Chapter 1 intro maternity & peds nursing ppt Flashcards
specialties of maternity nursing
prenatal care, labor and delivery, postpartum care, newborn care, neonatal intensive care, women’s health, infertility care.
pediatric nursing involves caring for children between…
birth and 18 years old
focus of pediatric nursing
safety is an important aspect. focus on normal growth and development, acute, chronic, and critical care issues, and end of life and palliative care
nursing manager
wise use of resources, lack of errors in providing care, positive patient feedback
bedside nurse
delivery of safe and effective care
physician/midwife
positive patient response to medications and interventions without complications
quality
the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
ways for nurses to improve quality
work within the scope of practice, utilize standards of care based on evidence based practice, and make sound decisions in providing care.
- deliver family and patient centered care with attention to specific needs, values, and expectations of patient and family.
- identify errors and hazards, implement safety principles
roles in maternal-child and pediatric nursing
- focus on childbearing women, newborn infants, children, and families
- provide patient centered and family centered care
- roles include: lpn, rn, np, cns, cnm, cna
role of LPN in maternal child and pediatric nursing
provides nursing care in multiple settings under RN, NP, physician or midwife
- may help prep patients for pregnancy and delivery
registered nurse role in maternal child and pediatric nursing
- assess, plan, and provide care to include teaching, monitoring the pregnancy through delivery, providing postpartum and newborn care, and caring for pediatric patients across developmental period
nurse practitioner role in maternal child and pediatric nursing
- passed a certification exam
- prescribe medications
- emphasis on contraception, fertility problems, pre pregnancy care, pregnancy care, postpartum care, lactation problems, newborn care, and menopause care
- pediatric NPs care for children across the developmental period
clinical nurse specialist role in maternal child and pediatric nursing
- RN who obtained an advanced degree in clinical preparation with an MSN level with a focus on education, management, and research roles relative to patient care
certified nurse midwife role in maternal child and pediatric nursing
- MSN or DNP passed certification exam in pregnancy and delivery
- provides care through pregnancy, labor, delivery, and postpartum
- prescribes medications
- has hospital privileges to deliver babies
legalities and ethics
- be aware of state laws regarding care
- nurses who do not meet expected standards can be held legally responsible
- adhere to the scope of practice
delegation
delegator must know scope of practice of person carrying out task
- delegator assumes responsibility for appropriateness of delegated activity
use 3 steps to determine if task is appropriate for delegation
- clarify what the specific activity/task is by defining all aspects of issue
- review legal standards of task
- decide if the above elements support or reject the delegated action or task
standards of care
model of established practice as correct way to provide care
- guidelines used to determine nursing actions
- identifies knowledge, skills, attitude, and judgment needed
- Association of Women’s health, obstetric, and Neonatal nurses established standards for maternity care
- Society of Pediatric Nurses establishes standards for care of children and families
institution policies
- nurses held accountable for upholding agency or healthcare institution policies
evidence based practice
- nursing care in which all interventions are based on current and valid research evidence
- nursing research in practice at the bedside
- uses scientific studies to answer why interventions should be changed when providing care
informed consent
patient understands and accepts risks and benefits of procedure
- 18 years or older
- written consent must be signed by hcp and adult pt before procedure/treatment
- children: legal caregiver, parent or guardian signs consent
assent
feedback from child more than 7 years of age regarding medical treatment
- includes child in decision making process
- child is asked if she/he has any questions or concerns
- not all children are developmentally ready
emancipation of a minor
- grants adult rights to a child of age and appropriate developmental level
- minor is able to process complex information related to decisions in health care and medical treatments
- married pregnant teenager: automatic emancipation
- unmarried pregnant teenager: not emancipated
children have the right to
provisions, protection, and participation
children’s right to provisions
provisions of safe living, health care, education, clean water, appropriate diets, adequate rest, sleep, play, and recreation
children’s right to protection
protected from abuse, exploitation, neglect, discrimination at home, school, community areas, and health care institutions
children’s right to participation
offered full participation in community activities, art, sports, cultural events
families are entitled to protected rights including….
- right to full participation in healthcare discussions and decision making concerning the child
- right to active participation in cultural beliefs and practices whenever possible
- right to visitation and family participation in the treatment and care of the child
- right to comfort by having pain and discomfort addressed and treated promptly
- right to have interpretation services by a translator when a language barrier exists
- right to personal dignity and privacy during assessments, diagnostics, procedures, and treatments
- right to receive emergency treatment regardless of the ability to pay
- right to be free of restraints or seclusion unless clinically necessary
- right to refuse care provided by students
- right to decline to participate in research programs or projects
ethics
- moral principles that guide a person’s behavior
- concerned with right/wrong
- American Nurses Association Code of Ethics is used to guide nursing practice
- fairness, honesty, and respect for human beings are important in maternity and pediatric settings
autonomy
right to have control of body and make decisions
beneficence
spirit of compassion and kindness to benefit others
- balance the benefits of treatment against the risks and costs
nonmaleficence
“do no harm”
inflict the least possible harm to reach a beneficial outcome
justice
fairness for individuals, groups, organizations, and communities
- fair allocation of services and resources
ethical issues a nurse may encounter
- abortion
- pregnant mother smoking, drinking alcohol, using illicit drugs
- patient wanting elective c section
- provision of futile care or an extremely premature newborn
- a young adolescent with no family support leaving hospital with a newborn
- infertility treatment that is expensive and not successful
- a teenager with aggressive cancer who wants to be allowed to die
- a homeless child living in a car with his family being discharged with a new diagnosis of asthma
- a child with type 1 diabete4s being cared for by a mother who has dual mental health diagnoses
overarching goals of family centered care
- empowerment: interaction between family and hcp where family maintains sense of control over their lives
- enabling: providing opportunities for family members to master the child’s care
- families should be encouraged to be present with the child whenever possible
- siblings are to be included
therapeutic communication
- nurses support autonomy, allowing patients to make their own decisions
- help clarify patient’s values and viewpoints
special considerations in pediatric nursing
- children are not little adults
- there are anatomical and physiological differences between children and adults
anatomic and physiological differences between children and adults
- airways anatomically small
- nose breathers for first several weeks
- heads disproportionately large
- large posterior head bone occiput
- poorly developed intercostal chest muscles
- less lung tidal volume
- larger body surface area
- less total circulating blood volume
- high glucose needs
- relatively healthy cardiovascular system
- immature temperature regulation
- immature immune system
- challenges in assessment and treatment of the six human symptoms
by adolescence, differences lessen compared with adults
- how child is affected by trauma/injuries
- child’s physical illnesses in relation to severity
- child’s rapid rate of decompensation
- blood pressure changes demonstrate late sign of shock
- slower rate of metabolism of medications
