ATI RN MATERNAL NEWBORN PROCTORED EXAM (Version 25)

Maternal Child Exam 1 (module 1 & 2) • Family types o Nuclear (male partner, female partner, their children) o Extended (family unit plus other family member in the same household) o Married-blended (post death/divorce o Commune (group of men, women, and children living together) o Cohabitation (unmarried man and woman living together) o No-parent (children living independent, in foster care, or with close relative) • Family Systems Theory o Changes that occur in one member affect the entire family o Sum of the parts is greater than the whole o Balance and homeostasis (strive to return to “normal” state) o Subsystems Spouses Children Girls or boys Mother/child • Duvall’s Family Developmental Theory o Each stage has certain tasks that need to be accomplished before moving on to next stage Beginning (just married) Childbearing (new child) Preschool (child’s life becomes parent’s life) School age (personal values are shaped and clarified) Adolescent/teenage (teaching about sex, drugs, and health promotion) Launching (empty nest) Middle age (more socialization) Retirement o • Structural-Functional Theory o Functioning of the family and the roles assumed by each member Roles include: provider, housekeeper, child caregiver, socializer, sexual partner, therapist, recreational organizer, and kinship (social etiquette/moral teacher) • Community Theory o Emotional problems result from the way people interact with each other in the context of the family o Unhealthy families give mixed or double-binding messages, nonverbal expressions that are inconsistent and incongruent with the verbal message. o Healthy families have clear rules and communication is clear and congruent and nonverbal cues match what is being said. • Group Theory o Norms (rules of conduct), roles, goals, and power structure o Division of household chores, expectations of homework, and curfew enforcement o Stages of groups: Forming (through marriage or cohabitation) Storming (disordered time of confusion or chaos) Norming (adjust to members by applying rules that everyone agrees to) Performing (accomplishes their goals and produces results) Adjourning/terminating (when member dies, divorce, or leaves the family) • Bowen Family Systems Theory o Views the family as an emotional unit and uses systems thinking to describe the complex interactions within the family unit o Useful when identifying family problems or challenges that are rooted in communication, connecting between members, and teaching values o Views birth order as a predictor of certain patterns of behavior o Triangulation occurs when the dyad diverts attention away from its own conflict by focusing on a third person such as the child, teacher of the o problem child, or police officer who comes into a domestic disturbance. o The multigenerational transmission process describes how one learns or transmits family emotional systems across generations. o Family projection process is how and what children are taught • Family Assessment o Family size and structure Parenting style Authoritarian (dictatorial) Laissez-faire (permissive) Authoritative (democratic) o Religious, cultural, and social-economical orientation • Tools to facilitate the family assessment o Qualitative and quantitative surveys o Genogram or ecomap o Strengths and problems list • Components of the family assessment o Communication patterns o Roles and relationships o Family developmental stage o Family rituals o Triangulation o Presence of dyads and other subsystems • Examples of Family Nursing Diagnoses o Altered Family Process o Caregiver Role Strain (actual and risk for) o Dysfunctional Family Processes: Alcoholism o Family Coping: Compromised Family Coping: Disabled o Impaired Parenting (actual and risk for) o Ineffective Family Therapeutic Regimen Management o Readiness for Enhanced Family Coping o Readiness for Enhanced Parenting o Risk for Parent-Infant-Child Attachment o Social Isolation o Spiritual Distress o • Family with special needs o The loss of a home, job, family member, or close friend are all unexpected and unplanned-for events that initially send the family into a state of chaos and often require outside help for the process of reorganization o Situational crises include environmental disasters such as floods, hurricanes, or fires Developmental crises occur as part of expected growth events that can take place during any developmental stage of the family or its individual members. • Gene Inheritance o Nucleus has 23 pairs of chromosomes (22 autosomes and 1 sex chromosome) o Multifactorial (combination of genetic and environmental factors) o Unifactorial (single gene inheritance, such as autosomal dominant, autosomal recessive, X-linked disorders) • Autosomal Dominant o Single altered gene o Can be from one parent o 50% chance of passing altered gene to offspring o Can be from mutation o Examples: Huntington’s disease, achondroplasia, neurofibromatosis, Marfan’s syndrome • Autosomal Recessive o Each parent has the altered gene (carrier o 25% chance of passing trait o 50% chance of passing altered gene (carrier) o Examples: PKU, maple syrup disease, sickle cell anemia, cystic fibrosis, tay-sach’s disease) o Greater chance of occurrence in this population • X-Linked Dominant o Altered gene on X chromosome o If the father has the dominant gene (Xy): o All of daughters will inherit gene None of sons will inherit gene o If the mother has the dominant gene (Xx): 50% chance of inheriting the gene Some chance for son or daughter • X-Liked Recessive o More common than Xlinked dominant disorders o Trait occurs more frequently in males r/t X Male with trait will pass gene to all daughters o Female with gene (carrier) has 50% chance of passing on the gene o Examples: Hemophilia A, Duchenne muscular dystrophy • Process of fertilization o Ovulation – cervical mucus changes o Deposit of 200 – 600 million sperm o Approximately 200 sperm reach fertilization site o Oocyte (female) and sperm (male) meet in fallopian tube