Maternal -Newborn Nursing: The Critical Components of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman Chapter 1: Trends and Issues MULTIPLE CHOICE 1. The nurse is caring for a patient who is in labor with her first child. The patient’s mother is present for support and notes that things have changed in the delivery room since she last gave birth in t he early 1980s. Which current trend or intervention may the patient’s mother find most different? 1. Fetal monitoring throughout labor 2. Postpartum stay of 10 days 3. Expectant partner and family in operating room for cesarean birth 4. Hospital support for breastfeed ing ANS: 4 Chapter: Chapter 1 Trends and Issues Chapter Learning Objective: 1. Discuss current trends in the management of labor and birth Page: 4 Heading: Table 1 -1: Past and Present Trends Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Evidence -Based Practice Difficulty: Moderate Feedback 1 This is incorrect. Fetal monitoring during labor began in the late 1970s. As such, this likely would have occurred during the mother’s labor and delivery during the 1980s. 2 This is incorrect. In the past, the average hospital postpartum stay was 10 days. Presently, the average postpartum stay is 48 hours or less. 3 This is incorrect. In the past, expectant partners and families were excluded from the labor and birth experience. Present trends involve the expectant partner and family in the labor and birth experience, including presence in the operating room for cesarean births. 4 This is correct. Hospital support for breastfeeding, including a lactation consultant and employment of the Baby -Friendly Hospital Initiative, were both enacted during the early 1990s. PTS: 1 CON: Evidence -Based Practice 2. A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient’s blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death? 1. Early maternal death 2. Late maternal death 3. Direct obstetric death 4. Indirect obstetric death ANS: 4 Chapter: Chapter 1 Trends and Issues Chapter Learning Objective: 2. Discuss current trends in maternal and infant health outcomes. Page: 7 Heading: Trends > Maternal Death and Mortality Rates Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Application [Applying] Concept: Ante/Intra/Post -partum Difficulty: Hard Feedback 1 This is incorrect. Early maternal death is not an example of maternal death. Examples of maternal death include late maternal death, indirect obstetric death, direct obstetric death, and pregnancy -related death. 2 This is incorrect. Late maternal death occurs 42 days after termination of pregnancy from a direct or indirect obstetric cause. 3 This is incorrect. Direct obstetric death results from complications during pregnancy, labor, birth, and/or postpartum period. 4 This is correct. Indirect obstetric death is caused by a preexisting disease, or a disease that develops during pregnancy. PTS: 1 CON: Ante/Intra/Post -partum 3. The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered full -term. What will be most helpful thing to explain to the patient? 1. Uses of extracorporeal membrane oxygenation therapy (ECMO) 2. Uses of exogenous pulmonary surfactant 3. The Baby -Friendly Hospital Initiative 4. The Safe to Sleep campaign ANS: 4 Chapter: Chapter 1 Trends and Issues Chapter Learning Objective: 3. Identify leading causes of infant death. Page: 7 Heading: Trends > Infant Mortality Rates Integrated Processes: Nursing process Client Need: Safe and Effective Care Environment: Safety and Infection Control Cognitive Level: Application [Applying] Concept: Health Promotion Difficulty: Moderate Feedback 1 This is incorrect. EMCO has been cited as one of the factors that has reduced infant mortality among preterm infants. 2 This is incorrect. Although advances in medical treatments have decreased infant mortality, exogenous pulmonary surfactant is primarily used to reduce mortality of preterm infants. 3 This is incorrect. The Baby -Friendly Hospital Initiative was developed to support breastfeeding and is not directly linked to reduced infant mortality or SIDS. 4 This is correct. The Back to Sleep campaign and the Safe to Sleep campaigns were designed to promote healthy infant sleeping habits. The decrease in SIDS from 1995 to 2015 was attributed to the Safe to Sleep campaign. PTS: 1 CON: Health Promotion 4. The nurse is caring for a 14 -year-old patient who is 32 weeks pregnant. After complaining of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of which condition? 1. Diabetes 2. Blindness 3. Pneumonia 4. Hypertension ANS: 4 Chapter: Chapter 1 Trends and Issues Chapter Learning Objective: 4. Discuss current maternal and infant health issues. Page: 10 Heading: Issues > Teen Pregnancy > Implications of Teen Pregnancy and Birth Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Application [Applying] Concept: Ante/Intra/Post -partum Difficulty: Moderate Feedback 1 This is incorrect. Maternal obesity increases a child’s risk of developing childhood obesity and diabetes. 2 This is correct. Neonatal blindness, maternal death, and neonatal death are all associated with a patient who contracts syphilis during pregnancy. 3 This is incorrect. Chlamydial pneumonia is associated with maternal chlamydia. 4 This is incorrect. Teen mothers may have a higher risk of contracting sexually transmitted illnesses and hypertension during pregnancy; however, maternal syphilis is not associated with fetal hypertension. PTS: 1 CON: Ante/Intra/Post -partum 5. The nurse is caring for a 15 -year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient’s baby at higher risk for? 1. Intestinal problems 2. Neonatal conjunctivitis 3. Blindness 4. Pneumonia ANS: 1 Chapter: Chapter 1 Trends and Issues Chapter Learning Objective: 4. Discuss current maternal and infant health issues. Page: 11 Heading: Issue s > Teen Pregnancy Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Application [Applying] Concept: Health Promotion Difficulty: Difficult Feedback 1 This is correct. Infants born to teen mothers are at increased risk for various conditions related to prematurity, including infant death, intestinal problems, and/or respiratory distress syndrome. 2 This is incorrect. Infants born to teen mothers who have gonorrhea are at increased risk of neonatal conjunctivitis and blindness. 3 This is incorrect. Infants born to teen mothers with syphilis and gonorrhea are at increased risk of blindness. 4 This is incorrect. Infants born to teen mothers with chlamydia may be at increased risk of developing chlamydial pneumonia. PTS: 1 CON: Health Promotion 6. The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, “I do not need to stop smoking my electronic cigarette because it will not harm my baby.” Which is the best response by the nurse? 1. “You are correct. Electronic cigarettes are not harmful during pregnancy.” 2. “Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.” 3. “According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy.” 4. “Electronic cigarettes are considered harmful only in the first trimester.” ANS: 2 Chapter: Chapter 1 Trends and Issues Chapter Learning Objective: 4. Discuss current maternal and infant health issues. Page: 12 Heading: Issues > Tobacco and Electronic Cigarette Use During Pregnancy Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Safety and Infection Control Cognitive Level: Application [Applying] Concept: Ante/Intra/Post -partum Difficulty: Moderate Feedback
