Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
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J Obstet Gynecol Neonatal Nurs · Mar 1994
ReviewMaternal hypothermia: implications for obstetric nurses.
Hypothermia, a core body temperature of less than 95 degrees F (35 degrees C), is a common intraoperative complication among adult patients and may occur in obstetric patients. Obstetric patients are predisposed to hypothermia because of vasodilation from pregnancy, administration of anesthetics and pharmacologic agents, and inherent blood loss with rapid fluid replacement during delivery. Morbidity associated with hypothermia occurs from complications such as hypotension, cardiac arrhythmias, increased oxygen consumption or respiratory depression, and disseminated intravascular coagulation. Interventions include preventive measures such as maintaining reasonable ambient room temperatures, avoiding infusion of cold solutions, and promptly assessing postoperative temperature, as well as corrective measures--rewarming the patient, placing the patient on dry surfaces, minimizing additional heat loss, and providing external heat sources.
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The complexities of current societal trends impose a daunting challenge to providers of maternal child health services. Demographers, anthropologists, sociologists, policy makers, and health care providers struggle to grasp the multiple issues in an effort to create useful strategies for the 21st century. ⋯ Legislative and policy efforts have focused new and much-needed attention on women as recipients and providers of health care. The realities of mothers in the work force, the epidemic of adolescent pregnancy, the swelling ranks of women and children in poverty, the increasing number of women with acquired immune deficiency syndrome, the new advances in reproductive technology, and the effect of population and immigration trends greatly influence the childbearing client of the future and create enormous pressures for critical problem solving.
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J Obstet Gynecol Neonatal Nurs · Feb 1994
ReviewChildbearing, reproductive control, aging women, and health care: the projected ethical debates.
Of the many social trends that will have an impact on the ethical debates surrounding women's health in the 21st century, three are discussed: the shifting demographics of age and race in the United States; the fundamental change in the health care system to a community-based, preventive model; and the equal voice of women in the government. Using these trends as a framework, this article hypothesizes the ethical debates that will occur in the 21st century concerning such issues as fetal viability, abortion, contraception, infertility, genetic engineering, aggressive versus nonaggressive treatment of aging women, scarce resources, menopause, organ transplants, sexism in biomedical research, fertility in postmenopausal women, birthing centers, fetal surgery, and fetal therapy.
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While major trauma during pregnancy is usually managed in intensive-care units by critical-care nurses, obstetric nurses often care for patients who have experienced minor trauma. Obstetric nurses must understand the mechanisms of traumatic injury and the potential deleterious effects on mother and fetus. Nursing care of the pregnant victim of minor trauma is the focus of this article.
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J Obstet Gynecol Neonatal Nurs · May 1989
ReviewEthical principles: application to an obstetric case.
This article focuses on the application of the ethical principles of double effect versus consequentialism, autonomy, beneficence, utility, and justice. An obstetrical case study is presented and discussion of each ethical principle is used to resolve the conflict. The intents of the article are to promote ethical awareness; provide topic areas to facilitate ethical discussion; enhance nurses' knowledge of the discipline of ethics; and support the necessity of interdisciplinary ethics committees.