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Table of Contents


Chapter 1	Perinatal Patient Safety and Professional Liability Issues	1
	Leadership	1
	Shared Philosophy of Care	2
	Professional Behavior	2
	Common Areas of Liability and Patient Harm in Clinical Practice	3
	Conflict Resolution	13
	Medical Record Documentation	15
	Incident Management	16
	Methods of Measuring Patient Safety	18
	Perinatal Patient Safety Nurses	25
	Summary	25
Chapter 2	Integrating Cultural Beliefs and Practices When Caring for Childbearing Women and Families	29
	Cultural Frameworks and Cultural Assessment Tools	31
	Practices Associated with Childbearing	34
	Gender Roles	34
	Childbirth Pain and Culture	35
	Major Cultural Groups	35
	Health Differences in Populations of Childbearing Women	43
	Barriers to Culturally Competent Care	44
	Techniques to Integrate Culture into Nursing Care	46
	Summary	53
Chapter 3	Physiologic Changes of Pregnancy	59
	Hormones and Other Mediators	59
	Cardiovascular System	61
	Hematologic Changes	64
	Respiratory System	64
	Renal System	66
	Gastrointestinal System	68
	Metabolic Changes	70
	Endocrine System	71
	Neuromuscular, Sensory, and Integumentary Systems	73
	Reproductive Organs	74
	Immune System	74
	Summary	75
Chapter 4	Psychosocial Adaptation to Pregnancy and Postpartum	78
	Psychosocial Nursing Care	78
	Adaptations During Pregnancy	80
	Adaptations During Labor and Birth	83
	Adaptations in the Postpartum Period	84
	Summary	87
Chapter 5	Antenatal Care	88
	Preconception Care	88
	Prenatal Care	89
	Prenatal Risk Assessment	90
	Ongoing Prenatal Care	104
	Fetal Surveillance	112
	Nursing Assessment and Interventions	113
	Summary	116
Chapter 6	High-Risk Pregnancy	125
	Hypertensive Disorders	125
	Bleeding and Bleeding Disorders in Pregnancy	151
	Preterm Labor and Birth	169
	Diabetes in Pregnancy	189
	Cardiac Disease	207
	Pulmonary Complications	226
	Multiple Gestations	240
	Maternal Transfer	276
	Summary	276
Chapter 7	Labor and Birth	300
	Introduction	300
	Overview of Labor and Birth	300
	Emotional and Physical Support During Labor and Birth	333
	Clinical Interventions for Women in Labor	335
	Vaginal Birth	361
	Cesarean Birth	361
	Summary	375
Chapter 8	Fetal Assessment During Labor	399
	Introduction	399
	Historical Perspectives	399
�	Definitions and Appropriate Use of Terms Describing Fetal Heart Rate Patterns	400
	Techniques of Fetal Heart Rate Monitoring	403
	Physiologic Basis for Fetal Heart Rate Monitoring	407
	Characteristics of the Normal Fetal Heart Rate	412
	Interventions for Nonreassuring Fetal Heart Rate Patterns	413
	Fetal Heart Rate Patterns	416
	Clinical Implications for Monitoring the Preterm Fetus During Labor	426
	Assessment of Pattern Evolution	429
	Ancillary Tests of Fetal Well-Being	431
	Nursing Assessment and Management Strategies	433
	Issues in the Use of Fetal Heart Rate Monitoring During Labor	436
	Summary	437
Chapter 9	Pain Relief and Comfort Measures in Labor	443
	Physiologic Basis of Labor Pain	443
	Physiologic Responses to Pain	444
	Psychosocial Factors Influencing Pain Perception	444
	Nonpharmacologic Pain Management Strategies	450
	Pharmacologic Pain Management Strategies	457
	Summary	469
Chapter 10	Postpartum Care	473
	Planning for the Transition to Parenthood	473
	Anatomic and Physiologic Changes During the Postpartum Period	484
	Individualizing Care for Women with Special Needs	503
	Postpartum Learning-Needs Assessment and Education	506
	Psychological Adaptation to the Postpartum Period	509
	Women�s Perspectives on the Transition to Parenthood	512
	Family Transition to Parenthood	512
	Postpartum Discharge Follow-Up	514
	Evaluation of Postpartum Services	515
	Summary	517
Chapter 11	Newborn Adaptation to Extrauterine Life	527
	Maternal Medical and Obstetric Conditions Influencing Newborn Adaptation	527
	Unique Mechanisms of Newborn Physiologic Adaptation	527
	Apgar Score	536
	Physical Assessment	537
	Newborn Identification	538
	Vitamin K	539
	Eye Prophylaxis	539
	Umbilical Cord Care	541
	Psychological Adaptation	541
	Complications Affecting Transition	542
	Hepatitis B	542
	Summary	543
Chapter 12	Newborn Physical Assessment	546
	Gestational Age Assessment	547
	Skin Assessment	547
	Head Assessment	550
	Eye Assessment	553
	Nose Assessment	556
	Mouth Assessment	556
	Neck Assessment	558
	Chest and Lung Assessment	559
	Cardiovascular Assessment	560
	Abdominal Assessment	562
	Genitourinary System	564
	Musculoskeletal Assessment	566
	Neurological Assessment	570
	Summary	573
Chapter 13	Newborn Nutrition	582
	Incidence of Breastfeeding	582
	Physiology of Milk Production	586
	Biospecificity of Human Milk	587
	Breastfeeding Process	589
	Breastfeeding Management	591
	Potential Breastfeeding Problems	596
	Medications and Breastfeeding	602
	Postpartum Surgery and Breastfeeding	603
	Formula Feeding	603
	Lactation Suppression	605
	Summary	606
Chapter 14	Common Neonatal Complications	612
	Respiratory Distress	612
	Congenital Heart Disease	616
	Hypoglycemia	619
	Hyperbilirubinemia	621
	Neonatal Sepsis	626
	Neonatal Abstinence Syndrome	630
	Human Immunodeficiency Virus	634
	Late-Preterm Infants	636
	Transport and Return Transport	641
	Summary	642
Appendix A	Item Bank Questions and Answer Key	647
	Questions	647
	Answer Key	680
	Index	685