Nursing Ethics and Childbearing Families
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Questions and Answers

A nurse is providing care to a pregnant woman who is experiencing a high-risk pregnancy. The nurse recognizes the importance of respecting the woman's autonomy. Which of the following actions demonstrates the nurse's understanding of this ethical principle?

  • Providing the woman with a list of all available resources, regardless of her financial situation.
  • Ensuring that the woman's partner is involved in all decision-making processes, even if the woman prefers otherwise.
  • Sharing information about the potential risks and benefits of different interventions, allowing the woman to make informed decisions about her care. (correct)
  • Prioritizing the woman's comfort and well-being, even if it means delaying necessary medical procedures.
  • Which of the following ethical principles is violated when a nurse shares information about a patient's medical condition with unauthorized personnel?

  • Beneficence
  • Justice
  • Nonmaleficence
  • Privacy (correct)
  • A nurse is caring for a postpartum patient who is struggling to breastfeed. The nurse offers support and encouragement to the patient, while also providing information about alternative feeding methods. What ethical principle is the nurse demonstrating?

  • Beneficence (correct)
  • Autonomy
  • Fidelity
  • Veracity
  • A nurse is providing care to a pregnant woman who is experiencing a high-risk pregnancy. The nurse recognizes the importance of providing the woman with complete and accurate information about her condition and treatment options. This demonstrates the nurse's understanding of which ethical principle?

    <p>Veracity (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of the AWHONN (Association of Women’s Health, Obstetric, & Neonatal Nurses) in ethical nursing practice?

    <p>AWHONN advocates for nurses' right to refuse to participate in any reproductive health care service or research activity based on personal beliefs. (B)</p> Signup and view all the answers

    A nurse is providing care to a pregnant woman who is experiencing a high-risk pregnancy. The nurse educates the woman about the risks, benefits, and alternative options for a specific procedure. What ethical principle is the nurse upholding?

    <p>Informed consent (C)</p> Signup and view all the answers

    A nurse is providing care to a pregnant woman who is experiencing a high-risk pregnancy. The nurse recognizes the importance of providing the woman with culturally sensitive care. Which of the following actions demonstrates the nurse's understanding of cultural humility?

    <p>Respecting the woman's beliefs and practices while also being open to learning about her culture. (D)</p> Signup and view all the answers

    A nurse is providing care to a pregnant woman who is experiencing a high-risk pregnancy. The nurse recognizes the importance of promoting the woman's right to make decisions about her own healthcare. What ethical principle is the nurse demonstrating?

    <p>Autonomy (D)</p> Signup and view all the answers

    What is one of the four core tenets of cultural humility?

    <p>Creating beneficial partnerships with individuals from diverse backgrounds. (D)</p> Signup and view all the answers

    Which of the following is a trend that has been identified as contributing to challenges in maternal and infant health outcomes?

    <p>Prevalence of health disparities during pregnancy. (B)</p> Signup and view all the answers

    What is the definition of infant mortality?

    <p>The death of an infant within the first year of life. (D)</p> Signup and view all the answers

    Which of the following is NOT a Healthy People 2030 goal related to maternal and infant care?

    <p>Increase the rate of cesarean births. (B)</p> Signup and view all the answers

    Which of the following statements accurately describes evidence-based practice (EBP) in nursing?

    <p>EBP involves integrating clinical expertise, patient preferences, and current best evidence in nursing. (B)</p> Signup and view all the answers

    What is a key component of AWHONN's Perinatal Quality Measures?

    <p>Utilizing evidence-based education and practices to enhance perinatal care. (A)</p> Signup and view all the answers

    What does 'cultural humility' refer to in the context of healthcare?

    <p>The process of acknowledging and respecting cultural differences while being open to learning and adapting. (A)</p> Signup and view all the answers

    Which option is NOT considered a trend or issue impacting maternal and infant health outcomes?

    <p>Reduced rates of substance use during pregnancy. (C)</p> Signup and view all the answers

    What is NOT considered a red flag vital sign in a postpartum assessment?

    <p>RR between 12-20 (A)</p> Signup and view all the answers

    Which of these lab values is NOT included in a normal postpartum assessment?

    <p>Blood Glucose (B)</p> Signup and view all the answers

    What is a normal expected finding during a postpartum assessment of the lower extremities?

    <p>No tenderness or sensation of warmth (B)</p> Signup and view all the answers

    Which of the following is a normal expected finding in the postpartum vital signs?

    <p>Bradycardia (D)</p> Signup and view all the answers

    What is an expected finding regarding lochia during a normal postpartum assessment?

    <p>Lochia rubra transitioning to serosa within 1-3 days (A)</p> Signup and view all the answers

    What is the typical hospital stay for a mother after a Cesarean birth?

    <p>3 days (A)</p> Signup and view all the answers

    Which of the following is NOT a common complication after a Cesarean birth?

    <p>Premature Labor (C)</p> Signup and view all the answers

    What are the signs of a wound infection after a Cesarean birth?

    <p>All of the above (D)</p> Signup and view all the answers

    What is a major red flag to monitor for in the immediate post-operative period after a Cesarean birth?

    <p>Urinary output less than 30 mL/hr for 2 hours (A)</p> Signup and view all the answers

    What is the recommended frequency of vital sign monitoring in the first 24 hours after a Cesarean birth?

    <p>Every hour for the first 4 hours, then every 4 hours (D)</p> Signup and view all the answers

    Which of the following measures is NOT recommended for preventing blood clots after a Cesarean birth?

    <p>Bedrest for the first 24 hours (C)</p> Signup and view all the answers

    What is the primary focus of nursing care for the mother in the first 2 hours after a Cesarean birth?

    <p>Assessing vital signs, urinary output, and fundal height (C)</p> Signup and view all the answers

    What is the recommended sleep position for infants to reduce the risk of SIDS?

    <p>On their back (C)</p> Signup and view all the answers

    What is a safe temperature for bath water for infants?

    <p>100-105°F (A)</p> Signup and view all the answers

    Which of the following is NOT advised when caring for an infant?

    <p>Bed-sharing with the infant (C)</p> Signup and view all the answers

    Which of the following is NOT a long-term effect of Shaken Baby Syndrome?

    <p>Premature birth (B)</p> Signup and view all the answers

    What is the recommended water heater thermostat setting to prevent scalding?

    <p>120°F (C)</p> Signup and view all the answers

    What is the main difference between pharmacological pain management and non-pharmacological pain management in the postpartum period?

    <p>Pharmacological methods involve medications, while non-pharmacological methods involve non-medication strategies. (A)</p> Signup and view all the answers

    Which of the following is an example of a non-pharmacological pain management strategy for postpartum discomfort?

    <p>Warm compresses (A)</p> Signup and view all the answers

    Which of the following is NOT an example of a non-pharmacological pain management strategy that a nurse might recommend to a postpartum patient?

    <p>Opioid analgesics (A)</p> Signup and view all the answers

    What is the main purpose of encouraging early ambulation after a Cesarean birth?

    <p>To reduce the risk of blood clots (C)</p> Signup and view all the answers

    What is the primary function of the placenta?

    <p>All of the above (D)</p> Signup and view all the answers

    Which hormone is produced by the placenta and plays a crucial role in stimulating breast development in preparation for lactation?

    <p>hPL (A)</p> Signup and view all the answers

    Which of the following is true about amniotic fluid during the second and third trimesters?

    <p>It is primarily produced by the fetal kidneys. (C)</p> Signup and view all the answers

    What is the normal range for amniotic fluid volume at term?

    <p>500-600 mL (A)</p> Signup and view all the answers

    What condition is characterized by an excess amount of amniotic fluid?

    <p>Polyhydramnios (C)</p> Signup and view all the answers

    Which of the following is NOT a function of Wharton's jelly?

    <p>Regulation of blood flow through the umbilical cord vessels (D)</p> Signup and view all the answers

    During which stage of fetal development are the body organs formed and developed?

    <p>Organogenesis (A)</p> Signup and view all the answers

    What is the most vulnerable period for the developing human to be affected by teratogens?

    <p>First trimester (A)</p> Signup and view all the answers

    What is a recommended intervention for fatigue during pregnancy?

    <p>Encouraging optimal diet and regular exercise (B)</p> Signup and view all the answers

    Which of the following is NOT a recommended intervention for managing Braxton-Hicks contractions?

    <p>Using a heating pad to relax the uterine muscles (C)</p> Signup and view all the answers

    What is the main cause of supine hypotension during pregnancy?

    <p>Compression of the inferior vena cava (C)</p> Signup and view all the answers

    Which of the following is NOT a recommended intervention for managing dependent edema in the lower extremities during pregnancy?

    <p>Restricting fluid intake to reduce fluid retention (A)</p> Signup and view all the answers

    Which of the following is a recommended intervention for managing constipation during pregnancy?

    <p>Increasing fiber intake through fruits, vegetables, and whole grains (D)</p> Signup and view all the answers

    What is a recommended intervention for managing heartburn during pregnancy?

    <p>Remaining upright for 30-45 minutes after eating (C)</p> Signup and view all the answers

    What is a recommended intervention for managing leg cramps during pregnancy?

    <p>Massaging the affected area (B)</p> Signup and view all the answers

    Which of the following is a recommended intervention for managing skin pruritus during pregnancy?

    <p>Using tepid water and rinsing with cooler water (A)</p> Signup and view all the answers

    Which of the following is NOT a recommended intervention for managing headaches and syncope during pregnancy?

    <p>Restricting sodium intake (D)</p> Signup and view all the answers

    What is the primary cause of afterpains in postpartum women?

    <p>Increased oxytocin levels released in response to infant suckling. (B)</p> Signup and view all the answers

    What characterizes a pathological breast engorgement compared to a physiological one?

    <p>Breasts are firm, warm, and tender, accompanied by throbbing sensations. (B)</p> Signup and view all the answers

    Which of the following factors is NOT associated with an increased risk of mastitis in postpartum women?

    <p>Supportive bra that provides adequate support for the breasts. (C)</p> Signup and view all the answers

    At what point postpartum does the uterus typically descend below the umbilicus and become firm and midline?

    <p>Around 24 hours after birth. (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended treatment for a woman experiencing breast engorgement while breastfeeding?

    <p>Applying ice packs to the breast after feedings to reduce inflammation and discomfort. (B)</p> Signup and view all the answers

    What is the primary reason for instructing a postpartum woman to void before palpating her uterus?

    <p>To prevent a distended bladder from shifting the uterus to the side and hindering accurate assessment. (A)</p> Signup and view all the answers

    What is the primary mechanism by which uterine contractions help to reduce postpartum hemorrhage (PPH)?

    <p>They compress the open vessels at the placental site, reducing blood loss. (A)</p> Signup and view all the answers

    What is the earliest expected location of the fundus after birth, relative to the umbilicus?

    <p>Midway between the umbilicus and symphysis pubis. (C)</p> Signup and view all the answers

    What is the most likely cause of Subinvolution, a delay in the uterus's descent and involution?

    <p>Retained placental fragments or infection within the uterus. (B)</p> Signup and view all the answers

    Which of the following is NOT a recommended prevention strategy for breast engorgement in non-breastfeeding women?

    <p>Express milk manually or using a breast pump to relieve pressure and reduce swelling. (A)</p> Signup and view all the answers

    What is the primary purpose of assessing the location, position, and tone of the fundus in postpartum women?

    <p>To monitor the uterus's return to its pre-pregnant size and shape. (B)</p> Signup and view all the answers

    When are the breasts typically soft and nontender in the postpartum period?

    <p>Within the first 24 hours after birth. (D)</p> Signup and view all the answers

    What is the significance of colostrum in newborn infant health?

    <p>It delivers essential immunoglobulins that protect the infant against infections. (B)</p> Signup and view all the answers

    What is the recommended treatment for a woman experiencing a plugged milk duct while breastfeeding?

    <p>Massage the affected breast before feeding sessions to facilitate milk flow. (D)</p> Signup and view all the answers

    How often should a postpartum woman's uterus be assessed for location, position, and tone during the first hour following delivery?

    <p>Every 15 minutes. (C)</p> Signup and view all the answers

    What is the primary reason for instructing postpartum women to expose their nipples to air after feeding?

    <p>To promote faster drying of the nipples, reducing the risk of infection. (C)</p> Signup and view all the answers

    Flashcards

    Postpartum Assessment

    A comprehensive evaluation of a new mother’s health status including vital signs, pain, and emotional well-being.

    Red Flags in Assessment

    Critical warning signs indicating potential health issues after delivery, such as BP extremes or abnormal heart rates.

    Normal Vital Signs Postpartum

    Expected ranges for pulse, blood pressure, respiratory rate and oxygen saturation after delivery.

    BUBBLE HEB

    An acronym summarizing postpartum assessment areas: Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy, Hemorrhoids, Emotions, Bonding.

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    Lab Values Postpartum

    Expected laboratory findings include normal blood loss, hemoglobin, and hematocrit levels.

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    ANA Code of Ethics

    A set of guidelines for ethical nursing practice, including 9 provisions.

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    Beneficence

    An ethical principle requiring nurses to take actions that benefit others.

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    Nonmaleficence

    The ethical principle of avoiding harm to patients.

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    Fidelity

    Keeping promises made to patients, integral for trust.

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    Autonomy

    The right of individuals to make their own choices.

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    Justice

    The principle of fair and impartial treatment for all patients.

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    Informed Consent

    The process of educating patients on risks and benefits before procedures.

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    Culture in Nursing

    Understanding and respecting cultural factors in childbearing families' care.

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    Cultural Humility

    Building trusting relationships and acknowledging individual experiences, beliefs, and identities.

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    Four Core Tenets of Cultural Humility

    1. Critical self-reflection, 2) Recognizing power imbalances, 3) Creating partnerships, 4) Institutional accountability.
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    Evidence-Based Practice (EBP)

    Integrating best current evidence with clinical expertise and patient preferences for optimal health care.

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    Infant Mortality

    Death of an infant before reaching one year of age.

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    Maternal Mortality

    Death of a woman during pregnancy or within 42 days post-termination due to pregnancy-related conditions.

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    AWHONN Perinatal Quality Measures

    Standards using evidence-based education and practices to shape nursing environments.

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    Healthy People 2030 Goals

    Targeted goals for reducing maternal and infant mortality and enhancing health during pregnancy.

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    Postpartum Changes

    Physiological, emotional, and psychological changes occurring after childbirth.

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    Prolactin

    A hormone that stimulates breast milk production after delivery.

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    Milk Ejection Reflex

    The release of oxytocin causing milk to be ejected during breastfeeding.

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    Colostrum

    A yellowish fluid produced before mature milk, rich in proteins and immunoglobulins.

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    Mature Milk

    The nutritional fluid produced after colostrum, containing proteins, fats, and vitamins.

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    Breast Engorgement

    Swollen breasts due to milk accumulation, can be physiological or pathological.

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    Mastitis

    An infection of the breast occurring usually 3-4 weeks postpartum.

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    Afterpains

    Pain experienced as the uterus contracts post-delivery, more common in multiparous women.

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    Uterine Involution

    The process of the uterus returning to its prepregnant size and shape.

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    Postpartum Hemorrhage (PPH)

    Excessive bleeding after childbirth, primary occurring within 24 hours.

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    Subinvolution

    Failure of the uterus to return to its normal size and shape post-delivery.

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    Uterine Contractions

    Contractions helping to compress blood vessels and reduce blood loss after birth.

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    Breast Care Assessment

    Assessing breasts for signs of irritation, engorgement, or infection.

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    Plugged Milk Ducts

    Blocked ducts causing pain and tenderness, often due to inadequate milk removal.

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    Breastfeeding Techniques

    Methods to ensure effective nursing and prevent complications like engorgement.

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    Supporting Bra

    A bra worn by both breastfeeding and non-breastfeeding women to provide support.

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    Pharmacologic interventions

    Medications like NSAIDs and opioids to manage pain.

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    Non-pharmacologic interventions

    Non-medical methods such as ice packs and warm compresses for pain relief.

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    Postoperative monitoring frequency

    First 4 hours: Assess vitals every 15 mins, then hourly.

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    Main complications postpartum

    Possible issues: infection, hemorrhage, thromboembolism.

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    Signs of infection post-Cesarean

    Look for erythema, discharge, and induration at the incision site.

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    SIDS prevention strategies

    Infants should sleep on their backs, in their own beds, without bedding hazards.

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    Shaken Baby Syndrome (SBS)

    A leading cause of death in infants due to violent shaking.

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    Safe sleep environment for infants

    Use firm mattress, avoid soft bedding, keep objects out.

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    Tummy time for infants

    Supervised period when infants are placed on their stomachs to promote mobility.

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    Breastfeeding benefits

    Provides nutrients and immune support to infants.

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    Post-op care for the mother

    Includes monitoring vitals, managing pain, and assistance with activities.

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    Signs of thrombosis

    Look for swelling, pain, and redness in the legs postpartum.

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    Importance of hydration postpartum

    Ensure adequate fluid intake to avoid complications like urinary retention.

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    Morphine side effects

    Common side effects include nausea, vomiting, and itching.

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    Placenta

    An organ forming from fetal and maternal tissue, separating maternal and fetal blood.

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    Placental Membrane

    Barrier that prevents fetal and maternal blood from mixing, allowing gas and nutrient exchange.

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    Estrogen

    Hormone that stimulates breast and uterus enlargement during pregnancy.

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    Progesterone

    Hormone essential for implantation and reducing uterine contractions.

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    hCG

    Hormone that maintains the corpus luteum, ensuring continuous estrogen and progesterone secretion early in pregnancy.

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    hPL

    Hormone that regulates glucose for fetal growth and prepares breasts for milk production.

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    Amniotic Fluid

    Fluid within the amniotic sac that cushions the fetus and allows movement.

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    Oligohydramnios

    Condition of decreased amniotic fluid, less than 500 mL at term.

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    Polyhydramnios

    Excess amniotic fluid condition, more than 2,000 mL.

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    Umbilical Cord

    Contains 2 arteries and 1 vein, connecting fetus to placenta.

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    Organogenesis

    The formation and development of body organs, occurs in the first 8 weeks of gestation.

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    Teratogens

    Agents that can cause malformations during fetal development, especially during organogenesis.

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    Amniotic Fluid Index (AFI)

    Measurement that assesses the amount of amniotic fluid surrounding the fetus.

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    Braxton-Hicks Contractions

    Irregular, infrequent contractions that can occur during mid-pregnancy.

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    Study Notes

    Study Guide 1

    • Describe legal and ethical issues influencing nursing care for childbearing families.
    • American Nurses Association (ANA) code of ethics and practice standards include compassion, commitment, advocacy, accountability, personal growth, effort, research, human rights, and justice.
    • Association of Women's Health, Obstetric, & Neonatal Nurses (AWHONN) protects nurses' rights to participate in reproductive healthcare and promotes access to affordable care to improve outcomes for women and newborns.
    • State Nursing Practice Acts govern nursing practice within a state, specifying scope of practice, licensure requirements, standards of practice, education programs, and grounds for disciplinary procedures.

    Ethical Terms

    • Beneficence: acting to benefit others.
    • Nonmaleficence: avoiding harm to others.
    • Fidelity: keeping one's word.
    • Veracity: truthfulness.
    • Autonomy: the right of self-determination.

    Cultural Humility in Childbearing

    • Cultural humility involves building trust, acknowledging individual experiences, and understanding beliefs, values, and identities.
    • There are 4 core tenets: critical reflection, mitigating power imbalances, creating beneficial partnerships, and institutional alignment.

    Evidence-Based Practice in Nursing

    • Evidence-based practice in nursing incorporates best current evidence, clinical expertise, and patient/family preferences and values to deliver optimal healthcare.

    Maternal and Infant Health Outcomes

    • Define infant mortality as death before the age of 1 year.
    • Define maternal morality as death to a woman during pregnancy or within 42 days of the termination.
    • Trends in maternal and infant health include topics like teen pregnancy, tobacco use, substance use, and health disparities.

    AWHONN's Perinatal Quality Measures

    • AWHONN's perinatal quality measures involve the use of evidence-based education and practices that shape the environment.

    Healthy People 2030 Goals for Maternal and Infant Care

    • Goals include reducing rates of maternal mortality, infant mortality, and preterm births.

    Postpartum Period Changes

    • Rubin's three phases (taking in, taking hold, letting go) describe the physiological, emotional, and psychological changes in the postpartum period.
    • These phases include an initial dependent phase (taking in), a transitional independent phase (taking hold), and a phase of shifting focus to the new role as a mother (letting go).

    Postpartum Blues vs. Depression

    • Postpartum blues are characterized by sadness and crying spells, but are typically temporary (first few weeks postpartum).
    • Postpartum depression involves more severe symptoms, such as persistent sadness, loss of interest, and difficulty concentrating.
    • Postpartum psychosis involves more severe symptoms, including hallucinations and delusions.

    Postpartum Assessment

    • A comprehensive postpartum assessment considers vital signs, pain, breath and heart sounds, laboratory findings (CBC, rubella, Rh, vaccination status, etc.), breast examination, uterine assessment, bladder assessment, bowel assessment, lochia assessment, episiotomy/lacerations, perineum, hemorrhoids, lower extremities, emotions, bonding, psychosocial factors and red flags like blood pressure, heart rate, respiratory rate, oxygen saturation, etc.

    Assessment of Breastfeeding

    • Assess nipples for signs of irritation.
    • Mastitis is breast infection, commonly occurring postpartum and associated with milk stasis.

    Uterine Assessment

    • Assess uterine fundus for location, position, and tone.
    • The fundus (the top of the uterus) should be firm.
    • Lochia (discharge after birth) changes over time: from red, to pinkish-brown to yellowish.

    Bowel Assessment

    • Assess bowel sounds and frequency.
    • Constipation is common postpartum and can be addressed by increasing fluid and fibre.

    Postpartum Bladder Assessment

    • Assessment of bladder function, including time to void, volume of urine, frequency, and pain.
    • Monitor for signs of infection, such as increased frequency, urgency, burning on urination or fever
    • Prevent complications by getting the mother to urinate within 2-4 hours post-delivery
    • Monitor for urinary output.

    Lochia

    • Lochia rubra (red) occurs in the first few days postpartum, followed by lochia serosa (pink-brown) and lochia alba (white). It may vary in amount depending on the activity and feeding/pumping patterns.

    Episiotomy

    • Definition, usual types and care, or complications.

    Homan's Sign

    • Assessment for thrombosis in the legs that involves dorsiflexing the foot in a supine position
    • Pain/tenderness in the calf muscle or posterior calf might indicate blood clot.

    Emotional Considerations

    • Understand postpartum blues vs. depression vs. psychosis.
    • Assess for risk factors and support system.

    Cultural Considerations

    • Understand expectations, communication, and support systems within various cultures.
    • Tailor care to individual needs.

    Post-Cesarean Assessment

    • Post-Cesarean assessment should include detailed monitoring of vitals, including blood pressure, respiration, heart rate, oxygen saturation, and pain and detailed assessment of surgical wound, incision, or staples. Review of urinary output and bowel movements, and review of postpartum healing.

    Discharge Planning

    • Discuss home care, including diet, activity, medications, and follow-up appointments.
    • Include information about Shaken Infant Syndrome (SIS) and safe sleep practices for infants.

    Breastfeeding vs. Formula Feeding

    • Benefits and drawbacks of each.
    • Nutritional needs for both breastfeeding and formula-feeding mothers.
    • Discuss potential problems like colostrum and mature milk production.

    Stages of Fetal Development

    • Organogenesis (formation of organs), teratogens (factors that may harm a fetus), and the development throughout the different stages of the pregnancy.

    Common Problems/Discomforts of Pregnancy

    • Management principles for various discomforts of pregnancy.

    Assessment of Maternal & Fetal Well-being

    • Review different diagnostic tests (AFP, ultrasound, cell-free DNA) used to assess maternal and fetal health during pregnancy.

    Obstetric Terminology

    • Define common terms used in maternal-child health (gravida, para, multipara, primipara, GTPAL).
    • Calculate or determine the estimated date of birth using Nagele's Rule.

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    Maternity Study Guide 1 PDF

    Description

    This quiz explores the legal and ethical issues influencing nursing care for childbearing families, emphasizing the ANA code of ethics and standards of practice. It also addresses the role of cultural humility in providing equitable care. Test your knowledge on key ethical terms and the significance of advocacy and accountability in nursing.

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