Solutions Manual for Maternal and Child Nursing Care 6th Edition by London by TestBank Pro

Chapter 01 – ANSWER KEY Nursing Care in Action Questions

Feedback: Family is those persons defined by the mother. For example, the family of a single mother might include her mother, her sister, another relative, a close friend, a lesbian partner, or the father of the child. Many cultures also recognize the importance of extended families, and several family members might provide care and support.

Family-centered care is characterized by an emphasis on the family and the family's choices about their birth experience. Fathers and partners are active participants; siblings are encouraged to visit and meet the newest family member, and they might even attend the birth. Care is designed to meet the emotional, social, and developmental needs of children and families seeking healthcare.

Feedback: The nurse assesses the mother and identifies the nursing diagnoses that describe the responses of the individual and family to the pregnancy or illness. The nurse then implements and evaluates nursing care. The care is designed to meet specific physical and psychosocial needs.

Feedback: A "seamless" system of family-centered, comprehensive, coordinated healthcare, health education, and social services. The system requires coordination as clients move from primary care services to acute care facilities and then back into the community.

Feedback: Culture develops from socially learned beliefs, lifestyles, values, and integrated patterns of behavior that are characteristic of the family, cultural group, and community. Conflicts can occur within a family when traditional rituals and practices of the family do not conform to current healthcare practices. Nurses need to be sensitive to the potential implications for the client's healthcare. When cultural values are not part of the nursing care plan, the client might be forced to decide whether the family's beliefs should take priority over the healthcare professional's guidance.

London, Ladewig, Davidson, Ball, Bindler, and Cowen, Maternal & Child Nursing Care, 6e

CHAPTER 1 CONTEMPORARY MATERNAL, NEWBORN, AND CHILD

HEALTH NURSING

LEARNING OUTCOME 1

Identify the nursing roles available to maternal–newborn and pediatric nurses.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Assign students to work in groups. Allow each group to select one nursing specialty. Instruct members of the individual groups to review the educational preparation and responsibilities for each specialty. Allow each group to present the information to the class.

 Discuss commonalities of the various nursing roles and what skills are needed in each.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Because patient education is a major component of maternal–child nursing, ask students to check the reading level of printed material used to educate children and families about a health condition. See if the printed material meets the fifth grade reading equivalency.

 Summarize the use of community-based nursing care in meeting the needs of childbearing and childrearing families.

 Have students identify the nursing roles that they observe in the clinical setting. Discuss who makes up the nursing care team, how they support one another, and how roles may differ.

LEARNING OUTCOME 2

Describe the use of community-based nursing care in meeting the needs of childbearing and childrearing families.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Instruct one group of students to list institutions where community-based services are performed. Instruct another group to list all the services that are available. Allow the students to match institutions with the services provided.

 Break students into groups and give them the following scenario: A mother of 37week-old twins experiences 10% weight loss on day of discharge.

- Identify plan for follow up

- Identify goals of care

- Identify nursing care and community support recommended for this family

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Schedule students to obtain clinical experience in clinics, doctor’s offices, and community organizations involved in providing maternal–child healthcare. Students may also be assigned to work with perinatal home health nurses.

London, Ladewig, Davidson, Ball, Bindler, and Cowen, Maternal & Child Nursing Care, 6e

LEARNING OUTCOME 3

Summarize the current status of factors related to health insurance and access to healthcare.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Allow students to discuss the current status of healthcare and the implications. Ask individual students in the classroom to say whether or not universal healthcare will increase access to healthcare for all. Allow them to provide evidence to support their conclusions.

 Have students prepare for class by participating in an online discussion board. Each student should be responsible for:

1. An original post identifying a potential barrier to care (must be different than already posted by previous student).

2. Responding to a classmate’s post suggesting a strategy or program that might help overcome the listed barrier.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Have students research the requirement for Medicaid reimbursement and private insurance in a clinical facility. Allow them to compare and contrast the process.

 Have students identify the programs and local resources available in their clinical area to address access to care.

LEARNING OUTCOME 4

Report the most common public health data for maternal mortality and births and causes of child morbidity and mortality.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Lead a discussion among students about the various factors that influence maternal mortality and births and causes of child morbidity and mortality.

 Group pre-class assignment: Assign each group of students to research the maternal mortality rates in different countries and causes of child morbidity and mortality in the same countries.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Have students research the reasons for maternal mortality and child morbidity and mortality in hospitals used for clinical experience.

 Have the students report their findings during post-clinical conference.

LEARNING OUTCOME 5

Relate the availability of statistical data to the formulation of further research questions

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Lead a discussion among students about the various agencies and departments that collate data about birth rates, neonatal mortality rates, infant mortality rates, and maternal mortality rates.

London, Ladewig, Davidson, Ball, Bindler, and Cowen, Maternal & Child Nursing Care, 6e

 Group pre-class assignment: Assign each group to one of the below to investigate how statistical data is used to assess and implement strategies to improve care.

a. National Quality Forum

b. California Quality Collaborative (or your state Quality Collaborative)

c. The Joint Commission

d. Vermont Oxford Network

e. Professional Organizations (AWHONN, NANN, ANA, etc.)

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Allow students to conduct research to identify the birth rate, neonatal mortality rate, infant mortality rate, and maternal mortality rate in their state according to race or ethnic origin. Discuss findings during post-clinical conference.

 Have students observe and report on how the electronic health record assists nurses in improving care at the bedside.

LEARNING OUTCOME 6

Delineate significant legal and ethical issues that influence the practice of maternal–child nursing.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Break students into groups and play “What Would You Do?” Give students the following scenarios:

a. A prenatal client asks you about pregnancy termination when she finds out that her fetus will have cystic fibrosis.

b. As a student nurse, you witness your co-assigned nurse document a care practice that she did not actually complete.

c. Your classmate posts details about her day in clinicals on social media.

d. Your postpartum patient tells you that she is actively using drugs but denies it to the healthcare team.

e. You witness your patient put the hospital blankets and supplies in her suitcase but then tell the nurse that she needs more supplies.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Assign students to an ethics committee meeting addressing quality of life issues in the perinatal environment. Students may also research past cases where federal regulations were considered and engage in active discussion during clinical conferences.

 Have students find a clinical policy and or protocol in their clinical setting and report on whether they have witnessed the staff following the practice. Discuss how students, as new nurses, can use the policies to provide quality care and what they can do to decrease liability.

LEARNING OUTCOME 7

London, Ladewig, Davidson, Ball, Bindler, and Cowen, Maternal & Child Nursing Care, 6e

Explore the value of the QSEN project in promoting patient safety and high-quality care.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Lead a discussion on the six QSEN competencies support quality and safety when providing care.

 Divide the students into six groups. Provide each group with one of the competencies and have the students brainstorm situations that demonstrate the standard within each of the competencies.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Have the students observe patient care and identify situations in which each of the Q SEN competencies is being implemented.

 On the clinical unit, have the students locate policies that support the QSEN competencies. During post-conference, share the policies and have the students discuss if any of the policies need to be updated to incorporate the QSEN standards.

LEARNING OUTCOME 8

Contrast the policies for obtaining informed consent for minors with policies for adults.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 As a group, ask the students the actions to take if a guardian of a 15-year-old patient consents for the patient’s surgery; however, the patient refuses to have the procedure done.

 Discuss with the group a situation where a pregnant 14-year-old patient lives in a state that does not recognize emancipated minors. The patient delivers a fetus that needs neonatal intensive care and the patient needs a blood transfusion.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Have students observe care and identify areas in which patient teaching would be indicated. Discuss the teaching opportunities during post-conference.

 Have students research underage patients and identify how informed consent was obtained and documented in the medical record. Discuss the findings during postconference.

LEARNING OUTCOME 9

Analyze the role of evidence-based practice in improving the quality of nursing care for childbearing and childbearing families.

SUGGESTIONS FOR CLASSROOM ACTIVITIES

 Lead a discussion on the advantages of evidenced-based practice. Allow students to vocalize their views on that subject.

SUGGESTIONS FOR CLINICAL ACTIVITIES

 Ask students to inquire about the utilization of evidenced-based practice in healthcare institutions during their clinical rotation. Allow them to discuss their findings with the other students in their clinical groups.

London, Ladewig, Davidson, Ball, Bindler, and Cowen, Maternal & Child Nursing Care, 6e

 Have students select a care practice witnessed in their clinical setting. What evidence exists to support that practice? Have students bring 2–3 relevant articles and be prepared to discuss.

FOCUS YOUR STUDY

1. Nurses play various roles in the care of women and newborns. There are direct care providers in ambulatory and acute care settings.

2. There are various opportunities for nurses for advanced practice (i.e., nurse practitioners, CNS, CNM).

3. Case management is a process of coordinating the delivery of healthcare services that focuses on quality and cost outcomes.

4. Contemporary childbirth is family centered, offers choices about birth, and focuses on the needs of siblings and other family members.

5. Family-centered care is an approach in pediatric settings that takes into consideration family diversity and beliefs about child health and management of conditions.

6. The US healthcare system is being challenged with cost and quality.

7. Culturally appropriate care recognizes the family value system, differences among groups, and incorporates ethnic diversity.

8. Statistical data about infants and mothers helps identify areas for research.

9. Informed consent must be obtained before providing treatment. Parents have the authority to consent for children except for emancipated minors or mature minors.

10.Maternal-fetal conflict can occur when a fetus is viewed as a person of equal rights as the mother.

11.Abortion can be performed until the age of viability.

12.Assisted reproductive technology can be used to produce a pregnancy; however, some of the procedures can cause ethical dilemmas.

13.Embryonic stem cell research can be controversial.

14.Baby Doe regulations were developed to protect the rights of infants with severe defects.

15.Evidence-based practice is emerging as a positive force in healthcare.