Chapter 1 // current issues in maternal-newborn nursing

Infant mortality rates are higher among

-Infants born in multiple births -Infants born prematurely -Those born to unmarried mothers

Examples of ethical dilemmas:

-Termination of pregnancy -maternal-fetal conflict -embryonic and fetal research -reproductive assistance -embryonic stem cell research

What are HIPAAs 2 areas of focus

1) it protects the health insurance coverage of employees and their family if they lose a job or change jobs 2) addresses the privacy and security of health information and requires that national standards be established for the electronic transmission of healthcare data.

Different types of midwives

1. *Certified nurse-midwife (CNM)*: a registered nurse who is also prepared as a midwife 2. *Certified midwife (CM)*: Midwives who are not registered nurses but complete a direct-entry midwifery education program that meets the standards of ACNM 3. *Certified personal midwife* : Midwives certified through NARM, formal education program, or midwifery school, or through apprenticeship, or self-study 4. *Traditional midwives*: sometimes called lay midwives, they are not certified or licensed, often for religious or personal reasons.

Delineate significant legal and ethical issues that influence the practice of maternal-child nursing.

1. Abortion 2. ART (Artificial reproductive technology) 3. Cord Blood Banking-provides the opportunity to have stem cells available to treat a variety of cancers and blood disorders. 4. Federal Baby doe regulations- protect the rights of infants with severe defects. 5. Genetic testing-for conditions for which there is no treatment or benefit. 6. Organ donation and transplantation-ethical issues include selection and qualifications of donor recipients and payment for organs.

QSEN six areas of focus:

1. Patient-centered care 2. Teamwork and collaboration 3. Evidence-based practice 4. Quality improvement 5. Safety 6. Informatics patrick tolan eats safe quality icecream

The nurse is reviewing care of clients on a mother-baby unit. Which situation should be reported to the supervisor? 1. A 2-day-old infant has breastfed every 3 hours and voided four times. 2. An infant was placed in the wrong crib after examination by the physician. 3. The client who delivered by cesarean birth yesterday received oral narcotics. 4. A primiparous client who delivered today is requesting discharge within 24 hours.

2. Placing an infant in the wrong crib is malpractice. Malpractice is negligent action by a professional person.

A nurse who tells family members the sex of a newborn baby without first consulting the parents would have committed which of the following?

A breach of privacy

The joint comission

A private, nongovernmental agency that audits the operation of hospitals and healthcare facilities and contributes to the development of nursing standards

21) The maternal-newborn nurse reviewing charts recognizes that negligence (malpractice) occurs when which action occurs? Select all that apply. 1. There is no notification to the physician of change in condition. 2. There is a failure to give an ordered medication. 3. An infant is placed in the wrong crib. 4. There is compliance with medication administration principles. 5. There is compliance with the standards of care.

Answer: 1, 2, 3

Assisted reproductive technology (ART)

Any fertility treatment in which both the egg and sperm are handled. Ex: in vitro fertilization and embryo transfer (IVF-ET)

The nursing instructor explains to the class that according to the 1973 Supreme Court decision in Roe v. Wade, abortion is legal if induced:

Before the period of viability.

What is one of the most important approaches available to reduce adverse pregnancy outcomes?

Early prenatal care

Nurse researcher

Has an advanced doctoral degree, typically a PhD, generates new research typically.

Certified registered nurse

Has shown expertise in a particular field of nursing such as labor and birth by taking a national certification exam

Evidence-based practice

Nursing care in which all interventions are supported by current, valid research or other forms of evidence such as committee opinions or task force recommendations.

Abortion

Pregnancy that is terminated before 20 weeks' gestation, or fetus that weighs less than 500 g. -can be performed until the age of viability -nurses have the right to refuse to assist with the procedure, if abortion is contrary to their moral and ethical beliefs. However, the nurse may be diminished from refusing.

Clinical nurse specialist (CNS)

Professional nurse with a master's degree who has additional specialized knowledge and competence in a specific clinical area.

Pregnancy-related deaths

death of a woman while pregnant within 1 year or the termination of pregnancy from any cause aggravated by pregnancy or related to it.

Therapeutic insemination (TI)

depositing sperm into a woman obtained from her husband, partner, or other donor.

Self-care movement

emerged in the 1960s as consumers sought to understand technology and take an interest in their own health and basic self-care skills.

Professional nurse

graduate of an accredited basic program in nursing who has successfully completed the NCLEX and is currently licensed as an RN.

Perinatal mortality

includes both neonatal deaths and fetal deaths per 1000 live births. -pregnancy---->28 days following birth?

Maternal mortality rate

number of deaths from any cause related to or aggravated by pregnancy or its management during the pregnancy cycle per 100,000 live births. -black women have higher risk

Postneonatal mortality

number of deaths of infants between 28 days and 1 year of age.

Neonatal mortality

number of deaths of infants less than 28 days of age pr 1000 live births

Infant mortality rate

number of deaths of infants under 1 year of age per 1000 live births in a given population

Nurse practitioner (NP)

professional nurse who has received specialized education in either a Doctor of Nursing Practice (DNP) or a master's degree program and thus can function in an expanded role. The area of specialization determines the NP's title.

Intrauterine fetal surgery

therapy for anatomic lesions that can be corrected surgically and are incompatible with life if not treated. Ex: surgery for myelomeningocele and some congenital cardiac defects. -involves opening the uterus during the 2nd trimester, treating the fetal lesion, and replacing the fetus in the uterus.