Description

Nursing care for pregnant women and children is a family-centered process, and Maternal
and Child Nursing Care, 3e,is a text that addresses the needs of families across the
continuum, from conception through adolescence. The themes that shape this book- nursing
care in the community, client education, critical thinking, and evidence-based practice in
nursing-will prepare students for the responsibility of managing care for families with diverse
healthcare needs, and to work collaboratively with families and other health professionals to
enhance care.

Features
Each of the features in this text performs a specific function to benefit the student and
are designed to appeal to all learning styles. The features will help students with:

 organizing learning in manageable chunks

 enhancing retention
 demonstrating practical applications
 teaching clinical skills
 teaching critical thinking
 deepening understanding of the anatomic basis of nursing care
 applying research evidence to everyday practice
 working effectively with patients of different ages and cultures
 facilitating test preparation

The features in these chapters are intended:

…to set the stage for successful learning:

 Learning Outcomes and a personal Vignetteopen each chapter and illustrate the
diversity of cultures, parental concerns, and family situations that nurses will encounter
throughout the course of their careers.
 Key Terms appear opposite the chapter title page, listing important words to know that
will be introduced in the chapter.
 Page numbers are included with each key term to identify the place where the
term first appears in the chapter.

…to teach core skills with clinical and practical applications:

 Assessment Guides, found in the maternal-newborn chapters, assist students with

diagnoses by visually organizing physical assessment and normal findings, alterations
and possible causes, and guidelines for nursing interventions in a single convenient
table.
 Drug Guides for selected medications commonly used in maternal-newborn and child
nursing guide students in administering medications correctly and accurately and
evaluating their actions.
 Nursing Care Plans address the unique nursing care needs of women who have
complications such as preeclampsia or diabetes mellitus, as well as those of high-risk
newborns and children.
 Nursing Practice features offer hands-on suggestions and clinical tips.
 Boxes are placed close to narrative content that is related to them, where they
are most applicable.
  They include topics such as legal and ethical considerations, nursing alerts,
and home and community care considerations.
 Teaching Highlights focus on special healthcare issues or problems and the related
key teaching points for care by the family.
 Clinical Manifestations charts help students understand the association between the
pathophysiology and the signs and symptoms of a particular condition.
 Pathophysiology Illustrated boxes feature unique drawings that illustrate conditions
on a cellular or organ level, and may also portray the step-by-step process of a
disease.

…to teach the importance of evidence-based practice and critical thinking:

 Evidence-based Nursing boxes present recent nursing research in a consistent

format that is designed not only to help students learn how evidence is applied in
everyday nursing practice, but to gain valuable critical thinking skills as they do so.
 Each box poses a clinical question, presents a brief discussion of the evidence
and its implications, recommends best practices, and asks a series of follow-
up critical thinking questions that will help students integrate the research into
their nursing practice.
 MyNursingKit presents possible responses for each question.
 Evidence in Action boxes further prepare nursing students for today's evidence-
based practice by presenting concise, research-supported recommendations, as well
as the category of the evidence (metaanalysis, practice, etc.).
 Critical Thinking in Action at the end of each chapter proposes a real-life scenario
and a series of critical thinking questions that allow students to practice applying
chapter concepts to the clinical setting.

…to prepare students for contemporary nursing practice:

 Clinical Pathways prepare students to keep pace with the changing approaches to
nursing care management by helping them plan and manage care within normally
anticipated time frames.
 Developing Cultural Competence boxes highlight specific cultural issues and their
application to nursing care.
 Complementary Care boxes present information about common alternative and
complementary measures used to treat or provide comfort for various conditions.

…to highlight unique aspects of nursing caring for children:

 As Children Grow boxes illustrate the anatomic and physiologic differences between
children and adults.
 Growth & Development boxes, found exclusively in the pediatric chapters, provide
information about the different responses of children at various ages to health
conditions.
 Health Promotion boxes summarize the needs of children with specific chronic
conditions, such as asthma or diabetes.
 These overviews model for the student an attitude of treating the child with a
chronic illness like any other child, with health maintenance needs for
prevention, education, and basic care.

…to help students locate information quickly:

 Laboratory values are printed in blue font to make it easy for students to locate
essential information for assessing their patients' conditions.
  Cross-reference icons (8) help the student quickly locate related information in other
chapters.
 Figure locator icons make it easy for students to find their place in their reading after
stopping to examine a figure.

…to encourage integrated use of text and ancillaries:

 MyNursingKit thumbtabs in each chapter provide seamless integration between the

text and its online resources, reminding the student to use the accompanying
supplemental materials on the text's companion website, www.MyNursingKit.com.
 SKILLS icons further interweave the text with its ancillary components and point
students to the companion book, Clinical Skills Manual for Maternal & Child Nursing
Care, 3rd edition, where they will find practical skills related to that topic in the text.

…to facilitate test preparation and further study:

 Critical Concept Review at the end of each chapter outlines the main points of the
chapter, organizing them by Learning Outcome.
 References provide a complete list of supporting documentation for the chapter,
followed by a reminder to check the online resources in www.MyNursingKit.com for
additional activities and other supplements.

New to this Edition

Organization
In the new edition, there will be more emphasis on evidence-based practice and more blending
of the style of the two sections through the features and art.

Organizational changes will result in 59 chapters instead of 57. The two additional chapters
are caused by splitting two chapters into four:

Chapter 15, Pregnancy at Risk will become 15, Pregnancy at Risk: Pregestational Problems
and 16, Pregnancy at Risk: Gestational Problems
Chapter 31, The Newborn at Risk, will become 31, The Newborn at Risk: Prelabor
Complications and 32, The Newborn at Risk: Birth-Related Stressors.

This organization mirrors the changes to the Ladewig 7th edition which just published.

A new addition to the pediatrics section is Chapter 40, Nursing Considerations for the Child
and Family with a Chronic Condition. Eliminated from this edition is the chapter Home Care
for the Postpartum Family, with its content integrated into other chapters.

Table of Contents
Unit 1. Introduction to Family-Centered Care

1. Contemporary Maternal Newborn and Child Health Nursing

2. Conception and Fetal Development

Unit 2. Women’s Health

3. Health Promotion for Women

4. Common Gynecologic Problems

5. Families with Special Reproductive Concerns

Unit 3. Pregnancy and Family

6. Preparation for Parenthood

7. Physical and Psychologic Changes of Pregnancy
8. Antepartal Nursing Assessment
9. The Expectant Family: Needs and Care
10. Maternal Nutrition
11. Adolescent Pregnancy
12. Assessment of Fetal Well-Being
13. Pregnancy at Risk: Pregestational Problems
14. Pregnancy at Risk: Gestational Problems

Unit 4. Birth and the Family

15. Processes and Stages of Labor and Birth

16. Intrapartal Nursing Assessment

17. The Family in Childbirth: Needs and Care
18. Pharmacologic Pain Management
19. Childbirth at Risk: Prelabor Complications
20. Childbirth at Risk: Labor-Related Complications
21. Birth-Related Procedures

Unit 5. The Newborn and Postpartum Family

22. The Physiologic Responses of the Newborn to Birth

23. Nursing Assessment of the Newborn
24. Normal Newborn: Needs and Care
25. Newborn Nutrition
26. The Newborn at Risk: Conditions Present at Birth
27. The Newborn at Risk: Birth-Related Stressors
28. Postpartal Adaptation and Nursing Assessment
29. The Postpartum Family: Needs and Care
30. The Postpartum Family at Risk

Unit 6. Care and Needs of Children

31. Growth and Development

32. Infant, Child, and Adolescent Nutrition

33. Pediatric Assessment
34. Health Promotion and Maintenance: General Concepts, the Newborn, and the Infant
35. Health Promotion and Maintenance: The Toddler, the Preschooler, and the School-Age
Child
36. Health Promotion and Maintenance: The Adolescent
37. Family Assessment and Concepts of Nursing Care in the Community
38. Nursing Considerations for the Child and Family with a Chronic Condition
39. Nursing Considerations for the Hospitalized Child
40. Pain Assessment and Management in Children
41. The Child with a Life-Threatening Condition and End-of-Life Care
42. Immunizations and Communicable Diseases

Unit 7. Caring for Children with Alterations in Health Status

43. The Child with Alterations in Fluids, Electrolytes, and Acid-Base Balance
44. The Child with Alterations in Eye, Ear, Nose, and Throat Function
45. The Child with Alterations in Respiratory Function
46. The Child with Alterations in Cardiovascular Function
47. The Child with Alterations in Immune Function
48. The Child with Alterations in Hematologic Function
49. The Child with Cancer
50. The Child with Alterations in Gastrointestinal Function
51. The Child with Alterations in Genitourinary Function
52. The Child with Alterations in Endocrine Function
53. The Child with Alterations in Neurologic Function
54. The Child with Alterations in Mental Health and Cognitive Function
55. The Child with Alterations in Musculoskeletal Function
56. The Child with Alterations in Skin Integrity

Appendices

A. Selected Maternal-Newborn Laboratory Values

B. Selected Pediatric Laboratory Values

C. Physical Growth Charts
D. Pediatric Blood Pressure Values
E. Conversions and Equivalents
F. Actions and Effects of Selected Drugs During Breastfeeding
G. The Friedman Family Assessment Model
H. Dietary Reference Intakes and Recommended Dietary Allowances for Females,
Pregnancy, and Lactation
I. West Nomogram-Body Surface Area
Back Cover
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Author
Marcia L. London Marcia L. London has been able to combine her two greatest passions by
being both a nurse caring for children and families, and a teacher for almost 39 years. She
received her BSN and School Nurse Certificate from Plattsburgh State University in
Plattsburgh, New York, and her MSN in pediatrics as a clinical nurse specialist from the
University of Pittsburgh in Pennsylvania She began her nursing career as a pediatric nurse at
St. Luke's Hospital in New York City and began her teaching career at Pittsburgh Children's
Hospital Affiliate Program, Ms. London began teaching at Beth-El School of Nursing and
Health Science in 1974 (now part of the University of Colorado, Colorado Springs) after
opening the first intensive care nursery at Memorial Hospital of Colorado Springs. She has
served in many faculty and administrative positions at Beth-El, including assistant director of
the School of Nursing and coordiantor of undergraduate nursing care of children. Mrs. London
maintains her clinical skills working in an urgent care and after-hours clinic and doing
undergraduate pediatric clinical supervision. She obtained her postmaster's neonatal nurse
practitioner certificate in 1983 and subsequently developed the neonatal nurse practitioner
(NNP) program and the master's NNP program at Beth-El. She is active nationally in neonatal
nursing and was involved in the development of the Neonatal Nurse Practitioner Educational
Program Guidelines. She has contributed five chapters to various neonatal nursing texts. Mrs.
London is active in nurse practitioner education in general. She was involved in the revision
of the Core Competency for Nurse Practitioners and Curriculum Guidelines for Nurse
Practitioner Education, as a member of the Education Committee of the National Organization
of Nurse Practitioner Faculties and participated as part of the Core Competency Validation
Expert Panel. Mrs. London has also pursued her interest in college student learning by taking
doctoral classes in higher education administration and adult learning at the University of
Denver in Colorado. She feels fortunate to be involved in the education of her future
colleagues. Her teaching philosophy is that, with support, students can achieve more than
they may initially believe they are capable of achieving. Mrs. London and her husband David
enjoy reading, travel and hockey games. They have two sons. Craig, who lives in Florida,
works with internet companies. Matthew works in computer teleresearch. Both are more than
willing to give Mom helpful hints about computers.

Patricia A. Wieland Ladewig Patricia A. Wieland Ladewig received her BS from the College
of Saint Teresa in Winona, Minnesota. After graduation, she worked as a pediatric nurse
before joining the U.S. Air Force. After completing her tour of duty, she relocated to Florida,
where she accepted a faculty position at Florida State University. There she embraced
teaching as her calling. Over the years, she taught at several schools of nursing while earning
her MSN in maternal-newborn nursing from Catholic University of America in Washington,
D.C., and her PhD in higher education administration from the University of Denver in
Colorado. In addition, she became a women's health nurse practitioner and maintained a part-
time clinical practice. In 1988 Dr. Ladewig became the first director of the nursing program at
Regis College in Denver and, in 1991, when the college became Regis University, she became
dean of the Rueckert-Hartman College for Health Professions. Under her guidance, the School
of Nursing has added a graduate program. In addition, the College has added a School of
Physical Therapy, a School of Pharmacy, and two departments: the Department of Health
Services Administration and Management, and the Department of Health Care Ethics. When
not at work or writing textbooks, Pat and her husband, Tim, enjoy skiing, baseball games, and
traveling. However, their greatest pleasure comes from their family: son Ryan, his wife,
Amanda, and grandchildren Reed and Addison, and son Erik, his wife, Kedri, and
granddaughter Emma.

Jane W. Ball Jane W. Ball graduated from The Johns Hopkins Hospital School of Nursing,
and subsequently received a BS from The Johns Hopkins University. She worked in the
surgical, emergency, and outpatient units of the Johns Hopkins Children's Medical and
Surgical Center, first as a staff nurse and then as a pediatric nurse practitioner. This began
her career as a pediatric nurse and advocate for children's health needs. Jane obtained both
a master of public health and doctor of public health degree from the Johns Hopkins University
Bloomberg School of Public Health with a focus on maternal and child health. After graduation
she became the chief of child health services for the Commonwealth of Pennsylvania
Department of Health. In this capacity she oversaw the state-funded well-child clinics and
explored ways to improve education for the state's community health nurses. After relocating
to Texas, she joined the faculty at the University of Texas at Arlington School of Nursing to
teach community pediatrics to registered nurses returning to school for a BSN. During this
time she became involved in writing her first textbook, Mosby's Guide to Physical
Examination, which is currently in its seventh edition. After relocating to the Washington, D.C.,
area, she joined Children's National Medical Center to manage a federal project to teach
instructors of emergency medical technicians from all states about the special care children
need during an emergency. Exposure to the shortcomings of the emergency medical services
system in the late 1980s with regard to pediatric care was a career-changing event. With
federal funding, she developed educational curricula for emergency medical technicians and
emergency nurses to help them provide improved care for children. A textbook
entitled Pediatric Emergencies, A Manual for Prehospital Providers was developed from these
educational ventures. For the past 16 years, she was the executive director of the federally
funded Emergency Medical Services for Children National Resource Center, providing of
consultation and resource development for state health agencies, health professionals,
families, and advocates to improve the emergency healthcare system for children. Dr. Ball
currently serves as a consultant to the American College of Surgeons assisting states to
develop and enhance their trauma systems.

Ruth C. McGillis Bindler Ruth Bindler received her BSN from Cornell University-New York
Hospital School of Nursing in New York. She worked in oncology nursing at Memorial-Sloan
Kettering Cancer Center in New York, and then moved to Wisconsin and became a public
health nurse in Dane County. Thus began her commitment to work with children as she visited
children and their families at home, and served as a school nurse for several elementary,
middle, and high schools. Due to this interest in child healthcare needs, she earned her MS in
child development from the University of Wisconsin. A move to Washington State was
accompanied by a new job as a faculty member at the Intercollegiate Center for Nursing
Education in Spokane, Washington, now the WSU College of Nursing. Dr. Bindler has been
fortunate to be involved for 35 years in the growth of this nursing education consortium, which
is a combination of public and private universities and offers undergraduate, masters and
doctoral nursing degrees. She has taught theory and clinical courses in child health nursing,
cultural diversity, graduate research, pharmacology, and assessment, served as lead faculty
for child health nursing, and is presently director of the PhD Program. Her first professional
book, Pediatric Medications, was published in 1981, and she has continued to publish articles
and books in the areas of pediatric medications and pediatric health. Research efforts are
focused in the area of childhood obesity, type 2 diabetes, and cardiovascular risk factors in
children. Ethnic diversity has been another theme in her work.. Dr. Bindler believes that her
role as a faculty member has enabled her to learn continually, to foster the development of
students in nursing, and to participate fully in the profession of nursing. In addition to teaching,
research, publication, and leadership, she enhances her life by service in several professional
and community activities, and by outdoor activities with her family.

Kay J. Cowen Kay Cowen received her Bachelor of Science in Nursing degree from East
Carolina University in Greenville, North Carolina, and began her career as a staff nurse on the
pediatric unit of North Carolina Baptist Hospital in Winston Salem. She developed a special
interest in the psychosocial needs of hospitalized children and preparing them for
hospitalization. This led to the focus of her master's thesis at the University of North Carolina
at Greensboro (UNCG) where she received a Master of Science in Nursing Education degree
with a focus in maternal child nursing. Mrs. Cowen began her teaching career in 1984 at UNCG
where she continues today as Clinical Associate Professor in the Parent Child Department.
Her primary responsibilities include coordination of the pediatric nursing course, teaching
classroom content and supervising a clinical group of students. Mrs. Cowen shared her
passion for the psychosocial care of children and the needs of their families through her first
experience as an author in the chapter “Hospital Care for Children” in Child Health Nursing: A
Comprehensive Approach to the Care of Children and Their Families published in 1993. In the
classroom Mrs. Cowen realized that students learn through a variety of teaching strategies
and became especially interested in the strategy of gaming. She led a research study to
evaluate the effectiveness of gaming in the classroom and subsequently continues to
incorporate gaming in her teaching. In the clinical setting Mrs. Cowen teaches her students
the skills needed to care for patients and the importance of family-centered care, focusing on
not only the physical needs of the child but also the psychosocial needs of the child and family.
During her teaching career, Mrs. Cowen has continued to work part time as a staff nurse; first
on the pediatric unit of Moses Cone Hospital in Greensboro and then at Brenner Children's
Hospital in Winston Salem. In 2006 she became the part-time Pediatric Nurse Educator in
Brenner's Family Resource Center. Through this role she is able to extend her love of teaching
to children and families. Through her role as an author, Mrs. Cowen is able to extend her
dedication to pediatric nursing and nursing education. She is married and the mother of two
college-age sons.
Reader Review(s)
&n> •…impressed by the Evidence-Based Nursing section; timely, useful, and
relevant…literature is presented and summarized to illustrate how evidence is aggregated with
evidence-based practice…a nice overview and summary and leads into the critical thinking
piece with an excellent media link. -(Professor Keough, North Darmouth, MA) •I prefer the
London text after previewing it. Competing texts are not as up-to-date. London is more
thorough but an easy read. It also includes more in-depth cultural coverage. -(Professor
Lewis, Ina, IL) •Cultural values cannot be emphasized enough. The emphasis on cultural
competence related to how family deal with grief is especially well-done. The pace and depth
are excellent and written at an appropriate level. Detailed, but not so complex as to be
confusing. This book is superior to our current text. -(Professor Miedema, Titusville, FL) •I
especially liked the Critical Concept Review…which tied the information back to the
objectives. Other texts do not do this. They tend only to summarize the key concepts. -
(Professor Roberts, Beaumont, TX)
REVIEWER LIST - LONDON: MATERNAL & CHILD NURSING CARE, 3E

Susan Beggs, RN, MSN, CPN

Austin Community College
Austin, Texas

Constance Bobik, RN, BSN, MSN

Brevard Community College
Cocoa, Florida

Pam Bowden, RN, MS, PNP

North Hennepin Community College
Brooklyn Park, Minnesota

Pamela Cleveland, MSN, RN, FNP

South Texas College
McAllen, Texas

Cheryl DeGraw, RN MSN, CRNP, CNE

Florence-Darlington Technical College
Florence, South Carolina

Cherste K. Eidman BS, BSN

Metropolitan State University
St. Paul, Minnesota

Renee Zubay Fife, RN, MSN, CPN

Purdue Calumet School of Nursing
Hammond, Indiana

Pamela Fowler, MS, RN

Rogers State University
Claremore, Oklahoma

Mary Ann Helms, RN, MSN, MRE, EdD

Tennessee State University
Nashville, Tennessee

Rita Horgos, MSN, RN, CPN

Community College of Allegheny County, South Campus
West Mifflin, Pennsylvania

Kathy Jo Keever RNC-OB, CNM, MS

Anne Arundel Community College
Arnold, Maryland

Lori Keough, APRN-BC, MSN, MEd

University of Massachusetts
North Dartmouth, Massachusetts

Carmen Kiraly RN, BSN, MSN, C-WHNP

Suffolk Community College
Brentwood, New York

Kathleen Kleefisch RN, MSN, FNP, BC

Purdue Calumet University
Hammond, Indiana

Kelli D. Lewis, RN, MSN

Rend Lake College
Ina, Illinois

Karen Lincoln, RNC, MSN

Montcalm Community College
Sidney, Michigan

Kathy Martin MNSc, WHNP, RNC

Cox College
Springfield , Missouri

Linda L. Miedema, RN, BNS, MSA, PhD

Brevard Community College
Titusville, Florida

Carol Ann Moseley, PhD, MS, BAN, BA, RN

Blessing-Rieman College of Nursing
Quincy, Illinois

Deborah Naccarini, RN, MSN

Carroll Community College
Westminster, Maryland

Jeanette Nodorft, RNC, BSN, MSN

Southwest Wisconsin Technical College
Fennimore, Wisconsin
Janet Pinkelman MSN, RNC
Owens Community College
Toledo, Ohio

Leslie S. Reifel
Sentara School of Health Professions
Chesapeake, Virginia

Katherine Roberts MSN, RN

Lamar University
Beaumont, Texas

Nancy Rogers, RN, MA, BSN

Carroll Community College
Westminster, Maryland

Martha C. Ruder
Gulf Coast Community College
Panama City, Florida

Nora F. Steele, DNS, APRN

Delgado Community College
New Orleans, Louisiana

Marilyn L. Weitzel PhD, RN

Cleveland State University
Cleveland, Ohio

Donna Wilsker
Lamar University
Beaumont, Texas

Marianne M. Wollyung RN, MSN

Pottsville Hospital School of Nursing
Pottsville, Pennsylvania