Similarly, content that addresses community-based nursing care for women, families, and children explores strategies and resources for providing appropriate care in many. Many thanks to the following people who helped us provide sketches for the professional illustrator to create many of the line drawings in the text: John C.
Dedicated Participants
Miami Children's Hospital, The Mary Ann Knight International Institute of Pediatrics, opgericht als Variety Children's Hospital, Miami, Florida Chandra Vig, Ann Harms en Susan Ward's verpleging.
Acknowledgments
Contributors
Sue Gabriel, MSN, MFS, RN, SANE Assistant Professor
Anita Dupre Atleast, RNC, BSN, MSN Assistant Professor of Nursing Our Lady of Holy Cross College New Orleans, Louisiana. Barnesville, Georgia Linda Boostrom, RN, MSN Instructor at Henderson Community College Nursing Program Henderson, Kentucky.
Reviewers
Julie Moore, RNC, MSN, MPH, WHNP Associate Professor of Nursing Hawaii Community College Hilo, Hawaii. Pat Twedt, RN, MS, Med, MS Associate Professor of Nursing Dakota Wesleyan University Mitchell, South Dakota.
Detailed Table of Contents
The focused assessment 370 The psychosocial assessment 371 The cultural assessment 371 Laboratory tests 371 Documentation for hospitalization 371 First stage of labor 372. Nursing care of the mother during the third stage of labor 391 Immediate care of newborns 392.
- chapter 15
- chapter 16
- chapter 17
- chapter 18
- chapter 19
Definition and Incidence 520 Types of Obstetric Infections 520 Nursing Assessment 520 Collaborative Management 520 Thrombophlebitis and Thrombosis 527. Performing and Documenting a Newborn Physical Assessment 574 Newborn Assessment: A Systems Approach 574 Improving the Newborn's Transition to Extrauterine Life 593.
- chapter 23
- chapter 24
- chapter 25
- chapter 26
- chapter 27
- chapter 28
- chapter 29
- chapter 30
- chapter 31
- chapter 32
- chapter 33
- chapter 34
- chapter 35
Nursing care of a child with heart disease 879 Nursing a child in pediatric intensive care. The impact of a chronic illness on an infant 1136 The impact of a chronic illness on a toddler 1136 The impact of a chronic illness on a preschool child 1137 The impact of a chronic illness on a school-age child 1137 The impact of a chronic illness on an adolescent 1138 The impact of a chronic illness in a sibling 1138 A child living with a chronic illness 1139 Emotional responses to chronic illness 1140 Important aspects of caring for a child with a chronic illness 1140.
Across Care Settings
Assessment Tools
Be Sure To
Special Features
Case Studies
Clinical Alerts
Check identification Bracelet 471 Document after a patient seizure 312 Document appropriate birth information 569 Document family education 529. Signs of bleeding after tonsillectomy 765 Signs of kidney transplant rejection 1058 Signs of perforation and peritonitis 791.
Collaboration in Caring
Complementary Care
Critical Nursing Action
Transient tachypnea in the newborn 611 Understanding autism spectrum disorder 729 Removing the newborn from the incubator 608 When amniotic fluid embolism occurs 456 When attending a delivery with forceps 437.
Diagnostic Tools
Ethnocultural Considerations
Family Teaching Guidelines
Labs
Medications
Moving Toward Evidence-Based Practice
Now Can You
Discuss the developmental aspects of the reproductive system and identify the components of the female reproductive tract. Discuss important aspects of child care in a hospital or clinical setting.
Nursing Care Plans
Identify the vulnerable populations of women, children, and families that exist in the United States today.
Nursing Diagnoses
Nursing Insights
Methods for Administering an Epidural Block 420 Methods for Epidural Anesthesia Block 421 Miles and Perry's Stages of Grief 1149. Signs and Symptoms of Anaphylaxis 830 Signs and Symptoms of Aplastic Anemia 871 .
Optimizing Outcomes
When teaching patients about the use of spermicides 146 When teaching patients about the use of oral contraceptives. When teaching patients about the use of the diaphragm 144 When teaching patients about the use of the female.
Procedures
Use of time intervals and weight to improve the accuracy of perineal pad saturation estimation 515. Vitamin C and premature rupture of membranes 234 Waking the child at night due to vital signs 881.
What to Say
Measuring the head circumference 943 Measuring the newborn's body length 572 Obtaining a fecal occult blood test sample 1088 Obtaining a fungal culture 1010.
Where Research and Practice Meet
Families, and Children 1 1
The Concept Map Survey consisted of nine open-ended questions about the preference for creating concept maps. The researchers reported that nearly twice as many students in the abstract learning preference group preferred using concept maps.
Introduction
Because the course was conducted collaboratively, each faculty member revised half of the concept maps using the same criteria. The researchers concluded that learning style preference does not affect students' ability to use concept maps as a learning tool, so they can be used for all categories of learning styles.
Traditional Nursing Care
Explain the central focus of the nurse as a care provider and teacher before the 1950s. Describe how the introduction of the nursing process as a systematic framework changed the professional role of the nurse.
Contemporary Nursing Care
Collaboration with the patient and family about health education needs moves the nurse away from the traditional. Describe the need for nurse responsibility as a healthcare provider.
The Caring Art and Science of Nursing
- The new nurse explains to the clinic nurse that the nursing process currently being taught has an
- The clinic nurse collaborates with other multi- disciplinary members to provide care to a 60-year-old
- The clinic nurse knows that the patient’s _____ and preferences as well as the nurse’s clinical expertise
- The clinic nurse demonstrates for the new nurse strategies that are helpful to children in a crisis. The
- The clinic nurse understands that increased ________
- The clinic nurse demonstrates elements of spiritual caring by learning about a patient’s _________ or
- The nurse who is able to share the patient’s perception of a health threat, and support the patient’s changes
- The nurse collaborates with a family on outcomes that are realistic and culturally appropriate prior to
Listening to communication patterns can inform the nurse about components of the patient's value system and cultural approaches. The use of multiple communication approaches can facilitate the meeting of the nurse's health education with the patient and family.
This chapter examines contemporary trends in women's, children's, and family health care from a holistic, action-oriented perspective. An overview of legal, ethical and social justice is presented, with the nurse as a key player in transforming and maintaining a more effective healthcare system in the future.
Framework: The Public Health Intervention Model
Despite large health care expenditures, health care and other resources are unequally distributed in the United States. Now you can – Recognize the value of having national Healthy People 2010 goals to align efforts to improve health care.
Overview of Selected Societal Trends
Insurance status is also the greatest predictor of the quality of healthcare one receives. Discuss the trend toward inactivity in the United States and describe how it could impact the future health care status of Americans.
The Current Health Status of the Nation
Can Now— Describe nursing actions that can improve the current state of child health in the United States. The number of uninsured and underinsured citizens in the United States is increasing.
Politics, Socioeconomics, and Culture
There is greater understanding in research circles of the differences in the health care needs of women and men. Women are gaining more power in health care, which in turn allows them to make better health care decisions for their families.
Contemporary Infl uences and Trends
To do this, it is important to consider vulnerable populations in the United States. Now you can — Identify the vulnerable populations of women, children, and families that exist in the United States today.
Health Care for the Nation
- The clinic nurse is providing information to Tracy and her 5-year-old child who has just been diagnosed
- The clinic nurse is aware that a specifi c health concern for Black women in the population between
- The clinic nurse understands that nonmalefi cence is a concept used in ethical decision making. It means
- The perinatal nurse is aware of the Intervention Wheel and its potential for nurses working with
- Nurses who are taking a more proactive approach to childhood obesity would support the Food and Drug
- The clinic nurse is aware that with telemedicine, photos may be sent to the clinic doctors from remote
- The clinic nurse is aware of the Healthy People 2010 report and its identifi cation of health _______ for
- The public health nurse understands that when studying effects of diseases, it is the _________ rate
- The pediatric nurse is aware that “race” as a concept is best defi ned as how persons _______ one another
Can't win for losin'”: The impact of WAGES on single mothers with young children in a North Tampa community. Overview of the uninsured in the United States: An analysis of the 2005 Current Population Survey.
The Evolving Family
The themes were subdivided into three broad headings: parenting philosophies; influence of American culture and perceived opportunities for children; and parenting practices. See suggested answers for moving toward evidence-based practice on the electronic study guide or DavisPlus.
Families Today
When problems such as alcoholism were presented, they tended to be in the context of an outsider who touched the family temporarily and then left. Challenges that come from external forces outside the family system include environmental assaults such as catastrophic weather, forest fires and earthquakes.
Homosexuality and same-sex partnerships/marriages and their impact on the family raise political, social and religious issues that have increasingly found their way into today's discussions. The following case study provides an example of some of the problems and questions that the family and the patient's caregivers may need to address.
Family Theories and Models
At the beginning of the assessment process, the nurse asks the family to list their strengths (strengths list). The nurse assesses the type, frequency and direction of communication between family members.
Family-Centered Care
INTERVENTION: ASSESSMENT OF THE IMPACT OF IDENTIFIED PROBLEMS ON THE STABILITY AND FUNCTIONING OF THE FAMILY. The nurse helps the family recognize the meaning of the dysfunction and helps the family improve communication between its members.
Families with Special Needs
The nurse's role is a mediator/facilitator between the family system and the mental health system. Caregiver burden occurs when the primary caregiver becomes overwhelmed and feels "underpowered" in relation to the tasks related to caring for the family member.
Establishing a diagnosis serves as the starting point to help the family continue to care for their family member. Extended family should be recruited to help prevent caregiver strain by being available to help with the family member or provide relief.
Along with the family roles are family rules that are implicitly followed by all members, such as: "Don't talk and don't feel." Family members know not to discuss family problems with outsiders such as teachers, nurses or even friends. If treatment is not obtained for the affected member, the nurse should refer family members to organizations such as Alcoholics Anonymous or to legal agencies that can identify options for getting the member into treatment or strategies to keep the member's family safe.
The nurse and the family with drug abuse/alcohol abuse must determine the amount, type, and length of time the addiction has been part of the family. Although emotions do not cause these illnesses, they can worsen the symptoms by reducing the family member's compliance with treatment or by increasing the anxiety associated with the symptoms.
The nurse provides time and space (family visiting room, chapel or the patient's room) for the family to gather. The nurse may want to participate in prayer led by the family clergy or hospital chaplain.
Family Cultural Characteristics
- The obstetrical nurse who understands the systems theory of family interaction is aware that an integral
- The pediatric nurse who understands the developmental theory of families would provide
- The clinic nurse is providing assistance to the Macy family who has just lost their son in a tragic motor
- The clinic nurse is aware that in the 1990s, the media began to depict family challenges such as poverty
- The nurse who understands communication theory is aware that emotional problems surface with the
- The pediatric nurse recognizes that the most ideal way to describe a patient/family’s involvement in a
- The perinatal nurse understands that the process of passing values and cultural heritage between
- The clinic nurse talks to a family who has come in to describe their situation after a fi re in their home
The nurse also inquires about the family's preferences regarding participation in preparatory activities prior to the arrival of the mortuary representatives. Explain how culture affects the family's degree of connectedness and communication patterns in the health care setting.
Health promotion refers to the promotion of health to the highest possible extent for an individual. In the areas of infant and child health, major health promotion concerns include nutrition, safety, activity and play, and immunizations.
Health Promotion Screening
For this age group, health promotion screening includes mammography, colonoscopy, cholesterol and lipid screening, and osteoporosis screening. These changes alter health promotion concerns for older adults, including concerns related to sexual functioning, exercise and activity, and cognitive functioning.
Infant and Child Health
However, the influence of heredity must be considered in the context of the adolescent's environment. Another method (for example, the ThinPrep Pap Test) places the sample directly into a prepared preservative vial.
During pregnancy, the color of the nipple darkens, which is an improvement for the breastfeeding baby. A simple mastectomy removes all of the breast tissue, along with the area around the nipple and areola.
Older Adulthood Health
- The outpatient clinic nurse correctly makes a recommendation that Henry, a 65-year-old patient,
- The pediatric clinic nurse correctly identifi es the most appropriate milk to introduce to the child at
- The clinic nurse teaches new parents that the most normal time for children to ask about “where babies
- The clinic nurse teaches the new mother about feeding readiness that she may see in her infant
- The clinic nurse recognizes that adolescents have an increased risk of injury and disease due to
- The clinic nurse is aware that water safety is an important health promotion topic to discuss with
- The clinic nurse is aware that the greatest effect on ________ ________ is the media. Teens watch
Increased estrogen levels, which stimulate endometrial growth during the menstrual cycle, are the most common cause of endometrial cancer. Screening for postmenopausal osteoporosis: a review of the evidence for the US Preventive Services Task Force.
The follicular phase, defined as the interval from the first day of menstruation through the estimated day of ovulation. The luteal phase, defined as the interval from the first day after the estimated day of ovulation through the day before the next menstrual cycle.
Sexual Differentiation in the Embryo
There is considerable normal variation in the phases of the menstrual cycle among regularly menstruating women; the greatest amount of variability occurs in the follicular phase. A discussion of key hormones that influence the menstrual cycle enhances understanding of the symphony of cyclical events during the reproductive years.
Male Gender
The study findings confirmed and extended known information about the norms of menstrual cycle variability. The menstrual cycle and events that occur in the absence of conception as well as those that occur shortly after conception are examined.
Female Gender
This chapter provides an overview of the anatomy and physiology of the male and female reproductive tract.
Female Reproductive System
The muscles of the pelvic floor include the levator ani (consisting of the iliococcygeal, pubococcygeal [pubovaginal], and puborectal muscles) and the coccyx. The egg enters the fallopian tube through a small opening (ostium) at the bottom of the infundibulum.
Uterine Anatomy
The vasculature of the uterus is tortuous and tortuous, and as the gravida (pregnant) uterus expands, these vessels straighten, allowing a continuous rich blood supply throughout pregnancy. The part of the cervical canal leading to the uterine epithelium consists of columnar cells.
Uterine Support Structures
The round ligaments also play an important role during childbirth by pulling the uterus forward and downward, thereby keeping it stable to facilitate the movement of the fetus-presenting part towards the cervix. The cardinal ligaments prevent uterine prolapse and are the main support structures for the uterus and cervix.
Vagina
The round ligaments expand in both diameter and length during pregnancy and this normal physiological change may be associated with maternal discomfort called 'round ligament pain'. As the uterus expands, the round ligaments become tight and sudden movements such as position changes, coughing or stretching can result in sharp pains that can be quite worrying until the woman understands the physiology of the discomfort.
Ureters, Bladder, and Urethra
Bony Pelvis
True/False Pelves
The anterior landmarks of the true pelvis consist of the pubic bones, the superior ascending rami of the ischial bones, and the obturator foramen. Bilaterally, the true pelvis is bounded by the ischial bones and the sacrosciatic points and ligaments.
Pelvic Diameters and Planes
122 part two The process of human reproduction. the anterior protrusion of the base of the sacrum) and the sacral alae (broad bilateral projections from the base of the sacrum), the linea terminalis and the upper edges of the pubic bones. The true pelvis is divided into three sections: the inlet, the midpelvis, and the outlet, and each of these three components is important during the birthing process.
Pelvic Types
Breasts
The primary function of the breasts is to provide nourishment to the offspring through the process known as lactation. The Montgomery tubercles are papillae located on the surface of the nipple and the areola.
The Interplay of Hormones and Reproduction
After ovulation, the anterior pituitary gland secretes LH, which stimulates the development of the corpus luteum. Testosterone is responsible for the development of the male genital tract and the secondary sex characteristics (body hair distribution, growth and strength of the long bones, increase in muscle mass, deepening of the voice through enlargement of the vocal cords).
Sexual Maturation
The Menstrual Cycle and Reproduction
Uterine (Endometrial) Cycle
The ischemic phase is from the end of the secretory phase until the onset of menstruation (approximately day 27 to 28). The luteal phase of the ovarian cycle begins with ovulation and ends with the onset of menstruation.
Body Changes Related to the Menstrual Cycle and Ovulation
When pregnancy is not achieved after ovulation, the corpus luteum predominates over the second half of the menstrual cycle. As the end of the luteal phase approaches (about 8 to 10 days), low levels of FSH and LH cause regression of the corpus luteum.
Natural Cessation of Menses
Selective estrogen receptor modulators (SERMs) such as raloxifene (Evista) mimic the effects of estrogen without increasing the risk of breast cancer and endometrial cancer; However, hot flashes are a common side effect of SERMs. Describe the four stages of the uterine cycle and describe the major physiological events that occur during each stage.
Male Reproductive System
The urethra is a mucous-lined tube that runs from the bladder to the outside of the body. Each of the two bulbourethral glands is a small pea-shaped organ containing a 2.5 cm long duct leading to the urethra.
Characteristics of Semen and Sperm
Prostatic fluid helps protect sperm from the acidic environments of the vagina and male urethra and makes up 30% of the semen volume. These glands are located under the prostate gland and they function to secrete fluid to lubricate the end of the penis.
Male Hormonal Infl uences
From there, the seminal fluid moves to the ejaculatory duct before leaving the body through the urethra. The average time for sperm to travel from the cervix to the fallopian tubes is about 5 minutes under favorable conditions.
Fertility
There are about 120 million sperm in each milliliter of ejaculate, and usually about 40% of the sperm are motile. There are also approximately 5 million white blood cells in each milliliter of semen, along with secretions from the testes, epididymis, seminal vesicles, prostate, and bulbourethral glands.
Age-related Development of the Male Reproductive System
- The perinatal nurse explains to the new nurse that a female fetus has a developed ovary by
- The perinatal nurse describes to the prenatal class attendees that an incision for a Cesarean birth is
- The perinatal nurse knows that ova are produced and estrogen secreted at the time of
- The perinatal nurse teaches the new nurse that the assessment landmark for the fetal presenting part is
- The clinic nurse teaches the new nurse that the fallopian tubes or _______ measure about _______
- The perinatal nurse knows that uterine circulation is supplied by the _______ and _______ arteries, which
- The clinic nurse is aware that when a woman is undergoing a PAP test and physical examination, it
- The perinatal nurse knows that beginning at the 12th gestational week, a male fetus produces androgens
- The perinatal nurse describes the multiple functions of the uterus as
The male reproductive system consists of the testes, where spermatogonia and male sex hormones are formed; a series of continuous tubes that allow spermatozoa to be transported outside the body; accessory glands that produce secretions to promote sperm nutrition, survival and transport; and the penis, which functions as the reproductive organ of intercourse. The perinatal nurse knows that from the 12th week of pregnancy, a male fetus produces androgens Gestational week, a male fetus produces androgens that stimulate growth of the external genitalia.
A central role of nurses is to help women understand their sexual health and help them plan their reproductive lives. This chapter explores the roles of the nurse in various aspects of reproductive health care and concludes with a brief overview of some of the legal and ethical issues surrounding advanced reproductive technology methods.
Sexuality and Reproductive Health Care
Influenced by ethical, spiritual, cultural and moral factors, sexuality is an important part of women's health. Although the exact etiology of impaired health among this population is not clear, one factor may be related to gay/bisexual women's hesitancy in seeking health care.
A Nursing Framework for Promoting Women’s Sexual and Reproductive
PLANNING AND IMPLEMENTING CARE Regardless of the patient's age and contraceptive method chosen, the nurse must first seek confirmation from the woman that she really wants contraception. One of the primary goals during the contraceptive care visit is to determine and provide the "best fit" contraceptive method for the woman or couple.
Toward Achieving the National Goals for Reproductive Life Planning
The choice of a contraceptive method usually depends on the individual, although certain forms of contraception may not be best suited to particular population groups. When achieving contraception is the purpose of the reproductive health visit, an immediate evaluation can take place at the end of the patient encounter.
Providing Contraceptive Care: Methods of Contraception
Made of polyurethane in a "one size fits all," the female condom or vaginal sheath (Fig. 6-5) is used less frequently than the male condom. This method, known as "the pill" or the oral contraceptive pill (OCP), has been available for more than 40 years.
