | ||
| Content | xi | ||
| Scientific Base | xi | ||
| The Nursing Process | xi | ||
| Communication | xi | ||
| Teaching | xii | ||
| Critical Thinking | xii | ||
| Cultural Diversity | xii | ||
| Organization | xii | ||
| Features | xii | ||
| Ancillaries | xiii | ||
| For Students | xiii | ||
| For Instructors | xiii | ||
| Acknowledgments | xiv | ||
| Table Of Contents | xv | ||
| I Foundations for Nursing Care of Childbearing Families | 1 | ||
| 1 Maternity and Women’s Health Care Today | 1 | ||
| Objectives | 1 | ||
| Historical Perspectives on Childbearing | 1 | ||
| Granny Midwives | 1 | ||
| Emergence of Medical Management | 1 | ||
| Government Involvement in Maternal-Infant Care | 2 | ||
| Effects of Consumer Demands on Health Care | 2 | ||
| Development of Family-Centered Care | 3 | ||
| Current Settings for Childbirth | 3 | ||
| Traditional Hospital Setting | 3 | ||
| Labor, Delivery, and Recovery Rooms | 3 | ||
| Labor, Delivery, Recovery, and Postpartum Rooms | 3 | ||
| Birth Centers | 3 | ||
| Home Births | 4 | ||
| Current Trends in Perinatal and Women’s Health Care | 4 | ||
| Cost Containment | 4 | ||
| Diagnosis-Related Groups | 4 | ||
| Capitated Care | 4 | ||
| Effects of Cost Containment on Maternity Care | 5 | ||
| Managed Care. | 5 | ||
| Case Management. | 5 | ||
| Outcomes Management. | 5 | ||
| Clinical Pathways. | 5 | ||
| Variances. | 5 | ||
| Students’ Use of Clinical Pathways. | 5 | ||
| Evidence-Based Nursing Care. | 5 | ||
| Community-Based Perinatal and Women’s Health Nursing | 6 | ||
| Common Types of Perinatal Home Care | 6 | ||
| Antepartum Home Care. | 6 | ||
| Postpartum and Neonatal Home Care. | 6 | ||
| Home Care for High-Risk Neonates. | 6 | ||
| Standards of Practice for Perinatal and Women’s Health Nursing | 7 | ||
| Agency Standards | 7 | ||
| Organizational Standards | 7 | ||
| Legal Standards | 7 | ||
| Advances in Technology | 7 | ||
| Complementary and Alternative Medicine | 7 | ||
| The Family | 8 | ||
| Traditional Families | 8 | ||
| Nontraditional Families | 8 | ||
| Single-Parent Families | 8 | ||
| Blended Families | 9 | ||
| Extended Families | 9 | ||
| Same-Sex Parent Families | 9 | ||
| Adoptive Families | 9 | ||
| Characteristics of a Healthy Family | 9 | ||
| Factors That Interfere with Family Functioning | 9 | ||
| High-Risk Families | 9 | ||
| Cultural Perspectives in Childbearing | 10 | ||
| Implications of Cultural Diversity for Perinatal Nurses | 10 | ||
| Western Cultural Beliefs | 10 | ||
| Communication | 10 | ||
| Southeast Asians. | 10 | ||
| Hispanics. | 11 | ||
| African-Americans. | 11 | ||
| Native Americans. | 11 | ||
| Native Hawaiian and Pacific Islanders. | 11 | ||
| Middle Easterners. | 11 | ||
| Cross-Cultural Health Beliefs | 11 | ||
| Traditional Methods to Prevent Illness. | 11 | ||
| Traditional Practices to Maintain Health. | 12 | ||
| Traditional Practices to Restore Health. | 12 | ||
| Cultural Assessment | 12 | ||
| Statistics on Maternal, Infant, and Women’s Health | 12 | ||
| Maternal and Infant Mortality | 12 | ||
| Maternal Mortality | 12 | ||
| Infant Mortality | 12 | ||
| Disparity across Racial Groups | 12 | ||
| Infant Mortality across Nations | 13 | ||
| Adolescent Pregnancy | 13 | ||
| Women’s Health | 13 | ||
| Summary Concepts | 14 | ||
| References & Readings | 14 | ||
| 2 The Nurse’s Role in Maternity and Women’s Health Care | 16 | ||
| Objectives | 16 | ||
| Shortage of Nurses | 16 | ||
| Advanced Preparation for Maternal-Newborn and Women’s Health Nurses | 17 | ||
| Certified Nurse-Midwives | 17 | ||
| Nurse Practitioners | 17 | ||
| Clinical Nurse Specialists | 17 | ||
| Changing Roles for Nurses | 17 | ||
| Therapeutic Communication | 18 | ||
| Guidelines for Therapeutic Communication | 18 | ||
| Therapeutic Communication Techniques | 18 | ||
| The Nurse’s Role in Teaching and Learning | 18 | ||
| Principles of Teaching and Learning | 18 | ||
| Factors That Influence Learning | 20 | ||
| Developmental Level. | 20 | ||
| Language. | 20 | ||
| Culture. | 20 | ||
| Previous Experiences. | 21 | ||
| Physical Environment. | 21 | ||
| Organization and Skill of the Instructor. | 21 | ||
| Effects of Early Discharge | 21 | ||
| The Nurse’s Role as Collaborator | 21 | ||
| The Nurse’s Role as Researcher | 21 | ||
| The Nurse’s Role as Advocate | 21 | ||
| The Nurse’s Role as Manager | 21 | ||
| Critical Thinking | 22 | ||
| Purpose | 22 | ||
| Steps | 22 | ||
| Recognizing Assumptions | 22 | ||
| Examining Biases | 22 | ||
| Determining the Need for Closure | 22 | ||
| Becoming Skillful in Data Management | 23 | ||
| Collecting Data. | 23 | ||
| Validating Data. | 23 | ||
| Organizing and Analyzing Data. | 23 | ||
| Acknowledging Emotions and Environmental Factors | 23 | ||
| Application of the Nursing Process Maternal-Newborn and Women’s Health Nursing | 23 | ||
| Assessment | 24 | ||
| Screening Assessment | 24 | ||
| Focused Assessment | 24 | ||
| Nursing Diagnosis | 24 | ||
| Planning | 24 | ||
| Setting Priorities | 24 | ||
| Establishing Goals and Expected Outcomes | 25 | ||
| Developing Nursing Interventions | 25 | ||
| Interventions for Actual Nursing Diagnoses. | 25 | ||
| Interventions for Risk Nursing Diagnoses. | 25 | ||
| Interventions for Wellness Nursing Diagnoses. | 25 | ||
| Implementing Interventions | 25 | ||
| Evaluation | 25 | ||
| Individualized Nursing Care Plans | 25 | ||
| The Nursing Process Related to Critical Thinking | 26 | ||
| Nursing Research | 26 | ||
| Summary Concepts | 27 | ||
| References & Readings | 28 | ||
| 3 Ethical, Social, and Legal Issues | 29 | ||
| Objectives | 29 | ||
| Ethics and Bioethics | 29 | ||
| Ethical Dilemmas | 29 | ||
| Ethical Theories | 29 | ||
| Deontologic Model. | 29 | ||
| Utilitarian Model. | 29 | ||
| Human Rights Model. | 30 | ||
| Ethical Principles | 30 | ||
| Solving Dilemmas in Daily Practice | 30 | ||
| Ethical Issues in Reproduction | 31 | ||
| Elective Pregnancy Termination | 31 | ||
| Conflicting Beliefs about Abortion. | 31 | ||
| Belief That Abortion Is a Private Choice. | 31 | ||
| Belief That Abortion Is Taking a Life. | 32 | ||
| Implications for Nurses. | 32 | ||
| Personal Values. | 32 | ||
| Professional Obligations. | 32 | ||
| Mandated Contraception | 32 | ||
| Fetal Injury | 32 | ||
| Fetal Therapy | 32 | ||
| Issues in Infertility | 33 | ||
| Infertility Treatment. | 33 | ||
| Surrogate Parenting. | 33 | ||
| Ethical and Legal Reproductive Issues | 33 | ||
| Privacy Issues | 33 | ||
| Government Regulations | 33 | ||
| Online Communications. | 33 | ||
| Online Document Exchange. | 34 | ||
| Social Issues | 34 | ||
| Poverty | 34 | ||
| Homelessness | 34 | ||
| Access to Health Care | 35 | ||
| Prenatal Care in the United States | 35 | ||
| Government Programs for Health Care | 35 | ||
| Medicaid. | 35 | ||
| Shelters and Health Care for the Homeless. | 36 | ||
| Innovative Programs. | 36 | ||
| Allocation of Health Care Resources. | 36 | ||
| Care versus Cure | 36 | ||
| Late Preterm Infants | 36 | ||
| Legal Issues | 36 | ||
| Safeguards for Health Care | 36 | ||
| Nurse Practice Acts | 36 | ||
| Standards of Care | 37 | ||
| Agency Policies | 37 | ||
| Accountability. | 37 | ||
| Malpractice: Limiting Loss | 37 | ||
| Informed Consent | 38 | ||
| Competence. | 38 | ||
| Full Disclosure. | 38 | ||
| Understanding of Information. | 38 | ||
| Voluntary Consent. | 38 | ||
| Refusal of Care. | 38 | ||
| Documentation | 39 | ||
| Documenting Fetal Monitoring. | 39 | ||
| Documenting Discharge Teaching. | 39 | ||
| Documenting Incidents. | 39 | ||
| The Nurse as Patient Advocate | 39 | ||
| Maintaining Expertise | 39 | ||
| Cost Containment and Downsizing | 40 | ||
| Delegation to Unlicensed Assistive Personnel | 40 | ||
| Early Discharge | 40 | ||
| Concerns about Early Discharge | 40 | ||
| Methods to Deal with Short Lengths of Stay | 40 | ||
| Summary Concepts | 41 | ||
| References & Readings | 41 | ||
| 4 Reproductive Anatomy and Physiology | 43 | ||
| Objectives | 43 | ||
| Sexual Development | 43 | ||
| Prenatal Development | 43 | ||
| Childhood | 43 | ||
| Sexual Maturation | 43 | ||
| Initiation of Sexual Maturation | 44 | ||
| Female Puberty Changes | 44 | ||
| Breast Changes. | 44 | ||
| Body Contours. | 44 | ||
| Body Hair. | 44 | ||
| Skeletal Growth. | 44 | ||
| Reproductive Organs. | 44 | ||
| Menarche. | 44 | ||
| Male Puberty Changes | 46 | ||
| Nocturnal Emissions. | 46 | ||
| Body Hair. | 46 | ||
| Body Composition. | 46 | ||
| Skeletal Growth. | 46 | ||
| Voice Changes. | 46 | ||
| Decline in Fertility | 46 | ||
| Female Reproductive Anatomy | 46 | ||
| External Female Reproductive Organs | 46 | ||
| Mons Pubis | 46 | ||
| Labia Majora and Minora | 46 | ||
| Clitoris | 47 | ||
| Vestibule | 47 | ||
| Perineum | 47 | ||
| Internal Female Reproductive Organs | 47 | ||
| Vagina | 47 | ||
| Uterus | 47 | ||
| Divisions of the Uterus. | 47 | ||
| Corpus. | 47 | ||
| Isthmus. | 47 | ||
| Cervix. | 47 | ||
| Layers of the Uterus. | 47 | ||
| Perimetrium. | 47 | ||
| Myometrium. | 47 | ||
| Endometrium. | 48 | ||
| Fallopian Tubes | 49 | ||
| Ovaries | 49 | ||
| Support Structures | 49 | ||
| Pelvis | 49 | ||
| Muscles | 49 | ||
| Ligaments | 49 | ||
| Lateral Support. | 50 | ||
| Anterior Support. | 50 | ||
| Posterior Support. | 50 | ||
| Blood Supply | 50 | ||
| Nerve Supply | 51 | ||
| Female Reproductive Cycle | 51 | ||
| Ovarian Cycle | 51 | ||
| Follicular Phase | 51 | ||
| Ovulatory Phase | 51 | ||
| Luteal Phase | 51 | ||
| Endometrial Cycle | 51 | ||
| Proliferative Phase | 51 | ||
| Secretory Phase | 51 | ||
| Menstrual Phase | 52 | ||
| Changes in Cervical Mucus | 53 | ||
| The Female Breast | 53 | ||
| Structure | 53 | ||
| Function | 53 | ||
| Male Reproductive Anatomy and Physiology | 54 | ||
| External Male Reproductive Organs | 54 | ||
| Penis | 54 | ||
| Scrotum | 54 | ||
| Internal Male Reproductive Organs | 54 | ||
| Testes | 54 | ||
| Accessory Ducts and Glands | 55 | ||
| Summary Concepts | 55 | ||
| References & Readings | 56 | ||
| 5 Hereditary and Environmental Influences on Childbearing | 57 | ||
| Objectives | 57 | ||
| Hereditary Influences | 57 | ||
| Structure of Genes and Chromosomes | 57 | ||
| Deoxyribonucleic Acid | 57 | ||
| Genes | 58 | ||
| Chromosomes | 58 | ||
| Transmission of Traits by Single Genes | 60 | ||
| Dominance | 60 | ||
| Chromosome Location | 61 | ||
| Patterns of Single Gene Inheritance | 61 | ||
| Autosomal Dominant Traits | 61 | ||
| Autosomal Recessive Traits | 61 | ||
| X-Linked Traits | 61 | ||
| Chromosomal Abnormalities | 63 | ||
| Numerical Abnormalities | 63 | ||
| Trisomy. | 63 | ||
| Monosomy. | 64 | ||
| Polyploidy. | 64 | ||
| Structural Abnormalities | 64 | ||
| Multifactorial Disorders | 65 | ||
| Characteristics | 65 | ||
| Risk for Occurrence | 65 | ||
| Environmental Influences | 66 | ||
| Teratogens | 66 | ||
| Preventing Fetal Exposure | 67 | ||
| Infections. | 67 | ||
| Drugs and Other Substances. | 67 | ||
| Ionizing Radiation. | 67 | ||
| Maternal Hyperthermia. | 67 | ||
| Manipulating the Fetal Environment | 67 | ||
| Mechanical Disruptions to Fetal Development | 67 | ||
| Genetic Counseling | 68 | ||
| Availability | 68 | ||
| Focus on the Family | 68 | ||
| Process of Genetic Counseling | 68 | ||
| Supplemental Services | 69 | ||
| Nursing Care of Families Concerned about Birth Defects | 69 | ||
| Nurses as Part of a Genetic Counseling Team | 69 | ||
| Nurses in General Practice | 69 | ||
| Women’s Health Nurses | 69 | ||
| Antepartum Nurses | 69 | ||
| Identifying Families for Referral. | 69 | ||
| Helping the Family Decide about Genetic Counseling. | 70 | ||
| Teaching about Lifestyle. | 70 | ||
| Providing Emotional Support. | 70 | ||
| Helping the Family Deal with Abnormal Results. | 71 | ||
| Intrapartum and Neonatal Nurses | 71 | ||
| Pediatric Nurses | 71 | ||
| Summary Concepts | 71 | ||
| References & Readings | 72 | ||
| II The Family before Birth | 73 | ||
| 6 Conception and Prenatal Development | 73 | ||
| Objectives | 73 | ||
| The Family before Birth | 73 | ||
| Gametogenesis | 73 | ||
| Oogenesis | 73 | ||
| Spermatogenesis | 75 | ||
| Conception | 75 | ||
| Preparation for Conception in the Female | 75 | ||
| Release of the Ovum | 75 | ||
| Ovum Transport | 76 | ||
| Preparation for Conception in the Male | 76 | ||
| Ejaculation | 76 | ||
| Transport of Sperm in the Female Reproductive Tract | 76 | ||
| Preparation of Sperm for Fertilization | 76 | ||
| Fertilization | 76 | ||
| Entry of One Spermatozoon into the Ovum | 76 | ||
| Fusion of the Nuclei of Sperm and Ovum | 76 | ||
| Preembryonic Period | 77 | ||
| Initiation of Cell Division | 77 | ||
| Entry of the Zygote into the Uterus | 77 | ||
| Implantation in the Decidua | 77 | ||
| Maintaining the Decidua | 77 | ||
| Location of Implantation | 77 | ||
| Mechanism of Implantation | 78 | ||
| Embryonic Period | 78 | ||
| Differentiation of Cells | 78 | ||
| Weekly Developments | 81 | ||
| Week 2 | 82 | ||
| Week 3 | 82 | ||
| Week 4 | 82 | ||
| Week 5 | 82 | ||
| Week 6 | 82 | ||
| Week 7 | 82 | ||
| Week 8 | 83 | ||
| Fetal Period | 83 | ||
| Weeks 9 through 12 | 83 | ||
| Weeks 13 through 16 | 84 | ||
| Weeks 17 through 20 | 84 | ||
| Weeks 21 through 24 | 84 | ||
| Weeks 25 through 28 | 84 | ||
| Weeks 29 through 32 | 84 | ||
| Weeks 33 through 38 | 84 | ||
| Auxiliary Structures | 84 | ||
| Placenta | 84 | ||
| Maternal Component | 85 | ||
| Development. | 85 | ||
| Circulation on the Maternal Side. | 86 | ||
| Fetal Component | 86 | ||
| Development. | 86 | ||
| Circulation on the Fetal Side. | 86 | ||
| Metabolic Functions | 87 | ||
| Transfer Functions | 87 | ||
| Gas Exchange. | 87 | ||
| Nutrient Transfer. | 87 | ||
| Waste Removal. | 87 | ||
| Antibody Transfer. | 87 | ||
| Transfer of Maternal Hormones. | 87 | ||
| Endocrine Functions. | 87 | ||
| Fetal Membranes and Amniotic Fluid | 88 | ||
| Fetal Circulation | 88 | ||
| Umbilical Cord | 88 | ||
| Fetal Circulatory Circuit | 88 | ||
| Changes in Blood Circulation after Birth | 90 | ||
| Multifetal Pregnancy | 90 | ||
| Monozygotic Twinning | 90 | ||
| Dizygotic Twinning | 90 | ||
| High Multifetal Gestations | 90 | ||
| Summary Concepts | 91 | ||
| References & Readings | 92 | ||
| 7 Physiologic Adaptations to Pregnancy | 93 | ||
| Objectives | 93 | ||
| Changes in Body Systems | 93 | ||
| Reproductive System | 93 | ||
| Uterus | 93 | ||
| Growth. | 93 | ||
| Pattern of Uterine Growth. | 93 | ||
| Contractility. | 94 | ||
| Uterine Blood Flow. | 94 | ||
| Cervix | 94 | ||
| Vagina and Vulva | 94 | ||
| Ovaries | 95 | ||
| Breasts | 95 | ||
| Cardiovascular System | 95 | ||
| Heart | 95 | ||
| Heart Size and Position. | 95 | ||
| Heart Sounds. | 95 | ||
| Blood Volume | 95 | ||
| Plasma Volume | 95 | ||
| Red Blood Cell Volume. | 95 | ||
| Cardiac Output | 96 | ||
| Systemic Vascular Resistance | 96 | ||
| Blood Pressure | 96 | ||
| Effect of Position. | 96 | ||
| Supine Hypotension. | 96 | ||
| Blood Flow | 96 | ||
| Blood Components | 97 | ||
| Respiratory System | 97 | ||
| Oxygen Consumption | 97 | ||
| Hormonal Factors | 97 | ||
| Progesterone. | 97 | ||
| Estrogen. | 97 | ||
| Physical Effects of the Enlarging Uterus | 97 | ||
| Gastrointestinal System | 97 | ||
| Appetite | 97 | ||
| Mouth | 97 | ||
| Esophagus | 98 | ||
| Stomach | 98 | ||
| Large and Small Intestines | 98 | ||
| Liver and Gallbladder | 98 | ||
| Urinary System | 98 | ||
| Bladder | 98 | ||
| Kidneys and Ureters | 98 | ||
| Changes in Size and Shape. | 98 | ||
| Functional Changes of the Kidneys. | 98 | ||
| Integumentary System | 98 | ||
| Skin | 98 | ||
| Hyperpigmentation. | 98 | ||
| Cutaneous Vascular Changes. | 99 | ||
| Connective Tissue | 99 | ||
| Hair and Nails | 99 | ||
| Musculoskeletal System | 99 | ||
| Calcium Storage | 99 | ||
| Postural Changes | 99 | ||
| Abdominal Wall | 99 | ||
| Endocrine System | 99 | ||
| Pituitary Gland | 99 | ||
| Thyroid Gland | 100 | ||
| Parathyroid Glands | 100 | ||
| Pancreas | 100 | ||
| Adrenal Glands | 101 | ||
| Changes Caused by Placental Hormones | 101 | ||
| Human Chorionic Gonadotropin. | 101 | ||
| Estrogen. | 101 | ||
| Progesterone. | 101 | ||
| Human Chorionic Somatomammotropin. | 101 | ||
| Relaxin. | 101 | ||
| Changes in Metabolism | 101 | ||
| Weight Gain. | 101 | ||
| Water Metabolism. | 101 | ||
| Edema. | 101 | ||
| Carbohydrate Metabolism. | 102 | ||
| Sensory Organs | 102 | ||
| Eye | 102 | ||
| Ear | 102 | ||
| Immune System | 102 | ||
| Confirmation of Pregnancy | 102 | ||
| Presumptive Indications of Pregnancy | 102 | ||
| Amenorrhea | 102 | ||
| Nausea and Vomiting | 102 | ||
| Fatigue | 102 | ||
| Urinary Frequency | 102 | ||
| Breast and Skin Changes | 102 | ||
| Vaginal and Cervical Color Change | 102 | ||
| Fetal Movement | 102 | ||
| Probable Indications of Pregnancy | 104 | ||
| Abdominal Enlargement | 104 | ||
| Cervical Softening | 104 | ||
| Changes in Uterine Consistency | 104 | ||
| Ballottement | 104 | ||
| Braxton Hicks Contractions | 104 | ||
| Palpation of the Fetal Outline | 105 | ||
| Uterine Souffle | 105 | ||
| Pregnancy Tests | 105 | ||
| Inaccurate Pregnancy Test Results. | 105 | ||
| Positive Indications of Pregnancy | 105 | ||
| Auscultation of Fetal Heart Sounds | 105 | ||
| Fetal Movements Detected by an Examiner | 105 | ||
| Visualization of the Embryo or Fetus | 105 | ||
| Antepartum Assessment and Care | 105 | ||
| Preconception and Interconception Care | 106 | ||
| Initial Prenatal Visit | 106 | ||
| History | 106 | ||
| Obstetric History. | 106 | ||
| Menstrual History and Estimated Date of Delivery. | 107 | ||
| Gynecologic and Contraceptive History. | 107 | ||
| Medical and Surgical History. | 107 | ||
| Family History. | 107 | ||
| Partner’s Health History. | 108 | ||
| Psychosocial History. | 108 | ||
| Physical Examination | 108 | ||
| Vital Signs | 108 | ||
| Blood Pressure. | 108 | ||
| Pulse. | 108 | ||
| Respirations. | 108 | ||
| Temperature. | 108 | ||
| Cardiovascular System | 108 | ||
| Venous Congestion. | 108 | ||
| Edema. | 108 | ||
| Musculoskeletal System | 108 | ||
| Posture and Gait. | 108 | ||
| Height and Weight. | 108 | ||
| Abdomen. | 108 | ||
| Neurologic System | 108 | ||
| Carpal Tunnel Syndrome. | 108 | ||
| Integumentary System | 108 | ||
| Endocrine System | 108 | ||
| Gastrointestinal System | 108 | ||
| Mouth. | 108 | ||
| Intestine. | 109 | ||
| Urinary System | 109 | ||
| Protein. | 109 | ||
| Glucose. | 109 | ||
| Ketones. | 109 | ||
| Bacteria. | 109 | ||
| Reproductive System | 109 | ||
| Breasts. | 109 | ||
| External Reproductive Organs. | 109 | ||
| Internal Reproductive Organs. | 109 | ||
| Pelvic Measurements. | 109 | ||
| Laboratory Data | 109 | ||
| Risk Assessment | 109 | ||
| Subsequent Assessments | 109 | ||
| Vital Signs | 111 | ||
| Weight | 111 | ||
| Urine | 111 | ||
| Fundal Height | 111 | ||
| Leopold Maneuvers | 111 | ||
| Fetal Heart Rate | 112 | ||
| Fetal Activity | 112 | ||
| Signs of Labor | 112 | ||
| Ultrasonographic Screening | 112 | ||
| Glucose Screening | 112 | ||
| Isoimmunization | 112 | ||
| Pelvic Examination | 112 | ||
| Multifetal Pregnancy | 112 | ||
| Diagnosis | 112 | ||
| Maternal Adaptation to Multifetal Pregnancy | 112 | ||
| Antepartum Care in Multifetal Pregnancy | 112 | ||
| Common Discomforts of Pregnancy | 113 | ||
| Nausea and Vomiting | 113 | ||
| Heartburn | 113 | ||
| Backache | 113 | ||
| Round Ligament Pain | 113 | ||
| Urinary Frequency | 115 | ||
| Varicosities | 115 | ||
| Constipation | 115 | ||
| Hemorrhoids | 115 | ||
| Leg Cramps | 115 | ||
| Cultural Considerations | 115 | ||
| Application of the Nursing Process Family Responses to Physical Changes of Pregnancy | 117 | ||
| Assessment | 117 | ||
| Nursing Diagnosis | 118 | ||
| Planning: Expected Outcomes | 118 | ||
| Interventions | 118 | ||
| Teaching Health Behaviors | 118 | ||
| Bathing. | 118 | ||
| Hot Tubs and Saunas. | 118 | ||
| Douching. | 118 | ||
| Breast Care. | 118 | ||
| Clothing. | 118 | ||
| Exercise. | 118 | ||
| Sleep and Rest. | 119 | ||
| Sexual Activity. | 119 | ||
| Nutrition. | 119 | ||
| Employment. | 119 | ||
| Maternal Safety. | 119 | ||
| Exposure to Teratogens. | 119 | ||
| Travel. | 119 | ||
| Immunizations. | 119 | ||
| Teaching Necessary Lifestyle Changes | 119 | ||
| Prescription and Over-the-Counter Drugs. | 119 | ||
| Complementary and Alternative Therapies. | 120 | ||
| Tobacco. | 120 | ||
| Alcohol. | 120 | ||
| Illicit Drugs. | 120 | ||
| Teaching about Signs of Possible Complications | 120 | ||
| Providing Resources | 120 | ||
| Evaluation | 120 | ||
| Summary Concepts | 121 | ||
| References & Readings | 121 | ||
| Chapter8 Psychosocial Adaptations to Pregnancy | 124 | ||
| Objectives | 124 | ||
| Maternal Psychological Responses | 124 | ||
| First Trimester | 124 | ||
| Uncertainty | 124 | ||
| Ambivalence | 124 | ||
| The Self as Primary Focus | 125 | ||
| Second Trimester | 125 | ||
| Physical Evidence of Pregnancy | 125 | ||
| The Fetus as Primary Focus | 125 | ||
| Narcissism and Introversion | 125 | ||
| Body Image | 125 | ||
| Changes in Sexuality | 125 | ||
| Third Trimester | 127 | ||
| Vulnerability | 127 | ||
| Increasing Dependence | 127 | ||
| Preparation for Birth | 127 | ||
| Maternal Role Transition | 128 | ||
| Transitions Experienced throughout Pregnancy | 128 | ||
| Steps in Maternal Role Taking | 128 | ||
| Mimicry | 128 | ||
| Role Play | 128 | ||
| Fantasy | 128 | ||
| The Search for a Role Fit | 128 | ||
| Grief Work | 128 | ||
| Maternal Tasks of Pregnancy | 129 | ||
| Seeking Safe Passage | 129 | ||
| Securing Acceptance | 129 | ||
| Learning to Give of Herself | 129 | ||
| Committing Herself to the Unknown Child | 129 | ||
| Paternal Adaptation | 130 | ||
| Variations in Paternal Adaptation | 130 | ||
| Developmental Processes | 130 | ||
| The Reality of Pregnancy and the Child | 130 | ||
| The Struggle for Recognition as a Parent | 130 | ||
| Creating the Role of the Involved Father | 131 | ||
| Parenting Information. | 131 | ||
| Couvade. | 131 | ||
| Adaptation of Grandparents | 131 | ||
| Age | 131 | ||
| Number and Spacing of Other Grandchildren | 131 | ||
| Perceptions of the Role of Grandparents | 131 | ||
| Adaptation of Siblings | 132 | ||
| Toddlers | 132 | ||
| Older Children | 132 | ||
| Adolescents | 132 | ||
| Factors Influencing Psychosocial Adaptations | 132 | ||
| Age | 132 | ||
| Multiparity | 133 | ||
| Social Support | 133 | ||
| Absence of a Partner | 133 | ||
| Abnormal Situations | 133 | ||
| Socioeconomic Status | 133 | ||
| The Affluent | 133 | ||
| The Middle Class | 133 | ||
| The Working Poor and Unemployed | 134 | ||
| The New Poor | 134 | ||
| Barriers to Prenatal Care | 134 | ||
| Cultural Influences on Childbearing | 135 | ||
| Differences within Cultures | 135 | ||
| Cultural Differences Causing Conflict | 136 | ||
| Health Beliefs | 136 | ||
| Health Maintenance. | 136 | ||
| Belief in Fate. | 136 | ||
| Preventing Illness. | 136 | ||
| Restoring Health. | 136 | ||
| Modesty. | 136 | ||
| Female Genital Cutting. | 136 | ||
| Communication | 137 | ||
| Language. | 137 | ||
| Communication Style. | 137 | ||
| Decision Making. | 138 | ||
| Eye Contact. | 138 | ||
| Touch. | 138 | ||
| Time Orientation | 138 | ||
| Culturally Competent Nursing Care | 138 | ||
| Cultural Assessment | 138 | ||
| Cultural Negotiation | 138 | ||
| Application of the Nursing Process Psychosocial Concerns | 138 | ||
| Assessment | 138 | ||
| Nursing Diagnosis | 138 | ||
| Planning: Expected Outcomes | 139 | ||
| Interventions | 139 | ||
| Providing Information | 139 | ||
| Adapting Nursing Care to Pregnancy Progress | 139 | ||
| Discussing Resources | 139 | ||
| Helping the Family Prepare for Birth | 140 | ||
| Modeling Communication Technique | 140 | ||
| Identifying Conflicting Cultural Factors | 140 | ||
| Evaluation | 140 | ||
| Summary Concepts | 140 | ||
| References & Readings | 141 | ||
| 9 Nutrition for Childbearing | 142 | ||
| Objectives | 142 | ||
| Weight Gain during Pregnancy | 142 | ||
| Recommendations for Total Weight Gain | 142 | ||
| Pattern of Weight Gain | 143 | ||
| Maternal and Fetal Weight Distribution | 143 | ||
| Factors that Influence Weight Gain | 143 | ||
| Nutritional Requirements | 144 | ||
| Dietary Reference Intakes | 144 | ||
| Energy | 144 | ||
| Carbohydrates | 145 | ||
| Fats | 145 | ||
| Calories | 145 | ||
| Nutrient Density. | 145 | ||
| Protein | 145 | ||
| Vitamins | 146 | ||
| Fat-Soluble Vitamins | 146 | ||
| Water-Soluble Vitamins | 146 | ||
| Folic Acid | 146 | ||
| Minerals | 146 | ||
| Iron | 146 | ||
| Calcium | 149 | ||
| Sodium | 149 | ||
| Nutritional Supplementation | 150 | ||
| Purpose | 150 | ||
| Disadvantages and Dangers | 150 | ||
| Water | 150 | ||
| Food Plan | 150 | ||
| Whole Grains | 150 | ||
| Vegetables and Fruits | 150 | ||
| Dairy Group | 150 | ||
| Protein Group | 151 | ||
| Other Elements | 151 | ||
| Food Precautions | 151 | ||
| Factors That Influence Nutrition | 151 | ||
| Age | 151 | ||
| Nutritional Knowledge | 151 | ||
| Exercise | 152 | ||
| Culture | 152 | ||
| Southeast Asian Dietary Practices | 152 | ||
| Effect of Culture on Diet during Childbearing. | 152 | ||
| Increasing Nutrients with Traditional Foods. | 152 | ||
| Hispanic Dietary Practices | 153 | ||
| Nutritional Risk Factors | 153 | ||
| Socioeconomic Status | 153 | ||
| Poverty | 153 | ||
| Food Supplement Programs | 153 | ||
| Vegetarianism | 153 | ||
| Meeting the Nutritional Requirements of the Pregnant Vegetarian | 153 | ||
| Energy. | 153 | ||
| Protein. | 153 | ||
| Calcium. | 154 | ||
| Iron. | 154 | ||
| Zinc. | 154 | ||
| Vitamin B12. | 154 | ||
| Vitamin A. | 154 | ||
| Lactose Intolerance | 154 | ||
| Nausea and Vomiting of Pregnancy | 154 | ||
| Anemia | 154 | ||
| Abnormal Prepregnancy Weight | 154 | ||
| Eating Disorders | 154 | ||
| Food Cravings and Aversions | 155 | ||
| Pica | 155 | ||
| Multiparity and Multifetal Pregnancy | 155 | ||
| Substance Abuse | 155 | ||
| Smoking | 155 | ||
| Caffeine | 155 | ||
| Alcohol | 156 | ||
| Drugs | 156 | ||
| Adolescence | 156 | ||
| Nutrient Needs | 156 | ||
| Common Problems | 156 | ||
| Teaching the Adolescent | 156 | ||
| Other Risk Factors | 156 | ||
| Nutrition after Birth | 157 | ||
| Nutrition for the Lactating Mother | 158 | ||
| Energy | 158 | ||
| Protein | 158 | ||
| Fats | 158 | ||
| Vitamins and Minerals | 158 | ||
| Specific Nutritional Concerns | 158 | ||
| Dieting. | 158 | ||
| Adolescence. | 158 | ||
| Vegan Diet. | 158 | ||
| Avoidance of Dairy Products. | 158 | ||
| Inadequate Diet. | 159 | ||
| Alcohol. | 159 | ||
| Caffeine. | 159 | ||
| Fluids. | 159 | ||
| Nutrition for the Nonlactating Mother | 159 | ||
| Weight Loss | 159 | ||
| Application of the Nursing Process Nutrition for Childbearing | 159 | ||
| Assessment | 159 | ||
| Interview | 159 | ||
| Appetite. | 160 | ||
| Eating Habits. | 160 | ||
| Food Preferences. | 160 | ||
| Potential Problems. | 160 | ||
| Psychosocial Influences. | 160 | ||
| Diet History | 160 | ||
| Food Intake Records. | 160 | ||
| 24-Hour Diet History. | 160 | ||
| Food Frequency Questionnaires. | 160 | ||
| Physical Assessment | 160 | ||
| Weight and Height at Initial Visit. | 160 | ||
| Weight at Subsequent Visits. | 160 | ||
| Signs of Nutrient Deficiency. | 161 | ||
| Laboratory Tests | 161 | ||
| Ongoing Nutritional Status | 161 | ||
| Nursing Diagnosis | 161 | ||
| Planning | 161 | ||
| Interventions | 161 | ||
| Identifying Problems | 161 | ||
| Explaining Nutrient Needs | 161 | ||
| Providing Reinforcement | 161 | ||
| Evaluating Weight Gain | 162 | ||
| Encouraging Supplement Intake | 162 | ||
| Making Referrals | 162 | ||
| Evaluation | 162 | ||
| Summary Concepts | 162 | ||
| References & Readings | 163 | ||
| 10 Antepartum Fetal Assessment | 165 | ||
| Objectives | 165 | ||
| Indications for Fetal Diagnostic Tests | 165 | ||
| Ultrasound | 165 | ||
| Emotional Responses | 167 | ||
| Levels of Obstetric Ultrasound | 167 | ||
| First-Trimester Ultrasonography | 167 | ||
| III The Family during Birth | 196 | ||
| 12 Processes of Birth | 196 | ||
| Objectives | 196 | ||
| Physiologic Effects of the Birth Process | 196 | ||
| Maternal Response | 196 | ||
| Reproductive System | 196 | ||
| Characteristics of Contractions. | 196 | ||
| Coordinated. | 196 | ||
| Involuntary. | 196 | ||
| Intermittent. | 196 | ||
| Contraction Cycle. | 196 | ||
| Uterine Body. | 197 | ||
| Cervical Changes. | 197 | ||
| Effacement. | 198 | ||
| Dilation. | 198 | ||
| Cardiovascular System | 198 | ||
| Respiratory System | 198 | ||
| Gastrointestinal System | 198 | ||
| Urinary System | 198 | ||
| Hematopoietic System | 198 | ||
| Fetal Response | 199 | ||
| Placental Circulation | 199 | ||
| Cardiovascular System | 199 | ||
| Pulmonary System | 199 | ||
| Components of the Birth Process | 199 | ||
| Powers | 199 | ||
| Uterine Contractions | 199 | ||
| Maternal Pushing Efforts | 199 | ||
| Passage | 199 | ||
| Passenger | 199 | ||
| Fetal Head | 199 | ||
| Bones, Sutures, and Fontanels. | 199 | ||
| Fetal Head Diameters. | 201 | ||
| Variations in the Passenger | 202 | ||
| Fetal Lie. | 202 | ||
| Attitude. | 202 | ||
| Presentation. | 202 | ||
| Cephalic Presentation. | 202 | ||
| Breech Presentation. | 202 | ||
| Shoulder Presentation. | 203 | ||
| Position | 203 | ||
| Right (R) or Left (L). | 204 | ||
| Occiput (O), Mentum (M), or Sacrum (S). | 204 | ||
| Anterior (A), Posterior (P), or Transverse (T). | 204 | ||
| Psyche | 204 | ||
| Anxiety | 204 | ||
| Culture and Expectations. | 206 | ||
| Birth as an Experience | 206 | ||
| Support | 206 | ||
| Impact of Technology | 206 | ||
| Interrelationships of Components | 206 | ||
| Normal Labor | 206 | ||
| Theories of Onset | 206 | ||
| Premonitory Signs | 207 | ||
| Braxton Hicks Contractions | 207 | ||
| Lightening | 207 | ||
| Increased Vaginal Mucous Secretions | 207 | ||
| Cervical Ripening and Bloody Show | 207 | ||
| Energy Spurt | 207 | ||
| Weight Loss | 207 | ||
| True Labor and False Labor | 208 | ||
| Labor Mechanisms | 208 | ||
| Stages and Phases of Labor | 208 | ||
| First Stage | 208 | ||
| Latent Phase | 212 | ||
| Active Phase | 212 | ||
| Transition Phase | 212 | ||
| Second Stage | 213 | ||
| Third Stage | 213 | ||
| Fourth Stage | 214 | ||
| Duration of Labor | 214 | ||
| Summary Concepts | 214 | ||
| References & Readings | 215 | ||
| 13 Nursing Care during Labor and Birth | 220 | ||
| Objectives | 220 | ||
| Issues for New Nurses | 220 | ||
| Pain Associated with Birth | 220 | ||
| Inexperience and Negative Experiences | 220 | ||
| Unpredictability | 221 | ||
| Intimacy | 221 | ||
| Admission to the Birth Facility | 221 | ||
| The Decision to Go to the Birth Facility | 221 | ||
| Nursing Responsibilities during Admission | 221 | ||
| Establish a Therapeutic Relationship | 221 | ||
| Make the Family Feel Welcome. | 221 | ||
| Determine Family Expectations About Birth. | 222 | ||
| Convey Confidence. | 222 | ||
| Assign a Primary Nurse. | 222 | ||
| Use Touch for Comfort. | 222 | ||
| Respect Cultural Values. | 222 | ||
| Admission Assessments | 222 | ||
| Focused Assessment | 222 | ||
| Fetal Heart Rate. | 222 | ||
| Maternal Vital Signs. | 222 | ||
| Impending Birth. | 222 | ||
| Database Assessment | 228 | ||
| Basic Information. | 228 | ||
| Fetal Assessments. | 228 | ||
| Labor Status. | 229 | ||
| Physical Examination. | 229 | ||
| Admission Procedures | 229 | ||
| Notify the Birth Attendant. | 229 | ||
| Consent Forms. | 229 | ||
| Laboratory Tests. | 229 | ||
| Intravenous Access. | 229 | ||
| Assessments after Admission | 229 | ||
| Fetal Assessments. | 229 | ||
| Fetal Heart Rate. | 229 | ||
| Maternal Assessments. | 231 | ||
| Vital Signs. | 231 | ||
| Contractions. | 231 | ||
| Labor Progress. | 231 | ||
| Intake and Output. | 233 | ||
| Response to Labor. | 233 | ||
| Support Person’s Response. | 233 | ||
| Application of the Nursing Process False or Early Labor | 233 | ||
| Assessment | 233 | ||
| Analysis | 233 | ||
| Planning | 233 | ||
| Interventions | 233 | ||
| Reassurance | 233 | ||
| Teaching | 233 | ||
| Evaluation | 233 | ||
| Application of the Nursing Process True Labor | 233 | ||
| Fetal Oxygenation | 234 | ||
| Assessment | 234 | ||
| Nursing Diagnosis | 234 | ||
| Planning | 234 | ||
| Interventions | 234 | ||
| Promote Placental Function | 234 | ||
| Observe for Conditions Associated with Fetal Compromise | 235 | ||
| Evaluation | 235 | ||
| Discomfort | 235 | ||
| Assessment | 235 | ||
| Analysis | 235 | ||
| Planning | 236 | ||
| Interventions | 236 | ||
| Provide Comfort Measures | 236 | ||
| Lighting. | 236 | ||
| Temperature. | 236 | ||
| Cleanliness. | 236 | ||
| Mouth Care. | 236 | ||
| Bladder. | 236 | ||
| Positioning. | 236 | ||
| Water. | 236 | ||
| Teaching | 237 | ||
| First Stage. | 237 | ||
| Second Stage. | 237 | ||
| Laboring Down. | 237 | ||
| Positions. | 238 | ||
| Method and Breathing Pattern. | 239 | ||
| Encouragement | 240 | ||
| Giving of Self | 240 | ||
| Offering Pharmacologic Measures | 242 | ||
| Care for the Birth Partner | 243 | ||
| Evaluation | 243 | ||
| Prevent Injury | 244 | ||
| Assessment | 244 | ||
| Nursing Diagnosis | 244 | ||
| Planning | 244 | ||
| Interventions | 244 | ||
| Transferring to a Delivery Room | 244 | ||
| Positioning for Birth | 244 | ||
| Observe the Perineum | 244 | ||
| Evaluation | 244 | ||
| Nursing Care during the Late Intrapartum Period | 244 | ||
| Responsibilities during Birth | 244 | ||
| Responsibilities after Birth | 246 | ||
| Care of the Infant | 246 | ||
| Maintain Cardiopulmonary Function. | 248 | ||
| Support Thermoregulation. | 248 | ||
| Identify the Infant. | 248 | ||
| Care of the Mother | 249 | ||
| Observe for Hemorrhage. | 249 | ||
| Vital Signs. | 249 | ||
| Fundus. | 249 | ||
| Bladder. | 249 | ||
| Lochia. | 249 | ||
| Perineal and Labial Areas. | 250 | ||
| Promote Comfort | 250 | ||
| Ice Packs. | 250 | ||
| Analgesics. | 250 | ||
| Warmth. | 250 | ||
| Promote Early Family Attachment | 250 | ||
| Summary Concepts | 251 | ||
| References & Readings | 251 | ||
| 14 Intrapartum Fetal Surveillance | 253 | ||
| Objectives | 253 | ||
| Fetal Oxygenation | 254 | ||
| Uteroplacental Exchange | 254 | ||
| Fetal Circulation | 254 | ||
| Regulation of Fetal Heart Rate | 254 | ||
| Autonomic Nervous System | 254 | ||
| Baroreceptors | 254 | ||
| Chemoreceptors | 254 | ||
| Adrenal Glands | 254 | ||
| Central Nervous System | 254 | ||
| Pathologic Influences on Fetal Oxygenation | 254 | ||
| Maternal Cardiopulmonary Alterations | 254 | ||
| Uterine Activity | 255 | ||
| Placental Disruptions | 255 | ||
| Interruptions in Umbilical Flow | 256 | ||
| Fetal Alterations | 256 | ||
| Risk Factors | 256 | ||
| Auscultation and Palpation | 256 | ||
| Advantages | 256 | ||
| Limitations | 257 | ||
| Auscultation Equipment | 257 | ||
| Evaluation of Auscultated Fetal Heart Rate Data | 257 | ||
| Electronic Fetal Monitoring | 257 | ||
| Advantages | 257 | ||
| Limitations | 259 | ||
| Electronic Fetal Monitoring Equipment | 259 | ||
| Bedside Monitor Unit | 259 | ||
| Paper Strip | 259 | ||
| Data Entry Devices and Computer Software | 260 | ||
| Remote Surveillance | 260 | ||
| Devices for External Fetal Monitoring | 260 | ||
| Fetal Heart Rate Monitoring with an Ultrasound Transducer | 260 | ||
| Uterine Activity Monitoring with a Tocotransducer | 260 | ||
| Devices for Internal Fetal Monitoring | 261 | ||
| Fetal Heart Rate Monitoring with a Scalp Electrode | 261 | ||
| Uterine Activity Monitoring with an Intrauterine Pressure Catheter | 262 | ||
| Evaluating Intermittent Auscultation and Palpation Data | 262 | ||
| Evaluation of Electronic Fetal Monitoring Strips | 263 | ||
| Fetal Heart Rate Baseline | 263 | ||
| Baseline Fetal Heart Rate Variability | 263 | ||
| Periodic Patterns in the Fetal Heart Rate | 264 | ||
| Accelerations | 264 | ||
| Decelerations | 264 | ||
| Early Decelerations. | 265 | ||
| Late Decelerations. | 265 | ||
| Variable Decelerations. | 265 | ||
| Uterine Activity | 265 | ||
| Significance of Fetal Heart Rate Patterns | 267 | ||
| Reassuring Patterns | 267 | ||
| Indeterminate Patterns | 267 | ||
| Nonreassuring Patterns | 267 | ||
| Clarification of Data | 269 | ||
| Vibroacoustic Stimulation. | 269 | ||
| Fetal Scalp Stimulation. | 269 | ||
| Fetal Scalp Blood Sample. | 269 | ||
| Cord Blood Gases and pH. | 269 | ||
| Interventions for Nonreassuring (Category III) Patterns | 270 | ||
| Identify the Cause. | 270 | ||
| Improve Fetal Oxygenation. | 270 | ||
| Increasing Maternal Blood Oxygen Saturation. | 270 | ||
| Reducing Cord Compression. | 270 | ||
| Application of the Nursing Process Intermittent Auscultation and Electronic Fetal Monitoring | 270 | ||
| Learning Needs | 271 | ||
| Assessment | 271 | ||
| Nursing Diagnosis | 271 | ||
| Planning | 271 | ||
| Interventions | 271 | ||
| Explain Fetal Heart Rate Auscultation with Uterine Palpation | 271 | ||
| Explain the Electronic Fetal Monitor | 271 | ||
| Address Parents’ Safety Concerns | 271 | ||
| Coping with Misleading Data | 271 | ||
| Include the Labor Partner | 271 | ||
| Enhance Comfort | 272 | ||
| Evaluation | 272 | ||
| Fetal Oxygenation | 272 | ||
| Assessment | 272 | ||
| Nursing Diagnosis | 274 | ||
| Planning | 274 | ||
| Interventions | 274 | ||
| Take Corrective Actions | 274 | ||
| Reassure Parents | 274 | ||
| Notify Birth Attendant | 274 | ||
| Document Assessments and Care | 274 | ||
| Summary Concepts | 276 | ||
| References & Readings | 277 | ||
| 15 Pain Management during Childbirth | 278 | ||
| Objectives | 278 | ||
| Unique Nature of Pain during Birth | 278 | ||
| Adverse Effects of Excessive Pain | 279 | ||
| Physiologic Effects | 279 | ||
| Psychological Effects | 279 | ||
| Variables in Childbirth Pain | 279 | ||
| Physical Factors | 279 | ||
| Sources of Pain | 279 | ||
| Tissue Ischemia. | 279 | ||
| Cervical Dilation. | 279 | ||
| Pressure and Pulling on Pelvic Structures. | 279 | ||
| Distention of the Vagina and Perineum. | 279 | ||
| Factors Influencing Perception or Tolerance of Pain | 279 | ||
| Labor Intensity. | 279 | ||
| Cervical Readiness. | 280 | ||
| Fetal Position. | 280 | ||
| Pelvic Readiness. | 280 | ||
| Fatigue and Hunger. | 280 | ||
| Caregiver Interventions. | 280 | ||
| Psychosocial Factors | 280 | ||
| Culture | 280 | ||
| Anxiety and Fear | 280 | ||
| Previous Experiences with Pain | 280 | ||
| Preparation for Childbirth | 281 | ||
| Support System | 281 | ||
| Standards for Pain Management | 281 | ||
| Nonpharmacologic Pain Management | 281 | ||
| Advantages | 281 | ||
| Limitations | 281 | ||
| Gate-Control Theory | 281 | ||
| Preparation for Pain Management | 282 | ||
| Application of Nonpharmacologic Techniques | 282 | ||
| Relaxation | 282 | ||
| Environmental Comfort. | 282 | ||
| General Comfort. | 282 | ||
| Reducing Anxiety and Fear. | 282 | ||
| Specific Relaxation Techniques. | 282 | ||
| Cutaneous Stimulation | 282 | ||
| Self-Massage. | 282 | ||
| Massage by Others. | 282 | ||
| Counterpressure. | 283 | ||
| Touch. | 283 | ||
| Thermal Stimulation. | 283 | ||
| Acupressure. | 283 | ||
| Hydrotherapy | 283 | ||
| Mental Stimulation | 283 | ||
| Imagery. | 283 | ||
| Focal Point. | 283 | ||
| Breathing Techniques | 284 | ||
| First-Stage Breathing. | 284 | ||
| Taking a Cleansing Breath. | 284 | ||
| Slow-Paced Breathing. | 284 | ||
| Modified-Paced Breathing. | 285 | ||
| Patterned-Paced Breathing. | 285 | ||
| Breathing to Prevent Pushing. | 285 | ||
| Overcoming Common Problems. | 285 | ||
| Second-Stage Breathing. | 285 | ||
| Pharmacologic Pain Management | 287 | ||
| Special Considerations for Medicating a Pregnant Woman | 287 | ||
| Effects on the Fetus | 287 | ||
| Maternal Physiologic Alterations | 287 | ||
| Cardiovascular Changes. | 287 | ||
| Respiratory Changes. | 287 | ||
| Gastrointestinal Changes. | 287 | ||
| Nervous System Changes. | 287 | ||
| Effects on the Course of Labor | 287 | ||
| Effects of Complications | 287 | ||
| Interactions with Other Substances | 287 | ||
| Regional Pain Management Techniques | 287 | ||
| Epidural Block | 288 | ||
| Technique. | 288 | ||
| Dural Puncture. | 289 | ||
| Contraindications and Precautions. | 289 | ||
| Adverse Effects of Epidural Block. | 289 | ||
| Maternal Hypotension. | 289 | ||
| Bladder Distention. | 289 | ||
| Prolonged Second Stage. | 289 | ||
| Catheter Migration. | 289 | ||
| Cesarean Births. | 289 | ||
| Maternal Fever. | 290 | ||
| Adverse Effects of Epidural Opioids. | 290 | ||
| Nausea and Vomiting. | 290 | ||
| Pruritus. | 290 | ||
| Delayed Respiratory Depression. | 290 | ||
| Nursing Care. | 290 | ||
| Intrathecal Opioid Analgesics | 290 | ||
| Technique. | 290 | ||
| Adverse Effects of Intrathecal Opioids. | 290 | ||
| Nursing Care. | 291 | ||
| Subarachnoid (Spinal) Block | 291 | ||
| Technique. | 291 | ||
| Contraindications and Precautions. | 291 | ||
| Adverse Effects. | 292 | ||
| Postdural Puncture Headache. | 292 | ||
| Systemic Drugs for Labor | 292 | ||
| Nitrous Oxide | 292 | ||
| Parenteral Analgesia | 293 | ||
| Opioid Antagonists | 294 | ||
| Adjunctive Drugs | 294 | ||
| Sedatives | 294 | ||
| Vaginal Birth Anesthesia | 295 | ||
| Local Infiltration Anesthesia | 295 | ||
| Pudendal Block | 295 | ||
| General Anesthesia | 295 | ||
| Technique. | 295 | ||
| Adverse Effects. | 295 | ||
| Maternal Aspiration of Gastric Contents. | 295 | ||
| Respiratory Depression. | 296 | ||
| Uterine Relaxation. | 296 | ||
| Methods to Minimize Adverse Effects. | 296 | ||
| Application of the Nursing Process Pain Management | 296 | ||
| Pain | 296 | ||
| Assessment | 296 | ||
| Labor Status | 296 | ||
| Nursing Diagnosis | 297 | ||
| Planning | 297 | ||
| Interventions | 297 | ||
| Promoting Relaxation | 297 | ||
| Reducing Outside Sources of Discomfort | 297 | ||
| Reducing Anxiety and Fear | 297 | ||
| Helping the Woman Use Nonpharmacologic Techniques | 297 | ||
| Massage. | 297 | ||
| Mental Stimulation. | 297 | ||
| Breathing. | 298 | ||
| Incorporating Pharmacologic Methods | 298 | ||
| Evaluation | 298 | ||
| Epidural Analgesia | 298 | ||
| Assessment | 298 | ||
| Nursing Diagnosis | 298 | ||
| Planning | 298 | ||
| Interventions | 298 | ||
| Maternal Hypotension | 298 | ||
| Avoidance of Injury | 301 | ||
| Evaluation | 301 | ||
| Respiratory Compromise | 301 | ||
| Assessment | 301 | ||
| Nursing Diagnosis | 301 | ||
| Planning | 301 | ||
| Interventions | 301 | ||
| Identifying Risk Factors | 301 | ||
| Reducing Risk for Aspiration or Lung Injury | 301 | ||
| Perioperative Care | 301 | ||
| Postoperative Care | 302 | ||
| Evaluation | 302 | ||
| Summary Concepts | 302 | ||
| References & Readings | 302 | ||
| 16 Nursing Care during Obstetric Procedures | 304 | ||
| Objectives | 304 | ||
| Amniotomy | 304 | ||
| Indications | 304 | ||
| Risks | 304 | ||
| Prolapse of the Umbilical Cord | 304 | ||
| Infection | 304 | ||
| Abruptio Placentae | 304 | ||
| Technique | 305 | ||
| Nursing Considerations | 305 | ||
| Obtaining Baseline Information | 305 | ||
| Assisting with Amniotomy | 305 | ||
| Providing Care after Amniotomy | 305 | ||
| Identifying Complications. | 305 | ||
| Promoting Comfort. | 306 | ||
| Induction and Augmentation of Labor | 306 | ||
| Indications | 306 | ||
| Contraindications | 306 | ||
| Risks | 306 | ||
| Technique | 307 | ||
| Determining Whether Induction Is Indicated | 307 | ||
| Cervical Ripening | 307 | ||
| Medical Methods. | 307 | ||
| Mechanical Methods. | 307 | ||
| Oxytocin Administration | 307 | ||
| Serial Induction of Labor | 308 | ||
| Nursing Considerations | 308 | ||
| Observe the Fetal Response | 310 | ||
| Observe the Mother’s Response | 310 | ||
| Version | 311 | ||
| Indications | 311 | ||
| IV The Family Following Birth | 328 | ||
| 17 Postpartum Physiologic Adaptations | 328 | ||
| Objectives | 328 | ||
| Reproductive System | 328 | ||
| Involution of the Uterus | 328 | ||
| Descent of the Uterine Fundus | 329 | ||
| Afterpains | 329 | ||
| Etiology. | 329 | ||
| Nursing Considerations. | 329 | ||
| Lochia | 329 | ||
| Changes in Color. | 329 | ||
| Amount. | 330 | ||
| Cervix | 330 | ||
| Vagina | 330 | ||
| Perineum | 330 | ||
| Discomfort | 330 | ||
| Nursing Considerations | 330 | ||
| Cardiovascular System | 331 | ||
| Cardiac Output | 331 | ||
| Plasma Volume | 331 | ||
| Blood Values | 331 | ||
| Coagulation | 331 | ||
| Gastrointestinal System | 331 | ||
| Urinary System | 332 | ||
| Physical Changes | 332 | ||
| Musculoskeletal System | 332 | ||
| Muscles and Joints | 332 | ||
| Abdominal Wall | 332 | ||
| Integumentary System | 332 | ||
| Neurologic System | 333 | ||
| Endocrine System | 333 | ||
| Resumption of Ovulation and Menstruation | 333 | ||
| Lactation | 333 | ||
| Weight Loss | 334 | ||
| Postpartum Assessments | 334 | ||
| Initial Assessments | 334 | ||
| Chart Review | 334 | ||
| Need for Rho(D) Immune Globulin | 334 | ||
| Immunizations | 334 | ||
| Rubella Vaccine. | 334 | ||
| Pertussis Vaccine. | 335 | ||
| Varicella Vaccine. | 335 | ||
| Risk Factors for Hemorrhage and Infection | 335 | ||
| Focused Assessments after Vaginal Birth | 335 | ||
| Vital Signs | 335 | ||
| Blood Pressure. | 335 | ||
| Orthostatic Hypotension. | 335 | ||
| Pulse. | 336 | ||
| Respirations. | 336 | ||
| Temperature. | 336 | ||
| Pain. | 336 | ||
| Fundus | 336 | ||
| Lochia | 337 | ||
| Perineum | 337 | ||
| Bladder Elimination | 338 | ||
| Breasts | 338 | ||
| Lower Extremities | 338 | ||
| Homans’ Sign. | 338 | ||
| Edema and Deep Tendon Reflexes. | 338 | ||
| Care in the Immediate Postpartum Period | 339 | ||
| Providing Comfort Measures | 339 | ||
| Ice Packs | 339 | ||
| Sitz Baths | 339 | ||
| Perineal Care | 339 | ||
| Topical Medications | 339 | ||
| Sitting Measures | 340 | ||
| Analgesics | 340 | ||
| Promoting Bladder Elimination | 340 | ||
| Providing Fluids and Food | 340 | ||
| Preventing Thrombophlebitis | 340 | ||
| Nursing Care after Cesarean Birth | 340 | ||
| Assessment | 340 | ||
| Pain Relief | 340 | ||
| Respirations | 341 | ||
| Abdomen | 342 | ||
| Intake and Output | 342 | ||
| Interventions | 342 | ||
| The First 24 Hours | 342 | ||
| Providing Pain Relief. | 342 | ||
| Overcoming Effects of Immobility. | 342 | ||
| Providing Comfort. | 342 | ||
| After 24 Hours | 342 | ||
| Resuming Normal Activities. | 342 | ||
| Assisting the Mother with Infant Feeding. | 342 | ||
| Preventing Abdominal Distention. | 342 | ||
| Teaching for Discharge. | 343 | ||
| Application of the Nursing Process Knowledge of Self-Care | 343 | ||
| Assessment | 343 | ||
| Nursing Diagnosis | 343 | ||
| Planning | 343 | ||
| Interventions | 343 | ||
| Preparing for Teaching | 343 | ||
| Determining Teaching Topics | 343 | ||
| Teaching about the Process of Involution | 343 | ||
| Teaching Self-Care | 343 | ||
| Handwashing. | 343 | ||
| Breast Care for Lactating Mothers. | 343 | ||
| Measures to Suppress Lactation. | 344 | ||
| Care of the Cesarean Incision. | 344 | ||
| Perineal Care. | 344 | ||
| Kegel Exercises. | 344 | ||
| Promoting Rest and Sleep | 344 | ||
| Rest at the Birth Facility. | 344 | ||
| Rest at Home. | 344 | ||
| Infant Sleep and Feeding Schedules. | 345 | ||
| Providing Nutrition Counseling | 345 | ||
| Food Supply. | 345 | ||
| Diet. | 345 | ||
| Promoting Regular Bowel Elimination | 345 | ||
| Promoting Good Body Mechanics | 345 | ||
| Exercise. | 345 | ||
| Prevention of Back Strain. | 345 | ||
| Counseling about Sexual Activity | 345 | ||
| Instructing about Follow-Up Appointments | 347 | ||
| Teaching about Signs and Symptoms That Should Be Reported | 348 | ||
| Ensuring That All Elements Have Been Taught | 348 | ||
| Documenting Teaching | 349 | ||
| Evaluation | 349 | ||
| Postpartum Discharge and Community-Based Care | 349 | ||
| Criteria for Discharge | 349 | ||
| Community-Based Care | 349 | ||
| Summary Concepts | 349 | ||
| References & Readings | 350 | ||
| 18 Postpartum Psychosocial Adaptations | 351 | ||
| Objectives | 351 | ||
| The Process of Becoming Acquainted | 351 | ||
| Bonding | 351 | ||
| Attachment | 351 | ||
| Maternal Touch | 352 | ||
| Verbal Behaviors | 353 | ||
| The Process of Maternal Adaptation | 353 | ||
| Puerperal Phases | 353 | ||
| Taking-In Phase | 353 | ||
| Taking-Hold Phase | 353 | ||
| Letting-Go Phase | 353 | ||
| Maternal Role Attainment | 354 | ||
| Heading toward a New Normal | 354 | ||
| Appreciating the Body | 354 | ||
| Settling-In | 354 | ||
| Becoming a New Family | 354 | ||
| Redefined Roles | 354 | ||
| Role Conflict | 355 | ||
| Major Maternal Concerns | 355 | ||
| Body Image | 355 | ||
| Smoking | 355 | ||
| Postpartum Blues | 355 | ||
| The Process of Family Adaptation | 356 | ||
| Fathers | 356 | ||
| Siblings | 357 | ||
| Grandparents | 358 | ||
| Factors That Affect Family Adaptation | 358 | ||
| Discomfort and Fatigue | 359 | ||
| Knowledge of Infant Needs | 359 | ||
| Previous Experience | 359 | ||
| Expectations about the Newborn | 359 | ||
| Maternal Age | 359 | ||
| Maternal Temperament | 359 | ||
| Temperament of the Infant | 360 | ||
| Availability of a Strong Support System | 360 | ||
| Other Factors | 360 | ||
| Cesarean Birth | 360 | ||
| Preterm or Ill Infant | 360 | ||
| Birth of Multiple Infants | 360 | ||
| Cultural Influences on Adaptation | 360 | ||
| Communication | 360 | ||
| Health Beliefs | 361 | ||
| Dietary Practices | 362 | ||
| Home and Community-Based Care | 362 | ||
| Application of the Nursing Process Maternal Adaptation | 362 | ||
| Assessment | 362 | ||
| Nursing Diagnosis | 362 | ||
| Planning | 362 | ||
| Interventions | 362 | ||
| Assisting the Mother through Recovery Phases | 362 | ||
| “Mother” the Mother. | 362 | ||
| Monitor and Protect. | 362 | ||
| Listen to the Birth Experience. | 362 | ||
| Foster Independence | 362 | ||
| Promote Bonding and Attachment | 362 | ||
| Involve Parents in Infant Care | 364 | ||
| Evaluation | 364 | ||
| Application of the Nursing Process Family Adaptation | 364 | ||
| Assessment | 364 | ||
| Fathers | 364 | ||
| Siblings | 364 | ||
| Support System | 364 | ||
| Nonverbal Behavior | 364 | ||
| Nursing Diagnosis | 364 | ||
| Planning | 364 | ||
| Interventions | 364 | ||
| Teaching the Family about the Newborn | 364 | ||
| Infant Needs. | 366 | ||
| Infant Signals. | 366 | ||
| Helping the Family Adapt | 366 | ||
| Providing Anticipatory Guidance about Stress Reduction. | 366 | ||
| Helping the Father Co-Parent. | 366 | ||
| Providing Ways to Reduce Sibling Rivalry. | 366 | ||
| Identifying Resources. | 366 | ||
| Evaluation | 366 | ||
| Summary Concepts | 366 | ||
| References & Readings | 367 | ||
| 19 Normal Newborn: | 368 | ||
| Objectives | 368 | ||
| Initiation of Respirations | 368 | ||
| Development of the Lungs | 368 | ||
| Causes of Respirations | 369 | ||
| Chemical Factors | 369 | ||
| Mechanical Factors | 369 | ||
| Thermal Factors | 369 | ||
| Sensory Factors | 369 | ||
| Continuation of Respirations | 369 | ||
| Cardiovascular Adaptation: Transition From Fetal to Neonatal Circulation | 370 | ||
| Ductus Venosus | 370 | ||
| Foramen Ovale | 370 | ||
| Pulmonary Blood Vessels | 370 | ||
| Ductus Arteriosus | 370 | ||
| Changes at Birth | 370 | ||
| Neurologic Adaptation: Thermoregulation | 371 | ||
| Newborn Characteristics That Lead to Heat Loss | 371 | ||
| Methods of Heat Loss | 372 | ||
| Evaporation | 372 | ||
| Conduction | 372 | ||
| Convection | 372 | ||
| Radiation | 372 | ||
| Nonshivering Thermogenesis | 373 | ||
| Effects of Cold Stress | 373 | ||
| Neutral Thermal Environment | 374 | ||
| Hyperthermia | 374 | ||
| Hematologic Adaptation | 374 | ||
| Factors That Affect the Blood | 374 | ||
| Blood Values | 375 | ||
| Erythrocytes and Hemoglobin | 375 | ||
| Hematocrit | 375 | ||
| Leukocytes | 375 | ||
| Risk of Clotting Deficiency | 375 | ||
| Gastrointestinal System | 375 | ||
| Stomach | 375 | ||
| Intestines | 375 | ||
| Digestive Enzymes | 376 | ||
| Stools | 376 | ||
| Hepatic System | 376 | ||
| Blood Glucose Maintenance | 376 | ||
| Conjugation of Bilirubin | 376 | ||
| Source and Effect of Bilirubin | 376 | ||
| Normal Conjugation | 377 | ||
| Factors in Increased Bilirubin | 377 | ||
| Excess Production. | 377 | ||
| Red Blood Cell Life. | 377 | ||
| Albumin. | 377 | ||
| Liver Immaturity. | 378 | ||
| Blood Incompatibility. | 378 | ||
| Gestation. | 378 | ||
| Intestinal Factors. | 378 | ||
| Delayed Feeding. | 378 | ||
| Trauma. | 378 | ||
| Fatty Acids. | 378 | ||
| Family Background. | 378 | ||
| Other Factors. | 378 | ||
| Hyperbilirubinemia | 378 | ||
| Physiologic Jaundice | 378 | ||
| Nonphysiologic Jaundice | 378 | ||
| Jaundice Associated with Breastfeeding | 378 | ||
| Breastfeeding or Early-Onset Jaundice. | 378 | ||
| True Breast Milk Jaundice. | 379 | ||
| Blood Coagulation | 379 | ||
| Iron Storage | 379 | ||
| Metabolism of Drugs | 379 | ||
| Urinary System | 379 | ||
| Kidney Development | 379 | ||
| Kidney Function | 379 | ||
| Fluid Balance | 379 | ||
| Water Distribution | 379 | ||
| Insensible Water Loss | 380 | ||
| Urine Dilution and Concentration | 380 | ||
| Acid-Base and Electrolyte Balance | 380 | ||
| Immune System | 380 | ||
| Immunoglobulin G | 380 | ||
| Immunoglobulin M | 380 | ||
| Immunoglobulin A | 380 | ||
| Psychosocial Adaptation | 380 | ||
| Periods of Reactivity | 380 | ||
| First Period of Reactivity | 380 | ||
| Period of Sleep or Decreased Activity | 380 | ||
| Second Period of Reactivity | 380 | ||
| Behavioral States | 381 | ||
| Deep or Quiet Sleep State | 381 | ||
| Light or Active Sleep State | 381 | ||
| Drowsy State | 381 | ||
| Quiet Alert State | 381 | ||
| Active Alert State | 381 | ||
| Crying State | 381 | ||
| Summary Concepts | 381 | ||
| References & Readings | 382 | ||
| 20 Assessment of the Normal Newborn | 383 | ||
| Objectives | 383 | ||
| Early Focused Assessments | 383 | ||
| History | 383 | ||
| Assessment of Cardiorespiratory Status | 383 | ||
| Airway | 383 | ||
| Respiratory Rate. | 383 | ||
| Breath Sounds. | 384 | ||
| Signs of Respiratory Distress. | 384 | ||
| Tachypnea. | 384 | ||
| Retractions. | 384 | ||
| Flaring of the Nares. | 385 | ||
| Cyanosis. | 385 | ||
| Grunting. | 385 | ||
| Seesaw or Paradoxical Respirations. | 385 | ||
| Asymmetry. | 385 | ||
| Choanal Atresia. | 385 | ||
| Color | 385 | ||
| Pallor. | 385 | ||
| Ruddy Color. | 385 | ||
| Heart Sounds | 385 | ||
| Position. | 385 | ||
| Rhythm and Murmurs. | 385 | ||
| Brachial and Femoral Pulses | 386 | ||
| Blood Pressure | 386 | ||
| Capillary Refill | 386 | ||
| Assessment of Thermoregulation | 386 | ||
| General Assessment | 386 | ||
| Head | 386 | ||
| Molding. | 387 | ||
| Fontanels. | 387 | ||
| Caput Succedaneum. | 387 | ||
| Cephalhematoma. | 387 | ||
| Face. | 388 | ||
| Neck and Clavicles | 388 | ||
| Cord | 388 | ||
| Extremities | 389 | ||
| Hands and Feet. | 389 | ||
| Hips. | 389 | ||
| Vertebral Column | 389 | ||
| Measurements | 390 | ||
| Weight | 390 | ||
| Length | 391 | ||
| Head and Chest Circumference | 391 | ||
| Assessment of Body Systems | 392 | ||
| Neurologic System | 392 | ||
| Reflexes | 392 | ||
| Sensory Assessment | 392 | ||
| Ears. | 392 | ||
| Eyes. | 392 | ||
| Sense of Smell and Taste. | 395 | ||
| Other Neurologic Signs | 395 | ||
| Hepatic System | 395 | ||
| Blood Glucose | 395 | ||
| Bilirubin | 396 | ||
| Gastrointestinal System | 396 | ||
| Mouth | 396 | ||
| Suck | 397 | ||
| Initial Feeding | 398 | ||
| Abdomen | 398 | ||
| Stools | 398 | ||
| Genitourinary System | 398 | ||
| Kidney Palpation | 398 | ||
| Urine | 398 | ||
| Genitalia | 399 | ||
| Female. | 399 | ||
| Male. | 399 | ||
| Integumentary System | 399 | ||
| Skin | 399 | ||
| Color. | 399 | ||
| Harlequin Color Change. | 399 | ||
| Mottling (Cutis Marmorata). | 399 | ||
| Vernix Caseosa. | 399 | ||
| Lanugo. | 400 | ||
| Milia. | 400 | ||
| Erythema Toxicum. | 400 | ||
| Birthmarks. | 400 | ||
| Marks from Delivery. | 401 | ||
| Other Skin Assessments. | 401 | ||
| Documentation | 401 | ||
| Breasts | 401 | ||
| Hair and Nails | 401 | ||
| Assessment of Gestational Age | 401 | ||
| Assessment Tools | 406 | ||
| Neuromuscular Characteristics | 406 | ||
| Posture | 406 | ||
| Square Window | 406 | ||
| Arm Recoil | 406 | ||
| Popliteal Angle | 407 | ||
| Scarf Sign | 408 | ||
| Heel to Ear | 408 | ||
| Physical Characteristics | 408 | ||
| Skin | 408 | ||
| Lanugo | 409 | ||
| Plantar Surface | 409 | ||
| Breasts | 409 | ||
| Eyes and Ears | 410 | ||
| Genitals | 410 | ||
| Scoring | 411 | ||
| Gestational Age and Infant Size | 411 | ||
| Further Assessments | 411 | ||
| Assessment of Behavior | 411 | ||
| Periods of Reactivity | 412 | ||
| Behavioral Changes | 412 | ||
| Orientation | 412 | ||
| Habituation | 412 | ||
| Self-Consoling Activities | 412 | ||
| Parents’ Response | 413 | ||
| Summary Concepts | 413 | ||
| References & Readings | 413 | ||
| 21 Care of the Normal Newborn | 415 | ||
| Objectives | 415 | ||
| Early Care | 415 | ||
| Administering Vitamin K | 415 | ||
| Providing Eye Treatment | 415 | ||
| Application of the Nursing Process Cardiorespiratory Status | 417 | ||
| Assessment | 417 | ||
| Nursing Diagnosis | 417 | ||
| Expected Outcomes | 417 | ||
| Interventions | 417 | ||
| Positioning and Suctioning Secretions | 417 | ||
| Providing Continuing Care | 417 | ||
| Evaluation | 417 | ||
| Application of the Nursing Process Thermoregulation | 418 | ||
| Assessment | 418 | ||
| Nursing Diagnosis | 418 | ||
| Expected Outcome | 418 | ||
| Interventions | 418 | ||
| Preventing Heat Loss | 418 | ||
| Preparing the Environment before Birth. | 418 | ||
| Providing Immediate Care. | 418 | ||
| Providing Ongoing Prevention. | 418 | ||
| Restoring Thermoregulation | 419 | ||
| Performing Expanded Assessments | 419 | ||
| Evaluation | 419 | ||
| Application of the Nursing Process Hepatic Function | 419 | ||
| Blood Glucose | 419 | ||
| Assessment | 419 | ||
| Nursing Diagnosis | 419 | ||
| Expected Outcomes | 419 | ||
| Interventions | 419 | ||
| Maintaining Safe Glucose Levels | 419 | ||
| Repeating Glucose Tests | 420 | ||
| Providing Other Care | 420 | ||
| Evaluation | 420 | ||
| Bilirubin | 421 | ||
| Assessment | 421 | ||
| Nursing Diagnosis | 421 | ||
| Expected Outcomes | 421 | ||
| Interventions | 421 | ||
| Evaluation | 421 | ||
| Ongoing Assessments and Care | 421 | ||
| Providing Skin Care | 421 | ||
| Bathing | 421 | ||
| Providing Cord Care | 422 | ||
| Cleansing the Diaper Area | 422 | ||
| Assisting with Feedings | 423 | ||
| Positioning for Sleep | 423 | ||
| Positioning and Head Shape | 423 | ||
| Protecting the Infant | 423 | ||
| Identifying the Infant | 423 | ||
| Preventing Infant Abduction | 423 | ||
| Preventing Infection | 424 | ||
| Preventing Infant Falls | 425 | ||
| Circumcision | 425 | ||
| Reasons for Choosing Circumcision | 425 | ||
| Reasons for Rejecting Circumcision | 425 | ||
| Pain Relief | 425 | ||
| Methods | 426 | ||
| Nursing Considerations | 426 | ||
| Assisting in Decision Making | 426 | ||
| Providing Care during Circumcision | 426 | ||
| Evaluating Pain | 427 | ||
| Providing Postprocedure Care | 427 | ||
| Teaching Parents | 427 | ||
| Application of the Nursing Process Parents’ Knowledge of Newborn Care | 428 | ||
| Assessment | 428 | ||
| Nursing Diagnosis | 428 | ||
| Expected Outcomes | 428 | ||
| Interventions | 428 | ||
| Determining Who Teaches | 428 | ||
| Setting Priorities | 428 | ||
| Using Various Teaching Methods | 428 | ||
| Modeling Behavior | 429 | ||
| Teaching Intermittently | 429 | ||
| Including the Father | 429 | ||
| Documenting Teaching | 429 | ||
| Providing for Follow-Up Care | 429 | ||
| Incorporating Cultural Considerations | 429 | ||
| Evaluation | 429 | ||
| Immunization | 429 | ||
| Newborn Screening Tests | 432 | ||
| Critical Congenital Heart Defect Screening | 432 | ||
| Hearing Screening | 432 | ||
| Other Screening Tests | 433 | ||
| Commonly Screened Conditions | 433 | ||
| Phenylketonuria | 433 | ||
| Congenital Hypothyroidism | 433 | ||
| Galactosemia | 433 | ||
| Hemoglobinopathies | 433 | ||
| Congenital Adrenal Hyperplasia | 433 | ||
| Other Conditions | 433 | ||
| Discharge and Newborn Follow-Up Care | 433 | ||
| Discharge | 433 | ||
| Follow-Up Care | 434 | ||
| Summary Concepts | 434 | ||
| References & Readings | 434 | ||
| 22 Infant Feeding | 436 | ||
| Objectives | 436 | ||
| Nutritional Needs of the Newborn | 436 | ||
| Calories | 436 | ||
| Nutrients | 436 | ||
| Water | 436 | ||
| Breast Milk and Formula Composition | 437 | ||
| Breast Milk | 437 | ||
| Changes in Composition | 437 | ||
| Lactogenesis I. | 437 | ||
| Lactogenesis II. | 437 | ||
| Lactogenesis III. | 437 | ||
| Nutrients | 437 | ||
| Protein. | 437 | ||
| Carbohydrate. | 437 | ||
| Fat. | 437 | ||
| Vitamins. | 437 | ||
| Minerals. | 437 | ||
| Enzymes. | 438 | ||
| Infection-Preventing Components | 438 | ||
| Effect of Maternal Diet | 438 | ||
| Formulas | 438 | ||
| Cow’s Milk | 438 | ||
| Formulas for Infants with Special Needs | 438 | ||
| Considerations in Choosing a Feeding Method | 438 | ||
| Breastfeeding | 438 | ||
| Formula Feeding | 439 | ||
| Combination Feeding | 439 | ||
| Factors Influencing Choice | 439 | ||
| Support from Others | 439 | ||
| Culture | 440 | ||
| Employment | 440 | ||
| Staff Knowledge | 440 | ||
| Other Factors | 440 | ||
| Normal Breastfeeding | 441 | ||
| Breast Changes during Pregnancy | 441 | ||
| Milk Production | 441 | ||
| Hormonal Changes at Birth | 441 | ||
| Prolactin | 441 | ||
| Oxytocin | 441 | ||
| Continued Milk Production | 441 | ||
| Preparation of Breasts for Breastfeeding | 441 | ||
| Application of the Nursing Process Breastfeeding | 442 | ||
| Assessment | 442 | ||
| Maternal Assessment | 442 | ||
| Breasts and Nipples. | 442 | ||
| Knowledge. | 442 | ||
| Infant Feeding Behaviors | 442 | ||
| Nursing Diagnosis | 442 | ||
| Expected Outcomes | 442 | ||
| Interventions | 443 | ||
| Assisting with the First Feeding | 444 | ||
| Teaching Feeding Techniques | 444 | ||
| Position of the Mother and Infant. | 444 | ||
| Position of the Mother’s Hands. | 444 | ||
| Latch-On Techniques. | 445 | ||
| Eliciting Latch-On. | 445 | ||
| Position of the Mouth. | 445 | ||
| Suckling Pattern. | 445 | ||
| Removal from the Breast. | 446 | ||
| Frequency of Feedings. | 446 | ||
| Length of Feedings. | 446 | ||
| Preventing Problems. | 446 | ||
| Teaching. | 446 | ||
| Minimizing Interruptions. | 446 | ||
| Formula Gift Packs. | 447 | ||
| Formula Supplementation. | 447 | ||
| Insufficient Milk Supply. | 447 | ||
| Getting Help from Family. | 447 | ||
| Increasing Confidence. | 448 | ||
| Providing Resources. | 448 | ||
| Evaluation | 448 | ||
| Common Breastfeeding Concerns | 448 | ||
| Infant Problems | 448 | ||
| Sleepy Infant | 449 | ||
| Nipple Confusion | 449 | ||
| Suckling Problems | 449 | ||
| Infant Complications | 449 | ||
| Jaundice. | 449 | ||
| Prematurity. | 449 | ||
| Illness and Congenital Defects | 450 | ||
| Maternal Concerns | 450 | ||
| Common Breast Problems | 450 | ||
| Engorgement. | 450 | ||
| Nipple Pain. | 451 | ||
| Flat and Inverted Nipples. | 451 | ||
| Plugged Ducts. | 451 | ||
| Illness in the Mother | 452 | ||
| Drug Transfer to Breast Milk | 452 | ||
| Conditions in which Breastfeeding Should be Avoided. | 454 | ||
| Previous Breast Surgery | 454 | ||
| Employment | 454 | ||
| Milk Expression and Storage | 455 | ||
| Hand Expression. | 455 | ||
| Use of a Breast Pump. | 455 | ||
| Milk Storage. | 455 | ||
| Breastfeeding after Multiple Births | 456 | ||
| Weaning | 456 | ||
| Home Care | 456 | ||
| Formula Feeding | 457 | ||
| Application of the Nursing Process Formula Feeding | 457 | ||
| Assessment | 457 | ||
| Mother’s Knowledge | 457 | ||
| Infant Feeding Behaviors | 457 | ||
| Nursing Diagnosis | 457 | ||
| Expected Outcomes | 457 | ||
| Interventions | 458 | ||
| Teaching about Formula | 458 | ||
| Types of Formula. | 458 | ||
| Ready-to-Use Formula. | 458 | ||
| Concentrated Liquid Formula. | 458 | ||
| Powdered Formula. | 458 | ||
| Equipment. | 458 | ||
| Preparation. | 458 | ||
| Explaining Feeding Techniques | 458 | ||
| Positioning. | 458 | ||
| Burping. | 458 | ||
| Frequency and Amount. | 459 | ||
| Cautions. | 459 | ||
| Infant Variations. | 459 | ||
| Evaluation | 459 | ||
| Summary Concepts | 459 | ||
| References & Readings | 460 | ||
| 23 Home Care of the Infant | 462 | ||
| Objectives | 462 | ||
| Information for New Parents | 462 | ||
| Needs | 462 | ||
| Sources of Information | 462 | ||
| Care after Discharge | 462 | ||
| Home Visits | 462 | ||
| Visits to Low-Risk Families | 463 | ||
| Visits to Families with High-Risk Infants | 464 | ||
| General Considerations in Home Visits | 464 | ||
| Outpatient Visits | 464 | ||
| Parenting Classes | 464 | ||
| Telephone Counseling | 464 | ||
| Follow-Up Calls | 465 | ||
| Warm Lines | 465 | ||
| Telephone Techniques | 465 | ||
| Guidelines and Documentation | 465 | ||
| Infant Equipment | 465 | ||
| Safety Considerations | 465 | ||
| Car Safety Seats | 465 | ||
| Early Problems | 467 | ||
| Crying | 467 | ||
| Colic | 467 | ||
| Description | 467 | ||
| Interventions | 467 | ||
| Sleep | 469 | ||
| Parents | 469 | ||
| Infant Sleep Patterns | 469 | ||
| Sleeping through the Night | 469 | ||
| Concerns of Working Mothers | 469 | ||
| Concerns of Adoptive Parents | 470 | ||
| Common Questions and Concerns | 470 | ||
| Dressing and Warmth | 470 | ||
| Stool and Voiding Patterns | 470 | ||
| Smoking | 470 | ||
| Eyes | 470 | ||
| Baths | 470 | ||
| Nails | 470 | ||
| Sucking Needs | 470 | ||
| Common Rashes | 471 | ||
| Diaper Rash (Diaper Dermatitis) | 471 | ||
| Miliaria (Prickly Heat) | 471 | ||
| Seborrheic Dermatitis (Cradle Cap) | 471 | ||
| Feeding Concerns | 471 | ||
| Regurgitation | 471 | ||
| Introduction of Solid Foods | 472 | ||
| Growth and Development | 472 | ||
| Anticipatory Guidance | 472 | ||
| Growth and Developmental Milestones | 472 | ||
| Accident Prevention | 472 | ||
| Well-Baby Care | 472 | ||
| Well-Baby Checkups | 472 | ||
| Immunizations | 472 | ||
| Illness | 473 | ||
| Recognizing Signs | 473 | ||
| Calling the Pediatrician or Nurse Practitioner | 473 | ||
| Knowing When to Seek Immediate Help | 473 | ||
| Learning about Sudden Infant Death Syndrome | 473 | ||
| Summary Concepts | 474 | ||
| References & Readings | 475 | ||
| V Families at Risk during the Childbearing Period | 476 | ||
| 24 The Childbearing Family with Special Needs | 476 | ||
| Objectives | 476 | ||
| Adolescent Pregnancy | 476 | ||
| Incidence | 476 | ||
| Factors Associated with Teenage Pregnancy | 476 | ||
| Sex Education | 477 | ||
| Options When Pregnancy Occurs | 477 | ||
| Socioeconomic Implications | 477 | ||
| Implications for Maternal Health | 479 | ||
| Implications for Fetal and Neonatal Health | 479 | ||
| The Teenage Expectant Father | 479 | ||
| Impact of Teenage Pregnancy on Parenting | 479 | ||
| Application of the Nursing Process The Pregnant Teenager | 480 | ||
| Assessment | 480 | ||
| Physical Assessment | 480 | ||
| Cognitive Development | 480 | ||
| Knowledge of Infant Needs | 480 | ||
| Family Assessment | 480 | ||
| Nursing Diagnosis | 480 | ||
| Expected Outcomes | 480 | ||
| Interventions | 480 | ||
| Eliminating Barriers to Health Care | 480 | ||
| Applying Teaching and Learning Principles | 482 | ||
| Counseling | 482 | ||
| Nutrition. | 482 | ||
| Self-Care. | 483 | ||
| Stress Reduction. | 483 | ||
| Attachment to the Fetus. | 483 | ||
| Infant Care. | 483 | ||
| Breastfeeding. | 483 | ||
| Promoting Family Support | 483 | ||
| Providing Support during Labor | 483 | ||
| Providing Referrals | 483 | ||
| Evaluation | 484 | ||
| Delayed Pregnancy | 484 | ||
| Maternal and Fetal Implications | 484 | ||
| Advantages of Delayed Childbirth | 484 | ||
| Disadvantages of Delayed Childbirth | 484 | ||
| Nursing Considerations | 485 | ||
| Preconception Care | 485 | ||
| Reinforcing and Clarifying Information | 485 | ||
| Facilitating Expression of Emotions | 485 | ||
| Providing Parenting Information | 485 | ||
| Substance Abuse | 486 | ||
| Incidence | 486 | ||
| Maternal and Fetal Effects | 486 | ||
| Tobacco | 486 | ||
| Maternal and Fetal Effects. | 486 | ||
| Neonatal Effects. | 486 | ||
| Alcohol | 487 | ||
| Marijuana | 487 | ||
| Cocaine | 487 | ||
| VI Women's Health Care | 679 | ||
| 31 Family Planning | 679 | ||
| Objectives | 679 | ||
| Information About Contraception | 679 | ||
| Common Sources | 679 | ||
| Role of the Nurse | 680 | ||
| Considerations When Choosing a Contraceptive Method | 680 | ||
| Safety | 680 | ||
| Protection from Sexually Transmitted Diseases | 680 | ||
| Effectiveness | 680 | ||
| Acceptability | 682 | ||
| Convenience | 683 | ||
| Education Needed | 683 | ||
| Benefits | 683 | ||
| Side Effects | 683 | ||
| Effect on Spontaneity | 684 | ||
| Availability | 684 | ||
| Expense | 684 | ||
| Preference | 684 | ||
| Religious and Personal Beliefs | 684 | ||
| Culture | 684 | ||
| Other Considerations | 684 | ||
| Informed Consent | 684 | ||
| Adolescents and Contraception | 684 | ||
| Adolescent Knowledge | 685 | ||
| Misinformation | 685 | ||
| Risk-Taking Behavior | 685 | ||
| Counseling Adolescents | 685 | ||
| Contraception Use in Perimenopausal Women | 686 | ||
| Methods of Contraception | 686 | ||
| Sterilization | 686 | ||
| Tubal Sterilization | 687 | ||
| Vasectomy | 687 | ||
| Intrauterine Devices | 687 | ||
| Action | 687 | ||
| Side Effects | 688 | ||
| Teaching | 688 | ||
| Hormonal Contraceptives | 688 | ||
| Hormone Implant | 688 | ||
| Hormone Injections | 688 | ||
| Oral Contraceptives | 689 | ||
| Combination OCs. | 689 | ||
| Progestin Only. | 689 | ||
| Benefits, Risks, and Cautions. | 689 | ||
| Side Effects. | 690 | ||
| Teaching. | 690 | ||
| Blood Hormone Levels. | 691 | ||
| Missed Doses. | 691 | ||
| Postpartum and Lactation. | 691 | ||
| Other Medications. | 691 | ||
| Follow-Up. | 691 | ||
| Emergency Contraception | 691 | ||
| Transdermal Contraceptive Patch | 692 | ||
| Contraceptive Vaginal Ring | 692 | ||
| Barrier Methods | 693 | ||
| Chemical Barriers | 693 | ||
| Mechanical Barriers | 693 | ||
| Male Condom. | 693 | ||
| Female Condom. | 694 | ||
| Sponge. | 694 | ||
| Diaphragm. | 694 | ||
| Cervical Cap. | 694 | ||
| Natural Family Planning Methods | 695 | ||
| Calendar | 696 | ||
| Standard Days Method | 696 | ||
| Cervical Mucus | 696 | ||
| Two-Day Method | 696 | ||
| Symptothermal Method | 696 | ||
| Abstinence | 696 | ||
| Least Reliable Methods of Contraception | 697 | ||
| Breastfeeding | 697 | ||
| Coitus Interruptus | 698 | ||
| Application of the Nursing Process Choosing a Contraceptive Method | 698 | ||
| Assessment | 698 | ||
| Introducing the Subject | 698 | ||
| Determining the Woman’s Understanding | 698 | ||
| Assessing the Woman’s Satisfaction | 698 | ||
| Assessing Appropriate Choices | 698 | ||
| Nursing Diagnosis | 698 | ||
| Expected Outcomes | 698 | ||
| Interventions | 698 | ||
| Increasing Understanding of the Chosen Method | 698 | ||
| Teaching about Other Methods | 698 | ||
| Protecting against Sexually Transmitted Diseases | 698 | ||
| Including the Woman’s Partner | 699 | ||
| Providing Ongoing Teaching | 699 | ||
| Evaluation | 699 | ||
| Summary Concepts | 699 | ||
| References & Readings | 699 | ||
| 32 Infertility | 701 | ||
| Objectives | 701 | ||
| Extent of Infertility | 701 | ||
| Factors Contributing to Infertility | 701 | ||
| Factors in the Man | 702 | ||
| Abnormalities of the Sperm | 702 | ||
| Abnormal Erections | 702 | ||
| Abnormal Ejaculation | 702 | ||
| Abnormalities of Seminal Fluid | 702 | ||
| Factors in the Woman | 704 | ||
| Disorders of Ovulation | 704 | ||
| Abnormalities of the Fallopian Tubes | 704 | ||
| Abnormalities of the Cervix | 705 | ||
| Repeated Pregnancy Loss | 705 | ||
| Abnormalities of the Fetal Chromosomes | 705 | ||
| Abnormalities of the Cervix or Uterus | 705 | ||
| Endocrine Abnormalities | 705 | ||
| Immunologic Factors | 706 | ||
| Environmental Agents | 706 | ||
| Infections | 706 | ||
| Evaluation of Infertility | 706 | ||
| Preconception Counseling | 706 | ||
| History and Physical Examination | 706 | ||
| History | 706 | ||
| Physical Examination | 707 | ||
| Diagnostic Tests | 707 | ||
| Therapies to Facilitate Pregnancy | 707 | ||
| Medications | 708 | ||
| Surgical Procedures | 708 | ||
| Therapeutic Insemination | 708 | ||
| Egg Donation | 709 | ||
| Surrogate Parenting | 709 | ||
| Assisted Reproductive Technologies | 710 | ||
| In Vitro Fertilization | 710 | ||
| Gamete Intrafallopian Transfer | 711 | ||
| Zygote Intrafallopian Transfer | 711 | ||
| Comparison of In Vitro Fertilization, Gamete Intrafallopian Transfer, and Tubal Embryo Transfer | 711 | ||
| Intracytoplasmic Sperm Injection (ICSI) | 711 | ||
| Preimplantation Genetic Testing | 711 | ||
| Responses to Infertility | 711 | ||
| Assumption of Fertility | 712 | ||
| Growing Awareness of a Problem | 712 | ||
| Seeking Help for Infertility | 712 | ||
| Identifying the Importance of Having a Baby | 712 | ||
| Sharing Intimate Information | 712 | ||
| Considering Financial Resources | 712 | ||
| Committing to Involvement in Care | 712 | ||
| Reactions during Evaluation and Treatment | 712 | ||
| Influences on Decision Making | 713 | ||
| Social, Cultural, and Religious Values. | 713 | ||
| Difficulty of Treatment. | 713 | ||
| Probability of Success. | 713 | ||
| Financial Concerns. | 713 | ||
| Psychological Reactions | 713 | ||
| Guilt. | 713 | ||
| Isolation. | 713 | ||
| Depression. | 713 | ||
| Stress on the Relationship. | 713 | ||
| Outcomes after Infertility Therapy | 714 | ||
| Pregnancy Loss after Infertility Therapy | 714 | ||
| Parenthood after Infertility Therapy | 714 | ||
| Choosing to Adopt | 714 | ||
| Menopause after Infertility | 714 | ||
| Application of the Nursing Process Care of the Infertile Couple | 715 | ||
| Assessment | 715 | ||
| Nursing Diagnosis | 715 | ||
| Planning | 715 | ||
| Interventions | 715 | ||
| Assist Communication | 715 | ||
| Increase the Couple’s Sense of Control | 715 | ||
| Reduce Isolation | 716 | ||
| Promote a Positive Self-Image | 716 | ||
| Evaluation | 716 | ||
| Summary Concepts | 716 | ||
| References & Readings | 716 | ||
| 33 Preventive Care for Women | 718 | ||
| Objectives | 718 | ||
| National Emphasis on Women’s Health | 718 | ||
| Healthy People 2020 Goals | 718 | ||
| Health Maintenance | 719 | ||
| Health History | 719 | ||
| Physical Assessment | 720 | ||
| Preventive Counseling | 720 | ||
| Screening Procedures | 720 | ||
| Breast Self-Awareness and Breast Self-Examination | 720 | ||
| Clinical Breast Examination | 721 | ||
| Inspection | 721 | ||
| Palpation | 722 | ||
| Mammography | 722 | ||
| Vulvar Self-Examination | 722 | ||
| Pelvic Examination | 722 | ||
| External Organs. | 722 | ||
| Speculum Examination. | 723 | ||
| Bimanual Examination. | 723 | ||
| Cervical Cytology or Pap Test | 723 | ||
| Purpose. | 723 | ||
| Procedure. | 724 | ||
| Classification of Cervical Cytology. | 724 | ||
| Rectal Examination | 724 | ||
| Screening Tests | 724 | ||
| Immunizations | 725 | ||
| Application of the Nursing Process Promoting Health | 726 | ||
| Assessment | 726 | ||
| Nursing Diagnosis | 726 | ||
| Planning | 726 | ||
| Interventions | 726 | ||
| Reinforce the Woman’s Desire for Change | 726 | ||
| Identify Food Preferences | 726 | ||
| Financial Assistance | 727 | ||
| Activity | 727 | ||
| Evaluation | 727 | ||
| Summary Concepts | 727 | ||
| References & Readings | 727 | ||
| 34 Women’s Health Problems | 728 | ||
| Objectives | 728 | ||
| Breast Disorders | 728 | ||
| Diagnostic Evaluation | 728 | ||
| Benign Disorders of the Breast | 728 | ||
| Fibrocystic Breast Changes | 729 | ||
| Fibroadenoma | 729 | ||
| Ductal Ectasia | 729 | ||
| Intraductal Papilloma | 729 | ||
| Nursing Considerations | 729 | ||
| Malignant Tumors of the Breast | 730 | ||
| Incidence | 730 | ||
| Risk Factors | 730 | ||
| Pathophysiology | 730 | ||
| Staging | 730 | ||
| Management | 730 | ||
| Surgical Treatment. | 730 | ||
| Adjuvant Therapy. | 731 | ||
| Radiation Therapy. | 731 | ||
| Chemotherapy. | 731 | ||
| Hormone Therapy. | 731 | ||
| Immunotherapy. | 731 | ||
| Breast Reconstruction | 731 | ||
| Timing. | 731 | ||
| Methods. | 731 | ||
| Psychosocial Consequences of Breast Cancer | 732 | ||
| Nursing Considerations | 732 | ||
| Cardiovascular Disease | 733 | ||
| Recognition of Coronary Artery Disease | 733 | ||
| Risk Factors | 734 | ||
| Prevention | 734 | ||
| Hypertension | 734 | ||
| Smoking Cessation | 735 | ||
| Diet and Glucose Control | 735 | ||
| Increased Activity | 735 | ||
| Aspirin | 735 | ||
| Menstrual Cycle Disorders | 735 | ||
| Amenorrhea | 735 | ||
| Primary Amenorrhea | 735 | ||
| Secondary Amenorrhea | 736 | ||
| Appendix A Use of Drug and Botanical Preparations during Pregnancy and Breastfeeding | 756 | ||
| FDA Pregnancy Risk Categories | 756 | ||
| Drug Use during Lactation | 756 | ||
| References | 765 | ||
| Appendix B Keys to Clinical Practice: Components of Daily Care | 766 | ||
| Intrapartum Care | 766 | ||
| Text to Prepare You for Clinical Practice | 766 | ||
| New Terms | 766 | ||
| Equipment and Supplies | 766 | ||
| Normal Assessments | 766 | ||
| Fetus | 766 | ||
| Gestation. | 766 | ||
| Fetal Heart Rate (FHR). | 766 | ||
| Amniotic Fluid. | 766 | ||
| Woman | 766 | ||
| Temperature. | 766 | ||
| Blood Pressure. | 766 | ||
| Pulse Rate. | 766 | ||
| Respirations. | 766 | ||
| Contractions. | 766 | ||
| Bloody Show. | 766 | ||
| Lochia (Fourth Stage). | 766 | ||
| Fundus (Fourth Stage). | 766 | ||
| Nursing Care | 766 | ||
| Assessments | 766 | ||
| Interventions | 767 | ||
| Postpartum Care: Physiologic Aspects | 767 | ||
| Text to Prepare You for Clinical Practice | 767 | ||
| New Terms | 767 | ||
| Equipment and Supplies | 767 | ||
| Normal Assessments | 767 | ||
| Vital Signs | 767 | ||
| Temperature. | 767 | ||
| Blood Pressure. | 767 | ||
| Pulse Rate. | 767 | ||
| Respirations. | 767 | ||
| Breasts | 767 | ||
| Gastrointestinal System | 767 | ||
| Genitourinary System | 767 | ||
| Nursing Care | 768 | ||
| Assessments | 768 | ||
| Interventions | 768 | ||
| Postpartum Care: Psychosocial Aspects | 768 | ||
| Text to Prepare You for Clinical Practice | 768 | ||
| New Terms | 768 | ||
| Appendix C Answers to Check Your Reading | 773 | ||
| Chapter 1 | 773 | ||
| Chapter 2 | 773 | ||
| Chapter 3 | 774 | ||
| Chapter 4 | 775 | ||
| Chapter 5 | 776 | ||
| Chapter 6 | 776 | ||
| Chapter 7 | 777 | ||
| Chapter 8 | 778 | ||
| Chapter 9 | 779 | ||
| Chapter 10 | 779 | ||
| Chapter 11 | 780 | ||
| Chapter 12 | 780 | ||
| Chapter 13 | 781 | ||
| Chapter 14 | 782 | ||
| Chapter 15 | 783 | ||
| Chapter 16 | 784 | ||
| Chapter 17 | 785 | ||
| Chapter 18 | 785 | ||
| Chapter 19 | 786 | ||
| Chapter 20 | 786 | ||
| Chapter 21 | 787 | ||
| Chapter 22 | 787 | ||
| Chapter 23 | 788 | ||
| Chapter 24 | 788 | ||
| Chapter 25 | 789 | ||
| Chapter 26 | 790 | ||
| Chapter 27 | 792 | ||
| Chapter 28 | 793 | ||
| Chapter 29 | 794 | ||
| Chapter 30 | 794 | ||
| Chapter 31 | 794 | ||
| Chapter 32 | 795 | ||
| Chapter 33 | 796 | ||
| Chapter 34 | 796 | ||
| Appendix D Answers to Critical Thinking Exercises | 799 | ||
| Chapter 3 | 799 | ||
| Critical Thinking Exercise 3-1 | 799 | ||
| Chapter 7 | 799 | ||
| Case Study 7-1, Introduction, Critical Thinking Exercise | 799 | ||
| Case Study 7-1, Critical Thinking Exercise | 799 | ||
| Chapter 8 | 799 | ||
| Critical Thinking Exercise 8-1 | 799 | ||
| Chapter 9 | 799 | ||
| Case Study 9-1, Introduction, Critical Thinking Exercise | 799 | ||
| Critical Thinking Exercise 9-1 | 800 | ||
| Chapter 11 | 800 | ||
| Case Study 11-1, Introduction, Critical Thinking Exercise | 800 | ||
| Critical Thinking Exercise 11-1 | 800 | ||
| Chapter 12 | 800 | ||
| Critical Thinking Exercise 12-1 | 800 | ||
| Critical Thinking Exercise 12-2 | 800 | ||
| Chapter 13 | 800 | ||
| Critical Thinking Exercise 13-1 | 800 | ||
| Critical Thinking Exercise 13-2 | 801 | ||
| Chapter 14 | 801 | ||
| Critical Thinking Exercise 14-1 | 801 | ||
| Critical Thinking Exercise 14-2 | 801 | ||
| Chapter 16 | 801 | ||
| Critical Thinking Exercise 16-1 | 801 | ||
| Critical Thinking Exercise 16-2 | 801 | ||
| Chapter 17 | 801 | ||
| Case Study 17-1, Critical Thinking Exercise | 801 | ||
| Critical Thinking Exercise 17-1 | 802 | ||
| Chapter 18 | 802 | ||
| Critical Thinking Exercise 18-1 | 802 | ||
| Chapter 19 | 802 | ||
| Critical Thinking Exercise 19-1 | 802 | ||
| Critical Thinking Exercise 19-2 | 802 | ||
| Chapter 20 | 802 | ||
| Critical Thinking Exercise 20-1 | 802 | ||
| Critical Thinking Exercise 20-2 | 802 | ||
| Chapter 21 | 802 | ||
| Case Study 21-1, Critical Thinking Exercise | 802 | ||
| Case Study 21-1, Critical Thinking Exercise | 803 | ||
| Chapter 23 | 803 | ||
| Critical Thinking Exercise 23-1 | 803 | ||
| Chapter 24 | 803 | ||
| Critical Thinking Exercise 24-1 | 803 | ||
| Chapter 25 | 803 | ||
| Critical Thinking Exercise 25-1 | 803 | ||
| Critical Thinking Exercise 25-2 | 803 | ||
| Chapter 26 | 803 | ||
| Critical Thinking Exercise 26-1 | 803 | ||
| Chapter 27 | 804 | ||
| Critical Thinking Exercise 27-1 | 804 | ||
| Chapter 28 | 804 | ||
| Critical Thinking Exercise 28-1 | 804 | ||
| Critical Thinking Exercise 28-2 | 804 | ||
| Chapter 29 | 804 | ||
| Critical Thinking Exercise 29-1 | 804 | ||
| Glossary | 806 | ||
| Index | 813 | ||
| A | 813 | ||
| B | 816 | ||
| C | 818 | ||
| D | 822 | ||
| E | 823 | ||
| F | 825 | ||
| G | 827 | ||
| H | 828 | ||
| I | 831 | ||
| J | 833 | ||
| K | 834 | ||
| L | 834 | ||
| M | 835 | ||
| N | 837 | ||
| O | 839 | ||
| P | 840 | ||
| Q | 845 | ||
| R | 845 | ||
| S | 846 | ||
| T | 848 | ||
| U | 850 | ||
| V | 851 | ||
| W | 852 | ||
| X | 852 | ||
| Y | 852 | ||
| Z | 852 | ||
| Inside Back Cover | ibc1 |