Contents
Chapter 1 Contemporary Maternal, Newborn, and Child Health Nursing ........................................................................ 2
Chapter 2 Culture and the Family...................................................................................................................................15
Chapter 3 Genetic and Genomic Influences in Maternal, Newborn, and Child Health ................................................28
Chapter 4 Reproductive Anatomy and Physiology ......................................................................................................41
Chapter 5 Health Promotion for Women .....................................................................................................................57
Chapter 6 Common Gynecologic Problems .................................................................................................................70
Chapter 7 Conception and Fetal Development............................................................................................................88
Chapter 8 Physical and Psychologic Changes of Pregnancy ................................................................................... 101
Chapter 9 Antepartum Nursing Assessment ............................................................................................................. 115
Chapter 10 The Expectant Family: Needs and Care .................................................................................................. 130
Chapter 11 Maternal Nutrition ....................................................................................................................................... 145
Chapter 12 Pregnancy in Selected Populations............................................................................................................ 159
Chapter 13 Assessment of Fetal Well-Being ................................................................................................................ 178
Chapter 14 Pregnancy at Risk: Pregestational Problems ............................................................................................ 192
Chapter 15 Pregnancy at Risk: Gestational Onset ...................................................................................................... 207
Chapter 16 Processes and Stages of Labor and Birth ................................................................................................. 222
Chapter 17 Intrapartum Nursing Assessment ............................................................................................................. 237
Chapter 18 The Family in Childbirth: Needs and Care .............................................................................................. 250
Chapter 19 Pharmacologic Pain Management ............................................................................................................. 265
Chapter 20 Childbirth at Risk: Prelabor and Intrapartum Complications............................................................... 279
Chapter 21 Childbirth at Risk: Labor-Related Complications ................................................................................... 292
Chapter 22 Birth-Related Procedures............................................................................................................................ 310
Chapter 23 The Physiologic Responses of the Newborn to Birth ........................................................................... 324
Chapter 24 Nursing Assessment of the Newborn ...................................................................................................... 338
Chapter 25 The Normal Newborn: Needs, Care, and Feeding................................................................................. 351
Chapter 26 The Newborn at Risk: Conditions Present at Birth ............................................................................... 369
Chapter 27 The Newborn at Risk: Birth-Related Stressors ....................................................................................... 382
Chapter 28 Postpartum Adaptation and Nursing Assessment.................................................................................. 396
Chapter 29 The Postpartum Family: Early Care Needs and Home Care ...................................................................... 411
Chapter 30 The Postpartum Family at Risk ................................................................................................................. 426
Chapter 31 Growth and Development............................................................................................................................... 441
Chapter 32 Infant, Child, and Adolescent Nutrition ........................................................................................................ 455
Chapter 33 Pediatric Assessment ................................................................................................................................... 468
Chapter 34 Health Promotion and Maintenance: General Concepts, the Newborn, andthe Infant .................. 481
Chapter 35 Health Promotion and Maintenance: The Toddler and the Preschooler ........................................... 495
Chapter 36 Health Promotion and Maintenance: The School-Age Child and theAdolescent .................................. 509
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,Chapter 37 Family Assessment and Concepts of Nursing Care in the Community.............................................. 528
Chapter 38 Nursing Considerations for the Child and Family With a Chronic Condition .................................. 541
Chapter 39 Nursing Considerations for the Hospitalized Child .................................................................................... 558
Chapter 40 Pain Assessment and Management in Children ............................................................................................ 577
Chapter 41 The Child With a Life-Threatening Condition and End-of-Life Care ................................................ 592
Chapter 42 Social and Environmental Influences on the Child................................................................................ 609
Chapter 43 Immunizations and Communicable Diseases ......................................................................................... 626
Chapter 44 The Child With Alterations in Fluid, Electrolyte, and Acid–Base Balance .............................................. 645
Chapter 45 The Child With Alterations in Eye, Ear, Nose, and Throat Function ................................................ 659
Chapter 46 The Child With Alterations in Respiratory Function ............................................................................. 673
Chapter 47 The Child With Alterations in Cardiovascular Function ............................................................................. 685
Chapter 48 The Child With Alterations in Immune Function ........................................................................................ 702
Chapter 49 The Child With Alterations in Hematologic Function .......................................................................... 716
Chapter 50 The Child With Cancer ..................................................................................................................................... 734
Chapter 51 The Child With Alterations in Gastrointestinal Function ..................................................................... 750
Chapter 52 The Child With Alterations in Genitourinary Function ........................................................................ 763
Chapter 53 The Child With Alterations in Endocrine Function .............................................................................. 776
Chapter 54 The Child With Alterations in Neurologic Function ................................................................................... 790
Chapter 55 The Child With Alterations in Mental Health and Cognitive Function .............................................. 803
Chapter 56 The Child With Alterations in Musculoskeletal Function ..................................................................... 815
Chapter 57 The Child With Alterations in Skin Integrity .......................................................................................... 829
Chapter 1 Contemporary Maternal, Newborn, and Child Health
Nursing
1) A nurse is examining different nursing roles. Which statement best illustrates an advancedpractice
nursing role?
1. A registered nurse who is the manager of a large obstetric unit
2. A clinical nurse specialist working as a staff nurse on a mother–baby unit
3. A registered nurse who is the circulating nurse at surgical deliveries (cesarean sections)
4. A clinical nurse specialist with whom other nurses consult for this nurse’s expertise incaring
for high-risk infants
Answer: 4
Explanation:
1. A registered nurse who is the manager of a large obstetric unit or one who is a circulating
nurse at surgical deliveries (cesarean sections) is defined as a professional nurse, and has graduated
from an accredited program in nursing and completed the licensure examination.
2. A clinical nurse specialist working as a staff nurse on a mother–baby unit might have the
qualifications for an advanced practice nursing staff but is not working in that capacity.
3. A registered nurse who is the manager of a large obstetric unit or one who is a circulating nurse at
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, surgical deliveries (cesarean sections) is defined as a professional nurse, and has graduated from an
accredited program in nursing and completed the licensure examination.
4. A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk
infants would illustrate an advanced practice nursing role. This nurse has specialized knowledge
and competence in a specific clinical area, and is master’s-prepared.
Page Ref: 3
Cognitive Level: Remembering
Client Need/Sub: Safe and Effective Care Environment/Management of Care
Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member
of the health care team │AACN Essential Competencies: VI.1. Compare/contrast the rolesand
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.scope of
discipline, education and licensure requirements) │NLN Competencies: Teamwork; Knowledge; Scope of
practice, roles, and responsibilities of health care team members, including overlaps │Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1.1 Identify the nursing roles available to maternal-newborn and pediatricnurses.
MNL Learning Outcome: 1.1.2. Explore the role of the nurse in maternity care delivery.
2) What is the major focus of the nurse practitioner (NP)?
1. Leadership
2. Tertiary prevention
3. Physical and psychosocial clinical assessment
4. Independent care of the high-risk, pregnant client
Answer: 3
Explanation:
1. Leadership might be a quality of the NP, but it is not the major focus.
2. The NP cannot do tertiary prevention as a major focus.
3. Physical and psychosocial clinical assessment is the major focus of the NP.
4. NPs cannot provide independent care of the high-risk pregnant client, but must work undera
physician’s supervision.
Page Ref: 3
Cognitive Level: Remembering
Client Need/Sub: Safe and Effective Care Environment/Management of Care
Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member
of the health care team │AACN Essential Competencies: VI.1. Compare/contrast the rolesand
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.scope of
discipline, education and licensure requirements) │NLN Competencies: Teamwork; Knowledge; Scope of
practice, roles, and responsibilities of health care team members, including overlaps │Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1.1 Identify the nursing roles available to maternal-newborn and pediatricnurses.
MNL Learning Outcome: 1.1.2. Explore the role of the nurse in maternity care delivery.
3) What is the role of the certified nurse–midwife (CNM)? Select all that apply.
1. Give primary care for healthy newborns.
2. Be educated in two disciplines of nursing.
3. Give primary care for high-risk clients who are in hospital settings.
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, 4. Obtain a physician consultation for all technical procedures at delivery.
5. Be prepared to manage independently the care of women at low risk for complicationsduring
pregnancy and birth.
Answer: 1, 2, 5
Explanation:
1. The CNM is prepared to manage independently the care of women at low risk for
complications during pregnancy and birth and the care of healthy newborns.
2. The CNM is educated in the disciplines of nursing and midwifery.
3. CNMs cannot give primary care for high-risk clients who are in hospital settings. The
physician provides the primary care.
4. The CNM does not need to obtain a physician consultation for all technical procedures at
delivery. Situations in which the client is at risk, such as for a 4th-degree laceration or forceps
delivery, would need physician consultation.
5. The CNM is prepared to manage independently the care of women at low risk for
complications during pregnancy and birth and the care of healthy newborns.
Page Ref: 3
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment/Management of Care
Standards: QSEN Competencies: II.B.4. Function competently within own scope of practice as a member
of the health care team │AACN Essential Competencies: VI.1. Compare/contrast the rolesand
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.scope of
discipline, education and licensure requirements) │NLN Competencies: Teamwork; Knowledge; Scope of
practice, roles, and responsibilities of health care team members, including overlaps │Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1.1 Identify the nursing roles available to maternal-newborn and pediatricnurses.
MNL Learning Outcome: 1.1.2. Explore the role of the nurse in maternity care delivery.
4) During the hospital admission process, a child’s parent asks for information about family-centered
care. What should the nurse explain to this parent?
1. Mother is the principal caregiver in each family.
2. Father is the leader in each home; thus, all communications should include him.
3. Family serves as the constant influence and continuing support in the child’s life.
4. Child’s physician is the key person in ensuring the health of a child is maintained.
Answer: 3
Explanation:
1. Culturally competent care recognizes that both matriarchal and patriarchal households exist.
2. Culturally competent care recognizes that both matriarchal and patriarchal households exist.
3. The foundation for the development of trusting relationships and partnerships with families is the
recognition that the family is the principal caregiver, knows the unique nature of each individual
child best, plays the vital role of meeting the child’s needs, and is responsible for ensuring each
child’s health.
4. The physician is not present during the day-to-day routines in a child’s life. Page
Ref: 3
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment/Management of Care
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