Maternity Exam 1- Chapters 13-15, 17 and 18 (NUR 335) Review Questions and Correct Answers
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Course
NUR 335
Institution
NUR 335
Nursing Care During the Prenatal Period: Nursing plan and implementation 1.) Prioritize - Immediate needs, concerns perceived by woman 2.) Community-based nursing care - Value of primary care nurse- Family assumes equal responsibility - Home care = Useful for removing barriers such as lack of local...
Maternity Exam 1- Chapters 13-15, 17
and 18 (NUR 335) Review Questions and
Correct Answers
Nursing Care During the Prenatal Period: Nursing plan and implementation ✅1.)
Prioritize
- Immediate needs, concerns perceived by woman
2.) Community-based nursing care
- Value of primary care nurse- Family assumes equal responsibility
- Home care = Useful for removing barriers such as lack of local facilities, transportation
3.) Health promotion education
- Informal and formal teaching
Anticipatory guidance for changes that will occur during childbirth ✅- Postpartum
stress, depression
- Infant, household chores
- Help in the first few days
- Family finances
- Mother's return to work
Topics for Patient Teaching During Pregnancy ✅All Three Trimesters
- Discomforts of pregnancy
- Nutrition and weight gain
- Sexual activity
- Sibling preparation
1.) First Trimester
- Attitude toward pregnancy
- Exercise and rest
- Smoking; use of alcohol and other drugs
- Traveling
- Fetal growth and development
- Danger signals associated with spontaneous abortion
- Employment
- Early pregnancy classes
2.) Second Trimester
- Concerns related to changes in body
- Fetal growth and development
- Fetal movement
- Clothing
- Care of skin and breasts
- Beginning preparation for care of the newborn (equipment and room)
,- Decisions about newborn/infant feeding
3.) Third Trimester
- Exercise and rest
- Traveling
- Danger signals
- Preparation for labor and birth
- Completion of preparation in home for new baby
- Decisions about the newborn (circumcision, method of feeding, and so forth)
- Decision making for the early postpartum period
- Education about psychologic and physical expectations in the early postpartum period
Care of the Pregnant Woman's Family ✅1.) Needs of woman
- Relieve discomforts
- Maintain physical health
- Provide anticipatory guidance
2.) Needs of family
- Support, prenatal education
- Harmony, integrity
- Consider effect of pregnancy on other children
- Discussion about ambivalence = Open communication about feelings may prevent
children from hurting baby when unsupervised
- Encourage to bring children to antepartal visits
- Resolve conflicts with grandparents
3.) Needs of the father
- Assess support system if not part of family structure
- Provide anticipatory guidance = Information, feelings regarding pregnancy
- Assess intended degree of participation in labor, birth
- Support decisions
Cultural Considerations in Pregnancy ✅• Cultural humility
• Cultural assessment = Adapt to patient needs and Special, transitional event in all
cultures
Types of cultural beliefs ✅- Prescriptive
- Restrictive
- Taboo
Childbearing Decisions: Healthcare Provider ✅• One of the first decisions
• Explain various options
• Interview questions = Who can cover when healthcare provider unavailable and
Feelings on available options
Childbearing Decisions: Prenatal Care Services ✅Assist expectant parents in
obtaining care
1.) Individual
,2.) Centering
- Group prenatal care = Mothers and partners, Self-tracking
- Health assessment, education, and support
Childbearing Decisions: Birth Setting ✅• Tour facilities
• Speak with nurses, recent parents
- How closely birth plan was followed
- Support from partner, coach, healthcare team
• Concept of individuality = Encourage women to personalize birth setting
Labor Support Individual ✅1.) Who?
- Father/partner
- Doula
- Monitrice
2.) Positive outcomes and satisfaction with continuous support
- Less analgesia
- Fewer operative births
3.) Role of the doula
- Provide emotional, physical, informational support
- Advocate
- No clinical tasks
Siblings at Birth ✅• Children can be prepared
• Imperative that child has own coach = Should be able to intervene if necessary and
Flexibility to leave room if child desires
• Should be given options
• Generally engenders feelings of interest, nurturing
Classes for Family Members During Pregnancy ✅• Taught by certified childbirth
educators = CBE or CCE
• "Mother-Friendly Childbirth Initiative" in 1996
• Specific educational preparation• Not required to be RN
• Prenatal education = Opportunity to share information, Beneficial effect on labor and
delivery
Education of the Family Having Cesarean Birth ✅- 32% of all U.S. births (2017)
- What to expect
- Anesthesia
- Preparation for repeat cesarean birth
- Preparation for vaginal birth after cesarean (VBAC)
Preparation for Parents Desiring Trial of Labor After Cesarean Birth ✅• Vaginal birth
after cesarean (VBAC)
• Trial of labor under necessary criteria
• Prepare two birth plans = One for vaginal birth and One for cesarean birth
, Breastfeeding Programs ✅• Currently below objective rate, 81.9%
• Information about:
- Advantages and challenges
- Techniques and positioning
- Methods of pumping, milk storage
- How to involve father/partner in feeding process
- Ways of successfully breastfeeding and returning to work
Sibling Preparation: Adjustment to a Newborn ✅• Significant event in child's life
• Typical classes for ages 3-12
• Parents and children attend together
• Practice holding dolls and changing diapers
• Formal or informal
Classes for Grandparents ✅• Important source of support and information
• Transitioning to new role
• Ways to support new family unit
• Educational information updated
Relief of the Common Discomforts of Pregnancy ✅• Not minor to the pregnant woman
• Result of physiologic, anatomic changes
• Specific to either first trimester or second and third trimesters
First Trimester Discomforts ✅• Nausea and vomiting
• Urinary frequency
• Fatigue
• Breast tenderness
• Increased vaginal discharge
• Nasal stuffiness and epistaxis
• Ptyalism
Nausea and vomiting ✅- Very common
- Possibly due to elevated levels of hCG
- Health promotion education = Safe and effective treatment suggestions: Antihistamine
H1 receptor blockers, benzamines, phenothiazines, Acupressure, Dietary changes
Urinary frequency ✅- Pressure of enlarging uterus on bladder
- Health promotion education = Frequent bladder emptying and Maintain adequate fluid
intake
Fatigue ✅- Sleep-inducing effects of progesterone
- Health promotion education = Schedule to allow for napping
Breast tenderness ✅- Continues throughout pregnancy
- Health promotion education = Well-fitting, supportive bra
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