Maternal-Newborn Nursing Ch 5

Reva Rubin
identified significant maternal tasks women undergo during the course of pregnancy on their journey toward motherhood

Reva Rubin maternal tasks
-ensure safe passage for herself and baby
-ensure social acceptance of the child by significant others
-attachment or binding in to the child
-give oneself to the demands of being a mother

Regina Lederman
identified seven dimensions of maternal role development

7 dimensions of maternal role development
1-acceptance of pregnancy
2-identification with the motherhood role
3-relationship to her mother
4-reorder relationship with her husband or
partner
5-preparation for labor
6-prenatal fear of loss of control in labor
7- prenatal fear of loss of self-esteem in labor

Maternal Adaptation variables
-parity
-maternal age
-sexual orientation
-single parenting
-multiple pregnancies
-socioeconomic factors
-abuse

Pregnancy-Paternal Adaptation
-Announcement Phase
-Moratorium Phase
-Focusing Phase

Couvade Syndrome
men experience pregnancy symptoms such as weight gain, nausea, or abdominal pains

Nuclear Family
father, mother and child living together but apart from all grandparents

Extended Family
three generations including married brothers, sisters and their families

Single Parent Family
divorced, never married, separated or widowed man or woman with at least one child

Three-Generational Families
any combination of first, second, and third generation members living within a household

Dyad Family
couple living alone without children

Stepparent Family
one or both spouses have been divorced or widowed and remarried into a family with at least one child

Blended or Reconstituted Family
combination of two families with children from one or both families and sometimes children of the newly married couple

Cohabiting Family
unmarried couple living together

Gay or Lesbian Family
homosexual couple living together with or without children, children may be adopted, from a previous relationship or conceived via artificial insemination

Eight Stage Life Cycle of a Family
1-Beginning Family
2-Childbearing Family
3-Family with preschool children
4-Family with school aged children
5-Family with teenagers
6-Family launching young adults
7-Middle aged parents
8-Family in retirement

Maternal Maladaptation Signs
-strong intense resistance to pregnancy
-disabling physical symptoms
-quickening experienced as unpleasant
-avoidance of maternity clothes
-denial of need to change in couple relationship
-total avoidance of sexual contact with partner
-avoidance of weight gain
-strong distress about changing pregnant body
-denial of fears about childbirth
-unrealistic expectations about birth
-lack of preparation for infant

Maternal response to pregnancy complications depend on…
-pregnancy condition
-perceived threat to mother or fetus
-coping skills
-available support

Predominant support for pregnant woman is…
spouse or partner and her mother

Prescriptive Behavior
an expected behavior of the pregnant woman during the childbearing period

Restrictive Behavior
activities during the childbearing period that are limited for the pregnant woman

Taboos
cultural restrictions believed to have serious supernatural consequences

Barriers to culturally competent care
-protocols
-strange environment
-health care providers who only speak English
-nurses attitudes and Ethnocentrism

Ethnocentrism
belief that the customs and values of the dominant culture are preferred or superior in some way

Percentage of nurses from racial or ethnic minority
12%

Infant mortality rate twice overall population
African Americans

51% single-parent families with female head of household
African American

remain in bed 40 days after birth
Arab American

husband not expected to participate in birth
Arab American

believe in cold(yin) and hot (yang)
avoid showers 30 days after birth
may omit (hot) prenatal vitamins
Asian Americans

81% of population (dominant culture)
Caucasian/European American

most rapidly growing ethnic group in U.S.
Hispanic

circumcision of male child on 8th day by mohel
Jewish

greater pregnancy risk due to diabetes, alcohol use and smoking
Native American

Crucial questions about cultural practices
Is practice safe?
Is it feasible?
Is it important to the woman?

Cultural Stereotyping
sweeping generalizations about women based on ethnicity

Midwifery
focus on nonintervention care emphasis on normalcy of birth process

LDR
labor delivery and recovery rooms

LDRP
labor delivery recovery and postpartum room

Prenatal education classes began by
American Red Cross in New York City

Birth Plan
tool used by parents to communicate their expectations and desires to care providers

Doula
trained professional provides support but not clinical care

Doula care associated with…
-shorter labors
-decreased need for analgesics
-decreased need for many medical interventions
-increased maternal satisfaction

Safe Home Birth
-woman comfortable with decision
-should be in good health
-hospital 10-15 minute drive away
-woman should be attended by physician or midwife with medical supplies and resuscitation equipment

Signs of maladaptation to pregnancy include
denial of fears about childbirth and unrealistic expectations about birth

Nursing interventions that facilitate adaptation to pregnancy in the first trimester focus on
promoting pregnancy and birth as a family experience

Ambivalent feelings toward pregnancy in the third trimester may indicate
unresolved conflict

Prescriptive behavior is
expected behavior for pregnant women

Measurable outcomes of social support interventions during pregnancy include
improved coping and functional status

When conducting a psychosocial assessment it is important to determine the ____________, ____________, and _________ of mood or emotional disturbances.
frequency, duration, intensity

Which is considered a normal physiologic change during pregnancy? a. ECG T-wave changes b. Increased cardiac output c. Increased bleeding time d. Decreased renal perfusion increased cardiac output Which of the following exercises should be taught to a pregnant woman …

A child, age 14, is hospitalized for nutritional management and drug therapy after experiencing an acute episode of ulcerative colitis. Which nursing intervention would be appropriate? 1. Administering digestive enzymes before meals as prescribed 2. Providing small, frequent meals 3. …

-infants receiving phototherapy (for high bilirubin) need eye shields to protect eyes During phototherapy the unclothed infant is placed under a bank of lights approximately 45 to 50 cm from the light source. The distance may vary based on unit …

After giving birth to a healthy infant boy, a primiparous woman, 16, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is risk for impaired parenting related to deficient knowledge of newborn care. In …

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