Table Of Content3704_FM_i-xxiv 16/09/13 10:31 AM Page i
MATERNAL-NEWBORN NURSING
The Critical Components of Nursing Care
Second Edition
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MATERNAL-NEWBORN
NURSING
The Critical Components of Nursing Care
Second Edition
Roberta F. Durham, RN, PhD Linda Chapman, RN, PhD
Professor Professor Emeritus
Department of Nursing and Health Sciences Samuel Merritt University
California State University, East Bay Oakland, California
Hayward, California
Professor Alumnus
Samuel Merritt University
Oakland, California
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F. A. Davis Company
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Copyright © 2014 by F. A. Davis Company
All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,
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Printed in the United States of America
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
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Developmental Editor:Sarah M. Granlund
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Project Editor:Christina L. Snyder
Design and Illustration Manager:Carolyn O’Brien
Cover Photo:Courtesy of Baby Jane-Hope Hallowell
As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s)
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Library of Congress Cataloging-in-Publication Data
Durham, Roberta F.
Maternal-newborn nursing : the critical components of nursing care / Roberta F. Durham, Linda Chapman. — 2nd ed.
p. ; cm.
Rev. ed. of: Maternal-newborn nursing / Linda Chapman, Roberta F. Durham. c2010.
Includes bibliographical references and index.
ISBN 978-0-8036-3704-7 (hbk. : alk. paper)
I. Chapman, Linda, 1949- II. Chapman, Linda, 1949- Maternal-newborn nursing. III. Title.
[DNLM: 1. Maternal-Child Nursing. 2. Perinatal Care. WY 157.3]
RG951
618.2’0231—dc23 2013009079
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arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-3704-7/14 0 + $.25.
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To our mothers, Virginia “Ducky”
Durham and June Henderson
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Preface
In this second edition of Maternal-Newborn Nursing: The assessment and electronic fetal monitoring. We have devoted
Critical Components of Nursing Carewe continue to emphasize a chapter to the care of cesarean birth families; nearly one-
the basics of maternity nursing, focusing on evidence-based third of births in the United States are cesarean.
practice for all levels of nursing programs. Because we realize
F
that today’s students lead complex lives and must juggle
EATURES
multiple roles as student, parent, employee, and spouse, we
developed this textbook, with its accompanying electronic
This textbook presents the critical components of maternity in
ancillaries, to present the critical components of maternity
a pragmatic condensed format by using the following features:
nursing in a clear and concise format that lends itself to ease
of comprehension while maintaining the integrity of the sub- ■ Information presented in a bulleted format for ease of
stantive content. It may be particularly useful for programs reading
designed to present the subject of maternity in an abbreviated ■ Flowcharts, diagrams, tables, clinical pathways, and concept
or condensed way. maps to summarize information
We revised the textbook based on the recommendations ■ Case studies to assist integration of knowledge
of those who have used it—faculty from various states and
Audio Book
students in all types of programs—and our own experiences.
Revisions include enhanced rationale for nursing actions in all
In an effort to help students manage their time more effec-
chapters, increased content in pathophysiology in many areas,
tively, each book comes with access to downloadable audio
and expanded high-risk content. We have updated content
files that contain recorded abridged versions of chapters for
to keep current in standards in practice, including new guide-
students to listen to while commuting to and from classes and
lines for management of postpartum hemorrhage, manage-
clinical. Students can use these audio files to reinforce the
ment of intrapartal fetal heart rate abnormalities, assessment
content in the text, to refresh their reading before class, or to
and care of the late preterm infant, and assessment and care
review for an exam. The audio files provide two ways of learn-
of the newborn with hyperbilirubinemia. We have expanded
ing in one product.
sections on patient education, patient teaching resources, and
complementary and alternative therapies. Professional stan- Critical Components
dards of care for maternity nurses are based on current prac-
tice guidelines and research. This textbook focuses on the critical components of mater-
nity nursing. Critical components are the major areas of
O knowledge essential for a basic understanding of maternity
RGANIZATION
nursing. The critical components were determined from the
authors’ combined 50 years of teaching maternity nursing
This evidence-based text utilizes theory and clinical knowl-
in both traditional and accelerated programs and years of
edge of maternity nursing. The conceptual framework is
clinical practice in the maternity setting. Current guidelines
Family Developmental Theory, and substantive theory that
and standards are integrated and summarized for a prag-
forms the foundation for maternity care is presented. The
matic approach to patient and family-focused care. This
book is organized according to the natural sequence of the
focus is especially evident when discussing complications or
perinatal cycle, pregnancy, labor and birth, postpartum, and
deviations from the norm.
neonate. We have taken a bio-psycho-social approach dealing
The focus of the text is on normal pregnancy and childbirth.
with the physiological, psychological adaptation, social, and
Chapters on low-risk antenatal, intrapartal, postpartum, and
cultural influences impacting childbearing families, with
neonate are followed by chapters on high risk and complica-
emphasis on nursing actions and care of women and families.
tions in each area. Complications germane to the nursing
We believe childbirth is a natural, developmental process.
domain and childbearing population focus on understanding
Nursing is an ever-changing science. New research and
and synthesizing the critical elements for nursing care.
clinical knowledge expand knowledge and change clinical
practice. Maternal-Newborn Nursing: The Critical Components Care of Cesarean Birth Families
of Nursing Care reflects current knowledge, standards, and
trends in maternity services, including the trend toward higher Approximately one-third of births are by cesarean section. In
levels of intervention in maternity care. These standards and response to this increased trend, this book has dedicated a
trends are reflected in our inclusion of a chapter on tests dur- chapter to the intrapartum and postpartum care of the cesarean
ing the antepartal period, as well as a chapter devoted to fetal birth families.
vii
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viii Preface
Chapter Format ■ Standards of Careand Professional Position Statements:
Highlights key perinatal nursing issues from professional
This textbook clusters physiological changes, nursing assess-
organizations such as Association of Women’s Health,
ment, and nursing care content in each chapter. Typically, a
Obstetic and Neonatal Nurses (AWHONN)
chapter is divided into systems in which the physiology; nurs- ■ Quality and Safety Education in Nursing (QSEN):
ing care, including assessment and interventions; expected
Highlights QSEN concepts as they apply to the chapter
outcomes; and common deviations of one subsystem are pre-
content
sented. Psychosocial and cultural dimensions of nursing care
are highlighted in each chapter. Glossary
Flowcharts, Diagrams, Tables, Concept Maps,
For ease of looking up definitions, there is a glossary of terms
and Clinical Pathways used in the book related to maternal-newborn nursing.
Flowcharts, tables, concept maps, and clinical pathways Appendixes
present large amounts of information in a clear and concise
format. The appendixes include:
Case Studies ■ AWHONN guide to breastfeeding
■ Common and standard laboratory values for pregnant
Two case studies, one low-risk and one high-risk, are presented and nonpregnant women and the neonate
in the unit on antepartal care; these are developed further in ■ Temperature equivalents
subsequent chapters. These case studies are presented at the ■ Cervical dilation chart
end of each chapter as a strategy to summarize the key elements ■ Newborn weight conversion chart
of the chapter, to assist the students in their development of ■ Immunization and pregnancy table
critical thinking skills, and to help them integrate the content
into clinical practice. I
MPORTANT FEATURES FOR INSTRUCTORS
The development of the case studies over multiple content
areas—antepartum, intrapartum, and postpartum—allows stu-
The nursing shortage resulted in the widespread develop-
dents to analyze the assessment data in relationship to nursing
ment and expansion of nursing programs. Many nursing
care. This type of teaching/learning activity helps bring content
programs, which can be as short as 12 months, now teach
“to life” for students as they synthesize new knowledge.
maternity nursing in a compact or abbreviated format.
Review Questions Faculty are challenged to develop courses with fewer credit
units to be taught in 5 or fewer weeks. This requires a criti-
Review question appear at the end of each chapter to help
cal analysis to identify essential components of the subject
students review key chapter content.
area and the appropriate teaching-learning resources.
Maternity nursing textbooks are not designed for current
Teaching Cards
approaches to nursing education at the associate, traditional
Teaching cards are provided as an electronic resource to help baccalaureate, accelerated baccalaureate, or entry-level mas-
students instruct patients and families. The cards summarize ters’ nursing programs. This textbook addresses the reality
and organize information on key topics related to mother and of nursing education today and presents the critical compo-
baby care and discharge teaching and planning. The teaching nents of maternity in a pragmatic, condensed format with
cards have details regarding newborn care and feeding and ancillary course materials to facilitate student learning and
postpartum self-care as well as warning signs and guidance faculty teaching of maternity nursing.
about when to call the health-care practitioner. Current nursing students comprise a diverse group and
many are older, more mature learners. They may enter a nurs-
Special Features
ing program with prior degrees and work experience in fields
outside of nursing. Most students want materials presented in
A variety of boxes appears throughout the chapters to high-
a clear and concise format that allows them to use their criti-
light information:
cal thinking skills to integrate the new knowledge into their
■ Critical Component:Highlights critical information in previous knowledge base and life experiences. Because some
maternal-newborn nursing nursing students have completed their transition to adult-
■ Medication:Highlights the commonly administered hood, they are believed by education experts to be better
medications used during pregnancy, labor and birth, poised to master the knowledge they need to arrive at clinical
postpartum, and neonatal periods judgments and ethical and moral decisions inherent in
■ Cultural Awareness:Stresses the importance of cultural nursing practice. Utilization of critical elements, mapping,
factors in nursing care evidenced-based practice guidelines, and focused activities
■ Evidenced-Based Practice:Highlights current research and will satisfy the needs of these specialized learners who are
practice guidelines related to nursing care intolerant of “busy work” and extraneous material.
3704_FM_i-xxiv 16/09/13 10:31 AM Page ix
Preface ix
The theme for the new millennium in nursing educations ■ Interactive online student exercises
is “We can no longer teach as we were taught.” That includes ■ Exam test bank with over 500 updated questions in
teaching in shorter periods for both theory and clinical and ExamViewPro with item descriptors
teaching for understanding of critical elements. This book ■ Activities using Internet resources
responds to innovations in nursing curricula and the new pop-
Supplemental instructor materials for clinical include:
ulation of nursing students.
■ Detailed clinical syllabus for inpatient and community-
The ancillary products for this text respond to needs and
based perinatal settings
learning styles of current students. For example, some nursing
■ Clinical integration activities, with critical thinking activ-
students are already college graduates with academic, life, and
ities and directions on implementation including:
work experience contributing to their critical thinking and
■ Family study: format and directions for a community-
ability to synthesize complex information and seek evidenced-
based postpartum home family study for clinical students
based solutions to clinical problems. The ancillary resources
■ Topics for clinical integration seminars
allow them to utilize a variety of technology-based resources
■ Expectant parent interview activity
in place of outdated, more traditional approaches used in
■ Teaching cards for use with postpartum families
other maternity textbooks.
■ Medication cards
Supplemental instructor aids for theory class include:
■ Skill laboratory exercises
■ An 8-week syllabus guide ■ Chart review exercises
■ Detailed classroom activities for each content area ■ Clinical preparation tools
■ PowerPoint slides ■ Antepartal data collection worksheet
■ Image bank ■ Neonatal intensive care unit (NICU) data collection
■ Fully developed and integrated case studies with critical worksheet
thinking activities and rationales both for high and low risk. ■ Postpartum data collection worksheet
■ Interactive case studies for students to improve critical ■ Labor and delivery data collection worksheet
thinking and priority setting ■ Newborn assessment worksheet
■ Animations to enhance visual learning and application ■ Nursing care plans for postpartum and labor and delivery
