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Study Guide for
Foundations of
Maternal-Newborn
and Women’s Health
Nursing
Seventh Edition
Sharon Smith Murray, MSN
Professor Emerita, Health Professions
Golden West College
Huntington Beach, California
Emily Slone McKinney, MSN, RN, C
(deceased)
Nurse Educator and Consultant
Dallas, Texas
Karen Shaw Holub, MS, RNC-OB
Assistant Clinical Professor
Baylor University
Louise Herrington School of Nursing
Dallas, Texas
Renee Jones, DNP, RNC-OB, WHNP-BC
Assistant Clinical Professor
Baylor University
Louise Herrington School of Nursing
Dallas, Texas
ELSEVIER
ELSEVIER
3251 Riverport Lane
St. Louis, Missouri 63043
STUDY GUIDE FOR FOUNDATIONS OF MATERNAL-NEWBORN
AND WOMEN’S HEALTH NURSING, SEVENTH EDITION ISBN: 978-0-323-47966-0
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I Preface
The Study Guide for Foundations ofMaternal-Newborn Nursing requires more than textbook knowledge,
and Women is Health Nursing, 7th edition, has been writ- however. The feature Developing Insight guides you to
ten to help you grasp the important content in each chap- expand your knowledge from clinical experiences. These
ter of the main text. Each chapter in this Study Guide activities give you specific directions for comparing and
corresponds to the text chapter, having the same number using information that you study in class and in your text-
and title. Specific activities vary in each chapter accord- book.
ing to its content. Case Studies give you a chance to “try out” your
Learning Activities provide a variety of approaches nursing care with a simulated patient. The case studies
to facilitate learning. The exercises include activities such encourage you to use critical thinking to interpret infor-
as matching terms, listing important signs and symptoms, mation given in the situation and select appropriate nurs-
describing medical therapy and nursing measures and ing actions. The case studies can be used by an individual
their rationales, and labeling illustrations. or in a small group. If used in a small group, all members
Check Yourself questions give you an opportunity can benefit from the thinking skills of others in the group
to answer multiple-choice items that are similar to those as they choose and defend their nursing care. In addition,
encountered on a test at school or on the NCLEX® exam. you may often incorporate items such as facility proto-
The questions are a mixture of factual items and higher- cols in the simulated patient care.
level questions that require application of that factual Select answers to exercises are included at the end of
knowledge. the Study Guide.
Copyright © 2019, Elsevier Inc. All rights reserved.
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I Contents
PART 1 Foundations for Nursing Care of the PART 4 The Family Following Birth
Childbearing Families 17 Postpartum Adaptations and Nursing Care, 139
Maternity and Women’s Health Care Today, 1 18 Postpartum Maternal Complications, 151
k
—
Social, Ethical, and Legal Issues, 7 19 Normal Newborn: Processes ofAdaptation, 157
h
N
Reproductive Anatomy and Physiology, 11 20 Assessment of the Normal Newborn, 165
M
B
Hereditary and Environmental Influences on 21 Care of the Normal Newborn, 173
Childbearing, 19 22 Infant Feeding, 183
23 High-Risk Newborn: Complications Associated
with Gestational Age and Development, 191
24 High-Risk Newborn: Acquired and Congenital
PART 2 The Family Before Birth
Conditions, 199
Conception and Prenatal Development, 25
I
U
N Maternal Adaptations to Pregnancy, 33
G
Antepartum Assessment, Care, and Education, 45
Q
O Nutrition for Childbearing, 53 PART 5 Women’s Health Care
O
Assessing the Fetus, 65 25 Family Planning, 207
©
Complications of Pregnancy, 73 26 Infertility, 213
¢
H
lH
—
The Childbearing Family with Special Needs, 87 27 Women’s Health, 219
b
PART 3 The Family During Birth Answers to Selected Questions, 229
12 Processes of Birth, 93
13 Pain Management During Childbirth, 103
14 Intrapartum Fetal Surveillance, 109
15 Nursing Care During Labor and Birth, 117
16 Intrapartum Complications, 131
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PART 1 FOUNDATIONS FOR NURSING CARE OF
THE CHILDBEARING FAMILIES
Maternity and Women’s Health Care
1 Today
LEARNING ACTIVITIES
1. Match each term With its definition (a-h).
. Independent organization that accredits health care organizations
Association of Women’s Health,
Obstetric and Neonatal Nurses
. National organization that sets standards for perinatal nurses
(AWHONN)
_ Sheppard-Towner Act of 1921 . Trained labor support person
Family-centered care . Set often-year objectives for improving the health ofAmericans
. Safe, high-quality care that recognizes and adapts to the physical
Doula
and psychosocial needs ofthe family, including the newborn
Evidence-based practice
. First federally sponsored program that provided funds for
_ Healthy People 2020 state-sponsored programs for mothers and children.
. Care based on use of reliable research findings to determine
The Joint Commission
best nursing practice to achieve desired outcomes
2. List three major factors that influenced moving the place of birth from home to hospital.
a.
3. Describe each of the following settings for childbirth.
a. Traditional hospital setting
b. Labor, delivery, and recovery (LDR) rooms
c. Labor, delivery, recovery, and postpartum (LDRP) rooms
Copyright © 2019, Elsevier Inc. All rights reserved.
2
Chapter 1 Maternity and Women’s Health Care Today
d. Birth centers
e. Home births
4. Explain how each of the following factors led to the development of family-centered maternity care.
a. Consumer demands for involvement in their care
b. Childbirth education to control labor pain
c. Research about early parent-newborn contact
5. Describe nursing care that may be encountered in each of these areas of community-based perinatal nursing.
a. Antepartum high-risk women
b. Postpartum women
c. Normal newborns
d. High-risk newborns
6. Describe the education required and qualified services provided by each type of advanced practice nurse.
a. Certified nurse-midwife (CNM)
b. Nurse practitioners
i. Women’s health nurse practitioner (WHNP)
ii. Family nurse practitioner (FNP)
iii. Neonatal nurse practitioner (NNP)
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Chapter 1 Maternity and Women’s Health Care Today 3
iv. Pediatric nurse practitioner (PNP)
0. Clinical nurse specialist (CNS)
7. A dialogue between a woman and a nurse follows. Nonverbal behaviors are in brackets. For each of the nurse’s
responses, label the communication techniques or blocks that the response illustrates. Explain what feelings you
think the woman seems to express. If the nurse’s response indicates a communication block, write an alternate nurs-
ing response.
Situation: A 36-year-old woman is being seen in her gynecologist’s office for an annual well-woman checkup.
a. Nurse: Well, it’s time again for your annual examination, isn’t it? Tell me how you have been doing since we last
saw you.
Woman: I haven’t had any real problems; I’m doing okay, I suppose . . . [Woman looks down at her hands and is
silent]
b. Nurse: That’s great! We’re glad you’re doing well, and coming in for a checkup helps keep you that way.
Woman: I just wish I were coming because I was pregnant.
c. Nurse: Are you saying that you want to become pregnant?
Woman: Well, I’m 36 years old, and time is running out.
d. Nurse: Oh, not necessarily. Women have babies even into their 40s. Miracles happen every day.
Woman: I don’t know . . .
e. Nurse: You were saying that time is running out. Can you tell me more about your concerns?
Woman: Well, when I was in my 20s, I wanted to finish graduate school and get established in a career. Then when
I was in my early 30s, I just seemed too busy to take time to have a baby. Now... [Her voice trails off.]
f. Nurse: [Waiting quietly while the woman gathers her thoughts] It sounds as if you may regret your decision to
wait.
Woman: Well, my husband and I decided to try to have a baby about 9 months ago. Since I never had trouble with my
periods or anything, I thought it would be 3 or 4 months at most until I was pregnant.
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