MATERNITY, NEWBORN, AND WOMEN'S HEALTH
NURSING 2E: A CASE-BASED APPROACH SECOND,
NORTH AMERICAN EDITION BY DR. AMY
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,TABLE OF CONTENTS
UNIT 1: SCENARIOS FOR CLINICAL PREPARATION ........................................................................................ 3
CHAPTER 1: BESS GASKELL: IMMEDIATE POSTPARTUM HEMORRHAGE .................................................. 3
CHAPTER 2: TATIANA BENNETT: LATER POSTPARTUM HEMORRHAGE ................................................. 15
CHAPTER 3: SUSAN ROCKWELL: GESTATIONAL DIABETES, DEEP VEIN THROMBOSIS, AND
POSTPARTUM PULMONARY EMBOLISM ................................................................................................ 27
CHAPTER 4: SOPHIE BLOOM: PREECLAMPSIA ........................................................................................ 41
CHAPTER 5: LETITIA RICHFORD: CORD PROLAPSE AND NONREASSURING FETAL STATUS .................... 53
CHAPTER 6: REBECCA SWEET: PLACENTAL ABRUPTION AND FETAL LOSS ............................................. 69
CHAPTER 7: HANNAH WILDER: CHORIOAMNIONITIS AND NEONATAL SEPSIS ...................................... 78
CHAPTER 8: GRACIELLA MUÑEZ: PRETERM PREMATURE RUPTURE OF MEMBRANES AND NEONATAL
RESPIRATORY DISTRESS SYNDROME....................................................................................................... 83
CHAPTER 9: NANCY NG: GESTATIONAL DIABETES, MACROSOMIA, AND NEONATAL
CEPHALHEMATOMA ............................................................................................................................. 105
CHAPTER 10: LEXI COWSLIP: ADVANCED MATERNAL AGE, HELLP SYNDROME, AND NEONATAL
NECROTIZING ENTEROCOLITIS .............................................................................................................. 122
CHAPTER 11: EDIE WILSON: MIGRAINE WITH AURA, SHOULDER DYSTOCIA, AND BRACHIAL PLEXUS
PALSY..................................................................................................................................................... 132
CHAPTER 12: LORETTA HALE: INTIMATE PARTNER VIOLENCE, FORMULA FEEDING, AND POSTPARTUM
DEPRESSION .......................................................................................................................................... 142
CHAPTER 13: TANYA GREEN: GESTATIONAL TROPHOBLASTIC DISEASE (MOLAR PREGNANCY) AND
ADVANCED MATERNAL AGE ................................................................................................................. 160
UNIT 2: MATERNITY AND NEWBORN NURSING FOR UNCOMPLICATED PREGNANCIES .......................... 169
CHAPTER 14 BEFORE CONCEPTION ...................................................................................................... 169
CHAPTER 15 PREGNANCY ..................................................................................................................... 183
CHAPTER 16 LABOR AND DELIVERY ...................................................................................................... 199
CHAPTER 17 AFTER DELIVERY ............................................................................................................... 216
CHAPTER 18 THE NEWBORN ................................................................................................................. 232
,UNIT 3: HIGH-RISK CONDITIONS AND COMPLICATIONS........................................................................... 255
CHAPTER 19 CONDITIONS EXISTING BEFORE CONCEPTION ................................................................. 255
CHAPTER 20 CONDITIONS OCCURRING DURING PREGNANCY ............................................................. 266
CHAPTER 21 COMPLICATIONS OCCURRING BEFORE LABOR AND DELIVERY........................................ 290
CHAPTER 22 COMPLICATIONS OCCURRING DURING LABOR AND DELIVERY ....................................... 307
CHAPTER 23 CONDITIONS OCCURRING AFTER DELIVERY ..................................................................... 321
CHAPTER 24 CONDITIONS IN THE NEWBORN RELATED TO GESTATIONAL AGE, SIZE, INJURY, AND PAIN
.............................................................................................................................................................. 333
CHAPTER 25 ACQUIRED CONDITIONS AND CONGENITAL ABNORMALITIES IN THE NEWBORN .......... 347
UNIT 4: WOMEN’S AND GENDERED HEALTH ............................................................................................ 364
CHAPTER 26 WELLNESS AND HEALTH PROMOTION............................................................................. 364
CHAPTER 27 COMMON GYNECOLOGIC CONDITIONS........................................................................... 385
CHAPTER 28 INFECTIONS ...................................................................................................................... 406
CHAPTER 29 FAMILY PLANNING ........................................................................................................... 414
CHAPTER 30 VULNERABLE POPULATIONS ............................................................................................ 428
UNIT 1: SCENARIOS FOR CLINICAL PREPARATION
CHAPTER 1: BESS GASKELL: IMMEDIATE POSTPARTUM HEMORRHAGE
MULTIPLE CHOICE
1. A PREGNANT WOMAN IS BEING DISCHARGED FROM THE HOSPITAL AFTER THE PLACEMENT OF A
CERVICAL CERCLAGE BECAUSE OF A HISTORY OF RECURRENT PREGNANCY LOSS, SECONDARY TO AN
INCOMPETENT CERVIX. WHICH INFORMATION REGARDING POSTPROCEDURAL CARE SHOULD THE
NURSE EMPHASIZE IN THE DISCHARGE TEACHING?
A. ANY VAGINAL DISCHARGE SHOULD BE IMMEDIATELY REPORTED TO HER HEALTH CARE PROVIDER.
B. THE PRESENCE OF ANY CONTRACTIONS, RUPTURE OF MEMBRANES (ROM), OR SEVERE PERINEAL
PRESSURE SHOULD BE REPORTED.
C. THE CLIENT WILL NEED TO ARRANGE FOR CARE AT HOME, BECAUSE HER ACTIVITY LEVEL WILL BE
RESTRICTED.
D. THE CLIENT WILL BE SCHEDULED FOR A CESAREAN BIRTH.
CORRECT ANS>>>B
NURSING CARE SHOULD STRESS THE IMPORTANCE OF MONITORING FOR THE SIGNS AND SYMPTOMS
OF PRETERM LABOR. VAGINAL BLEEDING NEEDS TO BE REPORTED TO HER PRIMARY HEALTH CARE
, PROVIDER. BED REST IS AN ELEMENT OF CARE. HOWEVER, THE WOMAN MAY STAND FOR PERIODS OF
UP TO 90 MINUTES, WHICH ALLOWS HER THE FREEDOM TO SEE HER PHYSICIAN. HOME UTERINE
ACTIVITY MONITORING MAY BE USED TO LIMIT THE WOMAN'S NEED FOR VISITS AND TO MONITOR HER
STATUS SAFELY AT HOME. THE CERCLAGE CAN BE REMOVED AT 37 WEEKS OF GESTATION (TO PREPARE
FOR A VAGINAL BIRTH), OR A CESAREAN BIRTH CAN BE PLANNED.
2. A PERINATAL NURSE IS GIVING DISCHARGE INSTRUCTIONS TO A WOMAN, STATUS POST-SUCTION,
AND CURETTAGE SECONDARY TO A HYDATIDIFORM MOLE. THE WOMAN ASKS WHY SHE MUST TAKE
ORAL CONTRACEPTIVES FOR THE NEXT 12 MONTHS. WHAT IS THE BEST RESPONSE BY THE NURSE?
A. "IF YOU GET PREGNANT WITHIN 1 YEAR, THE CHANCE OF A SUCCESSFUL PREGNANCY IS VERY SMALL.
THEREFORE, IF YOU DESIRE A FUTURE PREGNANCY, IT WOULD BE BETTER FOR YOU TO USE THE MOST
RELIABLE METHOD OF CONTRACEPTION AVAILABLE."
B. "THE MAJOR RISK TO YOU AFTER A MOLAR PREGNANCY IS A TYPE OF CANCER THAT CAN BE
DIAGNOSED ONLY BY MEASURING THE SAME HORMONE THAT YOUR BODY PRODUCES DURING
PREGNANCY. IF YOU WERE TO GET PREGNANT, THEN IT WOULD MAKE THE DIAGNOSIS OF THIS CANCER
MORE DIFFICULT."
C. "IF YOU CAN AVOID A PREGNANCY FOR THE NEXT YEAR, THE CHANCE OF DEVELOPING A SECOND
MOLAR PREGNANCY IS RARE. THEREFORE, TO IMPROVE YOUR CHANCE OF A SUCCESSFUL PREGNANCY,
NOT GETTING PREGNANT AT THIS TIME IS BEST."
D. "ORAL CONTRACEPTIVES ARE THE ONLY FORM OF BIRTH CONTROL THAT WILL PREVENT A
RECURRENCE OF A MOLAR PREGNANCY."
CORRECT ANS>>>B
BETA-HUMAN CHORIONIC GONADOTROPIN (BETA-HCG) HORMONE LEVELS ARE DRAWN FOR 1 YEAR TO
ENSURE THAT THE MOLE IS COMPLETELY GONE. THE CHANCE OF DEVELOPING CHORIOCARCINOMA
AFTER THE DEVELOPMENT OF A HYDATIDIFORM MOLE IS INCREASED. THEREFORE, THE GOAL IS TO
ACHIEVE A ZERO HUMAN CHORIONIC GONADOTROPIN (HCG) LEVEL. IF THE WOMAN WERE TO BECOME
PREGNANT, THEN IT MAY OBSCURE THE PRESENCE OF THE POTENTIALLY CARCINOGENIC CELLS.
WOMEN SHOULD BE INSTRUCTED TO USE BIRTH CONTROL FOR 1 YEAR AFTER TREATMENT FOR A
HYDATIDIFORM MOLE. THE RATIONALE FOR AVOIDING PREGNANCY FOR 1 YEAR IS TO ENSURE THAT
CARCINOGENIC CELLS ARE NOT PRESENT. ANY CONTRACEPTIVE METHOD EXCEPT AN INTRAUTERINE
DEVICE (IUD) IS ACCEPTABLE.
3. THE NURSE IS PREPARING TO ADMINISTER METHOTREXATE TO THE CLIENT. THIS HAZARDOUS DRUG
IS MOST OFTEN USED FOR WHICH OBSTETRIC COMPLICATION?