OB Exam 1 Objectives

Chapter 1:
1. Differentiate between standard and integrative health care: -Integrative health care encompasses complementary and alternative therapies in combination with conventional Western modalities of treatment. The focus of these on the whole person, not just the disease complex. This allows for more client autonomy in health care decisions. This also combines modern technology with ancient healhing practices and encompasses the whole of body, mind, and spirit. -Examples: acupuncture, macrobitotics, herbal, massage, biofeedback, meditation, yoga, and chelation therapy.

2. Describe the scope of maternity and women’s health nursing: -Maternity nursing encompasses care of childbearing women and their families through all stages of pregnancy and childbirth, as well as the first 4 weeks after birth. -Women's health care focuses on the physical, psychologic, and social needs of women, their overall experience is emphasized.

3. List the National Quality never events and discuss how these could be avoided: -pg.4 Box 1-4 -Infant discharged to the wrong person -Maternal death or serious disability associated with labor or birth in a low risk pregnancy while being cared for in a health care facility -Death or serious disability (kernicterus) associated with failure to identify and treat hyperbilirubinemia in neonates -Artificial insemination with the wrong donor sperm or donor egg

4. Describe how the nurse can effect change in each of the following areas to improve the quality and effectiveness of health care available to Americans:
a. Structure -Nurses have opportunities to manage care, integrate delivery systems, and redefine roles by having more technology and the Internet.
b. Medical errors -Nurses can recognize what the top errors are and ways to prevent them; trust others, but also verify, double check information -pg.4 Box 1-5: create and sustain a health care culture of safety, ask each client to "teach back" in their own words key information, ensure that care information is transmitted and appropriately documented in a timely manner; standardize methods for the labeling and packaging of medications; comply with current CDC and prevention hand hygiene guidelines.
c. Cost -Educate the public more about preventive health and prenatal care in order to avoid the high costs of preterm births; hire more midwives.
d. Access -Most significant barrier is the inability to pay; transportation, dependent child care, lack of insurance. -Educating the public on these issues, looking at different communities and educating the public on the resources available to them could help; bus schedules, taxis, free childcare services, church services, local food pantries.
e. Disparities -Higher infant and maternal mortality rates, more birth defects, and more sexually transmitted infections are found among ethnic and racial minority groups. -Nurses can look at community and ethnic trends and become educated about each client and their how their culture effects their health and try to develop individualized care plans that take those things into account and try to find solutions or healthy alternatives (examples- a culture that eats a lot of fried foods, try to eat more baked foods or fish, etc); include nutrition, exercise, and overall health practices
f. Health literacy -Most client education materials are written at too high a level for the average adult -Health care providers can help by using simple, common words, avoiding jargon, and assessing whether the client understands the discussion. Speaking slowly and clearly and focusing on what is important will increase understanding. -Nurses can have the clients and their families repeat back and do hands on demonstrations to test knowledge

5. When assessing pregnant women, what factors would you recognize as having the potential to contribute to the birth rate and the rate of infant