Transcript Review and Refresh

Review and Refresh
Packet, Class & Readings
And Clinical Revelations
What is maternal-child health?
6 interconnected aspects
What is maternal-child health?
6 interconnected aspects
Maternal
physiology
Patient
experience
Fetal/newborn
physiology
Family
experience
Medical
Care
Nursing
Care
Maternal
physiology
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Nutrition
Hemoglobin
Weight gain
Blood pressure
Kidney and liver function
Uterus
Contractions
Placenta & cord
Tubes & ovaries
Fetal/newborn
physiology
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Fetal heart tones
Pulse, temp, respiratory rate
Weight
Amniotic fluid volume
Anomalies
Placental blood flow
Family
experience
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Knowledge
Previous experiences
Cultural roles and expectations
Significant other, older siblings,
grandparents, extended family
• Facility
• Inclusion/exclusion
• Staff attitudes
Patient
experience
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Knowledge
Previous experiences
Fear
Cultural roles and expectations
Presence/absence of support person
Facility
Staff attitudes
Medical care
• What physician orders and does
• Based primarily on physiology
• Patient or family experience is much lower
priority
• Physicians receive less training in patient
education and support
Nursing Care
• Physiology top priority, but patient and
family experience is dealt with
simultaneously
• Education high priority
• Culture more important
• Independent nursing interventions
• Medically delegated tasks
Cardinal Movements of Childbirth
Which Are….
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Flexion
Descent
Internal rotation
Extension
External rotation
Positions for birthing-kneeling
Side lying
Birthing stool
Hands and Knees
Water birth
Hospital birthing room
Typical hospital birth
Crowning
NCLEX-style question
The highest priority in nursing care of the
laboring client is:
1. Pain relief
2. Partner involvement
3. Fluid intake
4. Fetal heart rate
Maternal-Child Medications
• Pain Medications
• Tylenol & NSAIDs
• Stronger NSAIDs:
– Keterolac (Toradol)
• Narcotics po:
• codeine po
• Hydrocodone
• Oxycodone
– Injectables:
• Nubain
• Stadol
What question should the nurse ask before
administering 10 mg of Nubain IV to a
laboring client?
1.“Have you ever had surgery?”
2. “Do you use narcotics regularly?”
3. “What vitamins do you take daily?”
4. “Is your baby a boy or a girl?”
NCLEX –Style Question
A Client who is Latino is in labor and the father is
refusing to come into the labor and delivery room. The
nursing student assisting in the care believes he should
participate in the birth and repeatedly urges the father to
come into the labor and delivery room even though he
keeps refusing. This nursing student is exhibiting:
A. Cultural sensitivity
B. Ethnocentrism
C. Encouragement
D. Discouragement
NCLEX Style ?
Which of the following methods places
emphasis on natural childbirth?
A. Leboyer
B. Lamaze
C. Dick-Read
D. Bradley
NCLEX Style ?
The nurse auscultates the fetal heart rate and determines a
rate of 150 to 155 beats/minute. Which of the following
nursing interventions is most appropriate?
A. Inform the client that the FHr is normal and document
the findings.
B. Document and reassess the FHE in 5 minutes because
the rate is too high.
C. Report the FHR to the primary provider immediately and
then document.
D. Document and tell the mother she is having a boy
because the heart rate is fast.
NCLEX-style question
The laboring primiparous client is in early labor. She asks
the nurse how her labor will progress? What is the
nurse’s best response?
1.The contractions will gradually get stronger and
closer together.”
2. “If you don’t progress fast enough, we’ll start
Pitocin to hurry things along.”
3. “Don’t worry. We’ll take good care of you and
make sure everything is fine.”
4. “When your water breaks we will check your
cervix to see how far along you are.”