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Nursing Key Topics Review: Maternity - E-Book

Nursing Key Topics Review: Maternity - E-Book

(2016)

Additional Information

Book Details

Abstract

Study efficiently with Nursing Key Topics Review: Maternity! This quick review and accompanying mobile web app focus on the most critical, practical, and relevant maternal nursing information to prepare you for success on course exams.  Concise coverage includes topics from pregnancy, labor, and birth to postpartum and newborn nursing care.  Summary tables and quick, bulleted lists make it easier to glance through and remember concepts.   Mobile web app audio summaries reinforce content when you are on the go. Best of all, it’s easy to assess your understanding as you go along — because key maternity topics are always immediately followed by review questions with correct answers and rationales.

  • Emphasis on critical, practical, and relevant information helps you study and learn maternity nursing in the most time-efficient way possible.
  • Quick-access format reflects what busy students want — quality content sprinkled with review questions.
  • Audio summaries on a mobile web app make it easy to review anytime, anywhere.
  • NCLEX® exam-style review questions include answers and rationales, allowing you to assess your understanding and retention of the material.
  • Bulleted lists let you see key content at a glance, allowing for quick comprehension.
  • Summary tables and illustrations make learning and review easier.

Table of Contents

Section Title Page Action Price
Front cover Cover
Inside front cover IFC
You’ve just purchased more than a book! IFC
Front matter i
Nursing key topics review maternity iii
Copyright iv
Reviewers v
Preface vi
Table of Contents vii
1 Conception and fetal development 1
Conception 1
Cell division 1
Gametogenesis 1
Fertilization 1
Implantation 2
Embryo and fetus 2
Primary germ layers (fig. 1.2) 2
Development of the embryo 4
Membranes (fig. 1.3) 4
Amniotic fluid 5
Yolk sac 5
Umbilical cord 6
Placenta 6
Fetal maturation 6
Multifetal pregnancy 7
2 Anatomy and physiology of pregnancy 10
Gravidity and parity 10
Terms related to pregnancy 10
Pregnancy tests 10
Human chorionic gonadotropin (hcg) 10
Adaptations to pregnancy 11
Signs of pregnancy 11
Reproductive system and breasts 11
General body systems 12
Application and review 17
Answer key: Review questions 19
3 Nursing care of the family during pregnancy 22
Preconception care 22
Rationale 22
Purpose 22
Patient teaching 22
Diagnosis of pregnancy 23
Estimating date of birth 23
Signs of pregnancy (see chapter 2 for presumptive, probable, and positive signs of pregnancy) 23
Adaptation to pregnancy 23
Maternal adaptation 23
Paternal adaptation 24
Sibling adaptation 24
Grandparent adaptation 24
Application and review 24
Care management 25
Goals of prenatal care 25
Initial visit 25
Application and review 27
Follow-up visits 28
Nursing interventions 28
Evaluation/outcomes 31
Collaborative care 31
Application and review 31
Variations in prenatal care 32
Cultural influences 32
Age differences 32
Multifetal pregnancy 32
Perinatal and childbirth education 33
Classes for expectant parents 33
Perinatal care choices 33
Provider choices 33
Birth plans 34
Birth setting choices 34
Answer key: Review questions 34
4 Maternal and fetal nutrition 37
Nutrient needs before conception 37
Nutrient needs during pregnancy 37
Energy needs 37
Weight gain (table 4.1) 38
Protein 39
Omega-3 fatty acids 39
Fluids 39
Minerals 40
Vitamins 41
Multivitamin-multimineral supplements during pregnancy 42
Additional considerations 43
Daily intake 44
Application and review 44
Nutrient needs during lactation 46
Food plan 46
Energy 46
Fluid 46
Protein 47
Minerals and vitamins 47
Care management 47
Assessment 47
Physical examination 48
Laboratory testing 48
Nutritional care and patient education 48
Application and review 50
Answer key: Review questions 52
5 Assessment of high-risk pregnancy 55
Assessment of risk factors 55
Antepartum testing 55
Biophysical assessment 55
Biochemical assessment 57
Assessment and review 57
Antepartum assessment using electronic fetal monitoring 60
Psychologic considerations related to high-risk pregnancy 61
Nurses’ role in assessment and management of the high-risk pregnancy 61
Assessment and review 61
Answer key 62
6 High-risk complications of pregnancy 64
Hypertensive disorders 64
Classification of hypertensive states 64
Risk factors 64
Hellp syndrome 65
Guidelines for prevention 65
Therapeutic interventions 65
Nursing care of women with hypertensive disorders of pregnancy 65
Application and review 66
Hemorrhagic disorders 67
Early pregnancy bleeding 67
Late pregnancy bleeding 71
Application and review 74
Endocrine and metabolic disorders 76
Diabetes mellitus 76
Hyperemesis gravidarum 77
Thyroid disorders 78
Maternal phenylketonuria (pku) 81
Application and review 82
Medical-surgical disorders 83
Cardiovascular disorders 83
Pulmonary disorders 84
Integumentary disorders 87
Neurologic disorders 88
Autoimmune disorders 92
Gastrointestinal disorders 95
Hematologic disorders 96
Genitourinary disorders 97
Application and review 99
Cancer 100
Risk factors 100
Incidence 100
Therapeutic interventions 100
Care of pregnant women with cancer 100
Surgical emergencies during pregnancy 101
Appendicitis 101
Cholelithiasis/cholecystitis 101
Application and review 102
Trauma 103
Immediate stabilization 103
Cardiopulmonary resuscitation (CPR) of the pregnant woman 103
Nursing care of pregnant women with special needs 106
The pregnant adolescent 106
The older pregnant woman (35 years of age or older) 107
The woman with a multifetal pregnancy 108
The pregnant woman with human immunodeficiency virus (HIV) 108
Application and review 108
Answer key: Review questions 108
7 Mental health disorders and substance abuse 117
Mental health disorders during pregnancy 117
Overview 117
Perinatal mood disorders 117
Major depression 117
Application and review 118
Anxiety disorders 119
Overview 119
Panic disorder 119
Agoraphobia 120
Generalized anxiety disorder 121
Obsessive-compulsive disorder 121
Posttraumatic stress disorder 122
General care management 123
Application and review 124
Postpartum mood disorders 125
Paternal postpartum depression 125
Postpartum blues/maternal blues 125
Postpartum (also called peripartum) depression without psychotic features 125
Screening for postpartum depression 127
Postpartum depression with psychotic features 127
Application and review 128
Perinatal substance abuse 128
Perinatal considerations 128
Substance abuse definitions 128
Barriers to treatment 129
Commonly abused drugs: Tobacco and alcohol 129
Commonly abused drugs: Other 132
Care management: Nursing care of clients who abuse drugs 134
Application and review 135
Answer key: Review questions 135
8 Labor and birth processes 141
Factors affecting labor 141
Passenger 141
Passageway 142
Powers 143
Position of the laboring woman 143
Process of labor 143
Clinical findings preceding labor 143
Clinical findings of true labor 144
Stages of labor and maternal changes 144
Application and review 145
Answer key: Review questions 147
9 Maximizing comfort for the laboring woman 150
Pain during labor and birth 150
Definition and description 150
Neurologic origins 150
Perception of pain 150
Expression of pain 150
The joint commission standards 150
Factors influencing pain response 151
Physiologic factors 151
Culture 151
Anxiety 151
Previous experience 151
Gate-control theory of pain 151
Support 151
Environment 152
Application and review 152
Nonpharmacologic pain management 153
Advantages 153
Disadvantages 153
Childbirth preparation 153
Positional changes 153
Relaxation and breathing techniques 153
Effleurage and counterpressure 154
Touch and massage 154
Application of heat and cold 154
Acupressure and acupuncture 154
Transcutaneous electrical nerve stimulation 155
Hydrotherapy (water therapy) 155
Intradermal water block 155
Aromatherapy 155
Music 155
Hypnosis 155
Biofeedback 156
Application and review 156
Pharmacologic pain management 157
Overview 157
Sedatives 157
Analgesia and anesthesia 157
Care management 159
Assessment/analysis 159
Nursing care during nonpharmacologic interventions 159
Nursing care of clients receiving analgesic/anesthetic agents 159
Application and review 160
Answer key: Review questions 161
10 Fetal assessment during labor 165
Basis for monitoring 165
Fetal response 165
Uterine activity 165
Fetal compromise 165
Goals 165
Monitoring techniques 165
Intermittent auscultation 165
Electronic fetal monitoring 165
Application and review 166
Fetal heart rate patterns 167
Baseline fetal heart rate 167
Periodic and episodic changes in fetal heart rate 168
Categorization of patterns**From Macones, G., Hankins, G., Spong, C., Hauth, J., & Moore, T. (2008). The 2008 National Ins ... 170
Other methods of assessment and interventions 171
Assessment techniques 171
Interventions 171
Client and family teaching 172
Documentation 172
Application and review 172
Answer key: Review questions 174
11 Nursing care of the family during labor and birth 176
First stage of labor 176
Assessment 176
Nursing interventions 178
Application and review 178
Second stage of labor 181
Description 181
Assessments 181
Positioning 182
Bearing-down efforts 182
Fetal heart rate and pattern 182
Support of the father or partner 182
Birth room and equipment 182
Additional interventions 182
Immediate care of the newborn (see chapter 17) 182
Perineal trauma 183
Third stage of labor 183
Placental separation and expulsion 183
Nursing care 183
Fourth stage of labor 183
Assessment (see also chapter 14) 183
Nursing interventions 183
Evaluation/outcomes 184
Application and review 184
Answer key: Review questions 184
12 Labor and birth complications 189
Preterm labor and birth 189
Definition 189
Nursing care of women during preterm labor 189
Preterm birth versus low birth weight 189
Spontaneous versus indicated preterm birth 189
Causes of spontaneous preterm labor and birth 189
Testing 189
Interventions 189
Premature rupture of membranes 191
Definition and implications 191
Therapeutic interventions 191
Nursing care of women with premature rupture of membranes 191
Chorioamnionitis 192
Definition and etiologies 192
Diagnosis 192
Risks 192
Therapeutic interventions 192
Postterm pregnancy, labor, and birth 192
Postterm pregnancy 192
Risk factors 192
Assessment 192
Therapeutic intervention 192
Nursing care of women during postterm labor 193
Dysfunctional labor (dystocia) 193
Definition 193
Maternal complications 193
Abnormal uterine activity/faulty uterine contractions 193
Abnormal labor patterns 194
Alterations in pelvic structure 194
Fetal causes 194
Position of the woman 195
Psychologic responses 196
Nursing care of women with dystocia 196
Precipitous labor 196
Overview 196
Nursing care of women during precipitate birth 196
Obesity 197
Overview 197
Care management 197
Application and review 197
Obstetric procedures 198
Version 198
Induction of labor 198
Augmentation of labor 200
Operative vaginal birth 200
Cesarean birth 201
Trial of labor 203
Vaginal birth after cesarean 203
Obstetric emergencies 203
Shoulder dystocia 203
Prolapsed umbilical cord 204
Rupture of the uterus 204
Amniotic fluid embolus 205
Application and review 205
Answer key: Review questions 206
13 Postpartum physiologic changes 209
Puerperium 209
Reproductive system and associated structures 209
Uterus 209
Cervix 210
Vagina and perineum 210
Menstruation 210
Endocrine system 210
Estrogen and progesterone 210
Metabolic changes 210
Pituitary hormones and ovarian function 210
Thyroid 211
Breasts 211
Breastfeeding mothers (see also chapter 18) 211
Nonbreastfeeding mothers 211
Weight loss 211
Urinary system 212
Components 212
Fluid loss (see also weight loss earlier) 212
Application and review 212
Cardiovascular system 212
Blood volume 212
Cardiac output (co) 213
Vital signs 213
Blood components 214
Varicosities 214
Respiratory system 214
Gastrointestinal system 214
Neurologic system 215
Musculoskeletal system 215
Integumentary system 215
Immune system 215
Application and review 216
Answer key: Review questions 217
14 Nursing care of the family during the postpartum period 219
Transfer from the recovery area 219
Planning for discharge 219
Continual process 219
Length of stay is variable 219
Criteria for discharge 219
Care management: Physical needs 219
Ongoing physical assessment 219
Routine laboratory tests 220
Nursing interventions 220
Application and review 223
Care management: Psychosocial needs 225
Effect of the birth experience 225
Maternal self-image 226
Adaptations to parenthood and parent–infant interactions 226
Effect of cultural diversity 226
Discharge teaching 226
Content 226
Safety 227
Evaluation/outcomes 227
Application and review 227
Answer key: Review questions 228
15 Transition to parenthood 233
Parental attachment, bonding, and acquaintance 233
Attachment and bonding 233
Assessment of attachment behaviors 234
Parent–infant contact 234
Early contact 234
Extended contact 234
Communication between parent and infant 234
The senses 234
Entrainment 235
Biorhythmicity 235
Reciprocity and synchrony 235
Parental role after birth 235
Transition to parenthood 235
Parental tasks and responsibilities 235
Becoming a mother 235
Becoming a father 236
Adjustment for the couple 236
Diversity in transitions to parenthood 236
Age 236
Parenting in same-sex couples 236
Socioeconomic conditions 237
Personal aspirations 237
Parental sensory impairment 237
Visually impaired parent 237
Hearing-impaired parent 237
Sibling adaptation 237
Grandparent adaptation 237
Emotional and role changes 237
Practical considerations 238
Care management 238
Application and review 238
Answer key: Review questions 238
16 Postpartum complications 242
Postpartum hemorrhage 242
Risk factors 242
Clinical findings 242
Therapeutic interventions 242
Nursing care of women with postpartum hemorrhage 243
Application and review 243
Hemorrhagic (hypovolemic) shock 244
Clinical findings 244
Therapeutic interventions 244
Nursing care of women in shock 244
Application and review 245
Coagulopathies 245
Idiopathic thrombocytopenic purpura (itp) 245
Von willebrand disease (vwd) 246
Episiotomy 246
Nursing care of women after an episiotomy 246
Application and review 247
Venous thromboembolic disorders 247
Risk factors 247
Clinical findings 247
Therapeutic interventions 247
Nursing care of women with venous thromboembolic disorders 248
Postpartum infections 248
Endometritis 249
Wound infections 249
Urinary tract infections 250
Maternal death 251
Answer key: Review questions 251
17 Nursing care of the newborn and family 253
Physiologic and behavioral adaptations of the newborn 253
Transition to extrauterine life 253
Physiologic adjustments 253
Behavioral characteristics 255
Application and review 257
Care management: Birth through the first 2 hours 258
Immediate care after birth 258
Initial assessment of the newborn 259
Special care of the newborn 262
Application and review 263
Care management: From 2 hours after birth to discharge 264
Bathing 264
Common newborn problems 264
Laboratory and diagnostic tests 265
Neonatal pain (see chapter 19, newborn complications) 265
Discharge planning 266
Application and review 266
Answer key: Review questions 267
18 Newborn nutrition and feeding 271
Recommended infant nutrition 271
Options 271
Psychologic considerations 271
Choosing an infant feeding method 271
Factors influencing decision 271
Breastfeeding 271
Formula feeding 273
Application and review 274
Cultural influences on infant feeding 276
Beliefs vary 276
Nutrient needs 276
Overview 276
Fluids 276
Energy 276
Carbohydrate 277
Protein 277
Vitamins 277
Minerals 277
Anatomy and physiology of lactation 277
Overview 277
Lactogenesis 277
Uniqueness of human milk 277
Supporting breastfeeding mothers and infants 278
Keys 278
Positioning 278
Latch 278
Milk ejection or let-down 278
Frequency of feedings 278
Indicators of effective breastfeeding 279
Special considerations 279
Sleepy baby/fussy baby 279
Slow weight gain 279
Preterm infants 279
Multiple infants 279
Expressing and storing breast milk 279
Maternal employment 280
Weaning 280
Resource 280
Application and review 280
Answer key: Review questions 280
19 Newborn complications 284
Nursing care of high-risk newborns 284
Preterm infants 284
Nursing care of preterm infants 285
Application and review 286
Acquired problems of newborns 287
Respiratory distress syndrome 287
Birth injuries 287
Infections 289
Substance dependence (neonatal abstinence syndrome) 292
Application and review 293
Hemolytic disorders 294
Rh incompatibility 294
Abo incompatibility 294
Therapeutic interventions 295
Nursing care of infants with hemolytic disorders 295
Application and review 295
Infants of diabetic mothers 296
Clinical findings 296
Nursing care of infants of diabetic mothers 297
Congenital anomalies 297
Cardiac malformations 297
Nasopharyngeal and tracheoesophageal anomalies 303
Intestinal obstruction 304
Musculoskeletal anomalies 305
Genitourinary anomalies 307
Application and review 309
Preterm infants 311
Pain 311
Retinopathy of prematurity 311
Bronchopulmonary dysplasia 312
Germinal matrix hemorrhage-intraventricular hemorrhage 313
Necrotizing entercolitis 313
Late preterm infants 314
Respiratory distress 314
Thermoregulation 314
Hypoglycemia 314
Nutrition 314
Postterm/postmature infants 314
Meconium aspiration syndrome 314
Persistent pulmonary hypertension of the newborn 315
Large-for-gestational-age infants 316
Answer key: Review questions 316
20 Perinatal loss, bereavement, and grief 323
Loss, grief, and bereavement: Basic concepts and theories 323
Types of loss associated with pregnancy 324
Miles’ model of parental grief responses 325
Family aspects of grief 326
When a loss is diagnosed: Helping the woman and her family in the aftermath 327
Nurses’ reactions to caring for grieving families 328
Application and review 328
Answer key: Review questions 330
Bibliography 331
Index 333
A 333
B 334
C 335
D 337
E 337
F 338
G 340
H 340
I 341
J 342
K 342
L 342
M 342
N 344
O 345
P 345
Q 349
R 349
S 349
T 350
U 351
V 351
W 352
Y 352
Z 352
Inside back cover IBC