Essentials of Maternity, Newborn, and Women’s Health Nursing 2025

Chapter 18: Nursing Management of the Newborn 1. As a postpartum nurse your next client is an LGA baby boy who was born at 37 weeks’ gestation. He had Apgar scores of 8 and 9. He was circumcised. The mother is breast-feeding. Your unit requires a full assessment, screenings, discharge instructions, and documentation. (Learning Objectives 4, 7, 8, and 10) Describe what a normal head-to-toe assessment would be for an infant born at 37 weeks’ gestation. What test is used to determine this gestational age? What is the scale used to determine the Apgar score, and are this baby’s scores normal? As the discharging nurse, you are responsible for what screenings in an infant in the first 24 to 48 hours? What immunizations would be required? What discharge instructions would be pertinent to this mother? How would you educate her or the family? How would you document your discharge teaching? Write a sample narrative of your teaching. 2. You are the newborn nursery nurse and have been called to the labor and delivery suite to attend the delivery of a G5P4 mother whose pregnancy was complicated by gestational diabetes. At 2032 a male infant weighing 8 pounds 2 ounces was delivered vaginally with the assistance of a vacuum extractor. You have assigned Apgar scores of 7 and 9. (Learning Objectives 2, 3, 5, 6, and 8) Relate the assessments you need to carry out in this immediate postdelivery time period. Describe the nursing interventions you will perform before the baby is taken to the newborn nursery. After taking the baby to the newborn nursery, you notice that the baby has developed diffuse swelling and bruising on the occiput of his head from the vacuum extractor use. Discuss how you would differentiate between a cephalhematoma formation and caput succedaneum development. Which one is more serious? When the baby is 6 hours old, you notice that he has become jittery and is cyanotic. You check a heel stick blood sugar and it reveals a blood glucose level of 30. Discuss the immediate nursing interventions you will implement and what additional interventions you can implement to prevent this from occurring again in the future. Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy-Related Complications 1. Teresa is a 36-year-old primigravida who is expecting twins. She is 26 weeks pregnant. She stays after your “What to Expect with Twins” class to talk to you. Although Teresa is a nurse, she has many questions and concerns. Her twins are a result of years of trying to get pregnant and in vitro fertilization. She is nervous about whether she will have a vaginal delivery or a cesarean section. She is worried about having the babies prematurely. She wants you to tell her everything that could go wrong so she can be prepared. (Learning Objectives 1 and 2) Why is Teresa’s pregnancy considered a high-risk pregnancy? Discuss potential pregnancy-related complications for Teresa. Discuss the potential risks to the babies. 2. Sarah is 19-year-old G1P0 at 36 weeks’ gestation. Sarah has been followed weekly in the clinic for mild–moderate preeclampsia. At her clinic appointment today, Sarah’s blood pressure reading was 188/104. She is admitted to the antepartum unit for management of her worsening preeclampsia. You perform her admission assessment and note that her reflexes are brisk, her heart rate is 94, she complains of having an intense headache, and is seeing spots before her eyes. You perform an abdominal assessment and note that she has significant epigastric tenderness. (Learning Objective 5) Develop a plan of care for the woman experiencing preeclampsia, eclampsia, and HELLP syndrome.

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Ethical and Legal Implications of Prescribing Drugs 2025

Ethical and Legal Implications of Prescribing Drugs What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives on a daily basis. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. In this paper, you explore ethical and legal implications of the following scenario and consider how to appropriately respond. Scenario: You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident. To prepare: · Review the following: · Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins. Chapter 1, “Issues for the Practitioner in Drug Therapy” (pp. 3–14) This chapter introduces issues relating to drug therapy such as adverse drug events and medication adherence. It also explores drug safety, the practitioner’s role and responsibilities in prescribing, and prescription writing. Chapter 59, “The Economics of Pharmacotherapeutics” (pp. 1009-1018) This chapter analyzes the costs of drug therapy to health care systems and society and explores practice guideline compliance and current issues in medical care. Chapter 60, “Integrative Approaches to Pharmacotherapy—A Look at Complex Cases” (pp. 1021-1036) This chapter examines issues in individual patient cases. It explores concepts relating to evaluation, drug selection, patient education, and alternative treatment options . As well as : Drug Enforcement Administration. (n.d.). Code of federal regulations . Retrieved August 23, 2012, from http://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm Anderson, P., & Townsend, T. (2010). Medication errors: Don’t let them happen to you. American Nurse Today, 5 (3), 23–28. Retrieved from https://americannursetoday.com/medication-errors-dont-let-them-happen-to-you/ · Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. · Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario. With these thoughts in mind: Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.

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