Core Curriculum for Maternal- Newborn Nursing This page intentionally left blank Core Curriculum for Maternal- Newborn Nursing Fourth Edition Edited by: Susan Mattson, RNC-OB, CTN, PhD, FAAN Professor Emerita College of Nursing and Healthcare Innovation Arizona State University Tempe, Arizona Judy E. Smith, PhD, RNC-WHNP Professor School of Nursing California State University—Long Beach Long Beach, California 3251 Riverport Lane Saint Louis, MO 63043 CORE CURRICULUM FOR MATERNAL-NEWBORN NURSING ISBN: 978-1-4377-1576-7 Copyright © 2011 by Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Saunders, an imprint of Elsevier Inc. All rights reserved. Copyright © 2004, 2000, 1993 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: [email protected]. You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions. Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. Library of Congress Cataloging-in-Publication Data Core curriculum for maternal-newborn nursing/edited by Susan Mattson, Judy E. Smith. – 4th ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4377-1576-7 (hardcover : alk. paper) 1. Maternity nursing—Outlines, syllabi, etc. 2. Nursing—Study and teaching—Outlines, syllabi, etc. I. Mattson, Susan. II. Smith, Judy E. [DNLM: 1. Maternal-Child Nursing—Outlines. 2. Curriculum—Outlines. WY 18.2 C7965 2011] RG951.N33 2011 618.2’0231—dc22 2010005124 Executive Editor: Robin Carter Managing Editor: Laurie K. Gower Publishing Services Manager: Jeff Patterson Project Manager: Jeanne Genz Design Direction: Charlie Seibel Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 Contributors Linda Bond, PhD, RNC S. Kim Genovese, PhD, MSN, MSA, Professor Emerita, Kirkhof College of  RN-BC Nursing  Executive Director, Nursing 2000 North,  Grand Valley State University  Inc. Allendale, Michigan La Porte, Indiana Beverly Bowers, PhD, RN, CNS Elizabeth Gilbert, RNC, MS, FNP-BC, Associate Professor, College of Nursing CNS University of Oklahoma Health Sciences  Director of Professional Practice Center Banner Thunderbird Medical Center Oklahoma City, Oklahoma Glendale, Arizona Linda Callahan, CRNA, PhD Whitney Hardy, RN, BS Professor, School of Nursing Staff Nurse, Neonatal Intensive Care Unit California State University—Long Beach CJW Medical Center, Chippenham  Long Beach, California Campus Richmond, Virginia Natalie Diane Cheffer, PhD, RN, CPNP Denise G. Link, PhD, WHNP, CNE, Associate Professor, Department of  FNAP Nursing Associate Dean, Clinical Practice and  California State University—Long Beach Community Partnerships Long Beach, California College of Nursing and Healthcare  Innovation Catherine R. Coverston, PhD, RNC Arizona State University Associate Professor, College of Nursing Phoenix, Arizona Brigham Young University Provo, Utah Susan Mattson, RNC-OB, CTN, PhD, FAAN Dustine Dix, RN, MSN Professor Emerita Clinical Assistant Professor, School of  College of Nursing and Healthcare  Nursing Innovation University of North Carolina—Chapel Hill Arizona State University Chapel Hill, North Carolina Phoenix, Arizona Makeba B. Felton, RN, MSN, FNPC, Jacqueline M. McGrath, PhD, RN, WHNP FNAP, FAAN Clinical Assistant Professor Associate Professor, School of Nursing College of Nursing and Healthcare  Department of Family and Community  Innovation Health Arizona State University Virginia Commonwealth University Phoenix, Arizona Richmond, Virginia v vi Contributors Barbara A. Moran, PhD, CNM, Keiko L. Torgersen, BSN, MS, RNC FACCE Perinatal Educator Assistant Professor, School of Nursing MatSu Regional Medical Center The Catholic University of America Palmer, Alaska Washington, DC Gail M. Turley, MSN, RNC-OB, Susan Saffer Orr, PT, PCS, IBCLC NEA-BC Lactation Consultant Administrative Director, Nursing Services Torrance Memorial Medical Center Crozer-Chester Medical Center Torrance, California; Upland, Pennsylvania Columbia Pediatrics Long Beach, California Lucy R. Van Otterloo, RNC, MSN Assistant Professor, Department of  Debra Ann Rannalli, RN, MSN, Nursing CPNP California State University—Long Beach Lecturer Long Beach, California California State University—Long Beach Long Beach, California Connie Sampson von Köhler, Children’s Hospital—Los Angeles RNC-OB, MSN, C-EFM, CPHQ Los Angeles, California Clinical Nursing Instructor Long Beach Memorial Medical Center/ Kathryn Records, PhD, RN Miller Children’s Hospital Associate Professor Adjunct Faculty, School of Nursing Core Director, Research Mentoring and  California State University—Long Beach Collaboration Long Beach, California College of Nursing and Healthcare  Innovation Tamara Whitmer, MS, NPD, RN-BC Arizona State University Clinical Educator, Women’s Center Phoenix, Arizona Banner Desert Medical Center Mesa, Arizona Mary Ann Rhode, RN, MS, CNM Clinical Practice Coordinator Margaret Yancy, RN, MS, WHNP, Exempla Certified Nurse-Midwives ANP-C Exempla Saint Joseph Hospital Clinical Associate Professor Denver, Colorado Advanced Practice Nursing of Adults in  Primary Care Charlotte Stephenson, RN, DSN, College of Nursing and Healthcare  CLNC Innovation Clinical Professor, Nelda C. Stark College  Arizona State University of Nursing Phoenix, Arizona Texas Woman’s University Houston, Texas Judy E. Smith, PhD, RNC-WHNP Professor, Department of Nursing California State University—Long Beach Long Beach, California Reviewers Beverly Bowers, PhD, RN, CNS JoAnne M. Pearce, RNC, MS, FNP-C Associate Professor, College of Nursing ADRN Instructor, College of Technology  University of Oklahoma Health Sciences  Idaho State University  Center Pocatello, Idaho Oklahoma City, Oklahoma Elizabeth J.W. Scott, RN, MSN Kathleen Haubrich, PhD, RN Lead Clinical Development Specialist Associate Professor, Department of  Erlanger Health System Nursing Chattanooga, Tennessee Miami University—Hamilton Campus Hamilton, Ohio Charlotte Stephenson, RN, DSN, CLNC Janet Massoglia, BSN, MSN, FNP Clinical Professor, Nelda C. Stark College  Instructor, Department of Nursing of Nursing Delta College Texas Woman’s University University Center, Michigan Houston, Texas Administrator, VA Health Care Saginaw, Michigan Sandra L. Walker, PhD, RN Instructor, ADN Program Barbara Pascoe, RN, BA, MA Southwest Georgia Technical College Director, The Family Place Thomasville, Georgia Concord Hospital Concord, New Hampshire Sarah E. Whitaker, DNS, RN Program Director, Nursing Danielle Patrick, MSN, RN, WHCNP Dona Ana Community College at New  OB/GYN Nurse Practitioner Mexico State University Today’s Women’s Health Specialists Las Cruces, New Mexico Chandler, Arizona vii Preface This book is intended to be used by practicing  This will make it easier for the maternal-newborn  nurses for several purposes. First, it can be a  or LDR nurse to identify the high-risk infant and  study  guide  for  those  wishing  to  sit  for  the care required until the baby stabilizes or can  certification examinations in maternal-newborn  be  transferred  (if  necessary).  Theoretical  nursing.  Basic  and  complex  information  is  information about the continued care of high- presented  and  accompanied  by  an  extensive  risk neonates with selected conditions has also  reference list to augment the knowledge base. been reconfigured into one chapter titled “The  Second, the text may be used by development  Newborn at Risk.” The information is included  personnel and educators as an orientation for  to provide a basis from which the maternal- new staff, a source of information for nurses  newborn nurse may give answers to parents’  entering  or  returning  to  maternal-newborn  questions and provide anticipatory guidance to  nursing, and a reference for nurses on those  new parents of sick neonates. units. A change for the 4th edition has been the  Third, this  book can be  a classroom text,  deletion  of  nursing  diagnoses  as a  basis  for  particularly for students requiring a resource or  interventions.  It  became  apparent  that  using  reference. It is not designed to be a primary text  that approach led to repetitiveness in each chap- for undergraduate students, but it could be a  ter. Additionally, certain terminology fits more  resource for those graduate students in women’s  appropriately in some settings than in others  health nurse practitioner programs who want to  and can be used to express the needs of a partic- review some of the material relating to pregnancy  ular client at that time. Core curriculum for acute  that will be needed for their practice. care maternity nursing did not seem to be one of  This edition has several significant changes  those settings in most cases. The new format of  that should make the book more usable for a  the book is one of assessment/clinical practice  wider audience yet keep the content directed  and interventions, with continued use of a sec- toward the original audience. We carried forward  tion for health education, and the case studies  the  changes  regarding  complications  of  the  and questions.  newborn from the 3rd edition, in that most of the  We hope this text will be helpful to those of  content is integrated into those chapters dealing  you using it for all purposes. Its editing contin- with maternal complications, with reference to  ues to be an educational and a character- building  how the condition affects the fetus or neonate.  experience for us both. Susan Mattson Judy E. Smith viii Acknowledgments We would like to acknowledge the contributors  Denise G. Link, RNC, DNSc to the previous edition: Reproductive Anatomy, Physiology, and the Menstrual Cycle Linda Bond, PhD, RNC Family Planning Physiology of Pregnancy Susan Mattson, PhD, RNC-OB, CTN, Linda Callahan, CRNA, PhD FAAN Genetics Ethnocultural Considerations in the Fetal and Placental Development and Childbearing Period Functioning Intimate Partner Violence Surgery in Pregnancy Jacqueline M. McGrath, PhD, RN, Natalie Diane Cheffer, RN, CPNP, NNP, CCNS PhD Identification of the Sick Newborn Adaptation to Extrauterine Life and Immediate Nursing Care Barbara A. Moran, MS, MPH, CNM Newborn Biologic/Behavioral Maternal Infections Characteristics and Psychosocial Substance Abuse in Pregnancy Adaptations Susan Saffer Orr, PT, CLC, IBCLC Diana E. Clokey, MS, RD, RPh, CDE Breastfeeding Endocrine and Metabolic Disorders Judith H. Poole, PhD, BSN, BA, MN Catherine R. Coverston, PhD, RNC Hypertensive Disorders in Pregnancy Psychology of Pregnancy Hemorrhagic Disorders Sandra L. Gardner, RN, MS, CNS, Margaret A. Putman, RN, MS, NNP PNP Risks Associated with Gestational Age and Ethics Birth Weight Elizabeth Gilbert, RNC, MS, CFNP Debra Ann Rannalli, RN, PNP, MSN Labor and Delivery at Risk Newborn Biologic/Behavioral Characteristics and Psychosocial Starre Haney, RN, MS, TNCC-I, Adaptations ENPC Trauma in Pregnancy Janet Scoggin, PhD, CNM Physical and Psychologic Changes Patricia Grant Higgins, PhD, RN, BSHEd, BSN, MN Judy E. Smith, PhD, RNC-WHNP Postpartum Complications Age-Related Changes Marcia Liden Jasper, BSN, MS, RNC Kathleen V. Smith, RNC, BSN, MSN Antepartum Fetal Assessment Normal Childbirth ix