Essentials of Maternity, Newborn, and Women's Health Nursing 3rd Edition Chapter 1 Perspectives on Maternal, Newborn, and Women's Heath Care

a process of assessment, planning, application, coordination, follow-up, and evaluation of the options and services required to meet an individual's health needs through communication and available resources to promote quality cost-effective results - ANSWERScase management has postgraduate training in the care of normal pregnancy and childbirth and is certified by the American College of Nurse Midwives (ACNM) - ANSWERScertified nurse midwife (CNM) is the ability to apply knowledge about a client's culture so that the health care provided can be adapted to meet her needs - ANSWERScultural competence is a view of the world and a set of traditions that are used by a specific social group and are transmitted to the next generation - ANSWERSculture a birth assistant who provides emotional, physical, and educational support to the woman and family during childbirth and the postpartum period - ANSWERSdoula involves the use of research to establish a plan of care and to implement that care is a problem-solving approach to making nursing clinical decisions - ANSWERSevidence-based nursing practice the basic social unit of our society - ANSWERSfamily is the delivery of safe, satisfying, high-quality health care that focuses on and adapts to the physical and psychosocial needs of the family - ANSWERSfamily-centered care fetal death rate refers to the intrauterine death of a fetus at 20 weeks or more of gestation per 1,000 live births - ANSWERSfetal mortality rate is the number of deaths occurring in the first 12 months of life - ANSWERSinfant mortality rate is an agreement by a client to undergo an operation or medical treatment or take part in a clinical trial after being informed of and having understood the risks involved - ANSWERSinformed consent is the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy, per 100,000 live births, for a specified year - ANSWERSmaternal mortality ratio is the incidence or number of individuals who have died over a specific period - ANSWERSmortality is the number of infant deaths occurring in the first 28 days of life per 1,000 live births - ANSWERSneonatal mortality rate *Men did not attend births because is was considered indecent *Women faced birth , not with joy and ecstasy, but with fear of death *Female midwives attended the majority of all births at home - ANSWERS1700s *There is a shift from using midwives to doctors among middle-class women *The word obstetrician was formed from the Latin, meaning "to stand before" *Puerperal (childbed) fever was occurring in epidemic proportions *Louis Pasteur demonstrated that streptococci were the major cause of puerperal fever that was killing mothers after delivery *The first cesarean section was performed in Boston in 1894 *The x-ray was developed in 1895 and was used to assess pelvic size for birthing purposes - ANSWERS1800s *Twilight sleep (a heavy dose off narcotics and amnesiacs) was used on women during childbirth in the United States *The United States was the 17th out of 20 nations in infant mortality rates *Fifty to 75% of all women gave births in hospital by 1940 *Nurseries were started because moms could not care for their baby for several days after receiving chloroform gas *In 1933 Dr. Grantley Dick-Reed wrote a book entitled Childbirth Without Fear that reduced the "fear-tension-pain" cycle women experienced during labor and birth *In 1984 Dr. Fernand Lamaze wrote a book entitled Painless Childbirth: The Lamaze Method that advocated distraction and relaxation techniques to minimize the perception pf pain *Amniocentesis was first performed to assess fetal growth in 1966 *In the 1970s the cesarean section rate was about 5%. By 2000 it rose to 34%, where it stands currently *In the 1970s and 1980s saw a growing trend to return b - ANSWERS1900s *One in three women undergo a surgical birth (cesarean) *CNMs once again assist couples at home, in hospitals, or in freestanding facilities with natural childbirths. Research shows that midwives are the safest birth attendants for most women, with lower infant mortality and maternal rates, and fewer invasive interventions such as episiotomies and cesareans *Childbirth classes of every flavor abound in most communities *According to the latest available data, the United States ranks 50th in the world of maternal deaths. The maternal mortality rate is approximately 11 in 100,000 live births *According to the latest available data, the United States ranks 41st in the world in infant mortality rates. The infant mortality rate is approximately 6 in 1,000 live births - ANSWERS2000s *Childbirth is considered a normal, healthy event in the life of a family *Childbirth affects the entire family, and relationships will change *Families are capable of making decisions about their own care if given adequate information and professional support - ANSWERSThese are the basic principles of family-centered care: *Advocacy, communication, and resource management *Client-focused comprehensive care across a continuum *Coordinated care with an interdisciplinary approach - ANSWERSCase management involves the following components: Husband, wife, and children living in same household *May include natural or adopted children *Once considered the traditional family structure; now less common due to increased divorce rates and child rearing by unmarried persons - ANSWERSNuclear family Child who is a member of two families due to joint custody; parenting is considered a "Joint venture" *Always works better when the interests of the child are put first and above the parents' need and desires - ANSWERSBinuclear family One parent is responsible for care of children *May result from death, divorce, desertion, birth outside of marriage, or adoption *These families are likely to face challenges because of economic, social, and personal restraints; one person serves as homemaker, caregiver, and financial provider - ANSWERSSingle-parent family Adults in the family live and work apart for professional or financial reasons, often leaving the daily care of the children to one parent *Similar to single-parent family - ANSWERSCommuter family Adults with with children from previous marriages or from the new marriage *May lead to family conflict due to different expectations on the part of the child and adults; that may have different views and practices related to child care and health - ANSWERSStep- or blended family Nuclear family and grandparents, cousins, aunts, and uncles *Need to identify decision-maker and primary caretaker of the children *Popular in some cultures, such as Hispanic and Asian cultures - ANSWERSExtended family Adults of the same sex living together with or without children *May face negative attitudes about their "different" lifestyle - ANSWERSSame-sex family (also called homosexual or gay/lesbian family) Group of people living together to raise children and manage household; unrelated by blood or marriage *May face negative attitudes about their "different" lifestyle *Need to determine the decision-maker and caretaker of the children - ANSWERSCommunal family A temporary family for children who are placed away from their parents to ensure their emotional and physical well-being *May include the foster family's children and other foster children in the home *Foster children are more likely to have unmet health needs and chronic health problems because they may have been in a variety of health systems - ANSWERSFoster family Grandparents raising their grandchildren due to the inability or absence of the parents *May increase the risk for physical, financial, and emotional stress on older adults *May lead to confusion and emotional stress for child if biologic parents are in and out of child's life - ANSWERSGrandparents-as-parents families Young parents who are still mastering developmental tasks of their childhood *Are at greater risks for health problems in pregnancy and delivery; more likely to have premature infants, which leads to risk of subsequent health and developmental problems *Probably still need support from their family related to financial, emotional, and school issues - ANSWERSAdolescent families *Mental health issues such as anxiety, depression, or aggressive behavior *Chronic health problems and injuries *Nutritional deficiencies, affecting fetal growth and development *Behaviors such as illegal substance use or unprotected sex with multiple partners *Limited access to health care services such as preventive care, prenatal care, or dental care - ANSWERSHomelessness can have a negative impact on health and well-being in numerous ways, including: routinely screen every client for abuse - ANSWERSR affirm feelings and assess abuse - ANSWERSA document your findings - ANSWERSD assess for your client's safety - ANSWERSA review options and make referrals - ANSWERSR *View of health as harmony with nature, illness as disruption in harmony *Use of folk healing and home remedies common *View of pregnancy as a state of wellness *Emotional support during labor commonly from other women, primarily the woman's own mother *Liberal use of oil on newborn's and infant's scalp and skin *Belief in illnesses as natural (due to natural forces person hasn't protected self against) and unnatural (due to person or spirit) *Illness commonly associated with pain *Postpartum practices for the infant may include the use of a bellyband or a coin places on top of the infant's umbilicus to prevent umbilical hernias *Pain and suffering inevitable; relief achieved through prayers and laying on of hands - ANSWERSAfrican Americans *Use of complementary modalities along with Western health care practices *View of life as a cycle with everything connected to health *Usually attended by a female relative and tend to be quiet and sedate during labor and birth *Health viewed as a balance between the forces of yang and yin *Illness is the disharmony of yin and yang *Yang-energy outside of body where matter is dynamic, external, upward, ascending, and brilliant *Ying-energy inside of the body where is static, internal, downward, descending, dull, regressive, and hypoactive *During postpartum, women don't expose themselves to cold air or bathe themselves for the first month to avoid exposure to illness *Respect for authority emphasized *Women a very modest and may insist on a female health care provider for maternity care *View of pregnancy as a natural process and happy time for woman *Little involvement of the father during labor;quiet; stoic appear - ANSWERSAsian Americans *Women subordinate to men; young individuals subordinate to older persons *Family loyalty is primary *Woman value modesty and want their bodies covered during examinations *Procreation is regarded as the purpose of marriage, thus high fertility rates are favored *During labor, women openly express pain through facial expressions, verbalizations, and body movement *Mothers may be reluctant to bathe after childbirth because of beliefs that air gets into the mother and causes illness *Good health associated with eating properly, consuming nutritious foods, and fasting to cure disease *Illness is due to inadequate diet, shifts in hot and cold, exposure of stomach while sleeping, emotional or spiritual distress, and "evil eye" *Breast-feeding often delayed for 2 to 3 days after birth *Cleanliness important for prayer - ANSWERSArab Americans *Family is important: father is the source of strength, wisdom, and self-confidence; mother is the caretaker and decision-maker for health; children are persons who will continue the family and culture *During period of la curenentena (first 40 days after childbirth) women are thought to be susceptible to cold, so many will avoid taking showers, sitz baths, tub baths, washing their hair, or being exposed to cold air *Likely to be very vocal during labor by crying or frequently making loud screams *Newborn protection from the "evil eye" *Health as God's will, maintainable with a balance of hot and cold food intake *Freedom from pain indicative of good health; pain tolerated stoically due to belief that it is God's will *Folk medicine practices and prayers, herbal teas and poultices for illness treatment - ANSWERSHispanic *Place high value on family and tribe; respect for elders *Family as an extended network providing care for newborns and children *View of pregnancy as a normal and natural process; entire family may be present at birth *Use of food to celebrate life events and in healing and religious ceremonies *Health as harmony with nature; illness due to disharmony, evil spirits *Restoration of physical, mental, and spiritual balance through healing ceremonies - ANSWERSNative Americans *Ensuring that the consent form is completed with signatures from the client *Serving as a witness to the signature process *Determining whether the client understands that she is signing by asking her pertinent questions *In certain states, mature minors and emancipated minors may consent to their own health care and certain counseling. prenatal care, testing and treatment of sexually transmitted infections and communicable diseases (including HIV), substance abuse and mental illness counseling and treatment , and health care required as a result of a crime-related injury - ANSWERSThe nurse's responsibilities related to informed consent include the following: