In this second edition of Maternal-Newborn Nursing: The Critical Components of Nursing Care we continue to emphasize the fundamentals of maternity nursing, focusing on evidence-based practice for all levels of nursing programs. Maternal-Newborn Nursing: Critical Components of Nursing Care reflects current knowledge, standards, and trends in maternity services, including the trend toward higher levels of intervention in maternity care. This textbook brings together physiologic changes, nursing assessment, and nursing care content in each chapter.
Jessica Bence
Hazel Cortes, RN, BSN
Sylvia Fischer, MSN, RN, CNM
Jill George, RN, BSN
Melissa Goldsmith, PhD, RNC
Sarah Hampson, RN, MS
Connie Miller, MSN, RNC
Jessica Perez, RN, BSN
Kathleen Rehak
Janice Stinson, RN, PhD
Darice Taylor, MSN, RNC
Mabel Choy-Bland, RN, BS
Deanna Luz Reyes Delgado, RN, BS
Sylvia Fischer, RN, MSN, CNM
Stefanie Hahn, RN, BS
Vivian Chioma Nwagwu, RN, MSN
Corrine Marie Smith, RN, MS, ANP-c
Nora Webster, CNM, MSN
Betty Bowles, PhD, RNC
Tammy Buchholz, RN, MSN
Cathryn Collings, RN, BSN, MSN
Anita Crawford, RNC-OB, BSN, MSN
Carla Crider, MSN, RNC
Elisabeth Donohoe Culver, PhD, RN, CNM
Rachel Derr, RNC-LRN, MSN, DNP
Laura Dulski, RNC-HROB, CNE, MSN
Lisa Everhart, RN, MSN, WHNP-BC
Kara Flowers, RN, MSN, LC, IBCLC
Susan Hall, EdD, MSN, RNC, CCE
Stephen Hammer, BSeD, BSN, MA-CS, RN, CCE
Sara Harkness, RN, MS, NP
Kerrie Jennings, RN, BSN
Peggy Korman, MA, CNM, BSN, RN
Dottie Lay, RN, MSN, MBA, DNP
Margaret McManus, RN, BA
Zula Price, MSN, PhD student
Benita Kay Ryne, MSN, RNC
Cynthia Scaringe, RN, MSN
Carol Thomas, MSN-ED, MSA, RN
Jeanne Tucker, PhD, RN, MSN, HSAD, CHES
Paulina Van, RN, PhD, CNE
Marcie Weissner, MSN, RNC-OB
Nanette Wong, RNC, BSN
Our colleagues at Samuel Merritt University who helped us develop from novice to expert teachers. Our current and former colleagues at California State University, East Bay, and University of Arizona College of Nursing for their suggestions and support.
Maternity Nursing Overview
T RENDS
Between 1995 and 2010, there was a significant decrease in infant deaths related to sudden infant death syndrome (SIDS) and respiratory distress syndrome (RDS) in newborns. The decline in deaths related to RDS reflects advances in medical and nursing care for premature infants. The death is related to the pregnancy or aggravated by the pregnancy or management of the pregnancy.
I SSUES
Much of the cost is related to the consequences for the children of adolescent women, such as The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development. Qualitative research is increasingly recognized as an integral part of evidence that improves evidence-based practice.
Antepartal Period
Genetic diseases or disorders are usually related to a defective recessive gene and are present in the developing human when both pairs of the gene have the same defect. The Y chromosome does not have the corresponding genes for some genes on the X chromosome. There are several genetic tests that are used selectively in the care of childbearing families.
T ERATOGENS
The cervix is the narrow, lower end that opens into the vagina. The endometrium consists of the basilar layer (a permanent layer) and the functional layer (a regenerative layer). It surrounds the first inch of the urethra as the urethra extends from the bladder.
O OGENESIS
During this stage, the cells of the empty follicle undergo changes and form the corpus luteum. Through the process of meiosis, the primary oocyte forms into the secondary oocyte and a polar body. Through the process of mitosis, the spermatogonium (stem cell) within the seminiferous tubules of the testis is formed into two daughter cells: a new spermatogonia and a spermatogonium.
C ONCEPTION
Implantation, the embedding of the blastocyst in the endometrium of the uterus, begins around day 5 or 6. By the end of the 8th week of pregnancy, the developing human has transformed from the primary germ layers to. The chorionic membrane that develops from the trophoblast, together with the chorionic villi, forms the fetal side of the placenta.
Chorionic villi are outgrowths from the chorion that are embedded in the decidua basalis and later form the fetal blood vessels of the placenta. The decidua basalis, the part directly below the blastocyst, forms the maternal part of the placenta. The maternal side of the placenta is divided into compartments or lobes known as cotyledons.
The membranes stretch to accommodate the growth of the developing fetus and the increase in amniotic fluid. In GIFT, sperm and oocytes are mixed outside the woman's body and then inserted into the fallopian tube via laparoscopy. This raised the question of when life begins and the rights of the embryo.
The diagnostic confirmation of a pregnancy is based on a combination of the suspected, probable and positive changes.
P REGNANCY
Gestational age refers to the number of completed weeks of fetal development calculated from the first day of the last normal menstrual period. The duration of pregnancy is approximately 280 days or 40 weeks from the first day of LMP. An increase in vaginal discharge (leukorrhea), which is a response to estrogen-induced hypertrophy of the vaginal glands.
Varicose veins can develop in the legs or vulva as a result of increased venous pressure below the level of the uterus. Adaptations are related to hormonal influences as well as the impact of the enlarging uterus on the GI system as pregnancy progresses. Diastasis recti: This is the midline separation of the rectus abdominis muscle caused by abdominal distention.
Pregnancy hormones are responsible for most of the physiological adaptations and physical changes seen throughout pregnancy. The effectiveness of the current model for individual prenatal care visits has also been questioned (see Evidence-Based Practice: Centering Pregnancy). Show sensitivity to the patient regarding the personal nature of the interview and conversation.
Prevention of antibody response and hemolytic disease of the newborn (erythroblastosisfetalis) in future pregnancies of women who have conceived a Rho (D) positive fetus.
CONCEPT MAP
Explore with the woman and discuss with the healthcare provider the use of stool softener and/or bulk laxative.
Constipation
Cereal bran in the morning and have the woman check the labels for at least 4-5 grams of fiber per serving. She tells you that she is very tired all day, that she has some morning sickness, and that her breasts are tender. The nausea and fatigue disappeared.” She worries that she is not getting enough protein, as she has little interest in red meat and eats beans and rice for dinner.
For Margarita, describe the second trimester screening tests and what they are for. He says he feels fine, but has some swelling in his legs at the end of the day, back pain at the end of the day and trouble sleeping. He also has trouble sleeping, getting up two or three times a night to go to the bathroom.
Position of the American Dietetic Association and the American Society for Nutrition: Obesity, reproduction, and pregnancy outcomes. CLINICAL PATHWAY TO PRENATAL CARE: CONTENT AND TIMING OF ROUTINE PRENATAL VISIT FOR NORMAL PREGNANCY.
CLINICAL PATHWAY FOR PRENATAL CARE: CONTENT AND TIMING OF ROUTINE PRENATAL VISITS FOR NORMAL PREGNANCY
CLINICAL PATHWAY TO PRENATAL CARE: CONTENT AND TIMING OF ROUTINE PRENATAL VISIT FOR NORMAL PREGNANCY—cont.
CLINICAL PATHWAY FOR PRENATAL CARE: CONTENT AND TIMING OF ROUTINE PRENATAL VISITS FOR NORMAL PREGNANCY—cont’d
䊐 Describe the expected emotional changes of the pregnant woman and the appropriate nursing responses to these changes. Ensuring the social acceptance of the child by significant others refers to the woman engaging her social network in pregnancy. Successful adjustment to pregnancy and parenthood may depend greatly on the adolescent's age (Fig. 5-2).
The role of the woman's partner and legal considerations for the growing family will also influence the lesbian experience of pregnancy (McManus, Hunter, & Renn, 2006; Rondahl, 2009; Ross, 2005). Photo courtesy of Randi Willis and Gwen Ortiz.). They can manage the woman's diet and rest periods and act as trainers during the birth, but remain detached from the emotional aspects of the experience. C H A P T E R 5 ■ The psycho-social-cultural aspects of the prenatal period 97 This primary social group assumes a great deal of responsibility for.
The family has traditionally been defined as "the fundamental social group in society that typically consists of one or two parents and their children" (Friedman, Bowen, & . Jones, 2003). Children between the ages of 4-5 often enjoy listening to the fetal heartbeat and may show interest in the development of the fetus. C H A P T E R 5 ■ The Psycho-Social-Cultural Aspects of the Antenatal Period 101 of support, some community programs will para-.
Home births allow the expecting family to be in control of the experience, and the mother can be more relaxed than in a hospital environment.
Maternal Adaptation to Pregnancy Complications
For details on female care and magnesium sulfate, see Critical Item: Female Care with Magnesium Sulfate. Ensure a clear understanding of the treatment plan and the involvement of the woman and family in clinical decision-making. Ensure a clear understanding of the treatment plan and the woman's involvement in clinical decision-making.
Pregnancy complications pose a threat to the health of the woman and the fetus, as well as the emotional well-being of the family. The rate of preterm labor and delivery is 50% or more related to uterine overstretching. Provide information to the woman and her family about the signs and symptoms of preterm labor.
Whether pre-existing or gestational diabetes, the risk of perinatal morbidity and mortality for the woman and neonate is significant. Involvement of the woman and her family in the treatment regimen (essential for improving adherence to the treatment regimen).
I NFECTIONS
Emphasize the importance of medical follow-up with regular HCG levels due to the risk of malignant trophoblastic disease and choriocarcinoma. Pelvic inflammatory disease is a general term that refers to an infection of the uterus, fallopian tubes and other reproductive organs. Comprehensive discussion of management and care during pregnancy trauma is beyond the scope of this chapter, but key elements in stabilizing the woman and fetus and assessments are briefly reviewed.
Women often experience fear and anxiety about their health and that of the fetus regarding the impact of the chronic disease on the pregnancy outcome. Communicate the patient's values, preferences, and expressed needs to other members of the healthcare team. Determine the patient's and family's understanding of the impact of her heart disease on her pregnancy.
It is important to remember that some of the normal breathing changes during pregnancy can worsen respiratory conditions during pregnancy. Respiratory emergencies, such as pulmonary embolism and amniotic fluid embolism (anaphylactoid syndrome), are discussed in other parts of the chapter. Asthma is presented as an example of the impact of pregnancy on a pre-existing lung condition.
About half of cases of venous thromboembolism during pregnancy are associated with a common risk factor for thrombophilia.
