Unit 1 Chapter 2 The Nurse's Role in Maternity and Women's Health Care test| 25 questions with 100% correct answers.docx

Advanced practice nurses may practice as certified nurse-midwives (CNMs), nurse practitioners, nurse educators, and nurse researchers. -masters/doctoral degree Certified Nurse-Midwives (CNMs) -RN -must pass certification thru American College of Nurse-Midwives. -complete care during pregnancy, childbirth, and the postpartum period. *as long as everything is normal & not high risk. -annual well-woman exams (WWEs) -GYN services -family plan/counsel -childbirth: noninterventionist and supportive. -DON'T assist with birth Nurse Practitioners -advanced RN -hx, exam, order/interpret, primary care, maintenance, health promotion. -work under MD (depend on state) - women's health nurse practitioner (WHNP) provides wellness-focused, primary, reproductive, and gynecologic care over a woman's life span, beginning from adolescence. Common responsibilities include performing WWEs, screening for sexually transmitted diseases (STDs), and providing family planning services. Family nurse practitioners (FNPs) -may care for uncomplicated pregnancy & f/u care to mothers and infants. -DON'T assist with child birth Neonatal nurse practitioners (NNPs) assist in the care of high-risk newborns in the immediate post-birth care or in a neonatal intensive care unit. Pediatric nurse practitioners (PNPs) provide health maintenance care to infants and children who do not require the services of physicians. They may see infants at well-baby visits and to provide treatment for common illnesses. Clinical Nurse Specialists Perinatal clinical specialists are RNs who, through study and supervised practice at the graduate level (master's or doctorate), have acquired expertise in the care of childbearing women with complex problems. Core competencies for the clinical nurse specialist (CNS) include direct care, consultation, systems leadership, collaboration, coaching, research, and ethical decision making (National Association of Clinical Nurse Specialists [NACNS], 2012). Unlike nurse practitioners, clinical nurse specialists do not provide primary care. Clarifying Clearing up or following up to understand both content and feelings expressed, to check the accuracy of how the nurse perceives the message. "I'm confused about your plans. Could you explain?" "Tell me what you mean when you say you don't feel like yourself." "Are you saying that _____?" "Tell me more about _____." Paraphrasing Restating in words other than those used by the woman what she seems to express; a form of clarification Example 1 Woman: "My boyfriend won't even come into the room for the birth. I'm furious with him." Nurse: "You seem to be angry because he won't be here." Example 2 Woman: "My baby cries all the time. We aren't getting any sleep." Nurse: "You say that you're exhausted, and it seems like your baby cries a great deal. What is a typical day like?" Reflecting Verbalizing comprehension of what the patient said and what she seems to be feeling. It is important to link content and feeling and to reflect the woman as a mirror reflects a person. The opinion, values, and personality of the nurse should not be in the reflected image. Example 1 Woman: "I don't know what to do. My husband doesn't think a cesarean is needed, but the doctor says the baby is showing some stress." Nurse: "You're confused and frightened because they don't agree?" Example 2 Woman in early labor: "It was my husband's idea to have a baby. I wasn't too excited about it at first." Nurse: "I'll bet the dad will be a pushover as a father." The nurse's statement reflects the nurse's opinion and fails to acknowledge the mother's statement. A better response might be: "Your husband was more excited early in the pregnancy than you were?" Silence Waiting and allowing time for the patient to continue. Verbal communication need not be constant. The nurse waits quietly for the woman to continue. Structuring Creating guidelines or setting priorities. "You said you don't know how to take care of the baby and also that you're afraid of getting pregnant again. What should we talk about first?" Pinpointing Calling attention to differences or inconsistencies in statements. Nurse talking to an 8-year-old child: "You said you didn't want your mother to spend the night with you, but you cry every night after she leaves. It can be scary being alone. I'll sit with you, and we can talk about asking your mother to stay tomorrow night." Questioning Eliciting information directly; using open-ended questions to avoid "yes" or "no" answers and to prevent controlling the answers. "How do you feel about being pregnant?" instead of "Are you happy to be pregnant?" "How do you feel about your brother being very sick?" instead of "Are you frightened because your brother is very sick?" Directing Using nonverbal responses or succinct comments to encourage the person to continue. Nodding. "Um-mm." "You were saying?" "Please go on." Summarizing Reviewing the main themes or issues that were discussed. "You had two major concerns today." "We have talked about breastfeeding and how to bathe the baby today." ***communication Blocks 1. Conveying lack of interest (Looking away, fidgeting) 2. Conveying sense of haste. (Checking the time, standing near the door) 3. Closed posture (Arms crossed over chest, holding laptop computer in front of body) 4. Interrupting, finishing sentences. (Woman: "I'm not sure how to ... ." Nurse: "We'll have a bath demonstration later.") 5. Providing false reassurance ("You're going to be okay.") 6. Inappropriate self-disclosure (To woman in labor: "I was in labor for 12 hours, and then I had a cesarean.") 7. Giving advice ("You should ______." "If I were you, I would ______.") 8. Failure to acknowledge comments or feelings. (Woman: "Being a parent is hard work. I never have time for myself." Nurse: "It's going to get worse before it gets better. Parenting is hard work.") 2-2 Alternative 1. Attending behaviors such as eye contact, nodding. 2. Sitting at bedside 3. Leaning forward with arms relaxed 4. "Go on, _____." "You were saying _____." 5. "I sense you are concerned about how to care for the baby. I will help you give the bath today." 6. "What concerns you most about labor?" 7. "How do you feel about that?" "What do you think is most important?" 8. "Parenting is hard work. Let's talk about some ways that you might get a break." younger parents may learn better & different from parents. *Best from: -videos, computer lessons, group discussions. -NOT: written material Assumptions ideas, beliefs, or values that are taken for granted without basis in fact or reason. Such assumptions may lead to unexamined thoughts or unsound actions. Biases prejudices that sway the mind toward a particular conclusion or course of action on the basis of personal theories or stereotypes. Ambiguity Lack of clarity or certainty; having more than one meaning. Closure reaching a decision. To overcome pressure to reach an early conclusion, a conscious effort must be made to suspend (delay or bring to a stop) judgment. This is sometimes called reflective skepticism, or doubt in the absence of conclusive evidence. Independent Nursing Interventions Nurse-prescribed actions used in both nursing diagnoses and collaborative problems. -nursing diagnoses Nursing Process *ASSESSMENT: -Collecting complete data, validating data. -Clustering data (normal versus abnormal, important versus unimportant, relevant versus irrelevant). -Identifying emotions. *ANALYSIS: -Identifying cues and making inferences -Reflecting and suspending judgment -Examining thought processes for biases and assumptions -Identifying alternatives -Determining priorities *PLANNING: -Examining need for closure -Searching for alternative solutions -Validating plan with patient or co-worker -Communicating plan -Acknowledging defensive behavior *IMPLEMENTATION: -Testing plan -Carrying out plan *EVALUATION: -Examining insights gained -Recognizing new ways of thinking or acting -Examining options and criteria for action -Appraising self and others in the situation