Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 13 The Expectant Family: Needs and Care

1. The nurse is caring for a pregnant client. The client's husband has come to the prenatal visit. Which question is best for the nurse to use to assess the father's adaptation to the pregnancy?
2. "What kind of work do you do?"
3. "What furniture have you gotten for the baby?"
4. "How moody has your wife been lately?"
5. "How are you feeling about becoming a father?"

Page Ref: 259

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Describe actions the nurse can take to help maintain the well-being of the expectant father or partner and siblings during a family's pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse is preparing a class for expectant fathers. Which information should the nurse include?
2. Siblings adjust readily to the new baby.
3. Sexual activity is safe for normal pregnancy.
4. The expectant mother decides the feeding method.
5. Fathers are expected to be involved in labor and birth.

Page Ref: 259

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Describe actions the nurse can take to help maintain the well-being of the expectant father or partner and siblings during a family's pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The prenatal period should be used to expose the prospective parents to up-to-date, evidence-based information about which of the following topics?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Breastfeeding
2. Pain relief
3. Obstetric complications and procedures
4. Toddler care
5. Antepartum adjustment

Page Ref: 267

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 4 Identify information that expectant parents may need to assist them in making the best decisions possible about issues related to pregnancy, labor, and birth.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A Navajo client who is 36 weeks pregnant meets with a traditional healer as well as her physician. What does the nurse understand this to mean?
2. The client is seeking spiritual direction.
3. The client does not trust her physician.
4. The client will not adapt well to mothering.
5. The client is experiencing complications of pregnancy.

Page Ref: 261

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. C. 1. Value seeing healthcare situations "through patients' eyes." | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 3 Discuss the significance of cultural considerations in managing nursing care during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A Chinese woman who is 12 weeks pregnant reports to the nurse that ginseng and bamboo leaves help reduce her anxiety. How should the nurse respond to this client?
2. Advise the client to give up the bamboo leaves but to continue taking ginseng.
3. Advise the client to discuss all herbal remedies with the provider.
4. Tell the client that the provider thinks the remedies have no scientific foundation.
5. Assess where the client obtains her remedy, and investigate the source.

Page Ref: 261

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in healthcare. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 3 Discuss the significance of cultural considerations in managing nursing care during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The primiparous client has told the nurse that she is afraid she will develop hemorrhoids during pregnancy because her mother did. Which statement would be best for the nurse to make?
2. "It is not unusual for women to develop hemorrhoids during pregnancy."
3. "Most women don't have any problem until after they've delivered."
4. "If your mother had hemorrhoids, you will get them, too."
5. "If you get hemorrhoids, you probably will need surgery to get rid of them."

Page Ref: 272

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage the patient or designated surrogates in active partnership that promotes health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 6 Identify the common discomforts of pregnancy and their causes.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. Which statement, if made by a pregnant client, would indicate that she understands health promotion during pregnancy?
2. "I lie down after eating to relieve heartburn."
3. "I try to limit my fluid intake to 3 or 4 glasses each day."
4. "I elevate my legs while sitting at my desk."
5. "I am avoiding exercise to stay well rested."

Page Ref: 271

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse is teaching an early pregnancy class for clients in the first trimester of pregnancy. Which statement by a client requires immediate intervention by the nurse?
2. "When my nausea is bad, I will drink some ginger tea."
3. "The fatigue I am experiencing will improve in the second trimester."
4. "It is normal for my vaginal discharge to be green."
5. "I will urinate less often during the middle of my pregnancy."

Page Ref: 271

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Describe the significance of using the nursing process to promote health in the woman and her family during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse assessing a pregnant African American woman in the first trimester understands that a cultural practice is which of the following?
2. Use of herbs like dandelion during pregnancy to increase lactation
3. Drinking ginseng tea for faintness
4. Eating clay to supply dietary minerals
5. Consulting a spiritual advisor to ensure a healthy pregnancy and birth

Page Ref: 262

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in healthcare. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 3 Discuss the significance of cultural considerations in managing nursing care during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. Remedies for back pain in pregnancy that are supported by research evidence and may safely be taught to any pregnant woman by the nurse include which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Pelvic tilt
2. Water aerobics
3. Sit-ups
4. Proper body mechanics
5. Good posture is important because it allows more room for the stomach to function.

Page Ref: 273

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A client in her third trimester of pregnancy reports frequent leg cramps. What strategy would be most appropriate for the nurse to suggest?
2. Point the toes of the affected leg
3. Increase intake of protein-rich foods
4. Limit activity for several days
5. Flex the foot to stretch the calf

Page Ref: 273

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 7. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse in a prenatal clinic finds that four clients have called with complaints related to their pregnancies. Which call should the nurse return first?
2. Pregnant woman at 7 weeks' gestation reporting nasal stuffiness
3. Pregnant woman at 38 weeks' gestation experiencing rectal itching and hemorrhoids
4. Pregnant woman at 15 weeks' gestation with nausea and vomiting and a 15-pound weight loss
5. Pregnant woman at 32 weeks' gestation treating constipation with prune juice

Page Ref: 269

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 6 Identify the common discomforts of pregnancy and their causes.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A 38-year-old client in her second trimester states a desire to begin an exercise program to decrease her fatigue. What is the most appropriate nursing response?
2. "Fatigue should resolve in the second trimester, but walking daily might help."
3. "Avoid a strenuous exercise regimen at your age. Drink coffee to combat fatigue."
4. "Avoid an exercise regimen due to your pregnancy. Try to nap daily."
5. "Fatigue will increase as pregnancy progresses, but running daily might help."

Page Ref: 270

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 8 Delineate self-care actions a pregnant woman and her family can take to maintain and promote well-being during each trimester of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The pregnant client in her second trimester states, "I didn't know my breasts would become so large. How do I find a good bra?" The best answer for the nurse to give would be which of the following?
2. "Avoid cotton fabrics and get an underwire bra; they fit everyone best."
3. "Just buy a bra one cup size bigger than usual, and it will fit."
4. "Look for wide straps and cups big enough for all of your breast tissue."
5. "There isn't much you can do for comfort. Try not wearing a bra at all."

Page Ref: 276

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A pregnant client who swims 3-5 times per week asks the nurse whether she should stop this activity. What is the appropriate nursing response?
2. "You should decrease the number of times you swim per week."
3. "Continuing your exercise program would be beneficial."
4. "You should discontinue your exercise program immediately."
5. "You should consider a less strenuous type of exercise."

Page Ref: 278

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 1 Describe the significance of using the nursing process to promote health in the woman and her family during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse is presenting a class of important "dos and don'ts" during pregnancy, including travel considerations. What method of travel does the nurse recommend as most appropriate for a client in her 25th week of pregnancy?
2. Automobile
3. Airplane
4. Train
5. None; this client should not travel

Page Ref: 259

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 1 Describe the significance of using the nursing process to promote health in the woman and her family during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. After teaching a pregnant client about the effects of smoking on pregnancy, the nurse knows that the client needs further education when she makes which statement?
2. "I am at increased risk for preeclampsia."
3. "I am at increased risk for preterm birth."
4. "I am at increased risk for placenta previa."
5. "I am at increased risk for abruptio placentae."

Page Ref: 284

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 1 Describe the significance of using the nursing process to promote health in the woman and her family during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. Which of the following drugs and drug categories can cause multiple fetal central nervous system (C N S), facial, and cardiovascular anomalies?
2. Category C: Zidovudine
3. Category B: Penicillin
4. Category X: Isotretinoin
5. Category A: Vitamin C

Page Ref: 283

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Promote communication and open reporting as a priority in healthcare. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 4 Identify information that expectant parents may need to assist them in making the best decisions possible about issues related to pregnancy, labor, and birth.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The prenatal client in her third trimester tells the clinic nurse that she works 8 hours a day as a cashier and stands when at work. What response by the nurse is best?
2. "No problem. Your baby will be fine."
3. "Do you get regular breaks for eating?"
4. "Your risk of poor pregnancy outcomes may be higher."
5. "Standing might increase ankle swelling."

Page Ref: 277

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 1 Describe the significance of using the nursing process to promote health in the woman and her family during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The pregnant client has asked the nurse what kinds of medications cause birth defects. Which statement would best answer this question?
2. "Birth defects are very rare. Don't worry; your doctor will watch for problems."
3. "To be safe, don't take any medication without talking to your doctor."
4. "Too much vitamin C is one of the most common issues."
5. "Almost all medications will cause birth defects in the first trimester."

Page Ref: 283

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 1 Describe the significance of using the nursing process to promote health in the woman and her family during pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. Absolute contraindications to exercise while pregnant include which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Abruptio placentae
2. Placenta previa after 26 weeks' gestation
3. Preeclampsia-eclampsia
4. Cervical insufficiency (cerclage)
5. Intrauterine growth restriction (I U G R)

Page Ref: 278

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 4 Identify information that expectant parents may need to assist them in making the best decisions possible about issues related to pregnancy, labor, and birth.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. Intercourse is contraindicated if the pregnancy is vulnerable because of which diagnosis?
2. Gestational diabetes
3. Cervical insufficiency (cerclage)
4. Abruptio placentae
5. Placenta previa

Page Ref: 281

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 9 Identify some of the concerns that an expectant couple may have about sexual activity.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. What self-care measures would a nurse recommend for a client in her first trimester to reduce the discomfort of nausea and vomiting?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Avoid odors or causative factors.
2. Have small but frequent meals.
3. Drink carbonated beverages.
4. Drink milk before arising in the morning.
5. Eat highly seasoned food.

Page Ref: 275

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 8 Delineate self-care actions a pregnant woman and her family can take to maintain and promote well-being during each trimester of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse is preparing material to present to a group of patients in the second trimester of their pregnancies. Which topics should the nurse include in this presentation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Clothing
2. Infant feeding
3. Fetal movement
4. Exercise and rest
5. Skin and breast care

Page Ref: 259

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 5 Explain the basic goals of childbirth education in providing care to expectant couples and their families.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A pregnant patient in the early stages of labor asks for assistance to sit in the whirlpool tub. What are the advantages of using this intervention for the laboring patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Increases relaxation
2. Increases pain threshold
3. Reduces postural hypotension
4. Promotes maternal-infant bonding
5. Reduces the need for pain medication

Page Ref: 265

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning: Nursing Process.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. During a routine health visit the nurse notes that a patient who is 10 weeks pregnant is wearing the following items. On what should the nurse focus when assessing the patient?

1. Heartburn
2. Constipation
3. Hemorrhoids
4. Nausea and vomiting

Page Ref: 270

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment; Nursing Process.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. A patient in the first trimester of pregnancy is experiencing ptyalism. What should the nurse suggest to help this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Use chewing gum
2. Suck on hard candy
3. Snack on soda crackers
4. Use an astringent mouthwash
5. Brush the teeth with baking soda

Page Ref: 271

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 7 Summarize appropriate measures to alleviate the common discomforts of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.

1. The nurse learns that a patient who is 8 weeks pregnant continues to smoke 10 cigarettes a day. In which order should the nurse provide a 5 to 15 minute intervention about smoking with this patient?
2. Ask about tobacco use
3. Advise to quit smoking
4. Assist in attempt to quit
5. Arrange for follow-up care
6. Assess willingness to quit

Page Ref: 284

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 8 Delineate self-care actions a pregnant woman and her family can take to maintain and promote well-being during each trimester of pregnancy.

M N L L O: Demonstrate use of the nursing process in the care of the expectant family.