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A Comprehensive Textbook of Midwifery & Gynecological Nursing
Annamma Jacob
SECTION I: MIDWIFERY
CHAPTER 1:
Historical Review
STUDY QUESTIONS
Short Notes
CHAPTER 2:
Development of Maternity Services and Current Trends
CURRENT TRENDS
Trends
Changing Patterns of Childbirth and their Effects on Maternal-infant Mortality Statistics
Perinatal Risk Factors
Technological Advances
Current Problems
Decreased Length of Hospital Stay
Higher Patient Acuities
Lack of Facilities in the Rural Areas
Changes in Maternal Newborn Nursing
Family-centered Care
Labor, Delivery, Recovery and Postpartum Care
Mother-baby Couplet Care
STUDY QUESTIONS
Short Answer Questions
CHAPTER 3:
Midwife: Definition of the Term, Roles and Responsibilities
DEFINITION
DEVELOPMENT OF MIDWIFERY EDUCATION IN INDIA
Skills of the Midwife
Responsibilities of the Midwife
STUDY QUESTIONS
Short Notes
CHAPTER 4:
Nursing Process in Maternal-newborn Care
ASSESSMENT
Collecting Data
Database
Types of Data
Sources of Data
Data Collection Methods
Observing
Interviewing
Examining
Validating Data
Documenting Data
DIAGNOSIS
Definition
Types of Nursing Diagnoses
Components of a NANDA Nursing Diagnosis
Problem and Definition (Diagnostic Label)
Etiology (Related Factors and Risk Factors)
Defining Characteristics
Differentiating Nursing Diagnoses from Medical Diagnoses
Diagnostic Process
Formulating Diagnostic Statements
Avoiding Errors in Diagnostic Reasoning
Guidelines for Writing Nursing Diagnostic Statements
PLANNING
Types of Planning
Initial Planning
Ongoing Planning
Discharge Planning
Developing Nursing Care Plans
Standardized Approaches to Care Planning
Standardized Care Plans
Formats for Nursing Care Plan
Guidelines for Writing Nursing Care Plans
Planning Process
Setting Priorities
Establishing Desired Outcomes/Client Goals
Purposes of Desired Outcomes/Goals
Guidelines for Writing Desired Outcomes/Goals
Computerized Care Plans
Nursing Interventions
TYPES OF NURSING INTERVENTIONS
Writing Nursing Orders
IMPLEMENTING
Relationship of Implementing to Other Phases of Nursing Process
Implementing Skills
Process of Implementing
Reassessing the Client
Determining the Nurse's Need for Assistance
Implementing the Nursing Interventions
Supervising Delegated Care
Documenting Nursing Activities
EVALUATING
Relationship of Evaluating to Other Nursing Process Phases
Process of Evaluating
Collection of Data
Comparing Data with Outcomes
Relating Nursing Activities to Outcomes
Drawing Conclusions About Problem Status
Continuing, Modifying and Terminating the Nursing Care Plan
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
SECTION II: REPRODUCTIVE SYSTEM
CHAPTER 5:
Female Pelvis and Generative Organs
PELVIS
Innominate Bone
Sacrum
Coccyx
Pelvic Joints
Pelvic Ligaments
True Pelvis
Pelvic Brim
Pelvic Cavity
Pelvic Outlet
False Pelvis
Pelvic Inclination
TYPES OF PELVIS (FIG. 5.8)
Gynecoid Pelvis (50%)
Justo Minor Pelvis
Android Pelvis (20%)
Anthropoid Pelvis (20%)
Platypelloid Pelvis (5%)
OTHER PELVIC VARIATIONS
High Assimilation Pelvis
Deformed Pelvis
Muscles and Fascia
Pelvic Floor
Functions
Nerve Supply
Perineal Body
Evaluation of Pelvis
GENERATIVE ORGANS
External Genitalia (Vulva) (Fig. 5.10)
Mons Pubis or Mons Veneris
Labia Majora (Greater lips)
Labia Minora (lesser lips)
Clitoris
Vestibule
Blood Supply
Lymphatic Drainage
Nerve Supply
Internal Genital Organs
Vagina
Uterus (Fig. 5.11)
Uterine Tubes
Ovaries
Accessory Reproductive Organs
Breasts
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 6:
Hormonal Cycles
OVARIAN CYCLE
Graafian Follicle (Fig. 6.1)
Ovulation
Corpus Luteum
Hormonal Control (Fig. 6.2)
Prolactin
Ovarian Hormones
MENSTRUAL CYCLE
Phases
Early Proliferative Phase
Late Proliferative Phase
Secretory Phase
Premenstrual Phase
Menstrual Phase
Clinical Aspects of Menstruation
Menarche and Puberty
Menopause and Climacteric
Normal Menstrual Cycle
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 7:
Male Reproductive System
PARTS OF MALE REPRODUCTIVE SYSTEM
Scrotum
Testes
Spermatic Cord
Ejaculatory Ducts
Prostate Gland
Penis
MALE HORMONES
FORMATION OF THE SPERMATOZOA
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
SECTION III: EMBRYOLOGY AND FETOLOGY
CHAPTER 8:
Fertilization, Implantation and Development of the Fertilized Ovum
FERTILIZATION
Development of Fertilized Ovum (Fig. 8.1)
IMPLANTATION
Postimplantation Changes in the Uterus
DEVELOPMENT OF THE FERTILIZED OVUM (FIG. 8.3)
Trophoblast
Inner Cell Mass
Embryo
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 9:
Development of the Placenta and Fetus
DEVELOPMENT OF THE PLACENTA (FIG.9.1
Circulation Through the Placenta (Fig. 9.3)
Mature Placenta
Functions of the Placenta
Respiration
Nutrition
Storage
Excretion
Protection
Endocrine
Mechanisms for Transfer of Materials
AMNIOTIC FLUID
Constituents
Source
Volume
UMBILICAL CORD (FIG. 9.5)
VARIATIONS, ANOMALIES AND ABNORMALITIES OF PLACENTA
VARIATIONS, ANOMALIES AND ABNORMALITIES OF THE UMBILICAL CORD AND ITS INSERTION
DEVELOPMENT OF THE FETUS (FIG. 9.11)
First Trimester
Second and Third Trimester
Fourth Month (13–16 Weeks)
Fifth Month (17–20 Weeks)
Sixth Month (21–24 Weeks)
Seventh Month (25–28 Weeks)
Eighth Month (29–32 Weeks)
Ninth Month (33–36 Weeks)
37 to 40 Weeks
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 10:
Fetal Organs and Circulation
FETAL ANATOMY
Blood
Urinary Tract
Liver
Alimentary Tract
Lungs
Central Nervous System
Skin
FETAL CIRCULATION (FIG. 10.1)
Characteristics
Structures
Pattern of Altered Blood Flow
Normal Circulatory Changes at Birth
Closure of the Umbilical Arteries
Closure of the Ductus Arteriosus
Closure of the Umbilical Vein
Closure of the Ductus Venosus
Closure of Foramen Ovale
STUDY QUESTIONS
Short AnswerQuestions
Essay Question
CHAPTER 11:
Fetal Skull
BONES OF THE VAULT
Two Frontal Bones
Two Parietal Bones
Occipital Bone
SUTURES
FONTANELS
Anterior Fontanel or Bregma
Posterior Fontanel
REGIONS OF THE FETAL SKULL (FIG. 11.2)
LANDMARKS OF THE SKULL
DIAMETERS OF THE FETAL SKULL (FIG. 11.4)
Attitude of the Fetal Head
Presenting Diameters
Vertex Presentation
Brow Presentation
Face Presentation
MOLDING
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
SECTION IV: NORMAL PREGNANCY
CHAPTER 12:
Physiological Changes Due to Pregnancy
CHANGES IN THE REPRODUCTIVE SYSTEM
Body of Uterus
Changes in Uterine Shape
Decidua
Myometrium
Muscle Layers (Fig. 12.1)
Blood Supply
Fallopian Tubes
Cervix
Vagina
CHANGES IN THE CARDIOVASCULAR SYSTEM
Heart
Blood Volume
Plasma Protein
Iron Metabolism
Clotting Factors
White Blood Cells
Immunity
CHANGES IN THE RESPIRATORY SYSTEM
CHANGES IN THE URINARY SYSTEM
CHANGES IN THE GASTROINTESTINAL SYSTEM
CHANGES IN METABOLISM
MATERNAL WEIGHT CHANGES
SKELETAL CHANGES
SKIN CHANGES
BREAST CHANGES
CHANGES IN THE ENDOCRINE SYSTEM
Placental Hormones
Pituitary Hormones
Thyroid Function
Adrenal Glands
CHANGES IN THE NERVOUS SYSTEM
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 13:
Diagnosis of Pregnancy
DIAGNOSIS OF PREGNANCY
Presumptive Signs
Probable Signs
Positive Signs
Uterine Enlargement
Other Signs of Pregnancy
Fetal Contributions to the Diagnosis of Pregnancy
Anatomic
Hormonal Pregnancy Tests
Pregnancy Test Kits for Home Use (Figs 13.1A to D)
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 14:
Minor Disorders in Pregnancy
DIGESTIVE SYSTEM
Nausea and Vomiting
Heartburn
Excessive Salivation
Pica
Constipation
MUSCULOSKELETAL SYSTEM
Backache
Cramps
GENITOURINARY SYSTEM
Frequency of Micturition
Leukorrhea
CIRCULATORY SYSTEM
Fainting
Varicosities
Edema
INTEGUMENTARY SYSTEM
Skin
NERVOUS SYSTEM
Carpal Tunnel Syndrome
Insomnia
DISORDERS THAT REQUIRE IMMEDIATE ACTION
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 15:
Antenatal Care
MEANING
OBJECTIVES
ANTENATAL VISITS
INITIAL EXAMINATION
Health History
Family History
Menstrual History
Obstetric History
Gravida
Para
Present Pregnancy
Physical Examination
Review of Systems
Assessments and Laboratory Tests
General Assessments
Urinalysis
Blood Tests
Abdominal Examination
INSPECTION
Measurements of the Fundal Height (Table 15.1 and Fig. 15.1)
First Method
Second Method
Third Method (Fig. 15.3)
ABDOMINAL PALPATION AND LEOPOLD'S MANEUVERS
Inspection of the Abdomen
Leopold's Maneuvers (Figs 15.4A to D and Table 15.4)
Auscultation (Fig. 15.5)
Other Findings
Gestational Age
Lie
Presentation
Attitude
Denominator
Position
Engagement
PELVIC EXAMINATION
ONGOING ANTENATAL CARE
Nursing Process for the Antenatal Mother
Step 1: Collection of the Database
Step 2: Interpretation of Database
Step 3: Development of a Comprehensive Plan of Care
Risk Factors
Record Keeping
Indicators of Fetal Well-being
Preparation for Labor
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 16:
Specialized Investigations and Fetal Evaluation in the Antenatal Period
ULTRASONOGRAPHY
Diagnostic Uses in Obstetrics
AMNIOCENTESIS ANDAMNIOTIC FLUID STUDIES
Reasons for Amniocentesis
Technique of Amniocentesis
Diagnostic Studies Possible with Amniotic Fluid
ALPHA-FETOPROTEIN TESTING
AMNIOSCOPY AND FETOSCOPY
ESTRIOL LEVEL DETERMINATION
FETAL BLOOD SAMPLING (CORDOCENTESIS)
FETAL EVALUATION PROCEDURES
Fetal Movement
Non-stress Test
Contraction Stress Test
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
SECTION V: NORMAL LABOR
CHAPTER 17:
Physiology of the First Stage of Labor
DEFINITION OF LABOR
Normal Labor
Three P's of Normal Labor
STAGES OF LABOR
First Stage
Latent Phase
Active Phase
Transition Phase
Second Stage
Third Stage
Fourth Stage
SIGNS AND SYMPTOMS OF IMPENDING LABOR
Lightening
Cervical Changes
False Labor
Premature Rupture of Membranes
Bloody Show
Energy Spurt
Gastrointestinal Upsets
CAUSES FOR THE ONSET OF LABOR
PHYSIOLOGICAL PROCESSES IN THE FIRST STAGE OF LABOR
Uterine Action
Fundal Dominance
Polarity
Contraction and Retraction (Fig. 17.1)
Formation of Upper andLower Uterine Segments
Retraction Ring
Cervical Action
Cervical Effacement
Cervical Dilatation
Ripening of the Cervix
Mechanical Factors that Contribute to the Progress of Labor in the First Stage
Formation of the Forewaters (Fig. 17.5)
General Fluid Pressure
Rupture of the Membranes
Fetal Axis Pressure
Descent of the Presenting Part
INITIAL ASSESSMENT AND DIAGNOSIS
History
Age
Gravida and Para
Physical Examination
Vital Signs
Physical Measurements
Fetal Heart Tones
Contraction Pattern
Engagement
Estimated Fetal Weight and Fundal Height
Lie, Presentation, Position and Variety
Edema of Extremities
Pelvic Examination/Vaginal Examination
Effacement and Dilatation
Position of the Cervix
Station
Whether or not the Membranes have Ruptured
VAGINAL EXAMINATION FOR THE WOMAN IN LABOR
Purposes
Procedure
Findings
Condition of the Vagina
Cervix
Level or Station of the Presenting Part
Identity of the Presentation
Position
Molding
Completion of the Examination
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 18:
Management of the First Stage of Labor
ADMISSION TO LABORAND DELIVERY UNIT
Enema
Perineal Shave
Food and Fluid by Mouth
Intravenous Infusion
Position and Ambulation
Medication
Woman's Desire for Medication
Timing of Medication
Fetal Size
Fetal Condition
Maternal Size
Woman's Response to Support in Labor
Need for Medication
Monitoring Maternal Physiological Changes
Vital Signs
Renal System
Gastrointestinal Changes
Hematological Changes
Monitoring of Fetal Well-being
CONTINUING CARE AND EVALUATION
Evaluation of Maternal Well-being
Vital Signs
Bladder Care
Urine Testing
Hydration
Evaluation of Fetal Well-being
External Monitoring (Fig. 18.1)
Internal Monitoring (Fig. 18.3)
Nursing Care of the Monitored Patient
Evaluation of the Progress of Labor
Vaginal Examination
Screening for Maternal andFetal Complications
Interpretation ofCardiotocograph Recordings
Fetal Blood Sampling
Observation of Amniotic Fluid
Fetal Distress
Bodily Care of the Woman
Keeping Clean and Dry
Mouth Care
Back Rub
Abdominal Rub
Effleurage
Alleviation of Leg Cramps
Supportive Care of the Woman and her Significant Others
Use of Physical Touch
Significant Others
RECORDS
PARTOGRAPH (FIG. 18.9)
Definition
Principal Features
Purposes
Use of Partograph
Patient Information
Fetal Condition
Progress of labor
Maternal Condition
NURSING PROCESS DURING THE FIRST STAGE OF LABOR
Assessment
Nursing History (On Admission)
Physical Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 19:
Physiology of the Second Stage of Labor
PHYSIOLOGICAL PROCESSES
Descend
Uterine Action
Rupture of Membranes
Soft Tissue Displacement
PRESUMPTIVE SIGNS OF SECOND STAGE AND DIFFERENTIAL DIAGNOSIS
Expulsive Contractions
Rupture of Membranes
Dilatation, Gaping of Anusand Perineal Bulging
Progressive Visibility of theFetal Head at the Introitus
Congestion of the Vulva
MATERNAL PHYSIOLOGICAL CHANGES IN THE SECOND STAGE
Blood Pressure
Metabolism
Pulse Rate
Temperature
Gastrointestinal Changes
Renal and Hematological Changes
MECHANISM OF NORMAL LABOR
Positional Movements (Figs 19.1A to G)
Engagement
Descend
Flexion
Internal Rotation of the Head
Crowning
Birth of the Head
Restitution
Internal Rotation of Shoulders
External Rotation of the Head
Birth of the Shoulders andBody by Lateral Flexion
Degrees of Internal Rotation in Transverse and Posterior Positions
Curve of Carus
Summary of Mechanisms in Left Occipitoanterior Position (Figs 19.2A to H)
Principles
FETAL NORMALITY DURING THE SECOND STAGE
DURATION OF THE SECOND STAGE
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 20:
Management of the Second Stage of Labor
EVALUATION OF MATERNALWELL-BEING
Vital Signs
Bladder Care
Hydration and General Condition
Maternal Pushing Effort
Analgesia and Anesthesia
Local Infiltration
Pudendal Block
Lumbar Epidural Block
Perineal Integrity
EPISIOTOMY
Indications
Types of Episiotomies (Fig. 20.1)
Midline or Median
Mediolateral Episiotomy
Principles
Perineal Tears
Anterior Labial Tears
Posterior Perineal Trauma
EVALUATION OF THE FETAL WELL-BEING
EVALUATION OF THE PROGRESS OF LABOR
BODILY AND SUPPORTIVE CARE OF THE WOMAN
Breathing
Pushing
PREPARATION FOR DELIVERY
Location of the Delivery
Positions for the Delivery
General Preparation
CONDUCTING THE DELIVERY
Delivery of the Baby's Head
Delivery of the Head Between Contractions
Ritgen's Maneuver
Management of a Nuchal Cord
Delivery of the Shoulders
Clamping and Cutting the Umbilical Cord
Immediate Care of the Newborn
RECORDS
NURSING PROCESS DURING THE SECOND STAGE OF LABOR
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 21:
Physiology and Management of the Third Stage of Labor
PHYSIOLOGICAL PROCESSES OF PLACENTAL SEPARATION AND EXPULSION
Placental Separation
Descend of the Placenta
Expulsion of the Placenta
Hemostasis
MANAGEMENT OF THE THIRD STAGE OF LABOR
Delivery of the Placenta and Membranes
Expectant Management
Assisted Expulsion
Use of Oxytocic Agents
Prophylactic Use
Therapeutic Administration
Fundal Height During Third Stage
Completion of the Third Stage
Examination of Placenta and Membranes
Assessment of the Placenta
Immediate Care to Mother and Baby
Records
COMPLICATIONS OF THE THIRD STAGE
Postpartum Hemorrhage
Primary Postpartum Hemorrhage
Clinical Features
Prophylaxis
Management
Observations of the Mother Following Postpartum Hemorrhage
Secondary Postpartum Hemorrhage
Clinical Manifestations
Management
Hematoma Formation
NURSING PROCESS DURING THE THIRD STAGE
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 22:
Management of the Fourth Stage of Labor
EVALUATION AND INSPECTION
Evaluation of the Uterus
Hemostasis
Inspection of the Cervix and Upper Vaginal Vault
Inspection and Evaluation of the Placenta, Membranes and Umbilical Cord
Repairs
Perineal Cleansing and Positioning of Legs
CONTINUING CARE AND MONITORING
Vital Signs
Palpation of the Fundus of Uterus for Contractility
Massage of the Uterus and Expression of Clots
Measurement of the Fundus
Inspection of the Perineum
Inspection of the Bladder (Fig. 22.3)
Inspection and Change of Perineal Pad
Fluids and Food
USE OF OXYTOCIC DRUGS
Determination of the Need
Action and Effect
Dosage and Route
SUMMARY OF POSTPARTUM MANAGEMENT
NURSING PROCESS DURING THE FOURTH STAGE OF LABOR
Assessment
Nursing Diagnosis
Planning
Implementation
Evaluation
STUDY QUESTIONS
Essay Question
SECTION VI: NORMAL PUERPERIUM
CHAPTER 23:
Physiology and Management of the Normal Puerperium
DEFINITION
DURATION
ANATOMICAL AND PHYSIOLOGICAL CHANGES OF THE PUERPERIUM
Uterus
Cervix
Lochia
Vagina and Perineum
Breasts
Physiology of Lactation
Milk Production
Stimulation of Lactation
Care and Preparation of the Nipple
Suppression of Lactation
GENERAL PHYSIOLOGICAL CHANGES
Vital Signs
Renal System Changes
Gastrointestinal Changes
Weight Loss
Fluid Loss
Abdominal Wall
Hematologic Changes
Menstruation and Ovulation
MANAGEMENT OF EARLY PUERPERIUM
Immediate Attention
Rest and Ambulation
Diet
Perineal Care
Care of the Bladder
Care of the Bowel
Sleep
Care of the Breasts
Uterus and Involution
Rooming-in or Bedding-in
Immunization
Monitoring and Charting of Postpartum Events
Postpartum Exercises
CONTINUING PHYSICAL ASSESSMENT AND DAILY CARE
Breasts
Uterus
Assessment of Fundus
Management of Bleeding
Assessment of Uterine Pain
Bladder
Bowels and Gastrointestinal System
Lochia
Episiotomy
Extremities
Homans’ Sign (Fig. 23.2)
Prevention of Thrombophlebitis
Emotional Status
OTHER ASSESSMENTS
Hemodynamic Status
Integumentary System
Musculoskeletal System
Activity
Exercise
Pain Management
Sexuality
Contraception
Immune System
Documentation
Discharge Preparation
DISCOMFORTS OF THE PUERPERIUM AND RELIEF MEASURES
Afterbirth Pains
Excessive Perspiration
Breast Engorgement
Relief Measures for Non-breastfeeding Mothers
Relief Measures for Breastfeeding Mothers
Perineal (Stitch) Pain
Constipation
Hemorrhoids
BREASTFEEDING DIFFICULTIES AND MANAGEMENT
Preparation for Mother
Preparation for Baby
Positioning
Establishing Lactation
Breast Care
GUIDANCE AND INSTRUCTIONS IN PREPARATION FOR HOME CARE
Self
Self in Relation to Others
Baby
NURSING PROCESS DURING THE PUERPERIUM
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 24:
Family Planning
MAGNITUDE OF THE PROBLEM
Impact of Population Increase
FAMILY PLANNING
Definition
Basic Human Rights
Modern Concept of Family Planning
Health Aspects of Family Planning
Women's Health
Fetal Health
Child Health
Small Family Norm
Objectives of Family Planning Program in India
Conception Control
Maternity and Child Health Services
Other Services
Birth Control, Contraception and Family Planning
Role of the Midwife in Family Planning
TEMPORARY METHODS OF CONTRACEPTION
Barrier Methods
Male Condom
Female Condom (Femshield) (Fig. 24.1)
Diaphragm (Figs 24.2A and B)
Vaginal Contraceptives
Natural Contraception
Rhythm Method
Coitus Interruptus
Breastfeeding
Contraceptive Effectiveness of Conventional Methods of Contraception
Intrauterine Contraceptive Devices
Types of IUD
Description of Devices
Mode of Action of IUDs
Time of Insertion
Follow-up and Client Instructions
Side Effects and Complications
Indications for Removal of IUD
Advantages of Third Generation IUDs over the Others (Cu T-380A, ML Cu 375, LNG-IUS)
Disadvantages of Third Generation IUDs
Steroidal/Hormonal Contraceptives
Gonadal Steroids
Classification of Hormonal Contraceptives
PERMANENT METHODS (STERILIZATION)
Guidelines for Sterilization
Vasectomy or Male Sterilization
Advantages
Drawbacks
Selection of Candidates
Postoperative Advices
Complications
No-scalpel Vasectomy (Figs 24.7 and 24.8)
Open-ended Vasectomy
Female Sterilization
Methods of Tubal Ligation
Timing for Tubal Ligation
Advantages of Female Sterilization
Disadvantages or Possible Problems
Failure Rate
POSTCONCEPTION METHODSOF BIRTH CONTROL(TERMINATION OF PREGNANCY)
Menstrual Regulation
Menstrual Induction
Abortion
Abortion Hazards
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
SECTION VII: ABNORMALITIES OF PREGNANCY, LABOR AND PUERPERIUM
CHAPTER 25:
Abnormalities of Early Pregnancy
ABORTION
Classification
Definition
SPONTANEOUS ABORTION
Causes
Types
Threatened Abortion (Fig. 25.2)
Inevitable Abortion (Fig. 25.3)
Incomplete Abortion (Fig. 25.4)
Complete Abortion (Fig. 25.5)
Missed Abortion
Habitual Abortion
INDUCED ABORTION
Medical Termination of Pregnancy (Legal Abortion)
Provisions for MTP Under the MTP Act
Indications for MTP
Conditions to be Met Prior to the Procedure
Methods of Termination in the First Trimester
Second Trimester Terminations (up to 20 week)
SEPTIC ABORTION
Causes
Clinical Manifestations
Treatment
NURSES’ ROLE WITH PATIENTS UNDERGOING ABORTION
Nursing Process for Clients with Abortion
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
ECTOPIC PREGNANCY/ECTOPIC GESTATION
Tubal Pregnancy
Causes
Physiology
Outcomes (Figs 25.7A to C)
Clinical Presentation
Treatment
Abdominal Pregnancy
Cervical Pregnancy
Nursing Process for Clients with Ectopic Pregnancy
Assessment
Analysis/Nursing Diagnosis
Implementation
Evaluation
HYDATIDIFORM MOLE
Incidence
Pathology
Complete Hydatidiform Mole
Partial Mole
Clinical Features
Investigations
Possible Complications
Treatment
CHORIOCARCINOMA
Nursing Process for Clients with Hydatidiform Mole
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
HYPEREMESIS GRAVIDARUM
Causes
Clinical Presentation
Complications
Treatment
Nursing Process for Clients with Hyperemesis
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
RH ISOIMMUNIZATION AND ABO INCOMPATIBILITY
Investigations
RETROVERSION OF THE GRAVID UTERUS
Incarceration of the Retroverted Gravid Uterus
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 26:
Sexually Transmissible and Reproductive Tract Infections
EXTENT OF THE PROBLEM IN INDIA
Syphilis
Gonorrhea
Chancroid
Chlamydia Infections
Donovanosis
Other STDs
HOST FACTORS
Age
Sex
Marital Status
Socioeconomic Status
Social Factors
Prostitution
Broken Homes
Sexual Disharmony
Easy Money
Emotional Immaturity
Urbanization and Industrialization
Social Disruption
International Travel
Changing Behavioral Patterns
Social Stigma
RELEVANCE FOR WOMEN
CONTROL OF STDS
Case Detection
Screening
Contact Tracing
Cluster Testing
Case Holding and Treatment
Epidemiological Treatment
Personal Prophylaxis
Contraceptives
Health Education
FUNGAL INFECTIONS
Clinical Presentation and Diagnosis
Treatment
Female
Male
Instructions
PROTOZOAL INFECTIONS
Clinical Presentation and Diagnosis
Treatment
BACTERIAL INFECTIONS
Bacterial Vaginosis
Presentation, Diagnosis and Treatment
Chlamydial Infection
Presentation and Diagnosis
Treatment
Group B Streptococcus
Treatment of GBS Colonization in Pregnancy
Gonococcal Infection
Effects of Gonococcal Infection in Pregnancy
Manifestations of Gonococcal Infection in Pregnant Women
Diagnosis
Screening
Treatment
Syphilis
Early Infectious Stage
Late Non-infectious Stage
Congenital Syphilis
Treatment
VIRAL INFECTIONS
Herpes Simplex Virus (HSV)
Presentation of Infection with HSV
Management of HSV in Pregnancy
Cytomegalovirus
Infection in Pregnancy
Hepatitis B Infection
Transmission
Diagnosis
Screening
Management
Rubella (German Measles)
Diagnosis
Signs
Genital Warts
Acquired Immunodeficiency Syndrome in Pregnancy
Incidence in India
Mode of Transmission
HIV Infection in Pregnancy
Clinical Presentation
Diagnosis of HIV Infection
Management
Nursing Process for Pregnant Women with AIDS
STUDY QUESTIONS
Short Answer Questions
CHAPTER 27:
Disorders of Pregnancy
DEFINITION
TYPES
PLACENTA PREVIA
Definition
Incidence
Causes
Dropping Down Theory
Multiple Pregnancies
Defective Decidua
Degrees of Placenta Previa (Fig. 27.1)
Predisposing Factors
Signs of Placenta Previa
Risk to Mother and Fetus
Diagnosis
Management
Possible Complications
Summary of Nursing Process Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
ABRUPTIO PLACENTAE
Definition
Types of Placental Abruption
Revealed
Concealed
Mixed
Causes
Grading of Placental Abruption
Grade 1
Grade 2
Grade 3
Signs and Symptoms
Diagnosis
Management
Possible Complications
Nursing Care
Summary of Nursing Process
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
DISSEMINATED INTRAVASCULAR COAGULATION
Etiology
Obstetric Conditions, Which may Precipitate Disseminated Intravascular Coagulation
Management
Nursing Care
POLYHYDRAMNIOS (HYDRAMNIOS)
Causes
Types
Signs and Symptoms
Diagnosis
Complications
Management
OLIGOHYDRAMNIOS
Causes
Complications
Clinical Signs and Symptoms
Diagnosis
Management
Summary of Nursing Process
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
STUDY QUESTIONS
Short Answer Questions
Essay Questions
CHAPTER 28:
Hypertensive Disorders of Pregnancy
PREGNANCY-INDUCED HYPERTENSION
Preeclampsia
Definition
Incidence
Etiology
Pathophysiology
Clinical Classification of Preeclampsia
Clinical Features
Alarming Symptoms and Signs
Effects on the Fetus
Complications
Preventive Measures
Management and Nurse's Role
Treatment
Indications for Induction
Management of Labor
Puerperium
Acute Fulminant Preeclampsia
HELLP Syndrome
Eclampsia
Incidence
Pathophysiology
Onset of Convulsions
Eclamptic Convulsions
Management
Complications of Eclampsia
Prevention
Future Management
Summary of Nursing Process
Gestational Hypertension
CHRONIC HYPERTENSION IN PREGNANCY
Diagnosis
Complications
Essential Hypertension in Pregnancy
Diagnosis
Effects of Pregnancy on the Disease
Management
Summary of Nursing Process for Pregnant Women with Hypertension
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 29:
Medical Disorders Associated with Pregnancy
CARDIAC DISEASE
Changes in Cardiovascular Dynamics During Pregnancy and their Effects on Heart Lesion
Gradings
Rheumatic Heart Disease
Mitral and Aortic Valve Incompetence
Mitral Stenosis
Congenital Heart Disease
Risk to Mother and Fetus
Antenatal Care
Diagnosis
Assessment
General Management
Principles
Preconception Care and Advice
Place of Therapeutic Termination
Management
Hospitalization
Intrapartum Care
First Stage of Labor
Second Stage of Labor
Third Stage of Labor
Place of Cesarean Section
Puerperium
Summary of Nursing Process
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
RESPIRATORY DISORDERS
Pulmonary Tuberculosis
Effects on the Woman
Management
Antenatal Care
Intrapartum Care
Postnatal Care
Contraception
DIABETES MELLITUS
Carbohydrate Metabolism in Pregnancy
Glycosuria in Pregnancy
Causes of Glycosuria in Pregnancy
Gestational Diabetes
Detection of Diabetes in Pregnancy
Effects of Diabetes on Pregnancy
Effect of Pregnancy on Diabetes
Effects on the Fetus
Overt Diabetes
Classification of Pregnant Diabetics
Management
Preconceptional Counseling
Principles of Management
Antenatal Care
Hospitalization
Termination of Pregnancy
Management of Labor and Delivery
Postnatal Care
Care of the Baby
Contraception
Summary of Nursing Process
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
THYROID DYSFUNCTION IN PREGNANCY
Hyperthyroidism
Diagnosis
Treatment
Preconceptional Counseling
Hypothyroidism
Diagnosis
Antenatal Care
Postnatal Care
Postpartum Thyroiditis
ANEMIA IN PREGNANCY
Classification of Anemia
Physiological Anemia of Pregnancy
Erythropoiesis
Causes of Increased Prevalence of Anemia in the Tropics
Iron Requirements in Pregnancy
Routine Screening for Anemia
IRON DEFICIENCY ANEMIA
Causes
Signs and Symptoms
Effects of Anemia on the Mother
Effects of Anemia on the Fetus/Baby
Investigations
Prevention of Iron Deficiency Anemia
Management
Prophylaxis
Curative Management
Oral Iron
Side Effects of Oral Iron
Parenteral Iron
Intramuscular Iron
Blood Transfusion
Management During Labor
First Stage
Second Stage
Third Stage
Puerperium
FOLIC ACID DEFICIENCY ANEMIA (MEGALOBLASTIC ANEMIA)
Causes
Clinical Features and Diagnosis
Effects of Megaloblastic Anemia
Management
VITAMIN B12 DEFICIENCY
HEMOGLOBINOPATHIES
SICKLE CELL DISORDERS
Sickle Cell Trait
Sickle Cell Disease
Diagnosis
Effects on Pregnancy
Effects of Pregnancy on the Disease
Management
Preconceptional Counseling
During Pregnancy
During Labor
Postnatal Care
THALASSEMIA SYNDROMES
Alpha Thalassemia Major
Beta Thalassemia Major
Alpha and Beta Thalassemia Minor
RENAL PROBLEMS IN PREGNANCY
Asymptomatic Bacteriuria
Acute Pyelonephritis
Manifestations
Investigations
Effects on Pregnancy
Treatment
CHRONIC RENAL DISEASE
Examples of Pre-existing Renal Diseases
Management
AUTOIMMUNE DISEASES
Systemic Lupus Erythematosus
Effects of Pregnancy on SLE
Effects on Pregnancy
Investigation
Management
Intrapartum Care
Postnatal Care
IDIOPATHIC THROMBOCYTOPENIC PURPURA
Diagnosis
Effects of ITP on Pregnancy and the Fetus
Antenatal Care
Intrapartum Care
Postnatal Care
EPILEPSY IN PREGNANCY
Management
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 30:
Multiple Pregnancy
INCIDENCE
TWIN PREGNANCY
Varieties of Twins
Genesis of Twins
Etiology
Rare Forms
Determination of Zygosity
Examination of Placenta and Membranes
Sex
Genetic Features (Dominant Blood Group)
Diagnosis of Twin Pregnancy
History
Symptoms
General Examination
Abdominal Examination
Investigations
Duration of Pregnancy
Effects of Pregnancy
Maternal
Effects on Fetus
Antenatal Management
Advice
Hospitalization
Management During Labor
During the First Stage of Labor
Management of Delivery (Second Stage)
Management of the Third Stage
Indications for Cesarean Section
Associated Causes
Fetal Causes
Complications Associated with Multiple Pregnancy
Polyhydramnios
Fetal Abnormality
Malpresentations
Premature Rupture of Membranes
Prolapse of the Cord
Prolonged Labor
Monoamniotic Twins
Locked Twins
Delay in the Birth of the Second Twin
Premature Expulsion of the Placenta
Postpartum Hemorrhage
Undiagnosed Twins
Management of Postnatal Period
Care of the Babies
Care of the Mother
TRIPLETS AND HIGHER ORDER BIRTHS
DISABILITY AND BEREAVEMENT
EMBRYO REDUCTION/ SELECTIVE REDUCTION
Selective Feticide
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 31:
Preterm Labor, Premature Rupture of Membranes and Intrauterine Fetal Death
PRETERM LABOR
Definition
Causes
History
Complications in Previous Pregnancy
Presentation of the Woman
Objectives of Management
Management Approaches
Prevention
Preventive Measures
Investigations
To Arrest Preterm Labor
Short-term Therapy
Long-term Therapy
Management of Preterm Labor
First Stage
Second Stage
Immediate Management of the Preterm Baby Following Birth
Support for the Mother
PREMATURE RUPTURE OF MEMBRANES
Definition
Incidence
Causes
Manifestations
Risks of PROM
Management
Term PROM
Preterm PROM
INTRAUTERINE FETAL DEATH
Etiology
Pregnancy Complications
Pre-existing Medical Diseases and Acute Illnesses during Pregnancy
Fetal Causes
Iatrogenic
Idiopathic
Signs and Symptoms
Investigations
Complications
Prevention
Management
Expectant Management (Noninterference)
Interference
Bereavement Management
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 32:
Post-term Pregnancy, Induction of Labor, Prolonged Labor and Disorders of Uterine Action
POST-TERM PREGNANCY
Incidence
Etiology
Diagnosis
Menstrual History
Clinical Findings
Clinical Presentation for Retrospective Diagnosis
Dangers of Post-term Pregnancy
During Pregnancy
During Labor
Following Birth
Management of Post-term Pregnancy
Expectant Management
Elective Induction
Care During Labor
INDUCTION OF LABOR
Indications for Induction
Maternal Indications
Fetal Indications
Combined Indications
Contraindications to Induction of Labor
Dangers of Induction
Maternal
Fetal
Methods of Ripening of the Cervix
Assessment of the Cervix
Methods of Induction
Medical Induction
Surgical Induction
Combined Method
PROLONGED LABOR
Causes of Prolonged Labor
First Stage
Second Stage
Diagnosis
First Stage
Second Stage
Dangers of Prolonged Labor
Fetal
Maternal
Management
Prolonged Second Stage of Labor
Management of a Prolonged Second Stage
Options for Delivery
Maternal Distress
DISORDERS OF UTERINE ACTION
Precipitate Labor (Over-efficient Uterine Action)
Maternal Risks
Fetal Risks
Management
Cervical Dystocia
Management
Generalized Tonic Contraction (Uterine Tetany)
Causes
Clinical Manifestations
Treatment
Tonic Uterine Contraction and Retraction (Bandl's Ring)
Clinical Features
Prevention
Management
Constriction Ring (Contraction Ring)
Diagnosis
Management
Obstructed Labor
Causes
Signs of Obstructed Labor
Management of Obstructed Labor
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 33:
Malpositions and Malpresentations
OCCIPITOPOSTERIOR POSITION
Postulated Causes of Occipitoposterior Positions
Palpation
Auscultation
Vaginal Examination
Course of Labor
Mechanisms of Labor in Occipitoposterior Position
Mechanism of Labor in Right Occipitoposterior Position
Mechanism of Labor with Posterior Rotation of the Occiput
FACE PRESENTATION
Causes
Diagnosis of Face Presentation
Mechanisms of Labor
Engagement
Extension
Descent Occurs Throughout
Mentum Anterior Position
Restitution
Internal Rotation of the Shoulders
External Rotation of the Head
Birth of the Shoulders andBody by Lateral Flexion
Midwifery Management of a Face Presentation
Possible Complications
Obstructed Labor
Cord Prolapse
Facial Bruising
Cerebral Hemorrhage
Maternal Trauma
BROW PRESENTATION
Causes
Diagnosis
Abdominal Palpation
Vaginal Examination
Management
BREECH PRESENTATION
Positions of Breech Presentation
Types of Breech Presentation (Figs 33.7A to D)
Breech with Extended Legs (Frank Breech)
Complete Breech
Footling Breech
Knee Presentation
Diagnosis
Antenatal Diagnosis
Auscultation
Diagnosis During Labor
External Cephalic Version
Method
Complications
Contraindications
Assessment for Vaginal Delivery
Mechanism of Labor for Left Sacroanterior Position
Types of Breech Delivery
Management of Delivery
Delivery of the Shoulders
Delivery of the Head
Delivery of Extended Legs
Complications of Breech Presentation
SHOULDER PRESENTATION
Causes
Maternal Causes
Fetal Causes
Diagnosis
Antenatal
Intrapartum
Possible Outcome
Management
In the Antenatal Period
In the Intrapartum Period
COMPOUND PRESENTATION
SHOULDER DYSTOCIA
Incidence
Risk Factors
Warning Signs and Diagnosis
Management
Other Manipulative Procedures
McRoberts Maneuver
Suprapubic Pressure
Rubin's Maneuver
Wood's Maneuver
Zavanelli Maneuver
Complications Following Shoulder Dystocia
Maternal Complications
Fetal Complications
UNSTABLE LIE
Causes
Management
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 34:
Obstetric Operations
DILATION AND EVACUATION
One-stage Operation
Indications
Preparation for the Operation
Procedure
Two-stage Operation
Indications
Procedure
Dangers of Dilation and Evacuation Operation
Immediate Dangers
Late Dangers
FORCEPS DELIVERY
Basic Construction of the Forceps (Fig. 34.2)
Types of Currently Used Obstetric Forceps
Long Curved Obstetric Forceps
Short Curved Forceps (Wrigley's Forceps)
Kielland's Forceps
Classification According to the Level of the Fetal Head at which the Forceps are Applied
Indications of Forceps Operation
Prerequisites for Forceps Delivery
Preparation of the Woman
Procedure
Procedure of Low Forceps Operation
Manual Rotation of the Fetal Head Followed by Midforceps Operation
Difficulties in Forceps Operation
Causes of Failure
Complications of Forceps Operation
In the Mother
In the Infant
Prophylactic Forceps (Elective)
Trial Forceps
Failed Forceps
Causes for Failed Forceps
Management
VACUUM EXTRACTION (VENTOUSE DELIVERY)
Equipment
Indications
Advantages of Ventouse over Forceps
Advantages of Forceps over Ventouse
Contraindications for Ventouse
Conditions to be Fulfilled
Procedure (Fig. 34.7)
Step 1: Application of the Cup
Step 2: Traction
Silicone/Silastic Rubber Cup (Fig. 34.8)
Complications
Fetal
Maternal
Failure
CESAREAN SECTION
Incidence
Indications for Cesarean Section
Elective Cesarean Section
Emergency Cesarean Section
Contraindications
Types of Operations
Lower Segment Cesarean Section
Classical Cesarean Section
Preparation of the Mother
Psychological Preparation
Physical Preparation
Procedures in Cesarean Section
Anesthesia
Position
Incision on the Abdomen
Delivery of the Head
Delivery of the Trunk
Removal of the Placenta and Membranes
Suturing of the Uterine Wound
Postoperative Care
Immediate Care (4–6 Hours)
First 24 Hours
After 24 Hours
Complications of Cesarean Section
Cesarean Hysterectomy
DESTRUCTIVE OPERATIONS (EMBRYOTOMIES)
Craniotomy
Indications
Sites of Perforation
Procedure
Decapitation
Indications
Procedure
Evisceration
Indications
Cleidotomy
Postoperative Care FollowingDestructive Operations
Complications
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 35:
Obstetric Emergencies
VASA PREVIA
Diagnosis
Management
PRESENTATION AND PROLAPSE OF THE UMBILICAL CORD (Figs 35.1A and B)
Incidence
Predisposing Factors
Malpresentations
Prematurity
Multiple Pregnancy
Polyhydramnios
High Head
Multiparity
Diagnosis
Occult Prolapse
Cord Presentation
Cord Prolapse
Risks to Mother and Fetus
Maternal
Fetal
Management of Cord Presentation
Management of Cord Prolapse
Immediate Action
Definitive Management
DYSTOCIA CAUSED BY FETAL ANOMALIES
Fetal Macrosomia (Generalized Fetal enlargement)
Shoulder Dystocia
Hydrocephalus
Diagnosis
Management
Outcome
Neural Tube Defects
Anencephaly
Diagnosis
Complications
Management
Prevention
Enlargement of Fetal Abdomen
Conjoined Twins
AMNIOTIC FLUID EMBOLISM
Predisposing Factors
Clinical Features
Emergency Management
Complications
Effect on the Fetus
SHOCK
Classification of Shock
Hypovolemic Shock
Septic Shock
RUPTURE OF UTERUS
Definition
Rupture During Pregnancy
Rupture During Labor
Scar Rupture
Causes of Rupture of the Uterus
Signs of Intrapartum Rupture of the Uterus
Signs of Incomplete Rupture
Management
BASIC LIFE SUPPORT/ CARDIOPULMONARY RESUSCITATION
Sequence of Basic Life Support
Circulation
Airway (Figs 35.4A to C)
Breathing
When to Stop CPR
Summary of the Sequence of BLS
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 36:
Complications of Third Stage of Labor
POSTPARTUM HEMORRHAGE
Definition
Incidence
Classification
Causes
Atonic Uterus
Traumatic Hemorrhage in Third Stage
Blood Coagulation Disorders
Signs of Postpartum Hemorrhage
Prophylaxis
Antenatal
During Labor
Management of Third Stage Bleeding
Manual Removal of Placenta (Figs 36.1 and 36.2)
Observation of the Mother Following Third Stage Hemorrhage
PRIMARY POSTPARTUM HEMORRHAGE
Principles
Immediate Measures
Management Steps
Step 1
Step 2
Step 3: Bimanual Compression (Fig. 36.3)
Step 4: Hot Intrauterine Douche
Step 5: Tight Intrauterine Packing
Last Step: Hysterectomy
Prognosis
Breaking of the Cord
SECONDARY POSTPARTUM HEMORRHAGE
Causes
Clinical Features
Management
Supportive Therapy
Conservative Therapy
Active Management
Nursing Considerations
RETAINED PLACENTA
Causes
Signs of Retained Placenta
Dangers
Management
Hour-glass Contraction
Morbid Adherent Placenta
Complications Accompanying Retained Placenta and Management
PLACENTA ACCRETA
Diagnosis
Management
INVERSION OF THE UTERUS
Classification of Inversion (Figs 36.4A to C)
Causes
Spontaneous (40%)
Induced (60%)
Dangers
Diagnosis (Signs and Symptoms)
Management
Before Shock Develops
After Shock Develops
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 37:
Injuries to the Birth Canal
LACERATIONS OF PERINEUM
Injuries to Vulva
Perineal Tears/Lacerations
Classification
Prevention
Management
Repair
Aftercare
Vaginal Tears
Management
Colporrhexis
Cervical Tears
Causes
Signs
Management
PELVIC HEMATOMAS
Anatomical Types
Infralevator Hematoma
Supralevator Hematoma
RUPTURE OF THE UTERUS
Definition
Classification of Rupture
Scar Rupture and Dehiscence
Complete and Incomplete Rupture
Spontaneous and Traumatic Rupture
Risk Factors
Signs and Symptoms
Management
Nursing Care
Once a Rupture is Diagnosed
VISCERAL INJURIES
Injury to Bladder
Causes
Clinical Manifestations
Management
Injury to the Rectum
Injury to the Urethra
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 38:
Complications of Puerperium
PUERPERAL PYREXIA
Causes
PUERPERAL SEPSIS
Definition
Conditions that Favor the Development of Sepsis
Predisposing Factors of Puerperal Sepsis
Antepartum Factors
Intrapartum Factors
Organisms
Mode of Infection
Pathology
Clinical Features
Local Infection
Uterine Infection
Severe Infection
Parametritis
Pelvic Peritonitis
General Peritonitis
Thrombophlebitis
Septicemia
Investigations
Prevention
Antenatal
Intrapartum
Postpartum
Treatment
Surgical Treatment
Nursing Process for Mothers with Puerperal Sepsis
Assessment
Analysis/Nursing Diagnosis
Planning
Implementation
Evaluation
SUBINVOLUTION OF THE UTERUS
Causes of Subinvolution
Predisposing Factors
Aggravating Factors
Clinical Features
Management
BREAST COMPLICATIONS
Breast Engorgement
Symptoms
Preventive Measures
Management
Cracked
Causes
Treatment
Retracted Nipple
Acute Mastitis
Clinical Features
Treatment
Breast Abscess
Failing Lactation
Causes
Treatment
VENOUS THROMBOSIS
Causes
Types
Superficial Vein Thrombosis
Deep Vein Thrombosis
Thrombophlebitis
PULMONARY EMBOLISM
Signs and Symptoms
Small Pulmonary Embolism
Major Pulmonary Embolism
Diagnostic Procedures
Treatment and Management
PSYCHOLOGICAL DISTURBANCES IN THE PUERPERIUM
Postpartum Blues
Postpartum Depression
Causes
Diagnosis
Management
Puerperal Psychosis
Diagnosis
Treatment
Prognosis
Role of the Midwife
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
SECTION VIII: NORMAL NEONATE
CHAPTER 39:
Baby at Birth
EXTRAUTERINE ADAPTATION
Respiratory Changes
Circulatory Changes
Other Systems
Thermal Regulation
IMMEDIATE CARE OF THE BABY AT BIRTH
Initial Care
Clearing the Airway
Clamping and Cutting the Cord
Identification
Evaluation of the Newborn at Birth
Prevention of Heat Loss (Fig. 39.4)
NORMAL CHARACTERISTICS AND PHYSICAL FEATURES OF A HEALTHY NEWBORN
Posture
Skin
Head
Face
Neck
Trunk
Genitalia
Extremities
Temperature
Urine
Stool
Hematological Findings
INITIAL ASSESSMENT OF THE NEWBORN
General Appearance
Measurements
Activity
Color
Skin
Head
Eyes
Nose
Ears
Mouth
Neck
Chest
Abdomen
Genitalia
Male
Female
Back
Anus
Upper Extremities
Arms
Hands
Lower Extremities
Feet
Neurologic Examination
Cardiovascular Examination
Failure to Establish Respiration at Birth
Causes of Respiratory Depression in the Neonate
RESUSCITATION OF THE NEWBORN
Rationale for Resuscitation
Degrees of Resuscitation (Fig. 39.10)
Supplies and Equipments
Suctioning Equipments
Bag and Mask Equipments
Intubation Equipments
Medications
Miscellaneous
Initial Steps
Preventing Heat Loss
Positioning
Suctioning
Evaluation
Bag and Mask Ventilation/Positive Pressure Ventilation (Figs 39.12A to C)
Indications
Procedure
Evaluation
Signs of Improvement
Chest Compressions
Indications
Procedure
Endotracheal Intubation
Indications
Procedure
Medications
Changes Recommended in the 2010 AHA Guidelines for Neonatal Resuscitation
Anticipation of the Need to Resuscitate: Elective Cesarean Section
Assessment of Heart Rate, Respiratory Rate and Oxygenation
Supplementary Oxygen Administration
Suctioning
Compression-to-ventilation Ratio
Delayed Cord Clamping
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 40:
Physiology, Screening, Daily Care and Observation of the Newborn
PHYSIOLOGY
Respiratory System
Cardiovascular System
Thermal Regulation
Renal System
Gastrointestinal System
Reproductive System
Musculoskeletal System
Immunological Adaptations
Neurological System
Moro Reflex or Embracing Reflex (Fig. 40.1)
Tonic Neck Reflex (Fig. 40.2)
Palmar Reflex/Grasp Reflex (Fig. 40.3)
Plantar Reflex (Fig. 40.4)
Walking/Stepping Reflex (Fig. 40.5)
Reflexes of the Eyes
Reflexes of the Mouth
Body Reflex
Special Senses and Behavior Pattern
Vision
Hearing
Smell and Taste
Touch
Sleeping and Waking
Crying
Growth and Development
PHYSICAL EXAMINATION (SCREENING)
GESTATIONAL AGE ASSESSMENT
Assessment of Neuromuscular Maturity
Assessment of Physical Maturity
DAILY CARE AND OBSERVATION OF THE NEWBORN
Check Vital Signs
Weight
General Changes in Color and Activity
Feeding Status
Head
Mouth
Umbilical Cord
Elimination
Bath
Parent-infant Interaction
Vaccination and Immunization
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 41:
Infant Feeding
BREASTS AND LACTATION
PROPERTIES AND COMPONENTS OF BREAST MILK
Fat
Lactose
Protein
Fat-soluble Vitamins
Water-soluble Vitamins
Minerals and Trace Elements
Anti-infective Factors
MANAGEMENT OF BREASTFEEDING
Antenatal Preparation
Commencement of Breastfeeding
Preparation and Position of the Mother
Preparation and Position of the Baby
Helping the Mother to Begin
Feeding Behaviors
Timing and Frequency of Feeding
Care of the Breasts
Benefits of Breastfeeding
To the Mother
To the Baby
Volume of the Feed
Difficulties in Breastfeeding and Management
Difficulties due to Mother
Difficulties due to Baby
Contraindications to Breastfeeding
Underfeeding and Overfeeding
Features of Underfeeding
Features of Overfeeding
Suppression of Lactation
Complementary and Supplementary Feeds
Baby-friendly Hospital Initiative
ARTIFICIAL FEEDING
Indications of Artificial Feeding
Food Used
Cow's Milk
Dried Milk
Preparation of the Mother for Artificial Feeding
WEANING FROM THE BREAST
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 42:
Low Birth Weight, Preterm and Intrauterine Growth Retarded Babies
DEFINITION
INCIDENCE OF LOW BIRTH WEIGHT
‘SMALL FOR GESTATIONAL AGE’ TERM INFANT
Clinical Appearance
Causes of Intrauterine Growth Retardation
Management at Birth
Feeding
Temperature Control
Skin Care
PRETERM BABY
Incidence
Causes of Prematurity
Multiple Pregnancy
Maternal Disease in Pregnancy
Previous Obstetric History
Low Socioeconomic and Nutritional Status
Uterine Anomalies
Infections
Chronic Diseases
Fetal Causes
Clinical Appearance
Risks Associated with Prematurity
Asphyxia
Hypothermia
Pulmonary Problems
Cerebral Hemorrhage
Infection
Jaundice
Anemia
Retrolental Fibroplasia(Retinopathy of Prematurity)
Care of the Preterm Baby at Birth
Principles of Care
Body Temperature
Respiratory Support
Prevention of Infection
Nutritional Needs
Feeding Methods
Tube Feeding or Gavage
Dropper or Spoon Feeding
Bottle Feeding
Intravenous Fluid Therapy
Nature of Food
Skin Care
Promotion of Growth and Development
Kangaroo Care
Favorable Signs of Progress
Advice to Mother on Discharge
INTRAUTERINE GROWTH RESTRICTION
Incidence
Types of IUGR Fetuses
Causes of IUGH
Maternal
Fetal
Placental
Physical Features of the Baby at Birth
Neonatal Complications
Immediate Care of the Baby at Birth
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
SECTION IX: ILL BABY
CHAPTER 43:
Recognizing the III Baby
INTRODUCTION
ASSESSMENT OF GESTATIONAL AGE
Maternal Conditions, Which can Affect the Newborn
Factors Related to Labor and Delivery, Which may have Effects on the Newborn
WARNING SIGNS
Pallor
Cause of Anemia
Causes of Pallor other than Anemia
Plethora
Cyanosis
Jaundice
Other Factors that Affect the Appearance of the Skin
Skin Rashes
Infectious Lesions
Respiratory System
Body Temperature
Normal Body Temperature Range for Term Infants
Hyperthermia
Cardiovascular System
Central Nervous System
Neurological Disorders
Genitourinary System
Common Causes of Reduced Urinary Output
Gastrointestinal Tract
Vomiting and Diarrhea
Duodenal Atresia
Malrotation of the Gut
Volvulus
Meconium Ileus
Necrotizing Enterocolitis
Imperforate Anus
Rectal Fistulas
Hirschsprung's Disease
Metabolic Disorders
NURSING MANAGEMENT OF THE HOSPITALIZED NEWBORN AND THE FAMILY
Involvement of Parents of the Hospitalized Baby
CONCLUSION
STUDY QUESTIONS
Short Notes
Short Answer Questions
CHAPTER 44:
Respiratory Problems of the Newborn
ANATOMY AND PHYSIOLOGY OF THE RESPIRATORY SYSTEM
Differences in Anatomy and Physiology Between the Baby and Adult
CLINICAL SIGNS OF RESPIRATORY PROBLEMS
CAUSES OF RESPIRATORY PROBLEMS
Infection
Generalized Infection
Congenital or Acquired Pneumonia
Aspiration
Meconium Aspiration
Other Aspiration Problems
Lung Immaturity
Respiratory Distress Syndrome/Hyaline Membrane Disease
Transient Tachypnea of the Newborn
Pneumothorax
Congenital Problems
Upper Airway Problems
Lower Airway Problems
Central Nervous System Disorders
Cardiovascular and Circulatory Problems
Patent Ductus Arteriosus
Persistent Pulmonary Hypertension of the Newborn/Persistent Fetal Circulation
Structural Heart Defects
Apnea of Prematurity
PRINCIPLES OF CARING FOR A BABY WITH RESPIRATORY PROBLEM
Positioning
Observation
Oxygenation
Ambient or Head Box Oxygen
Nasal Cannula
Mechanical Ventilation
Nutrition and Hydration
Basic Physical Care Needs
Meeting the Emotional and Psychological Needs of the Baby and Family
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 45:
Birth Trauma, Hemorrhage and Convulsions
TRAUMA DURING BIRTH
Trauma to Skin
Trauma to Superficial Tissues
Caput Succedaneum (Figs 45.1A to C)
Other Injuries
Muscle Trauma
Torticollis
Nerve Trauma
Facial Nerve Palsy
Brachial Palsy
Bone Trauma
Clavicle Fracture
Humerus Fracture
Femur Fracture
Skull Fracture
Treatment
DISLOCATIONS
VISCERAL INJURIES
HEMORRHAGE
Hemorrhage Due to Trauma
Cephalohematoma (Figs 45.4A and B)
Subaponeurotic Hemorrhage (Fig. 45.5)
Subdural Hemorrhage
Hemorrhage Due to Hypoxia
Subarachnoid Hemorrhage
Periventricular or Intraventricular Hemorrhage
Hemorrhage Related to Coagulopathies
Hemorrhagic Disease of the Newborn
Thrombocytopenia
Disseminated Intravascular Coagulation
Inherited Coagulation Factor Deficiencies
Hemorrhage Related to Other Causes
Umbilical Hemorrhage
Hematemesis and Melena
Hematuria
PREVENTION OF TRAUMA IN THE NEWBORN
Antenatal Period
Intranatal Period
Preterm Delivery
Instrumental Delivery
Vaginal Breech Delivery
CONVULSIONS IN THE NEWBORN
Manifestations
Types of Neonatal Convulsions
Subtle Convulsions
Tonic Convulsions
Multifocal Clonic Convulsions
Myoclonic Convulsions
Causes of Convulsion in the Newborn
Investigations
Management
Control of Convulsions
Treatment of the Underlying Pathology
Observation and Recording
Managing Parents
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 46:
Congenital Abnormalities, Genetic Screening and Genetic Counseling
CAUSES OF CONGENITALAB NORMALITIES
Chromosome Abnormalities and Genetic Disorders
Teratogenic Causes
Multifactorial Causes
Unknown Causes
COMMON MALFORMATIONS AND SYNDROMES OF GASTROINTESTINAL TRACT
Gastroschisis and Exomphalos
Atresias
Esophageal Atresia
Duodenal Atresia
Rectal Atresia and Imperforate Anus
Pyloric Stenosis
Cleft Lip and Cleft Palate
Pierre Robin Syndrome
ABNORMALITIES RELATING TO RESPIRATORY SYSTEM
Diaphragmatic Hernia
Choanal Atresia
Laryngeal Stridor
CONGENITAL CARDIAC DEFECTS
Detection of Cardiac Defects
Cyanotic Cardiac Defects
Acyanotic Cardiac Defects
CENTRAL NERVOUS SYSTEM ABNORMALITIES
Anencephaly
Spina Bifida Aperta
Meningocele
Meningomyelocele
Spina Bifida Occulta
Hydrocephalus
Microcephaly
MUSCULOSKELETAL DEFORMITIES
Polydactyly and Syndactyly
Limb Reduction Anomalies
Talipes Equinovarus
Talipes Calcaneovalgus
Congenital Hip Dysplasia
Streeter's Dysplasia
ABNORMALITIES OF THEGENITOURINARY SYSTEM
Hypospadias and Epispadias
Cryptorchidism
Ambiguous Genitalia
Intersex
GENETIC DISORDERS
Autosomal Dominant Gene Disorders
Autosomal Recessive Disorders
X-linked Disorders
Duchenne's Muscular Dystrophy
Glucose-6-phosphate Dehydrogenase Deficiency
Hemophilia A
Lesch-Nyhan Syndrome
CHROMOSOMAL ABNORMALITIES
Numerical Abnormalities of Autosomes
Trisomy 21 or Down Syndrome
Trisomy 18 or Edwards’ Syndrome
Trisomy 13 or Patau Syndrome
Potter Syndrome
Numerical Abnormalities of the Sex Chromosomes
47,XXY (Klinefelter's Syndrome)
47,XYY (Jacob's Syndrome)
45,XO (Turner's Syndrome)
47,XXX (Triple X Females)
Structural Chromosomal Abnormalities
46,XX or XYB (5p- or Cri-du-chat/ Cat's Cry Syndrome)
Fragile X Syndrome
Chromosome Instability Syndrome
GENETIC SCREENING
Purposes
Timings of Genetic Disorders
Candidates for Genetic Screening
Detection Tests
Management of ‘At Risk’ Couples
GENETIC COUNSELING
Stages of Counseling Interview
Prenatal Diagnosis for Genetic Counseling
Trisomy Profile Test
Nuchal Translucency on Intravaginal Ultrasonography
Midtrimester Amniocentesis
Chorionic Villi Sampling
NURSING IMPLICATIONS
STUDY QUESTIONS
Short Notes
Short Answer Questions
CHAPTER 47:
Jaundice and Infections in the Newborn
JAUNDICE
Formation of Bilirubin
Excretion of Bilirubin
Complications of Hyperbilirubinemia
Kernicterus (Bilirubin Toxicity)
Types of Jaundice
Physiological Jaundice/Icterus Neonatorum
Pathological Jaundice
Management of Jaundice
Assessment and Diagnosis
Risk Factors
Laboratory Evaluation
Treatment
Phototherapy (Fig. 47.2)
Exchange Transfusion
Drug Therapy
HEMOLYTIC DISEASES OF THE NEWBORN
Rhesus Incompatibility
Effects on the Fetus
Management
ABO Incompatibility
NEONATAL INFECTIONS
Natural or Innate Immunity
Acquired Immunity
Modes of Acquiring Infection
Organisms in Newborn Infection
Management of Infection in the Baby
Prevention
Assessment and Diagnosis
Treatment of Infection
Infections Acquired Before or During Birth
Toxoplasmosis
Rubella
Cytomegalovirus Infection
Herpes Simplex Virus
Acquired Immunodeficiency Syndrome
Varicella Zoster Virus
Chlamydia Infection
Hepatitis B Virus
Syphilis
Gonococcal Infections
Ophthalmia Neonatorum
Candida Infections
Infections Acquired After Birth
Skin Infections
Omphalitis
Respiratory Infections
Gastrointestinal Infections
Urinary Tract Infections
Meningitis
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 48:
Metabolic and Endocrine Disorders in the Newborn
INBORN ERRORS OF METABOLISM
Common Features of IEM
Possible Indicators of IEM
Diagnosis of IEM
PHENYLKETONURIA
Clinical Features
Diagnosis
Management
GALACTOSEMIA
G6PD DEFICIENCY
CYSTIC FIBROSIS
THYROID PROBLEMS
Congenital Hypothyroidism
Clinical Presentation
Diagnosis and Treatment
ACQUIRED METABOLIC DISORDERS
Hypoglycemia
Etiology
Clinical Signs of Hypoglycemia
Management of Hypoglycemia
Hyperglycemia
Electrolyte Imbalance
Hypernatremia
Hyponatremia
Hypocalcemia
Hypercalcemia
Diarrhea in Newborn
Causes
Clinical Features
Dietetic Causes of Diarrhea (Noninfective)
Treatment of Infective Diarrhea
Vomiting in Newborn
Causes of Vomiting
Treatment
Drug or Substance Withdrawal
Neonatal Abstinence Syndromeor Withdrawal Signs
Treatment
Fetal Alcohol Syndrome
Characteristics of Babies with FAS
Management
STUDY QUESTIONS
Short Answer Questions
Essay Questions
SECTION X: COMMUNITY MIDWIFERY
CHAPTER 49:
Preventive Obstetrics and Domiciliary Care in Maternity Nursing
ANTENATAL CARE
Objectives
Antenatal Visits
PRENATAL CARE
Preventive Services for Mothers in the Prenatal Period
Risk Approach
Home Visits
Prenatal Advice
Diet
Personal Hygiene
Drugs
Radiation
Warning Signs
Childcare
Specific Health Protection
Other Nutritional Deficiencies
Tetanus Protection
Syphilis
German Measles
Rh Status
Infections of HIV
Prenatal Genetic Screening
Mental Preparation
Family Planning
INTRANATAL CARE
Objectives
Domiciliary Care
Advantages of the Domiciliary Midwifery Service
Disadvantages
Preparation for Home Delivery
Equipments for Conducting Home Delivery
POSTNATAL CARE
Breastfeeding
Family Planning
Health Education
STUDY QUESTIONS
Short Answer Question
Essay Questions
CHAPTER 50:
Primary Health Care and Maternal/Child Health Services in India
HEALTH CARE
Levels of Health Care
Primary Care Level
Secondary Care Level
Tertiary Care Level
Health Care at the Village Level
Health Care at the Subcenter Level
Primary Health Center Level
Community Health Center Level
MATERNAL AND CHILD HEALTH SERVICES
Objectives
Evaluation of Maternal and ChildHealth Programs in India
ANTENATAL CARE
Objectives
Antenatal Visits
Preventive Services
Risk Approach
Maintenance of Records
Home Visits
Prenatal Advice
Specific Health Protection
Mental Preparation
Family Planning
Pediatric Component
INTRANATAL CARE
Objectives
Domiciliary Care
Advantages
Disadvantages
Institutional Care
Rooming-in
POSTNATAL CARE
Objectives
Complications
Restoration of Mother's Health
Physical Aspects
Psychological Factors
Social Factors
Breastfeeding
Family Planning
Basic Health Education
NEONATAL CARE
Objectives
Immediate Care
Clearing the Airway
Apgar Scoring
Care of the Cord
Care of the Eyes
Care of the Skin
Maintenance of Body Temperature
Breastfeeding
Neonatal Examinations
First Examination
Second Examination
Measuring the Baby
Neonatal Screening
Identification of ‘At Risk’ Infants
Low-birth-weight Babies
SYSTEM OF DELIVERING MCHSERVICES IN THE COUNTRY
Recent Trends in MCH Care
Integrated Care
Risk Approach
Manpower Changes
Primary Health Care
MATERNAL MORTALITY
Causes of Maternal Deaths
Preventive Measures
MORTALITY IN INFANCY AND CHILDHOOD
Perinatal Mortality
Causes of Perinatal Mortality
Prevention
Neonatal Mortality
Causes of Neonatal Mortality
Prevention
Infant Mortality Rate
Infant Mortality in India
Causes of Infant Mortality
Factors Affecting Infant Mortality
Preventive and Social Measures
Child Mortality Rate (1–4 Year)
Leading Causes of Death
Preventive Measures
JOB FUNCTIONS OF HEALTH WORKERS FOR IMPLEMENTING MCH SERVICES
Female Health Worker
Registration
Care at Home
At the Health Center
In the Community
Other Responsibilities
Female Health Assistant
Selection of ASHA
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
SECTION XI: SPECIAL TOPICS
CHAPTER 51:
Pain Relief and Comfort in Labor
PERCEPTION OF PAIN
CAUSES OF PAIN
ANALGESICS
Analgesics and their Fetal/Maternal Side Effects
Commonly Used Narcotic Analgesics
Patient-controlled Analgesia
Assessment and Intervention
ANESTHESIA
Regional Anesthesia
Pudendal Block
Paracervical Block
Peridural (Epidural) Anesthesia
Spinal Anesthesia (Subarachnoid)
Actions Specific to Blocks
Advantages and Disadvantages of Regional Anesthesia
Nursing Considerations
General Anesthesia
Types of General Anesthesia
Recovery
Balanced Anesthesia
NON-PHARMACEUTICAL METHODS OF PAIN RELIEF
Gate Control Theory
Acupuncture
Acupressure
Yoga and Meditation
Therapeutic Touch
Transcutaneous Electrical Nerve Stimulation
Bathing, Showering, Warmth
POSITIONING
HYGIENE AND COMFORT
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 52:
Childbirth Education and Preparation
NATURAL CHILDBIRTH APPROACH
CHILDBIRTH PREPARATION PROGRAM
Goals of Educational Programs
METHODS OF CHILDBIRTH PREPARATION
Read Method
Lamaze Method (Psychoprophylaxis)
Kind and Rate of Breathing Change with Advancing Stages of Labor
Modified Lamaze Method
Bradley Method
Teaching Content
Refresher Courses
Cesarean Birth Preparation
Prenatal Exercise Classes
ROLE OF COACH OR SUPPORT PERSON
ROLE OF THE CHILDBIRTH EDUCATOR
Educational Needs
STUDY QUESTIONS
Short Notes
Short Answer Question
Essay Question
CHAPTER 53:
Special Exercises for Pregnancy, Labor and Puerperium
POSTURAL CHANGES IN PREGNANCY
POSTURE FOR COMFORT INDIFFERENT POSITIONS
Sitting
Standing
Lying
Household Activities
EXERCISES DURING PREGNANCY
Walking
Cycling
Swimming
POSTURE FOR RELIEF OF ACHES AND PAINS
Back and Pelvic Pain
Cramp
Rib Discomfort
ANTENATAL EXERCISES
Abdominal Tightening
Pelvic Floor Exercise (Kegel Exercise)
Foot and Leg Exercises
Breathing Exercise
POSITIONS FOR COMFORT DURING LABOR
First Stage of Labor
Early Stage
Later Stage
Second Stage of Labor
POSTNATAL EXERCISES
Circulatory Exercises
Pelvic Floor Exercises (Kegel Exercise)
Abdominal Exercises
Abdominal Breathing
Head and Shoulder Raising
Leg Raising
Pelvic Tilting or Rocking
Knee Rolling
Hip Hitching
Exercises Following Cesarean Section
Care of the Back Postnatally
IMMEDIATE POSTNATAL PHYSICAL PROBLEMS
Diastasis Symphysis
Diastasis Recti
Painful Perineum
Incontinence
Backache
Coccydynia
STUDY QUESTIONS
Short Notes
CHAPTER 54:
Drugs Used in Obstetrics
OXYTOCICS
Oxytocin
Preparations
Actions
Indications for Use
Contraindications
Adverse Effects
Dosage and Routes of Administration
Nursing Considerations
Ergot Derivatives
Preparations
Mode of Action
Indications
Contraindications
Adverse Effects/Side Effects
Nursing Considerations
Prostaglandins
Preparations
Actions
Indications
Contraindications
Side Effects/Adverse Reactions
Dosage and Routes of Administration
Nursing Considerations
ANTIHYPERTENSIVE DRUGS
Methyldopa
Preparations
Action
Indication
Contraindications
Side Effects/Adverse Reactions
Dosage and Route of Administration
Nursing Considerations
Labetalol
Preparations
Action
Indication
Contraindications
Side Effects/Adverse Reactions
Dosage and Routes of Administration
Nursing Considerations
Propranolol (Inderal)
Action
Indications
Contraindications
Side Effects/Adverse Reactions
Dosage and Routes of Administration
Nursing Considerations
Hydralazine
Preparations
Actions
Indication
Contraindications
Adverse Effects
Dosage and Routes of Administration
Nursing Considerations
Nifedipine
Preparations
Actions
Indications
Contraindications
Side Effects/Adverse Reactions
Dosage and Routes of Administration
Nursing Considerations
Diazoxide
Preparation
Action
Indication
Contraindications
Side Effects
Dosage and Routes of Administration
Nursing Considerations
Sodium Nitroprusside
Preparations
Actions
Indications
Contraindications
Side Effects/Adverse Reactions
Dosage and Route of Administration
Nursing Considerations
DIURETICS
Furosemide (Lasix)
Action
Dosage
Side Effects
Contraindications
Interactions/Incompatibilities
Nursing Considerations
Hydrochlorothiazide
Preparations
Actions
Uses
Dosage and Route
Side Effects/Adverse Reactions
Contraindications
Nursing Considerations
Spironolactone (Aldactone)
Mode of Action
Dose
Advantages
Nursing Considerations
TOCOLYTIC AGENTS
Isoxsuprine (Duvadilan)
Actions
Dosage and Routes
Side Effects
Contraindications
Nursing Considerations
Ritodrine Hydrochloride (Yutopar)
Action
Dosage and Routes
Side Effects/Adverse Reactions
Contraindications
Nursing Considerations
ANTICONVULSANTS
Magnesium Sulfate
Actions
Uses
Dosage and Route
Side Effects
Antidote
Nursing Considerations
Diazepam (Valium)
Actions
Dosage and Route of Administration
Side Effects
Nursing Considerations
Phenytoin (Dilantin)
Action
Dosage and Route of Administration
Side Effects
Nursing Considerations
Phenobarbital (Luminal)
Actions
Dose and Route of Administration
Side Effects
Nursing Considerations
ANTICOAGULANTS
Heparin Sodium
Action
Indications
Dosage and Routes
Side Effects
Nursing Considerations
Warfarin Sodium (Coumadin)
Action
Indications
Dosage and Route
Side Effects
Nursing Considerations
ANALGESICS
Pethidine (Meperidine)
Actions
Indications
Dosage and Route of Administration
Contraindication
Side Effects/Adverse Reactions
Nursing Considerations
Fentanyl
Actions
Indications
Dosage and Routes
Contraindications
Side Effects/Adverse Reactions
Nursing Considerations
Promethazine (Phenergan)
Actions
Indications
Dosage and Route of Administration
Contraindications
Side Effects/Adverse Reactions
Nursing Considerations
EFFECTS OF MATERNAL MEDICATIONS ON FETUS AND BREASTFEEDING INFANTS
Maternal Medications with Established Teratogenic Properties and their Effects
Possible Teratogens
Fetotoxic Drugs
Maternal Drug Intake and Breastfeeding
STUDY QUESTIONS
Short Answer
Essay Questions
CHAPTER 55:
Vital Statistics in Obstetrics
REGISTRATION OF VITAL EVENTS
MATERNAL MORTALITY
Maternal Mortality Rate
Classification of Maternal Deaths
Direct Maternal Deaths (75%)
Indirect Maternal Deaths (25%)
Non-obstetric or Unrelated Deaths
Reproductive Mortality
Magnitude of the Problem
Factors Associated with Maternal Mortality
Age
Parity
Socioeconomic Strata
Antenatal Care
Social Factors
Causes of Maternal Death
Hemorrhage
Sepsis
Hypertensive Disorders in Pregnancy
Anemia
Infective Hepatitis
Thromboembolism
Lack of Assistance of Trained Personnel
Preventive Measures
MATERNAL MORBIDITY
Classification
Direct Obstetric Morbidity
Indirect Morbidity
Reproductive Morbidity
PERINATAL MORTALITY
Causes of Perinatal Mortality
Antenatal Causes
Intranatal Causes
Postnatal Causes
Measures for Reduction of Perinatal Mortality
Preventive Measures
Stillbirths
Causes
NEONATAL MORTALITY
Causes of Neonatal Deaths
INFANT MORTALITY RATE
RECORD KEEPING
General Guidelines for Maintaining Records
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 56:
Perinatal Loss and Grief
LOSS, GRIEF AND MOURNING
Loss
Grief
Mourning
REPRODUCTIVE LOSS
Loss of the Perfect Baby
Grief Situations in the Perinatal Period
Nature of Perinatal Loss and Grief
Intense Feelings
Anticipatory Grief
Emotional and Physical Stress
Mourning
Guilt and Anger
Loss of Relationship
Limited Memories
Social Support
SYMPTOMS OF NORMAL GRIEF
PHASES OF GRIEVING/MOURNING
Period of Shock and Denial (24 Hour to 3 Week)
Phase of Anxiety and Searching (3 Week to 7 Month)
Phase of Disorganization (Intensity Reduces by 7 Month)
Resolution or Reorganization (18–24 month)
PATHOLOGICAL GRIEF
Caring for a Bereaved Family
Immediate Support
Attitude and Empathy
Validating the Loss
Making the Loss Real
For Mothers Who Grieve theLoss through Miscarriage
Death of an Infant in the Nursery
RIGHTS OF PARENTSWHEN AN INFANT DIES
CARING FOR THE CAREGIVER
RECORD KEEPING
CONTINUED CARE
NURSING PROCESS FOR THECLIENT EXPERIENCING A LOSS
Assessment
Nursing Diagnoses
Expected Outcomes
Nursing Interventions
Physical Care
Psychological and Emotional Care
Educational Care (Health Education)
Evaluation
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 57:
Radiology and Ultrasonics in Obstetrics
RADIOLOGY IN OBSTETRICS
Indications
Fetal
Radiation Hazards
Measures that Help to Reduce Radiation
ULTRASONICS IN OBSTETRICS
How Does Ultrasound Work?
Use of Ultrasound in Obstetrics
Selective Sonography
Transvaginal Ultrasonography
Doppler Ultrasound (Audible Signal)
MIDWIFE'S RESPONSIBILITYREGARDING PRENATAL SCREENING
STUDY QUESTIONS
Short Notes
Short Answer Questions
CHAPTER 58:
Legal and Ethical Aspects of Midwifery
LAWS AND ETHICS
Standards of Practice
State License or Registration
Institutional Policies
Community Standards
Code of Ethics
Ethical Principles thatGuide Nursing Practice
Legal Issues in Midwifery Practice
A Patient's Bill of Rights
Practice Guidelines for Legal Protection
STUDY QUESTIONS
Short Notes
Essay Question
CHAPTER 59:
National Population Policy and Family Welfare Programs
NATIONAL POPULATION POLICY 2000
Objectives of NPP
Strategies of NPP 2000
Promotional Measures
Legislation
Action Plan of the NPP 2000
NATIONAL FAMILY WELFARE PROGRAM
Evaluation of the FWP
Vital Statistics 2011 (India)
Population
Vital Rates
Fertility and Family Welfare
Implementation of the FWP
REPRODUCTIVE AND CHILD HEALTH PROGRAM
Essential Components of RCH Program
Services Included in the Program for Mothers and Children
Strategies
Services Included
JANANI SURAKSHA YOJANA
Salient Features of the JSY
VANDE MATARAM SCHEME
SAFE ABORTION SERVICES
NATIONAL RURAL HEALTH MISSION
Goals to be Achieved by NRHM
At National Level
At Community Level
Plan of Implementation of NRHM
Selection of ASHA
Roles and Responsibilities of ASHA
Role and Integration with ANM
INTEGRATED CHILDDEVELOPMENT SERVICES
Integrated Child Development Service Team
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Question
CHAPTER 60:
Obstetric and Gynecological Instruments
SPONGE HOLDING FORCEPS (FIG. 60.1)
Specifications and Uses
KOCHER'S HEMOSTATIC FORCEPS (Figs 60.2A and B)
Specifications and Uses
HEMOSTATS (ARTERY FORCEPS) (Figs 60.3A and B)
Specifications and Uses
OVUM FORCEPS (Figs 60.4A and B)
Specifications and Uses
VULSELLUM FORCEPS (FIG. 60.5)
Specifications and Uses
GREEN ARMYTAGE'S FORCEPS (Figs 60.6A and B)
Specifications and Uses
UTERINE PACKING FORCEPS/UTERINE DRESSING FORCEPS (FIG. 60.7)
Specifications and Uses
ALLIS TISSUE FORCEPS (FIG. 60.8)
Specifications and Uses
TENACULUM FORCEPS (FIG. 60.9)
Specifications and Uses
LAMINARIA TENT INTRODUCINGFORCEPS (FIG. 60.10)
Specifications and Uses
LAMINARIA TENT (FIG. 60.11)
Specifications and Uses
DISSECTING FORCEPS (Figs 60.12A and B)
Specifications and Uses
DOYEN'S TOWEL CLIP (FIG. 60.13)
Specifications and Uses
DOYEN'S RETRACTOR (FIG. 60.14)
Specifications and Uses
ANTERIOR VAGINAL WALL RETRACTOR (FIG. 60.15)
Specifications and Uses
KELLY'S DEEP RETRACTOR (FIG. 60.16)
Specifications and Uses
SIMS’ DOUBLE-BLADEDVAGINAL SPECULUM (FIG. 60.17)
Specifications and Uses
CUSCO'S BIVALVED SPECULUM (FIG. 60.18)
Specifications and Uses
AUVARD'S WEIGHTED VAGINAL SPECULUM (FIG. 60.19)
Specifications and Uses
SIMS’ DOUBLE-ENDED UTERINE CURETTE (FIG. 60.20)
Specifications and Uses
DAS’ CERVICAL DILATORS (FIG. 60.21)
Specifications and Uses
FLUSHING CURETTE (Figs 60.22A and B)
Specifications and Uses
DREW SMYTHE CATHETER MEMBRANE PERFORATOR (FIG. 60.23)
Specifications and Uses
UTERINE SOUND (FIG. 60.24)
Specifications and Uses
SCISSORS (Figs 60.25A to C)
Specifications and Uses
BULB SYRINGE (FIG. 60.26)
Specifications and Uses
MUCUS SUCKER (FIG. 60.27)
Specifications and Uses
CORD CLAMP (FIG. 60.28)
Specifications and uses
WRIGLEY'S OUTLET FORCEPS (FIG. 60.29)
Specifications and Uses
DAS’ LONG CURVED OBSTETRIC FORCEPS (FIG. 60.30)
Specifications and Uses
AXIS TRACTION FORCEPS (Figs 60.31A and B)
Specifications and Uses
KIELLAND'S FORCEPS (FIG. 60.32)
Specifications and Uses
VENTOUSE CUP WITH TRACTION DEVICE/ VACUUM EXTRACTOR (Figs 60.33A and B)
Specifications and Uses
SIMPSON'S PERFORATOR (FIG. 60.34)
Specifications and Uses
CRANIOCLAST (FIG. 60.35)
Specifications and Uses
EMBRYOTOMY SCISSORS (FIG. 60.36)
Specifications and Uses
BREECH HOOK AND CROCHET (FIG. 60.37)
Specifications and Uses
JARDINE'S DECAPITATION HOOK (FIG. 60.38)
Specifications and Uses
COMBINED CRANIOCLAST ANDCEPHALOTRIBE (FIG. 60.39)
Specifications and Uses
EXTERNAL PELVIMETER (FIG. 60.40)
Specifications and Uses
PINARD'S STETHOSCOPE/FETOSCOPE (FIG. 60.41)
Specifications and Uses
NEEDLE HOLDER (FIG. 60.42)
Specifications and Uses
FEMALE METAL CATHETER (FIG. 60.43)
Specifications and Uses
RING PESSARY (FIG. 60.44)
Specifications and Uses
HODGE-SMITH PESSARY (FIG. 60.45)
Specifications and Uses
BABCOCK'S TISSUE FORCEPS (FIG. 60.46)
Specifications and Uses
SECTION XII: GYNECOLOGICAL NURSING
CHAPTER 61:
Menstrual Cycle Disorders and Abnormal Bleeding
AMENORRHEA
Primary Amenorrhea
Causes
Symptoms
Management
Secondary Amenorrhea
Causes
Investigations
Management
DYSMENORRHEA
Primary Dysmenorrhea
Causes
Symptoms
Treatment
Secondary Dysmenorrhea
Causes
Symptoms
Treatment
MITTELSCHMERZ'S SYNDROME (OVULAR PAIN)
Characteristics
Probable Causes
Treatment
DYSFUNCTIONAL UTERINE BLEEDING
Causes
Pathophysiology
Clinical Manifestations
Investigations
Management
PREMENSTRUAL SYNDROME
Pathophysiology
Clinical Features
Related to Water Retention
Neuroendocrine and Psychological Related
Autonomic Symptoms
Behavioral Symptoms
Treatment
Nursing Process for Client with Menstrual Cycle Disorders
MENORRHAGIA
Definition
Causes
Uterine
Ovarian
Others
Diagnosis
Treatment
Medications
Surgery
POLYMENORRHEA
Causes
Treatment
Hormone Therapy
METRORRHAGIA
Causes
Acyclic Bleeding
Contact Bleeding
Intermenstrual Bleeding
Treatment
OLIGOMENORRHEA
Causes
Treatment
HYPOMENORRHEA
Causes
Treatment
STUDY QUESTIONS
Short Notes
Short Answer Questions
Essay Questions
CHAPTER 62:
Displacement of Uterus
RETROVERSION OF UTERUS (Figs 62.1A to C)
Degrees of Displacement
Causes
Incidence
Signs and Symptoms/Clinical Presentation
Prevention
Corrective Treatment
UTERINE PROLAPSE (Fig. 62.2)
Definition
Description
Associated Conditions
Degrees of Prolapse (Figs 62.5A and B)
Causes
Symptoms
Examination and Diagnosis
Management of Uterine Prolapse
Preventive
Conservative
Non-surgical Management
Surgical Management
Possible Complications Following Surgical Management
Immediate
Late
CHRONIC INVERSION OF UTERUS
Definition
Causes
Types of Inversion
Signs and Symptoms
Treatment
Nursing Implications
STUDY QUESTIONS
Short Answer Question
Essay Questions
CHAPTER 63:
Infectious Conditions of Pelvic Organs
PELVIC INFLAMMATORY DISEASE
Risk Factors
Types of Infections
Causative Organisms
Pathology
Clinical Features
Investigations
Treatment
Indications for Surgical Interventions
Complications
Measures to Prevent Reinfection
ENDOMETRITIS
Causes
Risk Factors
Signs and Symptoms
Tests and Investigations
Treatment
Prognosis
Possible Complications
Prevention
CERVICITIS
Causative Organisms
Clinical Features
Treatment
VULVAL AND VAGINAL INFECTIONS
Common Infectious Conditions
Causative Organisms and Clinical Manifestations
Clinical Features
Treatment
NURSING PROCESS FOR CLIENTS WITH PELVIC INFECTIONS
Assessment
Nursing Diagnosis
Nursing Interventions
STUDY QUESTIONS
Short Answer Questions
Essay Question
CHAPTER 64:
Benign Pelvic Conditions
FIBROID TUMORS
Growth of Fibroids
Incidence
Types of Fibroids (Fig. 64.1)
Clinical Features
Diagnosis
Management
BENIGN OVARIAN TUMORS
Clinical Features of Benign Tumors and Cysts of Ovary
Special Investigations
Complications of Benign Ovarian Tumors
Management
POLYPS
Mucoid Polyp
Clinical Features
Fibroid Polyp
Clinical Features
Management
POLYCYSTIC OVARY SYNDROME
Clinical Features
Causes
Investigations
Possible Late Sequelae
Management
Medical Management
Surgical Management
Nursing Process
Nursing Assessment
Nursing Diagnosis
Nursing Care Plans
Nursing Interventions
STUDY QUESTIONS
Short Notes
Essay Question
CHAPTER 65:
Gynecological Examinations and Diagnostic Procedures
History taking (Box 65.1)
EXAMINATION
General and Systemic Examination
Gynecological Examination
Abdominal Examination
Pelvic Examination
Inspection of Vulva
Vaginal Examination
Rectal Examination
Blood Investigations
Urine Examination
DIAGNOSTIC PROCEDURES
Colposcopy
Patient Selection
Procedure
X-ray Examination
Ultrasound Examinations
Use of Ultrasound Examinations
Computed Tomography
Magnetic Resonance Imaging
Uses of Magnetic Resonance Imaging
Positron Emission Tomography
Surgical Methods
STUDY QUESTIONS
Short Notes
Short Answer Questions
CHAPTER 66:
Congenital Malformations of Female Genital Organs
UTERINE ABNORMALITIES
Prevalence
Types
Diagnosis
Complications
Management
VAGINAL MALFORMATIONS
Vaginal Agenesis/Hypoplasia
Diagnosis
Treatment
Vaginal Atresia
Vaginal Septum
Hymen Abnormalities
Clinical Features
Narrow Introitus
Associated Abnormalities
ABNORMALITIES OF EXTERNAL GENITALIA
Labia Minora Abnormalities
Labia Majora Abnormalities
Clitoral Abnormalities
ANOMALIES OF THE OVARIES
Ovarian Agenesis/Dysgenesis
True Hermaphroditism
Female Hermaphroditism due to Congenital Adrenal Hyperplasia
Accessory Ovary and Supernumerary Ovaries
STUDY QUESTIONS
Short Notes
CHAPTER 67:
Genital Fistulae
GENITOURINARY FISTULA
Definition
Types (Fig. 67.1)
Bladder
Ureter
VESICOVAGINAL FISTULA
Causes
Sites
Clinical Features
Diagnosis of Fistula
Investigations
Treatment
Postoperative Care
Special Care Following VVF Repair
Instructions During Discharge from Hospital
URETHROVAGINAL FISTULA
Causes
Diagnosis
Treatment
URETEROVAGINAL FISTULA
Causes
Diagnosis
Investigations
Management
Complications Following Repair of Ureteric Injury
RECTOVAGINAL FISTULA
Causes
Acquired
Congenital
Diagnosis
Investigations
Treatment
Preventive
Definitive
STUDY QUESTIONS
Short Notes
Essay Questions
CHAPTER 68:
Perioperative Care of Gynecological Patient
TYPES OF SURGERY
Purposes of Surgical Procedure
Degrees of Urgency
Degree of Risk
MANAGEMENT IN PREOPERATIVE PHASE
Preoperative Evaluation
History
Physical Examination
Routine Investigations
Preoperative Consent
Preoperative Teaching
Physical Preparation
Preoperative Checklist
Presurgery Medications
MANAGEMENT IN INTRAOPERATIVE PHASE
MANAGEMENT IN POSTOPERATIVE PHASE
STUDY QUESTIONS
Short Answer Questions
CHAPTER 69:
Infertility and its Management
INFERTILITY
Definitions
Incidence
Factors Required for Fertility (Male and Female)
Causes of Infertility
Male Factors that Cause Infertility
Causes of Female Infertility
Investigations of Female
History
Examinations
Diagnostic Evaluation
Management of Infertility
General Instructions
Management of Male Infertility
Management of Female Infertility
Management of Unexplained Infertility
ASSISTED REPRODUCTIVE TECHNOLOGY
Different Techniques of ART
Intrauterine Insemination
In Vitro Fertilization and Embryo Transfer
Gamete Intrafallopian Transfer
Zygote Intrafallopian Transfer
Intracytoplasmic Sperm Injection
Prognosis of Artificial Reproductive Methods
ROLE OF NURSES IN MANAGEMENT OF INFERTILITY
STUDY QUESTIONS
Short Answer Questions
Essay Questions
CHAPTER 70:
Genital Malignancies
OVARIAN CANCER
Incidence
Epidemiology
Origin
Genetics and Ovarian Malignancy
Classification of Ovarian Cancers
Epithelial Ovarian Cancers
Stromal Cell Cancers
Specialized Stromal Cell Cancers
Features of Specific Types of Tumors
Epithelial Cancers
Germ Cell Tumors
Specialized Stromal Cell Tumors
Risk Factors for Ovarian Cancer
Clinical Features
Special Investigations
Preventive Management
Primary Prevention
Secondary Prevention
Treatment
Surgery
Chemotherapy
Radiation
Immunotherapy
Prognosis
UTERINE CANCER
Incidence
Etiology
Classification
Carcinoma
Sarcoma
Carcinosarcoma
Signs and Symptoms
Risk Factors
Diagnosis
Preoperative Evaluation
Treatment
Complications of Treatment
Prognosis
GESTATIONAL TROPHOBLASTIC DISEASE
Types
Invasive Mole
Choriocarcinoma
Placental Site Trophoblastic Tumor
Persistent Trophoblastic Disease
Spread of GTN
Clinical Features of GTN
Management of GTN
Preventive
Curative
Prognosis
Prevention of Recurrence and Follow-up
CANCER OF CERVIX
Epidemiology
Causes
Signs and Symptoms
Diagnosis
Diagnosis of Precancerous Lesions
Staging
Complications
Management
Primary Prevention
Secondary Prevention
Treatment
Prognosis
CANCER OF THE VULVA
Incidence
Etiology
Types of Vulval Cancer
Clinical Features
Diagnosis
Staging
Treatment
Prognosis
BARTHOLIN'S GLAND CANCER
VAGINAL CANCER
Types
Signs and Symptoms of Primary Vaginal Cancer
Diagnosis
Staging
Treatment
Surgery
Radiotherapy
Prognosis
CANCER OF FALLOPIAN TUBE
Primary Fallopian Tube Cancer
Pathology
Clinical Manifestations
Diagnosis
Treatment
Prognosis
Secondary Fallopian Tube Cancer
BREAST CANCER
Normal Breast (Figs 70.1A and B)
Lymphatic System of Breast (Fig. 70.2)
Risk Factors of Breast Cancer
Malignant Breast Conditions
Localized Breast Cancer
Invasive Breast Cancer
Metastatic Breast Cancer
Staging of Breast Cancer
Clinical Manifestations
Diagnosis of Breast Cancer
Breast Self-examination
Clinical Examination
Mammography (Fig. 70.5)
Ultrasonography
Magnetic Resonance Imaging (Fig. 70.6)
Percutaneous Biopsy
Core Needle Biopsy
Surgical Biopsy
Types of Breast Cancer
Ductal Carcinoma In Situ
Invasive Cancer
Prognosis
Treatment/Management
Surgical Management
Radiation Therapy
Chemotherapy (Systemic)
Hormonal Therapy
Breast Reconstruction after Surgery
Prosthetics
Prevention Strategies in the High-risk Patients
Potential Complications of Surgical Management
Nursing Management
Nursing Assessment
Preoperative Nursing Diagnoses
Postoperative Nursing Diagnoses
Patient Goals to be Achieved
Nursing Interventions
Patient Education for Hand and Arm, and Care after Axillary Lymph Node Dissection
Exercise after Breast Surgery (Figs 70.8A to D)
Support of Family Members after Breast Surgery
NURSING MANAGEMENT OF PATIENTS WITH GENITAL MALIGNANCIES
Nursing Interventions
Nursing Diagnoses
STUDY QUESTIONS
Short Answer Questions
Essay Questions
CHAPTER 71:
Special Gynecological Conditions
ADENOMYOSIS
Pathology
Clinical Features
Treatment
ENDOMETRIOSIS
Common Sites (Fig. 71.1)
Prevalence
Pathology
Clinical Features
Diagnosis
Complications
Treatment
Medical
Surgical
DYSPAREUNIA
Causes
Male Causes
Female Causes
Treatment
PUBERTY
Physical Changes
In Girls
Pubertal Changes
In Boys
Stages of Pubertal Development in Girls (Tanner Stages)
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Endocrinology in Puberty
Menarche
Growth
Genital Organ Changes
Disorders of Puberty
MENOPAUSE
Age of Menopause
Endocrinology of Climacteric and Menopause
Organ Changes
Menstruation Pattern Prior to Menopause
Menopausal Symptoms
Diagnosis of Menopause
Management
Abnormal Menopause
Nursing implications for Menopausal Conditions
Nursing interventions
STUDY QUESTIONS
Short Answer Questions
Essay Question
Bibliography
APPENDIX:
Maternal Newborn nursing Care Plans
NURSING DIAGNOSES FOR PRENATAL CLIENTS
Deficient Knowledge Related to Self-care Activities during Pregnancy
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Nausea and Vomiting Related to Physiological Changes of Pregnancy
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Acute Pain: Backache Related to Physiological Changes of Pregnancy
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Urinary Frequency and Dysuria Related to Physiological Changes of Pregnancy
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Acute Pain: Leg Cramps Related to Physiological Changes of Pregnancy
Definition
Assessment
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Acute Pain: Heartburn Related to Physiological Changes of Pregnancy
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
NURSING DIAGNOSES FOR LABOR AND DELIVERY CLIENTS
Acute Pain: Related to Physiological Response of Labor
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Deficient Knowledge Related to Information about Birth Process
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Ineffective Coping Individual Related to Labor and Delivery
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Anxiety Related to Hospitalization and Birth Process
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Risk for Infection Related to Labor and Delivery
Definition
Assessments
Associated Medical Conditions
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcome
Documentation
Risk for Injury Related to Induction of Labor
Definition
Assessments
Risk Factor
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcome
Documentation
Deficient Knowledge Related to Premature Labor
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Deficient Fluid Volume Related to Altered Intake during Labor
Definition
Assessments
Defining Characteristics
Associated Medical Conditions
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
NURSING DIAGNOSES FOR POSTPARTUM CLIENTS
Deficient Knowledge Related to Postpartum Care
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Pain Related to Postpartum Physiological Changes
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Deficient Fluid Volume Related to Postpartum Hemorrhage
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Risk for Infection Related to Altered Primary Defenses during Postpartum Period
Definition
Assessments
Risk Factors
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Pain Related to Episiotomy or Cesarean Incision
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Impaired Skin Integrity Related to Episiotomy or Abdominal Incision
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
NURSING DIAGNOSES FOR NEONATES
Risk for Aspiration Related to Immature Cough or Gag Reflex
Definition
Assessments
Risk Factors
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Ineffective Breastfeeding Related to Difficulty with Breastfeeding Process
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Interrupted Breastfeeding Related to Contraindicating Conditions
Definition
Assessments
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Ineffective Breathing Pattern Related to Adjustment to Extrauterine Existence
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcome
Documentation
Ineffective Breastfeeding Related to Limited Maternal Experience
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Risk for Infection Related to Neonate's Immature Immune System
Definition
Assessments
Risk Factors
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Imbalanced Nutrition less than Body Requirement Related to Ineffective Suck Reflex
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Hypothermia Related to Cold Stress or Sepsis
Definition
Assessments
Defining Characteristics
Expected Outcomes
Nursing Interventions
Evaluation of Expected Outcomes
Documentation
Glossary
INDEX
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