N 340 Women's Health & Illness in The Expanding Family & N345 Clinical Practicum

Infertility, Pregnancy Termination and Loss

Readings: Lowdermilk: Chapters: 8 (189-192), 9, 28 (670-680), 38, & adoption: pp. 208-209.

Chapter 8: Induced abortion (pp 189-192).
1. What is an induced abortion? What other terms are used to describe this interruption of pregnancy?
2. When do most induced abortions occur?
3. What are two reasons that the nurse could choose to not provide care for this patient?
4. What kind of counseling needs to be provided for patients seeking an induced abortion?
5. How pregnant should a patient be to safely have a vacuum aspiration abortion?
6. What three medications are used in combination for medical abortions (and why do they all have to start with M and have so many syllables!)
7. In general, who are the "best" candidates for medical abortions (this is an opinion question based on the info you have just read!)?
8. When is a D&E performed?

Chapter 9 Infertility
1. How common is infertility?
2. What percentage of time is infertility due to female factors, male factors and unexplained factors?
3. You are the charge nurse at an infertility clinic. It is your responsibility to schedule various infertility tests. Look at Table 9-1 on p. 199. A woman calls to schedule these tests. Her LMP is November 1st and she always has a 28-day cycle (fat chance!). When would you schedule these various tests?
4. A married couple is considering adoption after five years of infertility treatments. They had one SAB 1 ½ years ago. The woman is 42 and the man is 55. She would like to try one more shot at IVF (they have had three previous attempts without success) and he is ready to adopt. How would you assist contemplating adoptive parents in making decisions related to adoption?

Chapter 38
1. How can having a miscarriage affect a mother and a father? Look at Box 38-1 p. 933 as an overview.
2. What is the technical difference between miscarriage, fetal death, stillbirth, and newborn death?
3. Name three phases of grief and list at least 2 characteristics of each phase.
4. Name 4 important assessments when working with a family that has experienced a perinatal loss.
5. Name 5 nursing interventions when working with a family that has experienced a perinatal loss.
6. What are the pros and cons of autopsy?
7. Putting a baby up for adoption doesn’t seem to be in our text so I am including it here because it is also a loss of a newborn for the woman and her family who is choosing to relinquish her child. Look back through this chapter form the perspective of assisting this patient with her loss. What might their grief response be?