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Maternal and Child Nursing Care


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Table of Contents

Unit 1. Introduction to Family-Centered Care 1. Contemporary Maternal Newborn and Child Health Nursing 2. Conception and Fetal Development Unit 2. Women's Health 3. Health Promotion for Women 4. Common Gynecologic Problems5. Families with Special Reproductive Concerns Unit 3. Pregnancy and Family 6. Preparation for Parenthood7. Physical and Psychologic Changes of Pregnancy 8. Antepartal Nursing Assessment 9. The Expectant Family: Needs and Care 10. Maternal Nutrition 11. Adolescent Pregnancy 12. Assessment of Fetal Well-Being 13. Pregnancy at Risk: Pregestational Problems14. Pregnancy at Risk: Gestational Problems Unit 4. Birth and the Family 15. Processes and Stages of Labor and Birth 16. Intrapartal Nursing Assessment 17. The Family in Childbirth: Needs and Care 18. Pharmacologic Pain Management 19. Childbirth at Risk: Prelabor Complications 20. Childbirth at Risk: Labor-Related Complications21. Birth-Related Procedures Unit 5. The Newborn and Postpartum Family 22. The Physiologic Responses of the Newborn to Birth23. Nursing Assessment of the Newborn 24. Normal Newborn: Needs and Care25. Newborn Nutrition26. The Newborn at Risk: Conditions Present at Birth27. The Newborn at Risk: Birth-Related Stressors28. Postpartal Adaptation and Nursing Assessment 29. The Postpartum Family: Needs and Care 30. The Postpartum Family at Risk Unit 6. Care and Needs of Children 31. Growth and Development 32. Infant, Child, and Adolescent Nutrition 33. Pediatric Assessment 34. Health Promotion and Maintenance: General Concepts, the Newborn, and the Infant35. Health Promotion and Maintenance: The Toddler, the Preschooler, and the School-Age Child36. Health Promotion and Maintenance: The Adolescent37. Family Assessment and Concepts of Nursing Care in the Community38. Nursing Considerations for the Child and Family with a Chronic Condition 39. Nursing Considerations for the Hospitalized Child 40. Pain Assessment and Management in Children 41. The Child with a Life-Threatening Condition and End-of-Life Care 42. Immunizations and Communicable Diseases Unit 7. Caring for Children with Alterations in Health Status 43. The Child with Alterations in Fluids, Electrolytes, and Acid-Base Balance44. The Child with Alterations in Eye, Ear, Nose, and Throat Function 45. The Child with Alterations in Respiratory Function 46. The Child with Alterations in Cardiovascular Function 47. The Child with Alterations in Immune Function 48. The Child with Alterations in Hematologic Function49. The Child with Cancer 50. The Child with Alterations in Gastrointestinal Function51. The Child with Alterations in Genitourinary Function52. The Child with Alterations in Endocrine Function 53. The Child with Alterations in Neurologic Function 54. The Child with Alterations in Mental Health and Cognitive Function55. The Child with Alterations in Musculoskeletal Function 56. The Child with Alterations in Skin Integrity Appendices A. Selected Maternal-Newborn Laboratory Values B. Selected Pediatric Laboratory ValuesC. Physical Growth ChartsD. Pediatric Blood Pressure ValuesE. Conversions and EquivalentsF. Actions and Effects of Selected Drugs During BreastfeedingG. The Friedman Family Assessment ModelH. Dietary Reference Intakes and Recommended Dietary Allowances for Females, Pregnancy, and LactationI. West Nomogram-Body Surface Area

About the Author

Marcia L. London Marcia L. London has been able to combine her two greatest passions by being both a nurse caring for children and families, and a teacher for almost 39 years. She received her BSN and School Nurse Certificate from Plattsburgh State University in Plattsburgh, New York, and her MSN in pediatrics as a clinical nurse specialist from the University of Pittsburgh in Pennsylvania She began her nursing career as a pediatric nurse at St. Luke's Hospital in New York City and began her teaching career at Pittsburgh Children's Hospital Affiliate Program, Ms. London began teaching at Beth-El School of Nursing and Health Science in 1974 (now part of the University of Colorado, Colorado Springs) after opening the first intensive care nursery at Memorial Hospital of Colorado Springs. She has served in many faculty and administrative positions at Beth-El, including assistant director of the School of Nursing and coordiantor of undergraduate nursing care of children. Mrs. London maintains her clinical skills working in an urgent care and after-hours clinic and doing undergraduate pediatric clinical supervision. She obtained her postmaster's neonatal nurse practitioner certificate in 1983 and subsequently developed the neonatal nurse practitioner (NNP) program and the master's NNP program at Beth-El. She is active nationally in neonatal nursing and was involved in the development of the Neonatal Nurse Practitioner Educational Program Guidelines. She has contributed five chapters to various neonatal nursing texts. Mrs. London is active in nurse practitioner education in general. She was involved in the revision of the Core Competency for Nurse Practitioners and Curriculum Guidelines for Nurse Practitioner Education, as a member of the Education Committee of the National Organization of Nurse Practitioner Faculties and participated as part of the Core Competency Validation Expert Panel. Mrs. London has also pursued her interest in college student learning by taking doctoral classes in higher education administration and adult learning at the University of Denver in Colorado. She feels fortunate to be involved in the education of her future colleagues. Her teaching philosophy is that, with support, students can achieve more than they may initially believe they are capable of achieving. Mrs. London and her husband David enjoy reading, travel and hockey games. They have two sons. Craig, who lives in Florida, works with internet companies. Matthew works in computer teleresearch. Both are more than willing to give Mom helpful hints about computers. Patricia A. Wieland Ladewig Patricia A. Wieland Ladewig received her BS from the College of Saint Teresa in Winona, Minnesota. After graduation, she worked as a pediatric nurse before joining the U.S. Air Force. After completing her tour of duty, she relocated to Florida, where she accepted a faculty position at Florida State University. There she embraced teaching as her calling. Over the years, she taught at several schools of nursing while earning her MSN in maternal-newborn nursing from Catholic University of America in Washington, D.C., and her PhD in higher education administration from the University of Denver in Colorado. In addition, she became a women's health nurse practitioner and maintained a part-time clinical practice. In 1988 Dr. Ladewig became the first director of the nursing program at Regis College in Denver and, in 1991, when the college became Regis University, she became dean of the Rueckert-Hartman College for Health Professions. Under her guidance, the School of Nursing has added a graduate program. In addition, the College has added a School of Physical Therapy, a School of Pharmacy, and two departments: the Department of Health Services Administration and Management, and the Department of Health Care Ethics. When not at work or writing textbooks, Pat and her husband, Tim, enjoy skiing, baseball games, and traveling. However, their greatest pleasure comes from their family: son Ryan, his wife, Amanda, and grandchildren Reed and Addison, and son Erik, his wife, Kedri, and granddaughter Emma. Jane W. Ball Jane W. Ball graduated from The Johns Hopkins Hospital School of Nursing, and subsequently received a BS from The Johns Hopkins University. She worked in the surgical, emergency, and outpatient units of the Johns Hopkins Children's Medical and Surgical Center, first as a staff nurse and then as a pediatric nurse practitioner. This began her career as a pediatric nurse and advocate for children's health needs. Jane obtained both a master of public health and doctor of public health degree from the Johns Hopkins University Bloomberg School of Public Health with a focus on maternal and child health. After graduation she became the chief of child health services for the Commonwealth of Pennsylvania Department of Health. In this capacity she oversaw the state-funded well-child clinics and explored ways to improve education for the state's community health nurses. After relocating to Texas, she joined the faculty at the University of Texas at Arlington School of Nursing to teach community pediatrics to registered nurses returning to school for a BSN. During this time she became involved in writing her first textbook, Mosby's Guide to Physical Examination, which is currently in its seventh edition. After relocating to the Washington, D.C., area, she joined Children's National Medical Center to manage a federal project to teach instructors of emergency medical technicians from all states about the special care children need during an emergency. Exposure to the shortcomings of the emergency medical services system in the late 1980s with regard to pediatric care was a career-changing event. With federal funding, she developed educational curricula for emergency medical technicians and emergency nurses to help them provide improved care for children. A textbook entitled Pediatric Emergencies, A Manual for Prehospital Providers was developed from these educational ventures. For the past 16 years, she was the executive director of the federally funded Emergency Medical Services for Children National Resource Center, providing of consultation and resource development for state health agencies, health professionals, families, and advocates to improve the emergency healthcare system for children. Dr. Ball currently serves as a consultant to the American College of Surgeons assisting states to develop and enhance their trauma systems. Ruth C. McGillis Bindler Ruth Bindler received her BSN from Cornell University-New York Hospital School of Nursing in New York. She worked in oncology nursing at Memorial-Sloan Kettering Cancer Center in New York, and then moved to Wisconsin and became a public health nurse in Dane County. Thus began her commitment to work with children as she visited children and their families at home, and served as a school nurse for several elementary, middle, and high schools. Due to this interest in child healthcare needs, she earned her MS in child development from the University of Wisconsin. A move to Washington State was accompanied by a new job as a faculty member at the Intercollegiate Center for Nursing Education in Spokane, Washington, now the WSU College of Nursing. Dr. Bindler has been fortunate to be involved for 35 years in the growth of this nursing education consortium, which is a combination of public and private universities and offers undergraduate, masters and doctoral nursing degrees. She has taught theory and clinical courses in child health nursing, cultural diversity, graduate research, pharmacology, and assessment, served as lead faculty for child health nursing, and is presently director of the PhD Program. Her first professional book, Pediatric Medications, was published in 1981, and she has continued to publish articles and books in the areas of pediatric medications and pediatric health. Research efforts are focused in the area of childhood obesity, type 2 diabetes, and cardiovascular risk factors in children. Ethnic diversity has been another theme in her work.. Dr. Bindler believes that her role as a faculty member has enabled her to learn continually, to foster the development of students in nursing, and to participate fully in the profession of nursing. In addition to teaching, research, publication, and leadership, she enhances her life by service in several professional and community activities, and by outdoor activities with her family. Kay J. Cowen Kay Cowen received her Bachelor of Science in Nursing degree from East Carolina University in Greenville, North Carolina, and began her career as a staff nurse on the pediatric unit of North Carolina Baptist Hospital in Winston Salem. She developed a special interest in the psychosocial needs of hospitalized children and preparing them for hospitalization. This led to the focus of her master's thesis at the University of North Carolina at Greensboro (UNCG) where she received a Master of Science in Nursing Education degree with a focus in maternal child nursing. Mrs. Cowen began her teaching career in 1984 at UNCG where she continues today as Clinical Associate Professor in the Parent Child Department. Her primary responsibilities include coordination of the pediatric nursing course, teaching classroom content and supervising a clinical group of students. Mrs. Cowen shared her passion for the psychosocial care of children and the needs of their families through her first experience as an author in the chapter "Hospital Care for Children" in Child Health Nursing: A Comprehensive Approach to the Care of Children and Their Families published in 1993. In the classroom Mrs. Cowen realized that students learn through a variety of teaching strategies and became especially interested in the strategy of gaming. She led a research study to evaluate the effectiveness of gaming in the classroom and subsequently continues to incorporate gaming in her teaching. In the clinical setting Mrs. Cowen teaches her students the skills needed to care for patients and the importance of family-centered care, focusing on not only the physical needs of the child but also the psychosocial needs of the child and family. During her teaching career, Mrs. Cowen has continued to work part time as a staff nurse; first on the pediatric unit of Moses Cone Hospital in Greensboro and then at Brenner Children's Hospital in Winston Salem. In 2006 she became the part-time Pediatric Nurse Educator in Brenner's Family Resource Center. Through this role she is able to extend her love of teaching to children and families. Through her role as an author, Mrs. Cowen is able to extend her dedication to pediatric nursing and nursing education. She is married and the mother of two college-age sons.


&n> *...impressed by the Evidence-Based Nursing section; timely, useful, and relevant...literature is presented and summarized to illustrate how evidence is aggregated with evidence-based practice...a nice overview and summary and leads into the critical thinking piece with an excellent media link. -(Professor Keough, North Darmouth, MA) *I prefer the London text after previewing it. Competing texts are not as up-to-date. London is more thorough but an easy read. It also includes more in-depth cultural coverage. -(Professor Lewis, Ina, IL) *Cultural values cannot be emphasized enough. The emphasis on cultural competence related to how family deal with grief is especially well-done. The pace and depth are excellent and written at an appropriate level. Detailed, but not so complex as to be confusing. This book is superior to our current text. -(Professor Miedema, Titusville, FL) *I especially liked the Critical Concept Review...which tied the information back to the objectives. Other texts do not do this. They tend only to summarize the key concepts. -(Professor Roberts, Beaumont, TX) REVIEWER LIST - LONDON: MATERNAL & CHILD NURSING CARE, 3E
Susan Beggs, RN, MSN, CPNAustin Community CollegeAustin, Texas Constance Bobik, RN, BSN, MSNBrevard Community CollegeCocoa, Florida Pam Bowden, RN, MS, PNPNorth Hennepin Community CollegeBrooklyn Park, Minnesota Pamela Cleveland, MSN, RN, FNPSouth Texas CollegeMcAllen, Texas Cheryl DeGraw, RN MSN, CRNP, CNEFlorence-Darlington Technical CollegeFlorence, South Carolina Cherste K. Eidman BS, BSNMetropolitan State UniversitySt. Paul, Minnesota Renee Zubay Fife, RN, MSN, CPNPurdue Calumet School of Nursing Hammond, Indiana Pamela Fowler, MS, RNRogers State UniversityClaremore, Oklahoma Mary Ann Helms, RN, MSN, MRE, EdDTennessee State UniversityNashville, Tennessee Rita Horgos, MSN, RN, CPNCommunity College of Allegheny County, South CampusWest Mifflin, Pennsylvania Kathy Jo Keever RNC-OB, CNM, MS Anne Arundel Community CollegeArnold, Maryland Lori Keough, APRN-BC, MSN, MEdUniversity of MassachusettsNorth Dartmouth, Massachusetts Carmen Kiraly RN, BSN, MSN, C-WHNPSuffolk Community CollegeBrentwood, New York Kathleen Kleefisch RN, MSN, FNP, BCPurdue Calumet UniversityHammond, Indiana Kelli D. Lewis, RN, MSNRend Lake CollegeIna, Illinois Karen Lincoln, RNC, MSNMontcalm Community CollegeSidney, Michigan Kathy Martin MNSc, WHNP, RNCCox CollegeSpringfield , Missouri Linda L. Miedema, RN, BNS, MSA, PhDBrevard Community CollegeTitusville, Florida Carol Ann Moseley, PhD, MS, BAN, BA, RNBlessing-Rieman College of NursingQuincy, Illinois Deborah Naccarini, RN, MSNCarroll Community CollegeWestminster, Maryland Jeanette Nodorft, RNC, BSN, MSNSouthwest Wisconsin Technical CollegeFennimore, Wisconsin
Janet Pinkelman MSN, RNCOwens Community CollegeToledo, Ohio Leslie S. ReifelSentara School of Health ProfessionsChesapeake, Virginia Katherine Roberts MSN, RNLamar UniversityBeaumont, Texas Nancy Rogers, RN, MA, BSNCarroll Community CollegeWestminster, Maryland Martha C. RuderGulf Coast Community CollegePanama City, Florida Nora F. Steele, DNS, APRNDelgado Community CollegeNew Orleans, Louisiana Marilyn L. Weitzel PhD, RNCleveland State UniversityCleveland, Ohio Donna WilskerLamar UniversityBeaumont, Texas Marianne M. Wollyung RN, MSNPottsville Hospital School of NursingPottsville, Pennsylvania

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