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Maternal-Child Nursing Care: Optimizing Outcomes For Mothers, Children, and Families
by
Susan L. Ward, Shelton M. Hisley
Publisher:
F. A. Davis Company
Copyright Year:
2009
Publishing Date:
2009/01/28
eText ISBN-10:
0-8036-2280-5
eText ISBN-13:
978-0-8036-2280-7
Print ISBN-10:
0-8036-1486-1
Print ISBN-13:
978-0-8036-1486-4
Course:
Maternal and Child Health
Pages:
1499
eTextbook
$43.00
(360 day subscription)
Compare Online & Downloadable
About this Title
Table of Contents
|
Description
Instructor Resources
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Student Resources
ABOUT THIS TITLE - TABLE OF CONTENTS
Preface, vi
Philosophy, vi
Organization, vi
Themes and Key Features, vii
HOLISTIC CARE, vii
CRITICAL THINKING, vii
VALIDATING PRACTICE, vii
TOOLS FOR CARE, vii
Teaching Ancillaries and Other Related Products, viii
INSTRUCTOR’S RESOURCE DISK, viii
Instructor’s Guide, viii
Case Studies, viii
Concept Maps, viii
Electronic Test Bank, viii
PowerPoint Presentations, viii
Media Ancillary, viii
ELECTRONIC STUDY GUIDE, viii
Interactive Exercises, viii
Case Studies, viii
Nursing Care Plans, viii
Family Teaching Guidelines, viii
NCLEX-style Review Questions, viii
Sound Collection, viii
Podcasts, viii
Concept Maps, ix
Clinical Pathways, ix
DavisPlus Website, ix
CLINICAL POCKET COMPANION TO MATERNAL–CHILD NURSING, ix
Acknowledgements, x
Dedicated Participants, x
Contributors, xii
Reviewers, xvi
Special Features, xxxii
Unit One: Foundations in Maternal, Family, and Child Care, 1
Chapter 1. Traditional and Community Nursing Care for Women, Families, and Children, 3
Introduction, 4
Traditional Nursing Care, 4
HISTORICAL PERSPECTIVE, 4
HEALTH–WELLNESS CONTINUUM, 5
CHANGING DEMANDS AND DEMOGRAPHICS, 7
PROFESSIONAL NURSING ROLES, 7
Contemporary Nursing Care, 8
CURRENT HEALTH CARE SETTINGS, 8
FAMILY-CENTERED CARE, 10
COMBINING MODERN TECHNOLOGY WITH THE CARING TOUCH, 11
PROFESSIONAL NURSING ROLES, 13
The Caring Art and Science of Nursing, 13
THEORIES THAT FRAME CARING AS THE CORE OF NURSING, 14
ESSENTIAL CHARACTERISTICS OF CARING, 14
PROFESSIONAL NURSING ROLES, 15
Provider of Care, 15
Critical Thinker, 16
Effective Communicator, 16
Teacher, 17
Collaborator, 17
Advocate, 18
EVIDENCE-BASED PRACTICE, 18
THE NURSING PROCESS, 19
Multiple Choice, 22
Fill-in-the-Blank, 22
True or False, 22
Chapter 2. Contemporary Issues in Women’s, Families’, and Children’s Health Care, 25
Introduction, 26
Framework: The Public Health Intervention Model, 26
HOW THE INTERVENTION WHEEL WORKS, 27
Healthy People 2010: A Blueprint for Action, 28
Overview of Selected Societal Trends, 29
AGING POPULATION WITH MORE CHRONIC ILLNESSES, 29
INCREASED RACIAL AND ETHNIC DIVERSITY, 29
DISPARITIES IN HEALTH CARE, 30
CHILDBIRTH TRENDS, 30
PATTERNS OF PHYSICAL FITNESS, 30
THE INTERSECTION OF RACE, CLASS, AND HEALTH, 31
The Current Health Status of the Nation, 31
INFANTS AND YOUNG CHILDREN, 31
Adolescents, 32
FAMILIES, 33
WOMEN, 33
Perinatal Health, 33
Politics, Socioeconomics, and Culture: Contemporary Influences and Trends, 34
POLITICAL INFLUENCES AND TRENDS, 34
Health Care Delivery, 34
Public Policies and Programs, 34
SOCIOECONOMIC INFLUENCES AND TRENDS, 35
The Increasing Rate of Poverty, 35
The Feminization of Poverty, 35
The Wage Gap, 35
Communications and the Digital Divide, 35
Vulnerable Populations, 35
PERSONAL AND CULTURAL INFLUENCES AND TRENDS, 37
Self-Care and Patient Involvement, 38
Complementary and Alternative Therapies, 38
Health Care for the Nation, 38
DELIVERY SYSTEMS, 39
Telemedicine, 39
CHALLENGES FOR NURSES IN CONTEMPORARY SOCIETY, 39
An Ethical Framework for Professional Practice, 39
Current Trends in Clinical Practice, 41
NANDA-I Nursing Diagnoses for Holistic Nursing, 41
CONTEMPORARY ISSUES AND NURSING ROLES, 41
Multiple Choice, 42
True or False, 43
Fill-in-the-Blank, 43
Chapter 3. The Evolving Family, 46
Introduction, 47
The Evolving Family, 47
VIEWING THE FAMILY IN A NURSING CONTEXT, 47
THE, 47
NATIONAL INITIATIVE, 47
Families Today, 47
THE CHANGING FAMILY AS REFLECTED IN THE MEDIA, 48
STRESSORS ON FAMILIES TODAY, 49
Health Care, 49
Mental Illness, 49
Societal Pressures, 50
Family Theories and Models, 50
FAMILY SYSTEMS THEORY, 51
Boundaries, 51
Subsystems, 51
Balance and Homeostasis, 51
FAMILY DEVELOPMENTAL STAGES AND THEORY, 52
Beginning Families, 52
Childbearing Stage, 52
Preschool Stage, 52
School-Age and Adolescent/Teenage Stages, 52
Launching, Middle Age, and Retirement Stages, 52
STRUCTURAL–FUNCTIONAL THEORY, 53
Provider Role, 53
Housekeeper, 53
Child-Caregiver, 53
Socializer and Recreational Organizer, 53
Sexual Partner, 53
Therapist, 53
Kinship, 53
COMMUNICATION THEORY, 53
GROUP THEORY, 54
BOWEN’S FAMILY SYSTEMS THEORY, 54
NURSING THEORIES, 54
FAMILY ASSESSMENT, 55
THE NURSING ROLE IN FAMILY ASSESSMENT, 55
Family Size and Structure, 55
Parenting Style, 55
Religious, Cultural, and Socioeconomic Orientation, 56
TOOLS TO FACILITATE THE FAMILY ASSESSMENT, 56
Qualitative and Quantitative Surveys, 56
Genogram and Ecomap, 57
Strengths and Problems Lists, 57
COMPONENTS OF THE FAMILY ASSESSMENT, 58
Assessment of Communication Patterns, 58
ASSESSMENT OF ROLES AND RELATIONSHIPS, 59
ASSESSMENT OF THE FAMILY DEVELOPMENTAL STAGE, 59
ASSESSMENT OF FAMILY RITUALS, 60
ASSESSMENT FOR TRIANGULATION, 60
ASSESSMENT FOR THE PRESENCE OF DYADS AND OTHER SUBSYSTEMS, 60
Family-Centered Care, 61
NURSING DIAGNOSIS: ALTERED FAMILY PROCESSES, 61
Evaluation, 62
Families with Special Needs, 62
HOSPITALIZATION, 62
CHRONIC MENTAL ILLNESS, 62
SUBSTANCE ABUSE, 63
SEXUAL OR PHYSICAL ABUSE, 64
POSTTRAUMATIC STRESS DISORDER, 64
CHRONIC PHYSICAL ILLNESS, 65
DEATH of A FAMILY MEMBER, 65
Family Cultural Characteristics, 66
ACCULTURATION AND ASSIMILATION, 66
IDENTITY, 66
CONNECTEDNESS, 67
COMMUNICATION PATTERNS, 67
SOCIOECONOMIC CLASS, 67
HOLISTIC NURSING ENCOMPASSES A CULTURALLY SENSITIVE FAMILY APPROACH, 67
Multiple Choice, 68
True or False, 68
Fill-in-the-Blank, 68
Chapter 4. Caring for Women, Families, and Children in Contemporary Society, 71
Introduction, 72
Health Promotion Screening, 73
HEALTH SCREENING SCHEDULE, 73
Infant and Child Health, 73
NUTRITIONAL GUIDANCE, 73
Infant Feeding, 73
Introduction of Solid Foods, 75
Childhood Nutrition, 76
DENTAL CARE, 76
SLEEP AND REST, 76
SAFETY, 78
Injury Prevention, 78
Risk-taking Behaviors, 79
PLAY, 79
IMMUNIZATIONS, 80
SEXUALITY, 80
ADOLESCENT HEALTH, 80
Obesity in Adolescence, 82
NUTRITION, 82
Eating Disorders, 83
SLEEP AND REST, 84
SAFETY, 84
Accidents and Injuries, 84
Risk-taking Behaviors, 85
Injury Prevention, 85
HEALTH PROMOTION, 87
Prevention of Osteoporosis, 87
Gynecological Examinations, 88
MENSTRUAL DISORDERS, 91
YOUNG ADULTHOOD HEALTH, 92
SAFETY, 92
Substance Use, 92
HEALTH PROMOTION, 93
MIDDLE ADULTHOOD HEALTH, 95
HEALTH PROMOTION SCREENING, 96
Breast Self-examination, 97
Clinical Breast Examination, 97
Mammography, 97
Lifestyle Choices and Breast Health, 98
Colon Cancer Screening, 99
Cholesterol and Lipid Screening, 99
THE CLIMACTERIC, MENOPAUSE, PERIMENOPAUSE, AND POSTMENOPAUSE, 99
GYNECOLOGICAL DISORDERS, 101
Leiomyomas, 101
Ovarian Cysts, 101
Ovarian Cancer, 101
Older Adulthood Health, 102
HEALTH PROMOTION, 102
Sexual Functioning, 102
Exercise and Activity, 102
Cognitive Functioning, 102
Functional Ability, 103
Immunizations, 103
COMMON HEALTH PROBLEMS IN WOMEN, 103
Osteoporosis, 103
Pelvic Floor Dysfunction, 104
Endometrial Cancer, 105
PROSTATE CANCER SCREENING, 105
Preparation for Prostate Biopsy, 105
MENTAL AND EMOTIONAL HEALTH, 106
Multiple Choice, 106
Select All that Apply, 107
Fill-in-the-Blank, 107
Unit Two: The Process of Human Reproduction, 111
Chapter 5. Reproductive Anatomy and Physiology, 113
Introduction, 114
Sexual Differentiation in the Embryo, 114
Male Gender, 114
Female Gender, 114
Female Reproductive System, 115
EXTERNAL STRUCTURES (PUDENDUM MULIEBRE), 115
Mons Pubis, 115
Labia, 115
Clitoris, 115
Vestibule, 115
Urethral (Urinary) Meatus, 115
Skene’s Glands and Bartholin’s Glands, 115
Hymen, 116
Perineum, 116
PELVIC FLOOR, 116
INTERNAL STRUCTURES, 116
Ovaries, 116
ACCESSORY ORGANS, 118
Fallopian Tubes, 118
Uterus, 118
Uterine Anatomy, 119
CORPUS, 119
ISTHMUS, 119
CERVIX, 119
Uterine Support Structures, 120
Vagina, 121
Ureters, Bladder, and Urethra, 121
Bony Pelvis, 121
True/False Pelves, 121
Pelvic Diameters and Planes, 122
Pelvic Types, 123
Breasts, 123
PARTS OF THE BREAST, 124
Nipples, 124
Areola, 124
Montgomery Tubercles, 124
The Interplay of Hormones and Reproduction, 124
HORMONES RELEASED BY THE HYPOTHALAMUS, 124
HORMONES RELEASED BY THE PITUITARY GLAND, 124
HORMONES RELEASED BY THE GONADS, 125
Estrogen, 125
Progesterone, 125
Testosterone, 126
HUMAN CHORIONIC GONADOTROPIN, PROSTAGLANDINS, AND RELAXIN, 126
Sexual Maturation, 127
PUBERTY, 127
FEMALE SECONDARY SEXUAL CHARACTERISTICS, 127
The Menstrual Cycle and Reproduction, 128
Uterine (Endometrial) Cycle, 128
MENSTRUAL PHASE, 128
PROLIFERATIVE PHASE, 128
SECRETORY PHASE, 128
ISCHEMIC PHASE, 129
HYPOTHALAMIC–PITUITARY–OVARIAN CYCLE, 129
HYPOTHALAMIC–PITUITARY COMPONENT, 129
OVARIAN COMPONENT, 129
FOLLICULAR PHASE, 129
LUTEAL PHASE, 129
Body Changes Related to the Menstrual Cycle and Ovulation, 129
Natural Cessation of Menses, 130
CLIMACTERIC PHASE, 130
PERIMENOPAUSAL PHASE, 130
MENOPAUSE, 130
POSTMENOPAUSAL PHASE, 130
Male Reproductive System, 131
EXTERNAL STRUCTURES, 131
Perineum, 131
Penis, 131
Scrotum, 131
INTERNAL STRUCTURES, 132
Testicles/Testes, 132
Epididymis, 132
Ducts, 132
Urethra, 132
Spermatic Cords, 132
Accessory Glands, 132
Characteristics of Semen and Sperm, 132
Male Hormonal Influences, 134
TESTOSTERONE, 134
Fertility, 134
Age-related Development of the Male Reproductive System, 134
Multiple Choice, 135
Fill-in-the-Blank, 135
True or False, 135
Select All that Apply, 135
Chapter 6. Human Sexuality and Fertility, 137
Introduction, 138
Sexuality and Reproductive Health Care, 138
THE HUMAN SEXUAL RESPONSE, 138
EXPLORING DIMENSIONS OF SEXUALITY, 139
Sexual Orientations, 139
A Nursing Framework for Promoting Women’s Sexual and Reproductive Health, 139
ASSESSMENT, 139
Obtaining the Sexual History, 140
NURSING DIAGNOSES FOR PATIENTS SEEKING CONTRACEPTIVE CARE, 140
PLANNING AND IMPLEMENTATION OF CARE, 140
EVALUATION, 142
Toward Achieving the National Goals for Reproductive Life Planning, 142
Providing Contraceptive Care: Methods of Contraception, 143
MEDICATION-FREE CONTRACEPTION, 143
Effectiveness, 143
COITUS INTERRUPTUS, 143
Effectiveness, 143
LACTATIONAL AMENORRHEA METHOD (BREASTFEEDING), 143
Effectiveness, 144
ABSTINENCE, 144
BARRIER METHODS, 144
Diaphragm, 144
Cervical Cap, 144
Condoms, 145
Spermicides, 146
Contraceptive Sponge, 146
HORMONAL METHODS, 147
Oral Contraceptives, 147
Low-Dose Progestin-Only Contraceptive Pills, 149
Transdermal Contraceptive Patch, 149
Vaginal Contraceptive Ring, 149
Emergency Postcoital Contraception, 150
INJECTABLE HORMONAL CONTRACEPTIVE METHODS, 150
Depo-Provera (DMPA), Depo-SubQ Provera 104 (Depot Medroxyprogesterone), 150
INTRAUTERINE DEVICES, 151
SUBDERMAL HORMONAL IMPLANT, 151
Implanon, 151
STERILIZATION, 152
Female Sterilization, 152
Male Sterilization, 153
Clinical Termination of Pregnancy, 153
NURSING CARE RELATED TO ELECTIVE PREGNANCY TERMINATION, 153
SURGICAL TERMINATION OF PREGNANCY, 153
Vacuum Aspiration, 153
MEDICAL TERMINATION OF PREGNANCY, 154
Complications, 154
The Nurse’s Role in Infertility Care, 154
THE INITIAL ASSESSMENT, 154
LATER METHODS OF ASSESSMENT, 155
Treatment Options for Infertility, 156
MEDICATIONS, 156
Induction of Ovulation, 156
SURGICAL OPTIONS, 157
THERAPEUTIC INSEMINATION, 157
Embryo Cryopreservation, 158
Micromanipulation, 158
ADVANCED REPRODUCTIVE TECHNOLOGIES, 158
Gamete Intrafallopian Transfer, 158
Zygote Intrafallopian Transfer, 158
Tubal Embryo Transfer, 158
In Vitro Fertilization, 158
ART and Legal Considerations, 159
Infertility, ART, and Potential Effects on the Couple’s Relationship, 159
LIFESTYLE CHOICES AND INFERTILITY, 159
ADDITIONAL OPTIONS FOR THE INFERTILE COUPLE, 159
Multiple Choice, 161
True or False, 161
Fill-in-the-Blank, 161
Select All that Apply, 161
Chapter 7. Conception and Development of the Embryo and Fetus, 164
Introduction, 165
Basic Concepts of Inheritance, 165
THE HUMAN GENOME PROJECT, 165
CHROMOSOMES, DNA, AND GENES, 165
Inheritance of Disease, 167
MULTIFACTORIAL INHERITANCE, 167
UNIFACTORIAL INHERITANCE, 167
Autosomal Dominant Inheritance, 167
Autosomal Recessive Inheritance, 168
X-Linked Dominant Inheritance, 168
X-Linked Recessive Inheritance, 168
Cellular Division, 169
The Process of Fertilization, 170
The Process of Implantation and Placental Development, 171
Development of the Embryo and Fetus, 172
THE YOLK SAC, 172
ORIGIN AND FUNCTION OF THE UMBILICAL CORD, 173
THE FETAL CIRCULATORY SYSTEM, 173
FETAL MEMBRANES AND AMNIOTIC FLUID, 174
Human Growth and Development, 175
PRE-EMBRYONIC PERIOD, 175
EMBRYONIC PERIOD, 175
Week 1, 175
Week 2, 175
Week 3, 175
Week 4, 176
Week 8, 176
THE FETAL PERIOD, 176
Weeks 9 to 12, 177
Weeks 13 to 16, 177
Weeks 17 to 20, 177
Weeks 21 to 25, 177
Weeks 26 to 29, 177
Weeks 30 to 34, 177
Weeks 35 to 40, 177
Factors that May Adversely Affect Embryonic and Fetal Development, 178
CHROMOSOMES AND TERATOGENS, 178
Teratogen Exposure During Organogenesis, 179
Medications and Other Substances, 179
TORCH INFECTIONS, 181
Toxoplasmosis, 181
Other Infections, 181
Rubella, 182
Cytomegalovirus (CMV), 182
Herpes Simplex Virus (HSV), 182
The Nurse’s Role in Prenatal Evaluation, 182
Heredity and Genetics, 183
Maternal Age and Chromosomes, 184
Multifetal Pregnancy, 185
The Nurse’s Role in Minimizing Threats to the Developing Embryo and Fetus, 186
Multiple Choice, 187
True or False, 187
Fill-in-the-Blank, 187
Unit Three: The Prenatal Journey, 191
Chapter 8. Physiological and Psychosocial Changes During Pregnancy, 193
Introduction, 194
Physiological Preparation for Pregnancy, 194
HORMONAL INFLUENCES, 194
REPRODUCTIVE SYSTEM, 195
Uterus, 195
Cervix, 195
Vagina and Vulva, 196
Ovaries, 196
Breasts, 196
INTEGUMENTARY SYSTEM, 197
NEUROLOGICAL SYSTEM, 197
CARDIOVASCULAR SYSTEM, 198
Heart, 198
Blood Volume, 198
Iron, 198
Leukocytes, Proteins, Platelets, Immunoglobulins, 199
Cardiac Output, 200
Supine Hypotension Syndrome, 201
RESPIRATORY SYSTEM, 201
Eyes, Ears, Nose, and Throat, 201
GASTROINTESTINAL SYSTEM, 202
URINARY SYSTEM, 202
ENDOCRINE SYSTEM, 203
Thyroid Gland, 203
Parathyroid Glands, 203
Pituitary Gland and Placenta, 203
Adrenal Glands, 204
Pancreas, 204
Prostaglandins, 204
MUSCULOSKELETAL SYSTEM, 204
NURSING ASSESSMENT AND HEALTH EDUCATION, 205
Psychosocial Adaptations During Pregnancy, 205
DEVELOPMENTAL AND FAMILY CHANGES, 205
MATERNAL TASKS AND ROLE TRANSITION, 207
Acceptance of the Pregnancy, 207
Acceptance of the Child, 207
Reordering Relationships, 207
Seeking Safe Passage Through Pregnancy, Labor, and Birth, 208
Developmental Tasks and the Pregnant Adolescent, 209
PATERNAL ADAPTATION TO PREGNANCY, 209
ADAPTATION OF SIBLINGS AND GRANDPARENTS, 210
MATERNAL ADAPTATION DURING ABSENCE of A SIGNIFICANT OTHER, 210
CULTURAL INFLUENCES AND PSYCHOSOCIAL ADAPTATIONS, 210
HAZARDS OF HIGH-TECH MANAGEMENT ON MATERNAL ADAPTATION, 211
SOCIETAL AND CULTURAL INFLUENCES ON FAMILY ADAPTATION, 211
FACTORS THAT INTERFERE WITH PSYCHOSOCIAL ADAPTATIONS DURING PREGNANCY, 211
NURSING ASSESSMENT OF PSYCHOSOCIAL CHANGES AND PRENATAL HEALTH EDUCATION, 211
Multiple Choice, 212
Fill-in-the-Blank, 212
Select All that Apply, 212
True or False, 213
Chapter 9. The Prenatal Assessment, 215
Introduction, 216
A Time of Wonder and Growth…and Ambivalence, 216
Concerns over Self-Preservation, 216
Navigating the Health Care System, 217
CAREing for the Patient, 217
Diminishing Stress and Improving Pregnancy Outcomes, 218
Choosing a Pregnancy Care Provider, 219
The First Prenatal Visit, 220
THE COMPREHENSIVE HEALTH HISTORY, 220
Biographical Data, 222
Social History, 222
History of Intimate Partner Violence, 222
Psychological Assessment, 223
THE OBSTETRIC HISTORY, 225
Previous Pregnancies, 225
Current Pregnancy, 226
Establishing the Estimated Date of Birth, 226
THE PREGNANCY CLASSIFICATION SYSTEM, 227
PREGNANCY TESTING, 228
THE MEDICAL HISTORY, 229
Dental Health, 229
Eye Health, 229
Immunizations, 230
Other Preexisting Medical Conditions, 231
Environmental Hazards, 231
THE GYNECOLOGICAL HISTORY, 231
Screening and Diagnostic Tests During Pregnancy, 231
SEXUALLY TRANSMITTED INFECTIONS, 232
Human Immunodeficiency Virus, 232
Syphilis, 232
Herpes Simplex Virus, 233
CERVICAL CANCER, 233
The Prenatal Physical Examination, 233
PREPARING THE PATIENT, 233
PERFORMING THE GENERAL ASSESSMENT, 233
Obtaining Information and Promoting Good Nutrition, 234
Recording Vital Signs, 234
Obtaining the Urine Specimen, 234
PERFORMING THE GENERAL PHYSICAL EXAMINATION, 234
THE FOCUSED OBSTETRIC EXAMINATION, 236
Head, Neck, and Lungs, 236
The Skin, 236
The Breasts, 236
The Abdomen, 236
Uterine Size and Fetal Position, 236
Fetal Heart Auscultation, 238
The Vagina and Pelvis, 240
Subsequent Prenatal Examinations, 242
Assessing Special Populations, 243
THE ADOLESCENT, 243
Sexual Behavior and Pregnancy, 243
The Nurse’s Role, 243
Impact on Society, 245
Cultural Influences on Adolescent Pregnancy, 246
Identifying Adolescents at Greatest Risk for Unwanted Pregnancy, 247
The Impact of Pregnancy on Meeting the Developmental Tasks of Adolescence, 247
Delayed Entry into Care, 247
Nursing Care of the Pregnant Adolescent, 248
The Adolescent Expectant Father, 249
Evaluation, 249
THE PREGNANT WOMAN OLDER THAN AGE 35, 249
Screening for Fetal Chromosomal Abnormalities, 250
Multiple Choice, 252
True or False, 252
Fill-in-the-Blank, 252
Chapter 10. Promoting a Healthy Pregnancy, 256
Introduction, 257
Planning for Pregnancy, 258
PRECONCEPTION COUNSELING: A TOOL TO HELP PROMOTE A POSITIVE PREGNANCY OUTCOME, 258
THE HEALTHY BODY, 259
Menstrual and Medical History, 259
The Physical Examination, 260
Laboratory Evaluation, 260
Exposure to Childhood Illnesses, 260
Exposure to Sexually Transmitted Infections, 260
Genetic Testing, 260
Exposures Related to Lifestyle Choices, 261
THE HEALTHY MIND, 263
Readiness for Motherhood, 263
Psychological Changes During Pregnancy, 263
The Healthy Relationship, 263
Readiness for Fatherhood, 264
Nutrition and Weight Gain, 264
IMPORTANT NUTRITIONAL ELEMENTS, 265
Calories, 265
Protein, 265
Water, 265
Minerals and Vitamins, 265
WEIGHT GAIN DURING PREGNANCY, 267
Factors Affecting Weight Gain, 268
Management of Weight During Pregnancy, 268
PLANNING DAILY FOOD INTAKE, 268
FACTORS AFFECTING NUTRITION DURING PREGNANCY, 270
Eating Disorders, 270
Cultural Factors, 271
Vegetarian Diets, 271
Exercise, Work, and Rest During Pregnancy, 271
EXERCISE AND TRAVEL, 271
Safety Guidelines for Exercise, 272
Basic Prenatal Exercises, 272
WORK, 272
Evaluation of Work and Its Impact on the Pregnancy, 273
Planning for Maternity Leave, 273
REST, 273
Contributors to Fatigue During the First Trimester, 273
Contributors to Fatigue During the Second Trimester, 274
Contributors to Fatigue During the Third Trimester, 274
Medications, 274
SAFE VERSUS TERATOGENIC MEDICATIONS, 274
Over-the-counter Medications, 274
Herbal and Homeopathic Preparations, 274
Prescription Medications, 275
FDA CLASSIFICATION SYSTEM FOR MEDICATIONS USED DURING PREGNANCY, 275
Common Discomforts During Pregnancy, 276
NAUSEA, 276
VOMITING, 276
PTYALISM, 277
FATIGUE, 277
NASAL CONGESTION, 277
UPPER AND LOWER BACKACHE, 277
LEUKORRHEA, 277
URINARY FREQUENCY, 277
DYSPEPSIA, 277
FLATULENCE, 278
CONSTIPATION, 278
DENTAL PROBLEMS, 278
LEG CRAMPS, 278
DEPENDENT EDEMA, 278
VARICOSITIES, 278
DYSPAREUNIA, 278
NOCTURIA, 279
INSOMNIA, 279
ROUND LIGAMENT PAIN, 279
HYPERVENTILATION AND SHORTNESS OF BREATH, 279
NUMBNESS AND TINGLING IN THE FINGERS, 279
SUPINE HYPOTENSIVE SYNDROME, 279
Recognizing Signs and Symptoms of Danger, 279
FIRST TRIMESTER, 279
Nausea and Vomiting, 279
Abdominal Pain and Vaginal Bleeding, 279
Infection, 280
SECOND TRIMESTER, 280
Maternal Complications, 280
Fetal Complications, 280
THIRD TRIMESTER, 280
Maternal Complications, 280
Fetal Complications, 281
Using a Pregnancy Map to Guide Prenatal Visits, 281
Childbirth Education to Promote a Positive Childbearing Experience, 281
METHODS OF CHILDBIRTH PREPARATION, 281
Lamaze Method, 281
The Bradley Method of Natural Childbirth, 285
Other Methods, 286
FINDING INFORMATION ON CHILDBIRTH EDUCATION, 286
CREATING A BIRTH PLAN, 286
Birth Plan Choices, 287
Choosing a Health Care Provider, 287
Choosing a Birth Location, 287
Multiple Choice, 288
Select All that Apply, 288
True or False, 288
Fill-in-the-Blank, 288
Chapter 11. Caring for the Woman Experiencing Complications During Pregnancy, 291
Introduction, 292
Early Pregnancy Complications, 292
PERINATAL LOSS, 292
ECTOPIC PREGNANCY, 293
Diagnosis, 293
Management, 294
GESTATIONAL TROPHOBLASTIC DISEASE, 294
Pathophysiology, 294
Risk Factors, 294
Signs and Symptoms, 294
Diagnosis, 294
Management, 295
Prognosis, 295
SPONTANEOUS ABORTION, 295
Etiology, 295
Diagnosis, 295
Management, 295
INCOMPETENT CERVIX, 296
Etiology, 296
Management, 296
HYPEREMESIS GRAVIDARUM, 297
Etiology and Risk Factors, 297
Maternal and Fetal Effects, 297
Management, 297
Hemorrhagic Disorders, 297
Obstetric Causes of Vaginal Bleeding, 298
PLACENTA PREVIA, 298
Signs and Symptoms, 298
Maternal and Fetal Morbidity and Mortality, 298
Diagnosis, 298
PLACENTAL ABRUPTION, 299
Etiology and Classifications, 299
Perinatal and Maternal Morbidity and Mortality, 299
Signs and Symptoms, 299
Diagnosis, 299
Management, 300
Preterm Labor, 300
INCIDENCE, 300
ETIOLOGY AND RISK FACTORS, 300
MORBIDITY AND MORTALITY, 301
DIAGNOSIS, 301
BIOCHEMICAL MARKERS, 301
MANAGEMENT, 301
Premature Rupture of the Membranes, 303
PATHOPHYSIOLOGY, 303
DIAGNOSIS, 303
MANAGEMENT, 303
Hypertensive Disorders of Pregnancy, 304
CLASSIFICATIONS AND DEFINITIONS, 304
Chronic Hypertension, 304
Preeclampsia and Eclampsia, 304
Chronic Hypertension with Superimposed Preeclampsia, 304
Gestational (or Transient) Hypertension, 304
Preeclampsia, 305
PATHOPHYSIOLOGY, 305
RISK FACTORS FOR PREECLAMPSIA/ECLAMPSIA, 306
MATERNAL AND FETAL MORBIDITY AND MORTALITY, 306
MANAGEMENT OF PREECLAMPSIA/ECLAMPSIA, 307
NURSING ASSESSMENTS, 309
IDENTIFYING HYPERTENSION, 310
SIGNIFICANCE OF PROTEINURIA, 310
ASSESSING EDEMA, 310
CENTRAL NERVOUS SYSTEM ALTERATIONS, 310
Eclampsia, 311
HELLP Syndrome, 312
Disseminated Intravascular Coagulopathy, 313
NURSING CARE, 313
Multiple Gestation, 313
INCIDENCE, 313
ASSOCIATED COMPLICATIONS, 313
MATERNAL AND FETAL MORBIDITY AND MORTALITY, 314
DIAGNOSIS, 314
MANAGEMENT, 314
NURSING IMPLICATIONS, 314
Infections, 315
URINARY TRACT INFECTION, 315
Pathophysiology, 315
Morbidity, 315
Asymptomatic Bacteriuria, 315
Acute Cystitis, 315
Acute Pyelonephritis, 315
Group B Streptococcal Infection, 316
TORCH INFECTIONS, 316
SEXUALLY TRANSMITTED INFECTIONS, 316
Syphilis, 317
Human Papillomavirus Infection, 317
HIV and AIDS, 317
TUBERCULOSIS, 323
Inflammatory Disease and Pregnancy, 323
SYSTEMIC LUPUS ERYTHEMATOSUS, 323
Pathophysiology, 324
Effects During Pregnancy, 324
Perinatal Morbidity and Mortality, 324
Management, 324
Hemoglobinopathies of Pregnancy, 324
SICKLE CELL DISEASE, 325
Pathophysiology, 325
Effects During Pregnancy, 325
Management, 325
THALASSEMIA, 325
-Thalassemia, 326
Rh<sub>0</sub>(D) Isoimmunization, 326
PATHOPHYSIOLOGY, 326
MANAGEMENT, 328
SUMMARIZING CARE FOR THE SENSITIZED RhD-NEGATIVE PATIENT, 328
ABO, 328
Respiratory Complications, 328
PNEUMONIA, 328
Etiology, 329
Effects on Pregnancy, 329
Management, 329
ASTHMA, 329
Effects on Pregnancy, 329
Signs and Symptoms, 329
Management, 329
CYSTIC FIBROSIS, 329
Pathophysiology, 330
Effects on Pregnancy, 330
Management, 330
Cardiovascular Disease, 330
MANAGEMENT, 331
NURSING IMPLICATIONS FOR THE PREGNANT CARDIAC PATIENT, 332
MITRAL VALVE PROLAPSE, 332
PERIPARTUM CARDIOMYOPATHY, 332
Diabetes in Pregnancy, 333
DEFINITION AND CLASSIFICATION OF DIABETES MELLITUS, 333
RISK FACTORS FOR GESTATIONAL DIABETES, 333
PATHOPHYSIOLOGY, 333
MATERNAL AND PERINATAL MORBIDITY AND MORTALITY, 334
Ketoacidosis, 334
SCREENING AND DIAGNOSIS, 335
MANAGEMENT, 335
The Thyroid Gland and Pregnancy, 335
HYPERTHYROIDISM, 335
Signs and Symptoms, 335
Treatment, 336
HYPOTHYROIDISM, 337
Symptoms, 337
Treatment, 337
Venous Thrombosis and Pulmonary Embolism, 337
PATHOPHYSIOLOGY, 338
INCIDENCE AND RISK FACTORS, 338
Psychiatric Complications During Pregnancy, 338
CONSULTING WITH THE PREGNANT PSYCHIATRIC PATIENT, 338
DEPRESSION, 339
Bipolar Disorder, 339
Anxiety Disorders, 339
Eating Disorders, 339
MANAGEMENT, 339
Substance Abuse in Pregnancy, 339
SUBSTANCE ADDICTION, 339
Antepartum Fetal Assessment, 340
CHORIONIC VILLUS SAMPLING, 340
PERCUTANEOUS UMBILICAL BLOOD SAMPLING, 340
AMNIOCENTESIS, 340
ADDITIONAL INVASIVE TESTS, 341
Amnioscopy, 341
Fetoscopy, 341
ULTRASONOGRAPHY, 341
KICK COUNTS, 341
DOPPLER ULTRASOUND BLOOD FLOW STUDIES (UMBILICAL VELOCIMETRY), 341
FETAL BIOPHYSICAL PROFILE, 342
NONSTRESS TEST, 342
ACOUSTIC STIMULATION/VIBROACOUSTIC STIMULATION, 342
CONTRACTION STRESS TEST, 342
ELECTRONIC FETAL HEART RATE MONITORING, 343
Special Conditions and Circumstances that May Complicate Pregnancy, 343
THE PREGNANT WOMAN WHO REQUIRES ANTENATAL BED REST, 343
ADOLESCENT PREGNANT PATIENT, 344
ADVANCED AGE PREGNANT PATIENT, 344
THE PREGNANT PATIENT WHO HAS SUFFERED TRAUMA, 344
SURGERY DURING PREGNANCY, 345
Maternal and Fetal Risks During Surgery, 345
CANCER DURING PREGNANCY, 345
OBESITY, 345
THE PATIENT WITH A DISABILITY, 346
INTIMATE PARTNER VIOLENCE DURING PREGNANCY, 346
Multiple Choice, 347
True or False, 347
Select All that Apply, 347
Fill-in-the-Blank, 347
Unit Four: The Birth Experience, 353
Chapter 12. The Process of Labor and Birth, 355
Introduction, 356
Theories Concerning Labor Onset, 356
The Process of Labor and Birth, 356
POWERS, 357
Characteristics of Uterine Contractions, 357
Assessment of Uterine Contractions, 357
Maternal Pushing Efforts, 359
PASSAGEWAY, 359
PASSENGER, 359
Fetal Lie, 361
Fetal Attitude, 362
Fetal Presentation, 362
PASSAGEWAY, 364
PASSENGER, 364
Engagement, 364
Station, 364
Position, 364
PSYCHOSOCIAL INFLUENCES, 366
Signs and Symptoms of Impending Labor, 366
LIGHTENING, 366
BRAXTON-HICKS CONTRACTIONS, 366
CERVICAL CHANGES, 367
BLOODY SHOW, 367
RUPTURE OF THE MEMBRANES, 367
ENERGY SPURT, 367
WEIGHT LOSS, 367
GASTROINTESTINAL DISTURBANCES, 367
Distinguishing True Labor from False Labor, 367
Childbirth Settings and Labor Support, 369
Routine Hospital and Birth Center Admission Procedures, 369
ESTABLISHING A POSITIVE RELATIONSHIP, 370
COLLECTING ADMISSION DATA, 370
Initial Admission Assessments, 370
THE FOCUSED ASSESSMENT, 370
THE PSYCHOSOCIAL ASSESSMENT, 371
THE CULTURAL ASSESSMENT, 371
LABORATORY TESTS, 371
Documentation of Admission, 371
First Stage of Labor, 372
LATENT PHASE, 372
ACTIVE PHASE, 372
TRANSITION PHASE, 372
NURSING CARE DURING THE FIRST STAGE OF LABOR, 372
Labor Support, 374
PRESENCE, 374
PROMOTION OF COMFORT, 374
Position Changes, 374
Personal Comfort Measures, 375
ANTICIPATORY GUIDANCE, 376
CARING FOR THE BIRTH PARTNER, 376
ENSURING CULTURE-CENTERED CARE, 376
Assessment of the Fetus During Labor and Birth, 377
FETAL POSITION, 377
Leopold Maneuvers and Point of FHR Auscultation, 378
Vaginal Examination, 378
Ultrasound Examination, 378
ASSESSMENT OF THE FETAL HEART RATE, 378
Auscultation of Fetal Heart Sounds, 378
Electronic Fetal Monitoring, 379
Baseline Fetal Heart Rate, 381
VARIABILITY, 381
ACCELERATIONS, 382
DECELERATIONS, 382
Early Decelerations, 382
Variable Decelerations, 383
Late Decelerations, 383
INTERPRETATION OF FHR TRACINGS, 384
NURSING INTERVENTIONS AND DIAGNOSES, 384
Second Stage of Labor, 385
PROMOTING EFFECTIVE PUSHING, 385
ACHIEVING A POSITION OF COMFORT, 386
PREPARATION FOR THE BIRTH, 386
EPISIOTOMY, 386
Birth, 387
THE CARDINAL MOVEMENTS, 387
Descent, 387
Flexion, 387
Internal Rotation, 388
Extension, 388
Restitution, 388
External Rotation, 388
Expulsion, 388
CLAMPING THE UMBILICAL CORD, 388
Possible Nursing Diagnoses for the Intrapartal Patient, 389
Third and Fourth Stages of Labor, 389
Third Stage of Labor, 389
NURSING CARE OF THE MOTHER DURING THE THIRD STAGE OF LABOR, 391
Emotional Support, 392
Initiating Infant Attachment, 392
Immediate Nursing Care of the Newborn, 392
THE APGAR SCORING SYSTEM, 392
IDENTIFICATION OF THE NEWBORN, 393
Fourth Stage of Labor, 393
NURSING CARE DURING THE FOURTH STAGE OF LABOR, 393
Comfort, 394
Promoting Attachment and Breastfeeding, 394
Multiple Choice, 395
Fill-in-the-Blank, 396
True or False, 396
Select All that Apply, 396
Chapter 13. Promoting Patient Comfort During Labor and Birth, 399
Introduction, 400
The Physiology of Pain During Labor and Birth, 400
DEFINING PAIN, 400
PHYSICAL CAUSES OF PAIN RELATED TO LABOR AND BIRTH, 401
Pain Neurology, 401
PAIN PERCEPTION AND EXPRESSION, 401
FACTORS THAT AFFECT MATERNAL PAIN RESPONSE, 402
Physical Factors, 402
Physiological Factors, 402
Psychological Factors, 403
THE EFFECTS OF PREPARED CHILDBIRTH ON PAIN PATHWAYS, 403
BENEFITS OF COMFORT AND SUPPORT ON PAIN PERCEPTION, 404
Providing Comfort and Pain Relief, 404
NONPHARMACOLOGICAL PAIN RELIEF MEASURES, 405
Maternal Position and Movement, 405
Breathing Techniques, 405
Music, 407
Relaxation, 407
Other Attention-Focusing Strategies, 407
Massage and Touch, 407
Hydrotherapy, 408
Hypnotherapy, 408
Aromatherapy, 408
Application of Heat and Cold, 409
Biofeedback, 409
Transcutaneous Electrical Nerve Stimulation, 409
Intradermal Water Block, 410
Acupressure and Acupuncture, 410
Pharmacological Pain Relief Measures, 410
SEDATIVES AND ANTIEMETICS, 411
Barbiturates, 412
Benzodiazepines, 412
H, 412
-Receptor Antagonists, 412
DIFFERENTIATING ANALGESIA FROM ANESTHESIA, 412
SYSTEMIC ANALGESIA, 413
Opioid Agonist Analgesics, 413
Opioid Agonist–Antagonist Analgesics, 414
Opioid Antagonists, 415
NERVE BLOCK ANALGESIA AND ANESTHESIA, 415
Local Perineal In ltration Anesthesia, 415
Pudendal Nerve Block, 416
Spinal Anesthesia Block, 416
Epidural Anesthesia or Analgesia Block, 419
GENERAL ANESTHESIA, 421
Nursing Care for the Patient Receiving Interventions to Promote Comfort During Labor and Birth, 422
NURSING ASSESSMENT AND DIAGNOSES, 422
Multiple Choice, 423
Fill-in-the-Blank, 423
True or False, 424
Case Study, 424
Select All that Apply, 424
Chapter 14. Caring for the Woman Experiencing Complications During Labor and Birth, 427
Introduction, 428
Dystocia, 429
DYSFUNCTIONAL LABOR PATTERNS, 429
HYPERTONIC LABOR, 429
HYPOTONIC LABOR, 430
PRECIPITATE LABOR AND BIRTH, 431
Nursing Considerations, 431
PELVIC STRUCTURE ALTERATIONS, 432
Pelvic Dystocia, 432
Soft Tissue Dystocia, 432
TRIAL OF LABOR, 432
Obstetric Interventions, 432
AMNIOINFUSION, 432
AMNIOTOMY, 432
Pharmacological Induction of Labor, 433
INDICATIONS FOR INDUCTION, 433
Cervical Ripening Agents, 434
Mechanical Methods, 434
Oxytocin, 434
NURSING CONSIDERATIONS, 436
INSTRUMENTATION ASSISTANCE OF BIRTH, 437
Forceps-Assisted Birth, 437
Vacuum-Assisted Birth, 438
Maternal Conditions that Complicate Childbirth, 439
HYPERTENSIVE DISORDERS, 439
Nursing Considerations, 439
DIABETES, 440
PRETERM LABOR AND BIRTH, 441
Nursing Considerations, 441
Complications of Labor and Birth Associated with the Fetus, 442
FETAL MALPRESENTATION, 442
VERSION, 443
External Version, 443
Internal Version, 444
SHOULDER DYSTOCIA, 444
CEPHALOPELVIC DISPROPORTION, 445
Nursing Care, 445
MULTIPLE GESTATION, 445
NON-REASSURING FHR PATTERNS, 446
Fetal Scalp and Vibroacoustic Stimulation, 447
Fetal Oxygen Saturation Monitoring, 447
Fetal Scalp Blood Sampling, 447
Amniotic Fluid Complications, 448
OLIGOHYDRAMNIOS, 448
HYDRAMNIOS, 448
MECONIUM, 448
NUCHAL CORD, 448
Complications Associated with the Placenta, 448
PLACENTA PREVIA, 448
PLACENTAL ABRUPTION, 450
DISSEMINATED INTRAVASCULAR COAGULATION, 451
RUPTURE OF THE UTERUS, 451
UTERINE INVERSION, 453
UMBILICAL CORD PROLAPSE, 453
VARIATIONS RELATED TO UMBILICAL CORD INSERTION AND THE PLACENTA, 455
Velamentous Cord Insertion/Vasa Previa, 455
Circumvallate, Succenturiate, and Battledore Placenta, 455
Placenta Accreta, Placenta Increta, Placenta Percreta, 455
AMNIOTIC FLUID EMBOLISM, 456
Collaboration in Perinatal Emergencies, 456
Perinatal Fetal Loss, 457
CULTURAL ASPECTS OF LOSS, 458
Cesarean Birth, 458
DEFINITION AND INCIDENCE, 458
INDICATIONS, 458
ETHICAL CONSIDERATIONS OF ELECTIVE CESAREAN BIRTH, 458
SURGICAL PROCEDURES, 459
NURSING CARE, 459
SURGICAL CARE, 460
POSTOPERATIVE CARE, 460
VAGINAL BIRTH AFTER CESAREAN, 460
NURSING IMPLICATIONS, 460
RESEARCH FINDINGS AND IMPLICATIONS, 461
Postterm Pregnancy/Prolonged Pregnancy, 461
MEDICAL MANAGEMENT, 462
NURSING IMPLICATIONS, 462
Multiple Choice, 462
True or False, 463
Fill-in-the-Blank, 463
Case Study, 463
Unit Five: Care of the New Family, 467
Chapter 15. Caring for the Postpartal Woman and Her Family, 469
Introduction, 470
Ensuring Safety for the Mother and Infant, 470
Early Maternal Assessment, 471
VITAL SIGNS, 471
Temperature, 471
Pulse, 471
Blood Pressure, 472
Respirations, 472
FUNDUS, LOCHIA, PERINEUM, 472
HEMORRHOIDS, 473
A Concise Postpartum Assessment Guide to Facilitate Nursing Care, 473
THE, 473
MNEMONIC, 473
Breasts, 473
Uterus, 474
Bladder, 476
Bowel, 477
Lochia, 477
Episiotomy, 478
Homans’ Sign, 481
Emotional Status, 481
Maternal Physiological Adaptations and Continued Assessment of the Patient, 481
HEMATOLOGICAL AND METABOLIC SYSTEMS, 481
NEUROLOGICAL SYSTEM, 483
RENAL SYSTEM, FLUID, AND ELECTROLYTES, 483
RESPIRATORY SYSTEM, 483
INTEGUMENTARY SYSTEM, 483
CARDIOVASCULAR SYSTEM, 483
IMMUNE SYSTEM, 484
Rh, 484
(D) Immune Globulin, 484
Rubella Vaccine, 484
REPRODUCTIVE SYSTEM, 484
GASTROINTESTINAL SYSTEM, 484
MUSCULOSKELETAL SYSTEM, 485
Care for the Multicultural Family, 485
ENHANCING CULTURAL SENSITIVITY, 485
CULTURAL INFLUENCES ON THE PUERPERIUM, 485
CLINICAL IMPLICATIONS OF CULTURALLY APPROPRIATE CARE, 486
Promoting Recovery and Self-Care in the Puerperium, 486
ACTIVITY AND REST, 486
NOURISHMENT, 486
ELIMINATION, 486
PERINEAL CARE, 487
Ice Packs, 487
DISCOMFORT RELATED TO AFTERPAINS, 487
SPECIAL CONSIDERATIONS FOR WOMEN WITH HIV/AIDS, 487
Care of the Postpartal Surgical Patient, 488
PERMANENT STERILIZATION (TUBAL LIGATION), 488
CARE OF THE PATIENT AFTER A CESAREAN BIRTH, 488
CARE OF THE INCISIONAL WOUND, 488
RECOVERY FROM ANESTHESIA, 488
Respiratory Care, 489
Facilitating Infant Nourishment: Educating Parents to Make Informed Choices, 489
ENHANCING UNDERSTANDING OF THE PROCESS OF LA CTATION, 490
Normal Structure of the Breast, 490
Blood and Nerve Supply and Lymphatic Drainage, 490
The Physiology of Lactation, 491
ASSISTING THE MOTHER WHO CHOOSES TO BREASTFEED: STRATEGIES FOR BREASTFEEDING SUCCESS, 491
Initiating the Feeding, 492
EVALUATION OF NOURISHMENT: INFANT WEIGHT GAIN, 494
POSITIONS FOR BREASTFEEDING, 494
PROBLEMS THAT RESULT IN INEFFECTIVE BREASTFEEDING, 495
COLLECTING AND STORING BREAST MILK, 496
Electric Expression of Breast Milk, 496
Types of Breast Pumps, 496
INFANT WEANING, 497
ASSISTING THE MOTHER WHO CHOOSES TO FORMULA-FEED HER INFANT, 497
Safe Practices for Bottle Feeding, 497
Promoting Family and Infant Bonding, 498
FACILITATING THE TRANSITION TO PARENTHOOD, 498
ASSUMING THE MOTHERING ROLE, 498
Bonding and Attachment, 499
MATERNAL, 499
PATERNAL, 500
FACTORS THAT MAY INTERRUPT THE BONDING PROCESS, 500
ADJUSTMENT OF SIBLINGS TO THE NEWBORN, 501
ADJUSTMENT OF GRANDPARENTS TO THE NEWBORN, 501
Emotional and Physiological Adjustments During the Puerperium, 502
EMOTIONAL EVENTS, 502
Maternity Blues/Baby Blues/Postpartum Blues, 502
Postpartum Depression, 502
Postpartum Psychosis, 502
PHYSIOLOGICAL RESPONSES TO EMOTIONAL EVENTS, 502
Tiredness and Fatigue, 502
Postpartal Discharge Planning and Teaching, 503
PROMOTING MATERNAL SELF CARE, 503
COMPONENTS OF MATERNAL SELF-ASSESSMENT, 503
Fundus, 503
Lochia, 503
Hygiene, 503
Abdominal Incision, 503
Body Temperature, 504
Urination, 504
Bowel Function, 504
Nutrition, 504
Fatigue, 504
Weight Loss, 504
Exercise, 504
Pain Management, 505
Mood, 505
Sexual Activity and Contraception, 505
PLANNING FOR THE FOLLOW-UP EXAMINATION, 506
Patients with Special Needs During the Puerperium, 506
CARE OF THE ADOLESCENT, 506
THE WOMAN WHO IS PLACING HER INFANT FOR ADOPTION, 507
THE OLDER WOMAN, 507
Community Resources for the New Family, 507
SUPPORT GROUPS, 507
HOME VISITS, 507
TELEPHONE FOLLOW-UP, 507
OUTPATIENT CLINICS, 507
Multiple Choice, 508
Fill-in-the-Blank, 508
True or False, 508
Select All that Apply, 508
Case Study, 508
Chapter 16. Caring for the Woman Experiencing Complications During the Postpartal Period, 511
Introduction, 512
Postpartum Hemorrhage, 512
INCIDENCE AND DEFINITION, 512
EARLY VERSUS LATE HEMORRHAGE, 513
UTERINE ATONY, 513
TRAUMA, 513
TISSUE, 514
THROMBIN, 514
LATE POSTPARTUM HEMORRHAGE, 514
HYPOVOLEMIC SHOCK, 514
COLLABORATIVE MANAGEMENT OF PPH, 515
Hematomas, 518
DEFINITION, INCIDENCE, AND RISK FACTORS, 518
SIGNS AND SYMPTOMS, 518
COLLABORATIVE MANAGEMENT, 518
Puerperal (Postpartum) Infections, 520
DEFINITION AND INCIDENCE, 520
TYPES OF PUERPERAL INFECTIONS, 520
Endometritis, 520
Mastitis, 520
NURSING ASSESSMENT, 520
COLLABORATIVE MANAGEMENT, 520
Thrombophlebitis and Thrombosis, 527
DEFINITION, INCIDENCE, AND RISK FACTORS, 527
PATHOPHYSIOLOGY, 527
SIGNS AND SYMPTOMS, 527
DIAGNOSTIC TESTS, 528
COLLABORATIVE MANAGEMENT, 528
PULMONARY EMBOLUS, 530
Postpartum Psychosocial Complications, 530
POSTPARTUM BLUES, 530
POSTPARTUM DEPRESSION, 530
Incidence, Definition, and Risk Factors, 530
Signs and Symptoms and Diagnosis, 530
Etiology, 531
Assessment, 531
Collaborative Management, 532
Prognosis, 532
POSTPARTUM PSYCHOSIS, 532
Definition, Incidence, and Onset, 532
Collaborative Management, 533
Prognosis, 534
SUMMARIZING POSTPARTUM PSYCHOSOCIAL NURSING CARE, 534
Postpartum Nursing for Vulnerable Populations, 534
VICTIMS OF ABUSE, 535
UNDOCUMENTED IMMIGRANTS AND MINORITY HEALTH CARE, 536
HOMELESSNESS AND LIMITED ACCESS TO CARE, 537
POSTPARTUM CARE OF VULNERABLE POPULATIONS, 537
Multiple Choice, 538
True or False, 538
Fill-in-the-Blank, 538
Case Study, 538
Chapter 17. Physiological Transition of the Newborn, 541
Introduction, 542
Adaptations of the Respiratory System, 542
INTRAPULMONARY FLUID, FETAL BREATHING MOVEMENTS, AND SURFACTANT, 542
THE FIRST BREATH, 543
Chemical Factors, 543
Sensory Factors, 543
Thermal Factors, 543
Mechanical Factors, 543
FACTORS THAT MAY INTERFERE WITH INITIATION AND MAINTENANCE OF RESPIRATIONS, 544
CARDIOPULMONARY TRANSITIONS, 545
Cardiovascular Adaptation, 546
CHANGES AFTER PLACENTAL EXPULSION, 546
Closure of the Foramen Ovale, 546
Closure of the Ductus Arteriosus, 546
Closure of the Ductus Venosus, 547
ASSESSING THE CARDIOVASCULAR TRANSITION, 547
Thermogenic Adaptation, 547
THE NEUTRAL THERMAL ENVIRONMENT, 547
FACTORS RELATED TO COLD STRESS, 548
PHYSIOLOGICAL ADAPTATIONS FOR HEAT PRODUCTION, 548
MECHANISMS FOR NEONATAL HEAT LOSS, 548
Evaporation, 549
Conduction, 549
Convection, 549
Radiation, 549
PREVENTING HYPERTHERMIA, 549
Hematopoietic Adaptation, 550
BLOOD VOLUME, 550
BLOOD COMPONENTS, 550
Erythrocytes and Hemoglobin, 550
Hematocrit, 550
Leukocytes, 551
Platelets, 551
Hepatic Adaptation, 551
GLYCOGEN AND BLOOD GLUCOSE MAINTENANCE, 551
Hypoglycemia, 552
IRON STORAGE, 552
CONJUGATION OF BILIRUBIN, 552
Risk Factors for Hyperbilirubinemia, 553
Development of Physiological Jaundice, 554
Development of Nonphysiological or Pathological Jaundice, 554
Breastfeeding Jaundice (Early-Onset Jaundice), 554
Breast Milk Jaundice (Late-Onset Jaundice), 554
COAGULATION OF BLOOD, 555
Gastrointestinal Adaptation, 555
STOMACH AND DIGESTIVE ENZYMES, 555
INTESTINAL PERISTALSIS, 555
Genitourinary Adaptation, 555
KIDNEY FUNCTION, 555
Immunological Adaptation, 557
Psychosocial Adaptation, 557
EARLY STAGES OF ACTIVITY, 557
The First Period of Reactivity, 557
The Period of Inactivity and Sleep, 558
The Second Period of Reactivity, 558
Newborn Behavioral States, 558
SLEEP STATES, 558
ALERT STATES, 558
Drowsy or Semidozing, 560
Wide Awake, 560
Active Awake, 560
Crying, 560
Multiple Choice (Select all that apply.), 560
Fill-in-the-Blank, 560
True or False, 560
Chapter 18. Caring for the Normal Newborn, 563
Introduction, 564
The Immediate Neonatal Assessment, 564
IDENTIFICATION, 566
INFECTION AND INJURY PREVENTION, 567
The Later Neonatal Assessment, 569
BODY POSITIONING, 569
SKIN COLOR, 570
BODY SIZE, 571
LEVEL OF REACTIVITY, 571
OBTAINING MEASUREMENTS AND DETERMINING THE GESTATIONAL AGE, 571
Conducting and Documenting the Neonatal Physical Assessment, 574
ASSESSMENT OF THE NEONATE: A SYSTEMS APPROACH, 574
Assessment of the Integumentary System, 575
Assessment of the Infant’s Head, 577
Assessment of the Respiratory System, 581
Assessment of the Cardiovascular System, 582
Assessment of the Gastrointestinal System, 583
Assessment of the Genitourinary System, 584
Assessment of the Musculoskeletal System, 586
Assessment of the Neurological System, 589
Enhancing the Neonate’s Transition to Extrauterine Life, 593
TEMPERATURE ASSESSMENT, 593
BATHING THE NEWBORN, 593
NAIL CARE AND UMBILICAL CORD CARE, 594
CLOTHING, 594
DIAPERING, 594
FOSTERING ATTACHMENT, 595
CIRCUMCISION, 596
ENSURING OPTIMAL NUTRITION, 597
Discharge Planning for the Infant and Family, 598
CHILD CARE, 598
Newborn Metabolic Screening Tests, 599
Multiple Choice, 600
Select All that Apply, 600
True or False, 600
Fill-in-the-Blank, 600
Chapter 19. Caring for the Newborn at Risk, 603
Introduction, 604
The High-Risk Newborn, 605
CLASSIFICATION OF HIGH-RISK NEWBORNS, 605
Gestational Age, 605
Birth Weight, 606
INTRAUTERINE GROWTH RESTRICTION, 606
Small-for-Gestational-Age Infants, 606
CONDITIONS AFFECTING THE SGA NEWBORN, 607
Hypothermia, 607
Pain, 608
Hypoglycemia, 609
Polycythemia, 609
Large-for-Gestational–Age Infants, 610
CONDITIONS AFFECTING THE LGA NEWBORN, 611
Infant with a Diabetic Mother, 611
Transient Tachypnea of the Newborn, 611
Hypoglycemia, 612
Hypocalcemia, 612
Hypomagnesemia, 613
Birth Injuries, 613
Brachial Plexus Injuries, 613
Fractures, 613
The Premature Newborn, 614
PHYSICAL ASSESSMENT OF THE PREMATURE NEWBORN, 614
CONDITIONS AFFECTING THE PREMATURE NEWBORN, 614
Respiratory Distress Syndrome, 614
Apnea of Prematurity, 615
Jaundice, 618
Retinopathy of Prematurity, 620
Anemia of Prematurity, 620
Sudden Infant Death Syndrome, 620
The Postterm Newborn, 621
CONDITIONS AFFECTING THE POSTTERM NEWBORN, 621
Meconium Aspiration Pneumonia, 621
Persistent Pulmonary Hypertension of the Newborn, 621
Additional Conditions Affecting The High-Risk Newborn, 622
METABOLIC CONDITIONS, 622
Phenylketonuria, 624
Galactosemia, 624
Maple Syrup Urine Disease (Branched-Chain Ketoaciduria), 624
Homocystinuria, 624
Biotinidase Deficiency, 624
NEUROLOGICAL CONDITIONS, 624
Intraventricular and Periventricular Hemorrhage, 624
Anencephaly, 625
Encephalocele, 625
Microcephaly, 625
Holoprosencephaly, 625
GASTROINTESTINAL CONDITIONS, 625
Cleft Lip and Cleft Palate, 625
Necrotizing Enterocolitis, 626
ABDOMINAL WALL DEFECTS, 626
Gastroschisis and Omphalocele, 626
INFECTIONS IN THE NEWBORN, 627
Herpes Simplex, 627
Neonatal Sepsis, 627
DEVELOPMENTAL DELAY, 628
Neonatal Abstinence Syndrome, 628
Care of the High-Risk Newborn, 629
BLOOD PRESSURE, 629
NUTRITIONAL CARE, 629
Intravenous Feedings, 629
Total Parenteral Nutrition, 629
Enteral Feedings, 630
Bottleand Breastfeeding, 630
Non-nutritive Sucking, 630
Other Nutrients Needed for High-Risk Newborn Growth, 631
Intake and Output, 631
DEVELOPMENTAL CARE, 631
Noise, 631
Lighting, 632
Handling, 632
Positioning, 632
The Neonatal Intensive Care Unit, 632
CLASSIFICATION OF THE NEONATAL INTENSIVE CARE UNIT, 633
TRANSPORTING THE PRETERM NEWBORN, 633
The Transport Team, 634
Discharge Planning, 634
Multiple Choice, 634
True or False, 635
Fill-in-the-Blank, 635
Unit Six: Cairing for the Child and Family, 639
Chapter 20. Caring for the Developing Child, 641
Introduction, 642
Influences on Growth and Development, 642
Principles of Childhood Growth and Development, 642
Growth and Development Theories, 643
PSYCHOSOCIAL DEVELOPMENT THEORIES, 643
Sigmund Freud, Psychosexual, 643
Erik Erikson, 644
Trust versus Mistrust, 644
Autonomy versus Shame and Doubt, 644
Initiative versus Guilt, 644
Industry versus Inferiority, 644
Identity versus Role Confusion, 645
ATTACHMENT THEORIES, 645
John Bowlby, 645
Mary Ainsworth, 645
LEARNING THEORIES, 645
Albert Bandura, 646
Lev Vygotsky, 646
Urie Bronfenbrenner, 646
COGNITIVE THEORIES, 646
Jean Piaget, 647
INTELLIGENCE THEORIES, 647
MORAL DEVELOPMENT THEORIES, 647
Lawrence Kohlberg, 650
Carol Gilligan, 650
SPIRITUAL DEVELOPMENT THEORIES, 650
FAMILY DEVELOPMENT THEORIES, 651
Temperament, 651
Newborn and Infant, 652
REFLEXES AND NEUROLOGICAL DEVELOPMENT, 652
SENSORY DEVELOPMENT, 652
PHYSICAL DEVELOPMENT, 653
COGNITIVE DEVELOPMENT, 653
LANGUAGE, 654
PSYCHOSOCIAL DEVELOPMENT, 654
DISCIPLINE, 655
Toddler (1 to 3 years), 655
PHYSICAL DEVELOPMENT, 655
COGNITIVE DEVELOPMENT, 655
LANGUAGE DEVELOPMENT, 656
PSYCHOSOCIAL DEVELOPMENT, 656
MORAL DEVELOPMENT, 656
DISCIPLINE, 656
TEMPER TANTRUMS, 656
Early Childhood (Preschooler) (3 to 6 years), 657
PHYSICAL DEVELOPMENT, 657
COGNITIVE DEVELOPMENT, 657
LANGUAGE, 657
PSYCHOSOCIAL DEVELOPMENT, 658
MORAL DEVELOPMENT, 658
DISCIPLINE, 658
School-Age Child (6 to 12 years), 658
PHYSICAL DEVELOPMENT, 658
COGNITIVE DEVELOPMENT, 659
LANGUAGE DEVELOPMENT, 659
PSYCHOSOCIAL DEVELOPMENT, 659
MORAL DEVELOPMENT, 659
DISCIPLINE, 660
Adolescence (12 to 19 years), 660
PHYSICAL DEVELOPMENT, 660
COGNITIVE DEVELOPMENT, 660
LANGUAGE, 660
PSYCHOSOCIAL DEVELOPMENT, 660
MORAL DEVELOPMENT, 660
DISCIPLINE, 660
Multiple Choice, 661
True or False, 661
Fill-in-the-Blank, 661
Chapter 21. Caring for the Child in the Hospital and in the Community, 664
Introduction, 665
Gathering the Child’s Health History, 665
ESTABLISHING A RELATIONSHIP WITH THE PATIENT AND THE FAMILY, 665
ASKING QUESTIONS, 666
COMPREHENSIVE HEALTH HISTORY, 666
Family Medical and Social History, 666
Past Medical History, 666
Immunizations, 667
DEVELOPMENTAL MILESTONES, 667
Patterns of Daily Activities, 670
REVIEW OF SYSTEMS, 670
Health Assessment, 672
ANTHROPOMETRIC MEASUREMENTS, 672
Length, 672
Weight, 672
Body Mass Index, 672
Head Circumference, 672
Skinfold Thickness Measurements, 672
VITAL SIGNS, 673
Temperature, 673
Pulse, 673
Respirations, 673
Blood Pressure, 673
PHYSICAL ASSESSMENT, 673
General Impression, 673
Skin Assessment, 673
Head Assessment, 674
Neck Assessment, 674
Eye Assessment, 675
Ear Assessment, 675
Nose/Sinus Assessment, 677
Throat/Mouth Assessment, 677
Chest Assessment, 677
Lung Assessment, 677
Cardiac Assessment, 678
Abdominal Assessment, 679
Genitourinary and Perineal Assessment, 680
Musculoskeletal Assessment, 681
Neurological Assessment, 681
ROUTINE HEALTH SCREENING, 681
Lead Poisoning Screening, 681
Iron-Deficiency Anemia Screening, 682
Cholesterol Screening, 682
Tuberculosis Screening, 682
General Care Measures for the Child in the Hospital or Clinic Setting, 682
BATHING, 682
FEEDING, 683
REST, 683
SAFETY MEASURES, 683
INFECTION CONTROL MEASURES, 684
FEVER-REDUCING MEASURES, 684
EMOTIONAL AND SPIRITUAL SUPPORT, 685
Common Procedures for the Child in the Hospital or Clinic Setting, 685
EXPLAINING PROCEDURES, 685
INFORMED CONSENT, 687
INTRAVENOUS LINES, 687
MEASURING INTAKE AND OUTPUT, 688
X-RAY EXAMS, 688
SPECIMEN COLLECTION, 688
Urine Sample Collection, 688
Stool Sample Collection, 689
Blood Sample Collection, 689
Throat Culture Collection, 689
Cerebrospinal Fluid Collection, 689
Enteral Tube Feedings, 689
Ostomies, 691
RESTRAINING THE CHILD, 691
Physical Restraint, 691
Pharmacological Restraint, 692
The Child in Pain, 692
PAIN ASSESSMENT AND MANAGEMENT, 692
The Child with Disabilities, 694
EMOTIONAL CONCERNS, 694
DEVELOPMENTAL CONCERNS, 696
PHYSICAL CONCERNS, 696
CAREGIVER FATIGUE, 696
RESILIENCY, 696
Multiple Choice, 697
Select All that Apply, 697
Fill-in-the-Blank, 697
True or False, 698
Chapter 22. Caring for the Family Across Care Settings, 701
Introduction, 702
Across Care Settings, 702
PRIMARY HEALTH CARE PROVIDER OR CLINIC SETTING, 703
THE HOSPITALIZED CHILD, 704
Ways to Decrease the Stress of Hospitalization, 705
Effects of a Hospitalized Child on Parents, 707
TWENTY-FOUR-HOUR OBSERVATION UNIT, 709
AMBULATORY SURGERY CENTER, 709
CRITICAL CARE UNIT, 709
EMERGENCY DEPARTMENT, 710
Community Settings, 710
CLINICS, 711
SPECIALTY CAMPS, 711
CHURCHES, SYNAGOGUES, MOSQUES, 711
CARE IN SCHOOL SETTINGS, 712
Multiple Choice, 713
Select all that apply, 713
Fill-in-the-Blank, 713
Unit Seven: Ongoing Care of the Child in the Hospitlal and in the Community, 715
Chapter 23. Caring for the Child with a Psychosocial or Cognitive Condition, 717
Introduction, 718
Developmental Psychopathology, 718
Vulnerability and Resilience, 719
Culture, Diversity, and Health Disparities, 719
Barriers to Child and Adolescent Mental Health, 720
Psychopathology in Children, 720
ANXIETY, 720
Signs and Symptoms, 721
Diagnosis, 721
Nursing Care, 721
POSTTRAUMATIC STRESS DISORDER, 722
Signs and Symptoms, 722
Diagnosis, 722
Nursing Care, 722
Mood Disorders, 722
DEPRESSION, 723
Signs and Symptoms, 723
Diagnosis, 723
Nursing Care, 723
BIPOLAR DISORDER, 723
Signs and Symptoms, 724
Diagnosis, 725
Nursing Care, 725
SUICIDE, 725
Signs and Symptoms, 725
Diagnosis, 726
Nursing Care, 726
SCHIZOPHRENIA, 726
Signs and Symptoms, 726
Diagnosis, 728
Nursing Care, 728
AUTISM SPECTRUM DISORDERS, 728
Signs and Symptoms, 728
Diagnosis, 729
Nursing Care, 729
Psychosocial and Cognitive Disorders, 729
REACTIVE ATTACHMENT DISORDER, 729
Signs and Symptoms, 730
Diagnosis, 730
Nursing Care, 730
FAILURE TO THRIVE, 730
Signs and Symptoms, 730
Diagnosis, 731
Nursing Care, 731
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, 731
Signs and Symptoms, 731
Diagnosis, 731
Nursing Care, 732
OPPOSITIONAL DEFIANT DISORDER AND CONDUCT DISORDER, 732
Signs and Symptoms, 732
Diagnosis, 733
Nursing Care, 733
Tic Disorders, 734
TOURETTE’S SYNDROME, 734
Signs and Symptoms, 734
Diagnosis, 734
Nursing Care, 734
Maltreatment of Children, 735
Signs and Symptoms, 735
Diagnosis, 735
Nursing Care, 735
Substance Use and Abuse, 736
Signs and Symptoms, 737
Diagnosis, 737
Nursing Care, 737
Eating Disorders, 737
Signs and Symptoms, 737
Diagnosis, 738
Nursing Care, 738
Obesity, 738
Signs and Symptoms, 738
Diagnosis, 739
Nursing Care, 739
Sleep Disorders, 739
Signs and Symptoms, 739
Diagnosis, 740
Nursing Care, 740
Developmental Conditions, 740
DEVELOPMENTAL DISABILITIES, 740
Signs and Symptoms, 741
Diagnosis, 741
Nursing Care, 741
DOWN SYNDROME, 742
Signs and Symptoms, 742
Diagnosis, 742
Nursing Care, 742
FETAL ALCOHOL SPECTRUM DISORDER, 742
Signs and Symptoms, 742
Diagnosis, 743
Nursing Care, 743
Learning Disorders and Cognitive Impairment, 743
Signs and Symptoms, 743
Diagnosis, 743
Nursing Care, 743
Elimination Disorders, 743
ENURESIS, 743
Signs and Symptoms, 744
Diagnosis, 744
Nursing Care, 744
ENCOPRESIS, 744
Signs and Symptoms, 744
Diagnosis, 744
Nursing Care, 744
Multiple Choice, 745
Fill-in-the-Blank, 745
True or False, 746
Chapter 24. Caring for the Child with a Respiratory Condition, 750
Introduction, 751
The Child’s Respiratory System, 751
Congenital Respiratory Conditions and Structural Anomalies, 752
CHOANAL ATRESIA, 752
Signs and Symptoms, 752
Diagnosis, 752
Nursing Care, 752
ESOPHAGEAL ATRESIA AND TRACHEOESOPHAGEAL FISTULA, 753
Signs and Symptoms, 753
Diagnosis, 753
Nursing Care, 753
CONGENITAL DIAPHRAGMATIC HERNIA, 754
Signs and Symptoms, 755
Diagnosis, 755
Nursing Care, 755
RESPIRATORY DISTRESS SYNDROME, 756
Signs and Symptoms, 756
Diagnosis, 756
Nursing Care, 756
BRONCHOPULMONARY DYSPLASIA, 757
Signs and Symptoms, 757
Diagnosis, 757
Nursing Care, 757
CYSTIC FIBROSIS, 758
Signs and Symptoms, 758
Diagnosis, 759
Nursing Care, 759
Upper Airway Disorders, 761
SINUSITIS, 761
Signs and Symptoms, 761
Diagnosis, 761
Nursing Care, 761
NASOPHARYNGITIS, 762
Signs and Symptoms, 762
Diagnosis, 763
Nursing Care, 763
PHARYNGITIS, 763
Signs and Symptoms, 763
Diagnosis, 763
Nursing Care, 763
TONSILLITIS, 764
Signs and Symptoms, 764
Diagnosis, 764
Nursing Care, 764
CROUP OR LARYNGOTRACHEOBRONCHITIS, 765
Signs and Symptoms, 765
Diagnosis, 766
Nursing Care, 766
OTITIS MEDIA/EXTERNA, 766
Signs and Symptoms, 766
Diagnosis, 766
Nursing Care, 766
OTITIS MEDIA, 767
Signs and Symptoms, 767
Diagnosis, 767
Nursing Care, 768
Lower Airway Disorders, 768
BRONCHITIS, 768
Signs and Symptoms, 768
Diagnosis, 768
Nursing Care, 768
RESPIRATORY SYNCYTIAL VIRUS, 768
Signs and Symptoms, 769
Diagnosis, 769
Nursing Care, 769
PNEUMONIA, 769
Signs and Symptoms, 770
Diagnosis, 770
Nursing Care, 770
SEVERE ACUTE RESPIRATORY DISTRESS SYNDROME, 771
Signs and Symptoms, 771
Diagnosis, 771
Nursing Care, 771
Infectious Conditions, 771
PERTUSSIS, 771
Signs and Symptoms, 771
Diagnosis, 772
Nursing Care, 772
TUBERCULOSIS, 772
Signs and Symptoms, 773
Diagnosis, 773
Nursing Care, 773
INFLUENZA, 774
Signs and Symptoms, 774
Diagnosis, 774
Nursing Care, 774
Pulmonary Noninfectious Irritation, 774
FOREIGN BODY ASPIRATION, 774
Signs and Symptoms, 775
Diagnosis, 775
Nursing Care, 775
SMOKE INHALATION, 776
Signs and Symptoms, 777
Diagnosis, 777
Nursing Care, 777
PASSIVE SMOKING, 777
Signs and Symptoms, 777
Diagnosis, 777
Nursing Care, 777
Respiratory Conditions Related to Allergens, 778
ALLERGIC RHINITIS, 778
Signs and Symptoms, 778
Diagnosis, 778
Nursing Care, 778
ASTHMA, 778
Signs and Symptoms, 779
Diagnosis, 779
Nursing Care, 779
Multiple Choice, 781
True or False, 782
Fill-in-the-Blank, 782
Matching, 782
Chapter 25. Caring for the Child with a Gastrointestinal Condition, 785
Introduction, 785
Developmental Aspects of the Gastrointestinal System, 786
Structural Gastrointestinal Disorders, 787
INGUINAL HERNIA, 787
Signs and Symptoms, 787
Diagnosis, 787
Nursing Care, 787
UMBILICAL HERNIA, 788
Signs and Symptoms, 788
Diagnosis, 788
Nursing Care, 788
ANORECTAL MALFORMATIONS, 788
Signs and Symptoms, 788
Diagnosis, 789
Nursing Care, 789
Obstructive Gastrointestinal Disorders, 789
HYPERTROPHIC PYLORIC STENOSIS, 789
Signs and Symptoms, 789
Diagnosis, 790
Nursing Care, 790
INTUSSUSCEPTION, 790
Signs and Symptoms, 790
Diagnosis, 790
Nursing Care, 791
MALROTATION AND VOLVULUS, 791
Signs and Symptoms, 791
Diagnosis, 792
Nursing Care, 792
Inflammatory Disorders, 792
IRRITABLE BOWEL SYNDROME, 792
Signs and Symptoms, 792
Diagnosis, 793
Nursing Care, 793
INFLAMMATORY BOWEL DISEASE, 793
Crohn’s Disease, 793
Ulcerative Colitis, 795
APPENDICITIS, 795
OMPHALITIS, 797
MECKEL DIVERTICULUM, 797
Functional Gastrointestinal Conditions, 797
INFANTILE COLIC, 797
Signs and Symptoms, 797
Diagnosis, 797
Nursing Care, 798
ACUTE DIARRHEA, 798
Signs and Symptoms, 798
Diagnosis, 798
Nursing Care, 798
CHRONIC DIARRHEA, 800
Signs and Symptoms, 800
Diagnosis, 800
Nursing Care, 800
VOMITING, 800
Signs and Symptoms, 800
Diagnosis, 801
Nursing Care, 802
CYCLIC VOMITING SYNDROME, 802
Signs and Symptoms, 802
Diagnosis, 803
Nursing Care, 803
CONSTIPATION, 803
Signs and Symptoms, 804
Diagnosis, 804
Nursing Care, 804
ENCOPRESIS, 805
Signs and Symptoms, 805
Diagnosis, 805
Nursing Care, 805
GASTROESOPHAGEAL REFLUX AND GASTROESOPHAGEAL REFLUX DISEASE, 806
Signs and Symptoms, 806
Diagnosis, 806
Nursing Care, 806
HIRSCHSPRUNG DISEASE, 807
Signs and Symptoms, 807
Diagnosis, 808
Nursing Care, 808
Malabsorption Disorders, 808
LACTOSE INTOLERANCE, 808
Signs and Symptoms, 808
Diagnosis, 809
Nursing Care, 809
CELIAC DISEASE, 809
Signs and Symptoms, 809
Diagnosis, 810
Nursing Care, 810
SHORT BOWEL SYNDROME, 810
Signs and Symptoms, 811
Diagnosis, 811
Nursing Care, 811
Hepatic Disorders, 811
BILIARY ATRESIA, 811
Signs and Symptoms, 811
Diagnosis, 811
Nursing Care, 812
CIRRHOSIS, 812
Signs and Symptoms, 812
Diagnosis, 812
Nursing Care, 812
HEPATITIS, 813
Signs and Symptoms, 813
Diagnosis, 813
Nursing Care, 814
Abdominal Trauma: Injuries, 814
Multiple Choice, 816
Select All that Apply, 816
Case Study, 816
True or False, 816
Fill-in-the-Blank, 816
Chapter 26. Caring for the Child with an Immunological or Infectious Condition, 819
Introduction, 820
The Immune System, 820
The Body’s Defense, 821
Congenital Immunode ciency Disorders, 821
B-CELL DISORDERS, 822
T-CELL DISORDERS, 822
B-LYMPHOCYTE DISORDERS, 822
COMBINED IMMUNODEFICIENCY DISORDERS, 822
Immunode ciency Disorders, 822
HUMAN IMMUNODEFICIENCY VIRUS, 822
Signs and Symptoms, 824
Diagnosis, 824
Nursing Care, 824
Transplantation, 827
NURSING CARE, 827
Autoimmune Disorders, 827
SYSTEMIC LUPUS ERYTHEMATOSUS, 827
Signs and Symptoms, 828
Diagnosis, 828
Nursing Care, 828
JUVENILE RHEUMATOID ARTHRITIS, 829
Signs and Symptoms, 829
Diagnosis, 829
Nursing Care, 829
Allergic Reaction, 830
ANAPHYLAXIS, 830
Signs and Symptoms, 830
Diagnosis, 830
Nursing Care, 830
Infectious Diseases of Childhood, 831
INFECTION, 831
Signs and Symptoms, 839
Diagnosis, 839
Nursing Care, 839
Common Viral Infections, 841
CYTOMEGALOVIRUS INFECTIONS, 841
Signs and Symptoms, 841
Diagnosis, 841
Nursing Care, 841
HERPES ZOSTER, 842
Signs and Symptoms, 842
Diagnosis, 842
Nursing Care, 842
SMALLPOX, 842
Signs and Symptoms, 842
Diagnosis, 842
Nursing Care, 842
INFECTIOUS MONONUCLEOSIS, 842
Signs and Symptoms, 842
Diagnosis, 842
Nursing Care, 842
Common Fungal Infections, 843
(ORAL THRUSH), 843
Signs and Symptoms, 843
Diagnosis, 843
Nursing Care, 843
Immunizations, 844
NURSING CARE, 846
Animal-Borne Infectious Diseases, 847
RABIES, 847
Signs and Symptoms, 847
Diagnosis, 847
Nursing Care, 847
WEST NILE VIRUS, 847
Signs and Symptoms, 847
Diagnosis, 847
Nursing Care, 848
AVIAN INFLUENZA, 848
Signs and Symptoms, 848
Diagnosis, 848
Nursing Care, 848
An Emerging Issue in Infectious Disease: Resistant Organisms, 849
ANTIBIOTIC ALTERNATIVES, 849
Multiple Choice, 850
True or False, 850
Fill-in-the-Blank, 851
Case Study, 851
Chapter 27. Caring for the Child with a Cardiovascular Condition, 853
Introduction, 854
Congenital Heart Disease, 857
CYANOTIC VERSUS ACYANOTIC CONGENITAL HEART DEFECTS, 857
Segmental Classification of Congenital Heart Defects, 857
DEFECTS IN THE SEPTUM, 857
Atrial Septal Defect, 857
Ventricular Septal Defect, 859
Atrioventricular Canal Defect, 860
DEFECTS OF THE VESSELS AND VALVES, 860
Patent Ductus Arteriosus, 860
Pulmonic Stenosis, 861
Aortic Stenosis, 862
Coarctation of the Aorta, 862
Tricuspid Atresia, 862
Total Anomalous Pulmonary Venous Return, 863
CONAL–TRUNCAL DEFECTS, 864
Transposition of the Great Arteries or Vessels, 864
Truncus Arteriosus, 864
COMBINATION DEFECTS, 865
Tetralogy of Fallot, 865
Complex or Single Ventricle Type Defects, 865
Cardiac Diseases, 866
SUBACUTE BACTERIAL ENDOCARDITIS, 866
KAWASAKI DISEASE, 866
CARDIOMYOPATHY, 867
Additional Cardiac Conditions, 868
CARDIAC TRAUMA, 868
HYPERTENSION, 869
IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION, 869
NEURALLY MEDIATED SYNCOPE, 870
LONG Q-T SYNDROME, 870
Rhythm Disturbances, 871
Invasive Tests, 871
CARDIAC CATHETERIZATION, 871
ANGIOGRAPHY, 873
BIOPSY, 874
CLOSURE DEVICES, 874
OPENING DEVICES, 874
Angioplasty or Valvuloplasty, 874
Balloon Atrial Septostomy, 874
NURSING CARE, 874
Surgical Interventions, 875
PACEMAKERS, 875
CARDIAC TRANSPLANTATION, 875
Nursing Care for the Child with a Cardiac Condition, 879
CARING FOR THE CHILD IN THE PEDIATRIC INTENSIVE CARE UNIT, 879
TRANSFERRING THE STABLE CHILD TO A SURGICAL OR MEDICAL UNIT, 880
CARING FOR CHILDREN WITH CARDIAC CONDITIONS ACROSS CARE SETTINGS, 881
Multiple Choice, 882
True or False, 883
Fill-in-the-Blank, 883
Chapter 28. Caring for the Child with an Endocrinological or Metabolic Condition, 885
Introduction, 887
Pathophysiological Conditions of the Endocrine System, 887
CONDITIONS OF THE ANTERIOR PITUITARY, 887
Hypopituitary, 887
Pituitary Hyperfunction, 889
Acromegaly and Gigantism, 890
CONDITIONS OF THE POSTERIOR PITUITARY, 892
Diabetes Insipidus, 892
Syndrome of Inappropriate Antidiuretic Hormone, 894
CONDITIONS OF THE THYROID, 895
Hypothyroidism, 895
Graves’ Disease, 896
CONDITIONS OF THE PARATHYROID, 897
Hypoparathyroidism, 897
Hyperparathyroidism, 899
CONDITIONS OF THE ADRENALS, 899
Acute Adrenocortical Insuficiency, 899
Chronic Adrenocortical Insuficiency, 900
Cushing’s Syndrome, 902
Congenital Adrenal Hyperplasia, 903
Hyperaldosteronism, 904
Pheochromocytoma, 905
Metabolic Conditions, 906
DIABETES MELLITUS TYPE 1, 906
Diet and Nutrition, 909
Exercise, 910
Stress Management, 910
Blood Glucose and Ketone Monitoring, 910
Long-term Treatments, 910
Patient/Family Teaching that Optimizes Outcomes, 911
DIABETES MELLITUS TYPE 2, 912
DIABETIC KETOACIDOSIS, 914
Multiple Choice, 918
True or False, 918
Fill-in-the-Blank, 918
Chapter 29. Caring for the Child with a Neurological or Sensory Condition, 921
Introduction, 922
Altered States of Consciousness, 922
THE UNCONSCIOUS CHILD, 923
Caring for the Unconscious Child, 923
PERSISTENT VEGETATIVE STATE, 925
Family Support, 926
INCREASED INTRACRANIAL PRESSURE, 926
SEIZURE DISORDERS, 929
Inflammatory Neurological Conditions, 933
MENINGITIS, 933
ENCEPHALITIS, 934
BRAIN ABSCESS, 936
REYE SYNDROME, 936
GUILLAIN-BARRÉ SYNDROME, 938
Developmental Neurological Conditions, 939
SPINA BIFIDA, 939
HYDROCEPHALUS, 941
CEREBRAL PALSY, 944
Neurological Injuries, 945
NEAR DROWNING, 945
HEAD INJURY, 946
SHAKEN BABY SYNDROME, 947
SPINAL CORD INJURY, 947
Nontraumatic Neurological Conditions, 949
HEADACHES, 949
Sensory Conditions, 950
EYE DISORDERS, 950
Refractive Disorders, 950
Astigmatism, 950
Amblyopia, 952
Strabismus, 952
Color Blindness, 953
Nystagmus, 953
Cataracts, 953
Glaucoma, 954
Retinoblastoma, 954
EYE INJURIES, 954
Foreign Bodies, 954
Hyphema, 955
Chemical Burns, 955
HEARING LOSS, 955
Language Disorders, 957
Multiple Choice, 958
Select All that Apply, 959
True or False, 959
Fill-in-the-Blank, 959
Chapter 30. Caring for the Child with a Musculoskeletal Condition, 962
Introduction, 964
Immobilizing Devices, 965
CASTS, 965
Cast Complications, 966
Nursing Care, 966
Principles of Traction, 968
SKIN TRACTION, 968
Nursing Care, 968
SKELETAL TRACTION, 969
Crutchfield Tongs, 969
90/90 Femoral Traction, 969
Dunlop Traction, 969
Nursing Care, 970
Common Musculoskeletal Conditions found in Children, 972
CLUBFOOT, 972
Signs and Symptoms, 972
Diagnosis, 972
Nursing Care, 972
LEGG–CALVE–PERTHES DISEASE, 973
Signs and Symptoms, 973
Diagnosis, 973
Nursing Care, 973
SLIPPED FEMORAL CAPITAL EPIPHYSIS, 974
Signs and Symptoms, 974
Diagnosis, 974
Nursing Care, 974
FRACTURES, 975
Signs and Symptoms, 975
Diagnosis, 976
Nursing Care, 976
SOFT TISSUE INJURIES, 977
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