Chapter 2 The nurse's Role in Maternity and Women's Health Care |9 questions and answers.

How can a nurse recognize assumptions? What are assumptions? -Assumptions are ideas, beliefs, or values that are taken for granted without basis in fact or reason. -A list of EVERYTHING known about a specific situation may help in the identification of assumptions. -Evaluate each item on what ever list to be determined if it is true, whether it could be true, and whether it is untrue or evidence is insufficient to determine its truth. What are the following Nursing Specialties: 1.) Certified Nurse-Midwife 2.) Nurse Practitioner -WHNP -FNP -NNP -PNP 3.) Clinical Nurse Specialist. 1.) These are RN's who have completed an extensive program of study and clinical experience. They must pass a certification test. -They provide complete care during pregnancy, childbirth, and the postpartum period. -Only attend to the mother and infant if progress is normal. -They provide counseling and child support for the family. A lot of information regarding well-woman examinations, gynecology services, and family planning information is also included. -The practice approach for a CNM revolves around nonintervention and support. -Controversy over CNM's in the past has since resolved because they are now part of the health care team. 2.) Nurse practitioners are RN's with advanced preparation that allows them to provide primary care for specific groups of clients. -Their scope of practice involves taking a complete health history, performance of physical examinations, ordering and interpret laboratory and other diagnostic studies, and provide primary care/health maintenance/health promotion. -NP's normally work with the physician in regards to administration of Tx and medications. Depending on the state NP's may be able to prescribe some medications. Women's health nurse practitioner (WHNP) provides wellness focused primary, reproductive, and gynecologic care of a woman's life span beginning from adolescence. There is also STD screening and providing for family planning. -Women who arrive in an obstetric triage unit are unusually consulted by WHNP because they have non obstetric problems during pregnancy. Family nurse practitioners (FNP) are prepared to provide preventive, holistic care for the young and old family members. If pregnancies are NOT complicated they normally follow up on them and provide follow up care. There is normally NO assistance during childbirth. Neonatal nurse practitioners (NNP) assist in the care of high risk newborns and immediate post-birth care or NICU. Pediatric nurse practitioners (PNP) provide health maintenance care to infants and children who don't require services of the physician. 3.) Clinical Nurse Specialists (CNS) are RN's who through study and supervised practice level have acquired expertise in care of childbearing women with very complex problems. -This is normally involved in direct care, consultation, collaboration, coaching, research, and ethical decision making. -Normally don't provide primary care. What are guidelines for successful therapeutic communication? 1.) A restful setting that provides privacy, reduces distractions, and minimizes interruptions is ideal. 2.) Interactions should begin with introduction of yourself and describing your role. 3.) Therapeutic communication should be focused and directed toward meeting the needs expressed by the family. Use open ended questions or redirect the conversation towards the prime objective. 4.) Nonverbal behaviors may communicate more powerful messages than spoke words. Facial expressions and eye movements could confirm or contradict what the woman says. Avoid finger tapping, twirling a lock of hair, tapping a pen. This may indicate boredom or irritation. Women who are tired or depressed may neglect her own grooming. 5.) Active listening requires that the nurse attends to the words being said. -Make eye contact -have an erect posture with the upper body inclined towards the woman -use minimal cues like nodding, leaning closer, smiling, and expanding on information. -use of touch can be very powerful 6.) Be weary of cultural differences like prolonged eye contact with Asian cultures. Middle Eastern and Native American cultures may be uncomfortable with touch. 7.) Ensure that communication is clarified and that the message is what the sender of the message intended it to be. 8.) Reflect on their feelings that expressed verbally or non-verbally. What is the nurse's role in teaching and learning? Nurses need to apply principles that help the nurse become effective teachers. Including: -Looking at the readiness of the individual or the family to learn with relevance to the content. -Encourage active participation (it increases learning) when ever possible. Avoid passive listening and viewing! Discussion formats can help with participation and stimulation rather then a straight lecture. -Repetition of a skill increases retention and feeling of competence! Parents are more likely to if they can actively bathe, feed, and diaper an infant more than once. -Use praise and positive feed back for motivation! These can especially be helpful in frustrating tasks like breastfeeding. -Use of role modeling is an effective way to demonstrate behavior. Just be cautious that behaviors may be scrutinized at all times and may be repeated by the parent later. -Conflicts and frustration obviously impede learning. Recognize these problems and help them become resolved quickly. Have them verbalize any feelings about breast feeding for example. Expressing feelings about the issue must be dealt with before teaching can be done. -Structure the material from simple to complex tasks. -Be aware of their learning style and provide many different teaching methods to maintain interest. -Retention is great when the material is presented in small segments over time. So follow up care is especially important! What are some of the concepts behind critical thinking that nurses need to be aware of? What is the purpose of critical thinking? Steps of how critical thinking is learned? -For effective critical thinking nurses must gain insight into their own thought processes and analyze their own thinking by taking it apart for examination and criticism. -This is recognition and acknowledgement of specific habits and response that may interfere with productive thinking. -Purpose of critical thinking is obviously to help the nurse to make the best clinical judgement. -ABCDEs of critical thinking include: -Assumptions -examination of personal BIASES -analysis of the amount of pressure for CLOSURE -examination of how DATA are collected and analyzed -evaluation of how EMOTIONS may interfere with critical thinking What are assumptions and how can a nurse recognize them? -Assumptions are ideas, beliefs, or values that are taken for granted without basis in fact or reason. -Assumptions lead to examined thoughts or unsound action. -A list of everything known about a specific situation may help in the identification of assumptions. Each item on the list should be analyzed to determine whether it is true, whether it could be true, and weather it is untrue or evidence is insufficient to determine its truth. What are biases and how can a nurse examine biases? -Biases are prejudices that sway the mind toward a particular conclusion or course of action on the basis of personal theories or stereotypes. -When faced with a predisposition to judge a person or a group of people ASK QUESTIONS: Why do you think that? What is this was a different person? What if it were different circumstances?