Unit 1 Review: Ch 1 & 2 Perry Maternal Child

The hospital risk management nurse is providing annual in-service training at the obstetrical unit staff meeting. The risk management nurse should discuss which conditions included on the National Quality Forum list that pertain to maternity nursing? (Select all that apply.)

A. Falls and trauma C. Air embolism D. Foreign objects retained after surgery E. Blood incompatibility Catheter use should be minimized to decreased urinary tract infections. Five of the conditions are also on the National Quality Forum list. Conditions that might pertain to maternity nursing include a foreign object retained after surgery, air embolism, blood incompatibility, falls and trauma, and catheter-associated urinary tract infections. Almost 1300 U.S. hospitals waive (do not bill for) costs associated with serious reportable events (O'Reilly, 2008).

Which statement made by the nurse would indicate that she or he is practicing appropriate family-centered care techniques? (Select all that apply.)

A. The nurse allows the mother and father to make choices when possible. D. The nurse provides time for the partner to ask questions. It is important to allow for choices for the couple and to include the partner in the care process. Unless there is an institutional policy prohibiting the number of attendees at a birth, the patient should be allowed to have whomever she desires with her (unless the birth is emergent and the guests are requested to leave). Family-centered care involves collaboration between the health care team and the patient.

Healthy People 2020 goals include: (Select all that apply.)

A. promoting quality of life. C. attaining high-quality, longer lives. D. eliminating health disparities. E. creating social and physical environments that promote health. Healthy People 2020 promotes healthy behaviors across all life stages. Healthy People provides science-based 10-year national objectives for improving the health of all Americans. It has four overarching goals: (1) attaining high-quality, longer lives free of preventable disease, disability, injury, and premature death; (2) achieving health equity, eliminating disparities, and improving the health of all groups; (3) creating social and physical environments that promote good health for all; and (4) promoting quality of life, healthy development, and healthy behaviors across all life stages (www.healthypeople.gov/2020/about/default.aspx). The goals of Healthy People 2020 are based on assessments of major risks to health and wellness, changes in public health priorities, and issues related to the health preparedness and prevention of our nation.

The nurse is planning care for a patient with a different cultural background. What would be an appropriate goal?

As necessary adapt the patient's cultural practices to her health needs. The cultural background is part of the individual. It would be very difficult to eliminate the influence of the patient's background. The cultural practices need to be evaluated within the context of the health care setting to determine if they are conflicting. It is not appropriate to attempt to change someone's cultural practices. Whenever possible, the nurse should facilitate the integration of cultural practices into health needs.

A community women's health nurse knows that which groups of people are considered vulnerable populations? (Select all that apply.)

B. Adolescent girls C. Women with underlying health conditions D. Refugee women E. Incarcerated women

In which culture is the father more likely to be expected to participate in the labor and delivery?

European-American Asian-American fathers do not actively participate in labor or birth. African-American men view pregnancy as a sign of virility; however, they may be less likely to participate actively in labor or birth.

A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement?

Explain to the woman the importance of keeping her prenatal care appointments. Nutritional status is an important modifiable risk factor, but it is not the most important action a nurse should take in this situation. The client may need assistance from a social worker at some time during her pregnancy, but this is not the most important aspect the nurse should address at this time. If the woman has identifiable high risk problems, her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high risk issues. Additionally, this is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to receive. Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality.

A woman is giving birth to her third child in a setting that allows her husband and other two children to be actively involved in the process. The nurse caring for the woman must also consider the husband and family as patients and work to meet their needs. This type of setting is termed:

Family-Centered care. Family-centered care is any setting in which the pregnant woman and family are treated as one unit. The nurse assumes a major role in teaching, counseling, and supporting the family. In emergency care settings, the nurse deals primarily with the patient who is having difficulty. In hospice care settings, the nurse deals with patients who have terminal illnesses. Individual care deals only with the patient and does not include the family.

From the nurse's perspective, what measure should be the focus of the health care system to reduce the rate of infant mortality further?

Implementing programs to ensure women's early participation in ongoing prenatal care Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate of infant mortality. An increased length of stay has been shown to foster improved self-care and parental education. However, it does not prevent the incidence of leading causes of infant mortality rates, such as low birth weight. Early prevention and diagnosis reduce the rate of infant mortality. NICUs offer care to high risk infants after they are born. Expanding the number of NICUs would offer better access for high risk care, but this is not the primary focus for further reduction of infant mortality rates. A mandate that all pregnant women receive obstetric care would be nearly impossible to enforce. Furthermore, certified nurse-midwives (CNMs) have demonstrated reliable, safe care for pregnant women.

What has had the greatest impact on reducing infant mortality in the United States?

Improvements in perinatal care The improvements in perinatal care, particularly care of the mother-baby dyad before birth, have had the greatest impact. There has been a decrease in some congenital anomalies, such as spina bifida, but this has not had the greatest impact. This has had a positive influence but not the greatest overall impact. Changes in funding have not had the greatest impact.

What would a breastfeeding mother who is concerned that her baby is not getting enough to eat find most helpful and most cost-effective on the day after discharge?

Placing a call to the hospital nursery "warm line" The first course of action should be to call a warm line for advice from a nurse. Warm lines are telephone lines offered as a community service to provide new parents with support, encouragement, and basic parenting education. This action would not necessarily be cost-effective. The first course of action should be to call a warm line for advice from a nurse. This action would not necessarily be cost-effective. The first course of action should be to call a warm line for advice from a nurse.

Which personal safety precaution should guide the nurse working in home care?

Schedule visits during daylight hours. The nurse should carry keys and a cell phone in the event the keys must be used for self-defense or the cell phone is needed to call for help. Making a visit in pairs is a good personal strategy for nurses visiting families with a history of violence or substance abuse. For the nurse's personal safety, all home visits should be conducted during daylight hours. Dress should be casual but professional and should include a name tag.

Which statement made by the nurse would indicate that he or she is practicing appropriate family-centered care techniques?

The nurse encourages the mother and father to make choices whenever possible. With family-centered maternity care it is important to allow for choices for the couple and to include the partner in the care process. Unless there is an institutional policy prohibiting the number of attendees at a birth, the client should be allowed to have whomever she desires with her (unless of course the birth is emergent and guests may be requested to leave). FCMC involves collaboration between the health care team and the client. In a family-centered care model, the partner, or even a grandparent may be present for a cesarean birth.

What is descriptive of the family systems theory?

When the family system is disrupted, change can occur at any point in the system. Although the family is the sum of the individual members, the family systems theory focuses on the number of dyad interactions that can occur. The family systems theory describes an interactional model. Any change in one member will create change in others. Change in any family member will affect other members of the family. The interactions are considered to be the problem, not the individual family members.

A Native American woman gave birth to a baby girl 12 hours ago. The nurse notes that the woman keeps her baby in the bassinet except for feeding and states that she will wait until she gets home to begin breastfeeding. The nurse recognizes that this behavior is most likely a reflection of:

a belief that babies should not be fed colostrum. Delayed attachment is a cultural belief, not a delay in attachment. Embarrassment is a cultural belief, not an expression of embarrassment. This cultural belief does not indicate that there is disappointment regarding the sex of the baby. Native Americans often use cradle boards and avoid handling their newborn often; they believe that the infant should not be fed colostrum.

The term used to describe a situation in which a cultural group loses its identity and becomes part of the dominant culture is called:

assimilation. Assimilation is the process by which groups "melt" into the mainstream. Cultural relativism refers to learning about and applying the standards of another person's culture to activities within that culture. Acculturation refers to changes that occur within one group or among several groups when people from different cultures come in contact with one another. Ethnocentrism is a belief in the rightness of one's culture's way of doing things.

When providing health education to the client, the nurse understands that an example of the secondary level of prevention is:

breast self-examination (BSE). Infant car seats are an example of primary prevention. BSE is an example of secondary prevention, which includes health screening measures for early detection of health problems. Immunizations are an example of primary prevention. Support groups are an example of tertiary prevention, which follows the occurrence of a defect or disability (e.g., Down syndrome).

When a nurse is unsure about how to perform a client care procedure, the BEST action would be to:

consult the agency procedure manual and follow the guidelines for the procedure. Each nurse is responsible for his or her own practice. Relying on another nurse may not always be safe practice. Each nurse is obligated to follow the standards of care for safe client care delivery. Physicians are responsible for their own client care activity. Nurses may follow safe orders from physicians, but they are also responsible for the activities that they as nurses are to carry out. Information provided in a nursing textbook is basic information for general knowledge and may not reflect the current standard of care or individual state or hospital policies. It is always best to follow the agency's policies and procedures manual when seeking information on correct client procedures. These policies should reflect the current standards of care and state guidelines.

A mother's household consists of her husband, his mother, and another child. She is living in a/an:

extended family. An extended family includes blood relatives living with the nuclear family. Both parents and a grandparent are living in this extended family. Married-blended refers to families reconstructed after divorce. Both parents and a grandparent make up an extended family.

The two most frequently reported maternal medical risk factors are:

hypertension associated with pregnancy and diabetes. These are the most frequently reported maternal risk factors. Both are associated with obesity. Approximately 20% of U.S. women who give birth are obese. Obesity in pregnancy is associated with the use of increased health care services and longer hospital stays. Both drug and alcohol use continue to increase in the maternal population. These are associated with low-birth-weight infants, mental retardation, and birth defects. The number of these clients are increasing; however, these are not the most common risks. Behavior and lifestyle choices do contribute to the health of the mother and fetus.

Evidence-based practice is best described as:

providing care based on evidence gained through research and clinical trials. This will assist the nurse in determining areas of concern and potential involvement. It is not possible to meet all needs of the patient and family in all areas of practice. The nurse is an advocate for the family. This is part of professional role and licensure. Evidence-based practice is providing care based on evidence gained through research and clinical trials. Practitioners must use the best available information on which to base their interventions.

Providing treatment and rehabilitation for people who have developed disease is part of:

tertiary preventive care. Primary preventive care involves promoting healthy lifestyles. Secondary preventive care involves targeting populations at risk. Tertiary preventive care is the treatment or rehabilitation of those who already have a specific disease. Primordial preventive care refers to prevention of the risk factors themselves at either the social or environmental level.