JOGN nursing; journal of obstetric, gynecologic, and neonatal nursing最新文献

The Surgeon General's regulations requiring treatment of defective newborns were criticized for being simplistic and for interfering in medical decision-making. This public policy regulation was at variance with many of the recommendations of the President's Commission for the Study of Ethical Problems in Medicine. Taking the President's Commission's report into consideration, this article proposes tentative guidelines for making difficult clinical decisions, which may form the basis of an institutional or a professional response to dilemmas surrounding the birth of a defective child.

At Medical Center Hospital of Vermont a program was designed and implemented to expand the nurse's role through formal assessment and documentation of the neonate. Assessment criteria from NAACOG's Obstetric, Gynecologic, and Neonatal Nursing Functions and Standards were used to develop new Newborn Nursery Standards. The staff prepared for the expanded role through inservice programs that were videotaped for future orientation of new staff members. Over one year after implementation of the new standards, the nursing staff is functioning easily in its expanded role.

The association of adverse pregnancy outcome with Treponema pallidum. Neisseria gonorrhoeae and herpes simplex infections is well known and specific recommendations for management have been formulated. However, other agents that are not so well known can be transmitted sexually and threaten an otherwise healthy pregnancy. These agents are discussed in order to make the nurse more aware of related maternal and fetal diseases.

Nursing literature concerned with epidural anesthesia in obstetrics is scant and does not offer a synopsis of the pharmacology of local anesthetic agents employed in epidural block. A comprehensive review of the pharmacology and clinical uses of the common agents used in obstetrical epidural anesthesia is presented. Implications for nursing care are also described.

Women with sickle cell anemia have many specialized problems during labor and delivery. A description of the disease and how it affects women during the intrapartum period is presented. Also, the management of potential problems during labor and delivery is described.

Abstract

A quasi-experimental design was used to compare postpartum perineometer readings of an experimental group of 32 women receiving a prenatal teaching program for the use of Kegel exercises with a control group of 30 women for whom the instructional program was omitted. All subjects received postpartum instruction from a pre-existing program presented by hospital staff. Significantly higher mean postpartum perineometer readings (t = 4.07; P < .01) were found for the experimental group than for the control group, which supported the hypothesis that women who are offered the prenatal program for the use of Kegel exercises during the third trimester of pregnancy and are instructed on Kegel exercises by the staff during the hospitalized postpartum period will have significantly higher readings on the perineometer at the postpartum visit than those women for whom the prenatal program is omitted.

To compare the quality of neonatal care provided by nurse-supervised teams with that provided by physician-supervised teams, a prospective study was used to examine the condition of neonates transported under the supervision of a nurse clinician (55 infants), pediatric residents (141 infants), and neonatology faculty members or fellows (38 infants). Gestational age, birthweight, Apgar scores, vital signs, arterial blood gas values, length of stabilization time, type of respiratory support required, and death during transport were analyzed. Neonates in all groups demonstrated similar severity of illness before transport, showed significant improvement during transport, and were in comparable condition after transport.