Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig)
Chapter 1 Contemporary Maternal-Newborn Nursing
- The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect?
- Shortens newborn length of stay
- Decreases use of home health agencies
- Decreases healthcare costs
- Decreases the number of emergency department visits
Answer:C
Explanation:
- Length of stay is often determined by third-party payer (insurance company) policies as well as the physiologic stability of the mother and newborn. Home healthcare agencies often are involved in client care to decrease hospital stay time.
- Home healthcare agencies often are involved in client care to decrease hospital stay time.
- Research indicates that self-care significantly decreases healthcare costs.
- Acute emergencies are addressed by emergency departments, and are not delayed by those practicing self-care.
Page Ref: 3
Cognitive Level:Understanding
Client Need/Sub:Health Promotion and Maintenance: Self-Care
Standards: QSEN Competencies: Ⅰ.A.2. Describe strategies to empower patients or families in all aspects of the healthcare process. | AACN Essentials Competencies: Ⅸ.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models | Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome:1 Discuss the impact of the self-care movement on contemporary childbirth.
MNL LO:Recognize contemporary issues related to care of the childbearing family.
- Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following?
- There is less trauma to the mother.
- More childbirth education classes are available.
- They are instrumental in providing change in the birth environment at work.
- They advocate for more home healthcare agencies.
Answer:A
Explanation:
- Nurse-midwife models of care can be one way to ensure that mothers receive excellent prenatal and intrapartum care.
- It is appropriate for nurse-midwives, in conjunction with doctors and hospitals, to provide childbirth classes for expectant families.
- By working with other staff members and doctors, the nurse-midwife is able to implement changes as needed within the birthing unit.
- Clients are increasingly going home sooner, so there needs to be more follow-up in the home.
Page Ref: 3
Cognitive Level:Understanding
Client Need/Sub:Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: Ⅲ.A.6. Describe how the strength and relevance of available evidence influences the choice of interventions in provision of patient-centered care. | AACN Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO:Recognize contemporary issues related to care of the childbearing family.
- The nurse is telling a new client how advanced technology has permitted the physician to do which of the following?
- Treat the fetus and monitor fetal development.
- Deliver at home with a nurse-midwife and doula.
- Have the father act as the coach and cut the umbilical cord.
- Breastfeed a new baby on the delivery table.
Answer:A
Explanation:
- The fetus is increasingly viewed as a patient separate from the mother, although treatment of the fetus necessarily involves the mother.
- A nurse-midwife and a doula are not examples of technological care.
- Fathers being present during labor and coaching their partners represents nontechnological care during childbirth.
- Breastfeeding is not an example of technology impacting care.
Page Ref: 2—3
Cognitive Level:Understanding
Client Need/Sub:Safe and Effective Care Environment: Management of Care
Standards:QSEN Competencies: Ⅰ.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: Ⅸ.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Implementation.
Learning Outcome:6 Evaluate the potential impact of some of the special situations in contemporary maternity care.
MNL LO:Recognize contemporary issues related to care of the childbearing family.
- A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role?
- A registered nurse who is the manager of a large obstetrical unit
- A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections)
- A clinical nurse specialist working as a staff nurse on a mother-baby unit
- A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants
Answer:D
Explanation:
- A registered nurse who is the manager of a large obstetrical unit is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
- A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
- A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the qualifications for an advanced practice nursing staff member but is not working in that capacity.
- A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants is working in an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master’s prepared.
Page Ref: 5
Cognitive Level:Understanding
Client Need/Sub:Safe and Effective Care Environment: Management of Care
Standards:QSEN Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | AACN Essentials Competencies: Ⅵ. 6. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment.
Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO:Recognize contemporary issues related to care of the childbearing family.