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Maternal-Newborn-Nur Maternal-Newborn Nursing Demystified Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The author and the publisher of this work have checked with sources believed to be reliable in their efforts to provide informa- tion that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the author nor the publisher nor any other party who has been involved in the preparation or publi- cation of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Maternal-Newborn Nursing Demystified Joyce Y. Johnson, RN, PhD Dean and Professor College of Sciences and Health Professions Albany State University Albany, Georgia New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2010 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-181196-5 MHID: 0-07-181196-6 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-160914-2, MHID: 0-07-160914-8. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefi t of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. To contact a representative please e-mail us at [email protected]. TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. This book is dedicated to my mother Dorothy C. Young who has always been an inspiration to me, to my husband Larry, and to Virginia and Larry Jr. who are the wind beneath my wings. This book is also dedicated to our students who are the reason we teach and write. Much success in your nursing careers! Joyce Y. Johnson CONTRIBUTORS Edna Boyd Davis, RN MN Assistant Professor Department of Nursing Albany State University Albany, Georgia (Chapter 12, Newborn Care) Cathy H. Williams, RN MSN DNP Undergraduate Program Coordinator Associate Professor Department of Nursing Albany State University Albany, Georgia (Chapter 11, Postpartum Care) CONTENTS Preface xxi Acknowledgments xxiii UNIT I ROLES AND RELATIONSHIPS CHAPTER 1 Overview of Maternity Nursing 3 The Nursing Process 5 Family Planning 6 Child or Adolescent Pregnancy 6 Pregnancy After the Age of 40 9 Conclusion 10 CHAPTER 2 Families and Communities 15 Overview 16 Types of Families 17 Nursing Implications 17 Social And Economic Factors 18 Nursing Implications 18 Diversity Issues 19 Nursing Implications 20 Conclusion 21 CHAPTER 3 Health Assessment of the Pediatric Client 25 Overview 26 Health Assessment: Client History 26 Communication 26 viii Contents Nursing History 28 Nutritional Assessment 30 Biochemical Tests 31 Family History and Review of Systems 31 Family Assessment 32 Family Function 32 Physical Examination 34 General 34 Skin 34 Hair 34 Nails 35 Head and Neck 35 Eyes and Vision 36 Ears and Hearing 36 Mouth, Throat, Nose, Sinuses, and Neck 36 Chest 37 Abdomen 38 Genitourinary 38 Back and Extremities 39 Newborn Developmental Milestones 40 Physical Milestones 40 Sensory Milestones 40 Social Milestones 40 Emotional Growth 40 Language Development 41 Diagnostic Procedures 41 Laboratory Tests 41 Nursing Implications 43 Conclusion 44 UNIT II SYSTEMATIC EXPLORATION OF MATERNAL-NEWBORN CONDITIONS AND NURSING CARE CHAPTER 4 Pre-pregnancy Preparation, Conception, 51 and Genetic Considerations Overview 52 Pre-pregnancy Preparation 52 Nutrition 52 Age 52 Contents ix Substance Abuse 53 Toxin Exposure 53 Conception 53 Testing 54 Contraception 56 Genetic Considerations 57 Sickle Cell Anemia 59 What Went Wrong? 59 Signs and Symptoms 60 Test Results 61 Treatments 61 Nursing Intervention 61 Hemophilia 63 What Went Wrong? 63 Signs and Symptoms 63 Test Results 63 Treatments 64 Nursing Intervention 64 β-Thalassemia 65 What Went Wrong? 65 Signs and Symptoms 66 Test Results 66 Treatments 66 Nursing Intervention 67 Down Syndrome 67 What Went Wrong? 67 Signs and Symptoms 68 Test Results 68 Treatments 68 Nursing Intervention 69 Conclusion 69 CHAPTER 5 Reproductive Health Issues 73 Overview 74 Infertility 74 What Went Wrong? 75 Signs and Symptoms 75 Test Results 75 Treatment 76 x Contents Nursing Interventions 77 Pregnancy Termination 77 What Went Wrong? 78 Signs and Symptoms 78 Test Results 79 Treatments 79 Nursing Interventions 79 Sexually Transmitted and Other Diseases 80 Chlamydial Infection 81 What Went Wrong? 81 Signs and Symptoms 81 Test Results 81 Treatments 81 Nursing Interventions 81 Gonorrhea 82 What Went Wrong? 82 Signs and Symptoms 82 Test Results 82 Treatments 82 Nursing Interventions 83 Pelvic Inflammatory Disease (PID) 83 What Went Wrong? 83 Signs and Symptoms 83 Test Results 84 Treatments 84 Nursing Interventions 84 Herpes Genitalis 85 What Went Wrong? 85 Signs and Symptoms 85 Test Results 85 Treatments 85 Nursing Interventions 85 Syphilis 86 What Went Wrong? 86 Signs and Symptoms 86 Test Results 86 Treatments 87 Nursing Interventions 87 Conclusion 87 Contents xi CHAPTER 6 Physiologic Changes of Pregnancy 91 Overview 92 First Trimester of Pregnancy 92 Signs and Symptoms 92 Physiological Changes of Pregnancy 94 What Went Wrong? 95 Test Results in Early Pregnancy 96 Treatments 97 Nursing Interventions 97 Second Trimester of Pregnancy 99 Test Results 100 What Went Wrong? 101 Nursing Interventions 102 Third Trimester of Pregnancy 103 Test Results 104 What Went Wrong? 105 Treatments 105 Nursing Interventions 106 Conclusion 107 CHAPTER 7 Fetal Development 113 Overview 114 The Embryonic Stage 115 The Fetal Stage 120 Fetal Circulation 120 Multiple Fetuses 122 Disruption of Fetal Development 122 Neural Tube Defects 123 What Went Wrong? 123 Signs and Symptoms 124 Test Results 125 Treatments 125 Nursing Interventions 125 Genetic Abnormalities 126 Congenital Anomalies 126 Alterations in Fetal Growth 128 Preterm Newborn 128 What Went Wrong? 128 Signs and Symptoms, and Test Results 128 xii Contents Treatments 130 Nursing Interventions 131 Small for Gestational Age (SGA) 131 What Went Wrong? 131 Signs and Symptoms 131 Test Results 132 Treatments 132 Nursing Interventions 132 Large for Gestational Age (LGA) 133 What Went Wrong? 133 Signs and Symptoms 133
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