Module 1 Maternal-Neonatal Nursing

obstetrics Latin term obstetrix ("stand by," waiting for baby); branch of medicine pertaining to care of women during pregnancy, childbirth, and postpartum period (puerperium) maternal nursing nursing care provide to expectant family before, during, and following birth pediatrics branch of medicine that pertains to child development obstetrician physician specialized in caring for women during pregnancy (not the child) pediatrician physician specializing in the treatment of babies and children Sheppard-Towner Act of 1921 Funded state-managed programs for maternity care Title V of Social Security Act Provided funds for maternity care Title V amendment of the Public Health Services Act established maternal-infant care centers in public clinics Fair Labor Standards Act of 1938 -established a general minimum working age -16 years for nonhazardous jobs -18 years for hazardous jobs Title XIX of the Medicaid Program Increased access to care by indigent women Head Start Established to increase educational exposure of preschool children National Center for Family Planning Provides contraceptive information WIC (Women, Infants, and Children) provides supplemental food and education for families in need of assistance Family Medical Leave Act (FMLA, 1993) allows employees to take up to 12 weeks of unpaid leave to care for a newborn or family member; employee cannot lose benefits or pay status if they take FMLA Health Insurance Portability and Accountability Act (HIPAA, 2003) -set standards to protect patient health information -allowed patient access and control over health information -regulations mandate client name and personal information secure in private place -health care personnel expected to: --maintain strict confidentiality --access minimum information necessary to provide care Patient Protection and Affordable Care Act of 2010 (Affordable Care Act) -health care coverage expansions to millions previously uninsured -no longer denied coverage due to pre-existing conditions -constitutionality upheld by SCOTUS family-centered care family involvement in during pregnancy and birth, necessary for BONDING and support Three separate sections of maternity unit: 1. labor-delivery 2. postpartum 3. newborn nursery Some facilities have merged all areas into one Birthing centers Provide comprehensive care: Antepartum, labor-delivery, postpartum, mother's classes, lactation classes, followup family planning According to Institute of Medicine Report (IOM) in 1999, how many people die in hospitals each year as a result of medical errors that could have been prevented? 98,000 (e.g. adverse drug events, improper transfusions, surgical injuries, wrong site for surgery, suicides, restraint-related injuries or death, falls, burns, pressure ulcers, misidentified client Culture -affects how families perceive health and illness -socially inherited characteristics with patterns of expressing thoughts and actions (traditions) consisting of values, beliefs, and practices holistic nursing -regards and treats the mind-body-spirit of the patient -aware and sensitive to cultural diversity Suitable clients for LVN care stable, predictable client reportable situations ... Healthy People 2030 topic areas ... puberty physical and period of sexual maturation, during which a person becomes capable of reproducing male puberty -hormonal changes -outward changes -testosterone levels -nocturnal emissions ("wet dreams," ejaculations during sleep) male reproductive system ... testicuzzi ... female puberty ... female reproductive system ... Vagina Passageway between uterus and outside of the body; allows drainage of menstrual fluids Area likely to tear during childbirth: perineum Site of implantation uterus; upper posterior wall of the endometrium (innermost layer of uterus) Site of fertilization fallopian tubes Ovaries produces estrogen, progesterone, and eggs Bony pelvis Consist of two innominate bones (made up of an illium, pubis, and ischium), sacrum, and coccyx 3 functions of the bony pelvis 1. supports and distributes body weight 2. supports and protects pelvic organs 3. forms the birth passageway False pelvis upper pelvis supports the enlarging uterus, guiding fetus into true pelvis True pelvis lower pelvis consisting of pelvic inlet, pelvic cavity, and pelvic outlet Pelvic inlet ... Pelvic outlet ... Four basic types of pelves 1. gynecoid 2. anthropoid 3. android 4. platypelloid Gynecoid classic female pelvis; most favorable for vaginal birth Anthropoid long, narrow oval; vaginal birth more likely to be occiput posterior (back of fetal head toward mother's sacrum) Android typical male pelvis platypelloid flat; unfavorable for vaginal birth accessory organs of reproduction breasts (mammary gland) Montgomery glands Small sebaceous glands in the areola, secreting antibacterial oil to lubricate and protect nipples from drying and cracking during nursing reproductive cycle