Professional Documents
Culture Documents
Study Guide For Foundations of Maternal Newborn and Womens Health Nursing e Book 7th Edition Ebook PDF
Study Guide For Foundations of Maternal Newborn and Womens Health Nursing e Book 7th Edition Ebook PDF
atérnaI-New
W9m en’s H ea lth
1:1.
'h'
' 1'
H.
'-l
Study Guide for
Foundations of
Maternal-Newborn
and Women’s Health
Nursing
Seventh Edition
ELSEVIER
ELSEVIER
3251 Riverport Lane
St. Louis, Missouri 63043
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and re-
trieval system, without permission in writing from the publisher, except that, until further notice,
instructors requiring their students to purchase Study Guide for Foundations of Maternal-Newborn
and Women’s Health Nursing may reproduce the contents or parts thereof for instructional pur-
poses, provided each copy contains a proper copyright notice as follows: Copyright © 2019 by
Elsevier Inc.
Details on how to seek permission, further information about the Publisher’s permission policies,
and our arrangements with organizations, such as the Copyright Clearance Center and the Copyright
Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Although for mechanical reasons, all pages of this publication are perforated, only those pages
imprinted with an Elsevier Inc. copyright notice are intended for removal.
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices,
or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
using such information or methods, they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer of
each product to be administered and to verify the recommended dose or formula, the method and
duration of administration, and contraindications. It is the responsibility of practitioners, relying
on their own experience and knowledge of their patients, to make diagnoses, to determine dosages
and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or edi-
tors assume any liability for any injury and/or damage to persons or property as a matter of
products liability, negligence or otherwise, or from any use or operation of any methods, prod-
ucts, instructions, or ideas contained in the material herein.
- - .
Prmted 1n the United States of Amerlca
. ELRSEVIE
ZZI
300k Aid]
Internatlona
to grow libraries in
developing countries
Last digit is the print number: 9 8 7 6 5 4 3 2 1
www.clsevier.com o www.bookaid.org
I Preface
The Study Guide for Foundations ofMaternal-Newborn Nursing requires more than textbook knowledge,
and Women is Health Nursing, 7th edition, has been writ- however. The feature Developing Insight guides you to
ten to help you grasp the important content in each chap- expand your knowledge from clinical experiences. These
ter of the main text. Each chapter in this Study Guide activities give you specific directions for comparing and
corresponds to the text chapter, having the same number using information that you study in class and in your text-
and title. Specific activities vary in each chapter accord- book.
ing to its content. Case Studies give you a chance to “try out” your
Learning Activities provide a variety of approaches nursing care with a simulated patient. The case studies
to facilitate learning. The exercises include activities such encourage you to use critical thinking to interpret infor-
as matching terms, listing important signs and symptoms, mation given in the situation and select appropriate nurs-
describing medical therapy and nursing measures and ing actions. The case studies can be used by an individual
their rationales, and labeling illustrations. or in a small group. If used in a small group, all members
Check Yourself questions give you an opportunity can benefit from the thinking skills of others in the group
to answer multiple-choice items that are similar to those as they choose and defend their nursing care. In addition,
encountered on a test at school or on the NCLEX® exam. you may often incorporate items such as facility proto-
The questions are a mixture of factual items and higher- cols in the simulated patient care.
level questions that require application of that factual Select answers to exercises are included at the end of
knowledge. the Study Guide.
PART 1 Foundations for Nursing Care of the PART 4 The Family Following Birth
Childbearing Families 17 Postpartum Adaptations and Nursing Care, 139
Maternity and Women’s Health Care Today, 1 18 Postpartum Maternal Complications, 151
BMNh—k
Social, Ethical, and Legal Issues, 7 19 Normal Newborn: Processes of Adaptation, 157
Reproductive Anatomy and Physiology, 11 20 Assessment of the Normal Newborn, 165
Hereditary and Environmental Influences on 21 Care of the Normal Newborn, 173
Childbearing, 19 22 Infant Feeding, 183
23 High-Risk Newborn: Complications Associated
with Gestational Age and Development, 191
PART 2 The Family Before Birth 24 High-Risk Newborn: Acquired and Congenital
Conception and Prenatal Development, 25 Conditions, 199
H¢©OOQGNUI
LEARNING ACTIVITIES
1. Match each term With its definition (a-h).
Association of Women’s Health, . Independent organization that accredits health care organizations
Obstetric and Neonatal Nurses
(AWHONN) . National organization that sets standards for perinatal nurses
Family-centered care . Set of ten-year objectives for improving the health ofAmericans
Doula . Safe, high-quality care that recognizes and adapts to the physical
and psychosocial needs of the family, including the newborn
Evidence-based practice
. First federally sponsored program that provided funds for
_ Healthy People 2020 state-sponsored programs for mothers and children.
The Joint Commission . Care based on use of reliable research findings to determine
best nursing practice to achieve desired outcomes
2. List three major factors that influenced moving the place of birth from home to hospital.
a.
d. Birth centers
e. Home births
4. Explain how each of the following factors led to the development of family-centered maternity care.
a. Consumer demands for involvement in their care
5. Describe nursing care that may be encountered in each of these areas of community-based perinatal nursing.
a. Antepartum high-risk women
b. Postpartum women
c. Normal newborns
d. High-risk newborns
6. Describe the education required and qualified services provided by each type of advanced practice nurse.
a. Certified nurse-midwife (CNM)
b. Nurse practitioners
i. Women’s health nurse practitioner (WHNP)
7. A dialogue between a woman and a nurse follows. Nonverbal behaviors are in brackets. For each of the nurse’s
responses, label the communication techniques or blocks that the response illustrates. Explain what feelings you
think the woman seems to express. If the nurse’s response indicates a communication block, write an alternate nurs-
ing response.
Situation: A 36-year-old woman is being seen in her gynecologist’s office for an annual well-woman checkup.
a. Nurse: Well, it’s time again for your annual examination, isn’t it? Tell me how you have been doing since we last
saw you.
Woman: I haven’t had any real problems; I’m doing okay, I suppose . . . [Woman looks down at her hands and is
silent]
b. Nurse: That’s great! We’re glad you’re doing well, and coming in for a checkup helps keep you that way.
d. Nurse: Oh, not necessarily. Women have babies even into their 40s. Miracles happen every day.
e. Nurse: You were saying that time is running out. Can you tell me more about your concerns?
Woman: Well, when I was in my 20s, I wanted to finish graduate school and get established in a career. Then when
I was in my early 30s, I just seemed too busy to take time to have a baby. Now... [Her voice trails off.]
f. Nurse: [Waiting quietly while the woman gathers her thoughts] It sounds as if you may regret your decision to
wait.
Woman: Well, my husband and I decided to try to have a baby about 9 months ago. Since I never had trouble with my
periods or anything, I thought it would be 3 or 4 months at most until I was pregnant.
Woman: Now I’m afraid my selfishness will keep us from ever having a baby.
h. Nurse: Oh, they can do so many things to help couples conceive now. Miracles happen every day.
b. Active participation
0. Skill repetition
e. Role modeling
b. Focused assessment
11. For each broad goal, write at least three outcome criteria that (1) are patient-focused, (2) use measurable verbs, (3)
have a timeframe, and (4) are realistic.
a. After cesarean birth, the woman will have increased mobility.
c. The new parents will accept their infant who has a birth defect (cleft lip).
12. Draw a graph that shows the most recent differences in white non-Hispanic and African-American maternal and
infant mortality rates. Use the Internet to obtain the most recent information about these rates.
13. What is the leading cause of death in women in the United States?
14. List three major health problems that are linked to obesity.
Check Yourself
1. If a hospital spends more than expected on a patient for care under a specific diagnosis-related group (DRG), the
hospital will be:
a. Reimbursed the amount it spent on the patient’s care.
b. Unable to care for the next patient with that condition.
0. Required to absorb the excess costs.
d. Paid more for care of a patient with a less costly problem.
Which of these standards governs the nurse’s scope of perinatal nursing practice?
a. Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)
b. The Joint Commission on Accreditation of Healthcare Organizations (TJC)
c. The nurse’s state nurse practice act
d. Food and Drug Administration (FDA)
. The major concern about the use of complementary or alternative therapies is:
a. Cost that replaces more effective medicines.
b. Safety of some of the treatments used.
c. Questionable advertising by practitioners.
d. Ability to buy herbal preparations over the Internet.
Your friend says she is not sure that she wants a physician to deliver her second baby because she believes physicians
are too busy to talk with her when she has checkups. The best alternative professional for you to suggest is the:
a. Perinatal nurse practitioner.
b. Certified nurse-midwife.
0. Lay midwife.
d. Clinical nurse specialist.
. A primary difference between social communication and therapeutic communication is that therapeutic communica-
tion is:
a. Designed to obtain information in minimal time.
b. The only appropriate professional communication.
c. Focused on achieving a relevant goal for the person.
d. Limited to the information necessary for safe care.
A pregnant woman tells the nurse, “I’m so confused. My husband wants me to have my tubes tied after the baby
comes, but what if something happens to the baby?” The nurse replies, “You’re afraid of having permanent contra-
ception before you know if your baby is well.” The nurse’s response is an example of:
a. Directing.
b. Paraphrasing.
c. Summarizing.
d. Pinpointing.
The nurse has taught a group of four new mothers how to care for themselves while breastfeeding. At the end of the
class, it is most helpful if the nurse:
a. Asks whether the mothers have questions about breastfeeding.
b. Has each mother demonstrate a technique to the other women.
c. Distributes a small gift in return for attending the class.
(1. Summarizes the most important points about the lesson.
Developing Insight
1. Discuss health plans with several people. Ask them what, if any, restrictions are placed on their care providers. Deter-
mine how much these restrictions concern them and why.
What are the proportions of insured and uninsured people in your local area of practice?
. How do uninsured people obtain essential health care if they seek care?
. In the clinical setting, select a topic that a patient or family needs to learn. Use at least three of the principles of teaching
and learning in your presentation. Explain how you used each principle in your teaching.
a Social, Ethical, and Legal Issues
LEARNING ACTIVITIES
Ethical dilemma . The latest date by which a malpractice suit can be filed
Incident report . Government program that provides money for a limited time for basic liv-
ing costs of poor children
_ Malpractice
. Failure of a professional person to act in a reasonable and prudent way for
_ Medicaid the circumstances
_ Negligence . Government program to provide health care to the poor, aged, and disabled
2. Describe the types of problems that each type of nontraditional family may encounter.
a. Single-parent family
b. Blended family
0. Extended family
d. Same-sex family
e. Adoptive family
f. High-risk family
3. Describe the differences between the theories that guide ethical decision making.
a. Deontologic
b. Utilitarian
c. Human rights
4. Define each ethical principle and give examples of each principle based on your own experience.
a. Beneficence
b. Nonmaleficence
c. Autonomy
d. Justice
5. Describe provisions of the Roe v. Wade US. Supreme Court ruling on abortion.
a. First trimester
b. Second trimester
c. Third trimester
b. Standardized procedures
0. Standards of care
d. Agency policies
b. Breach of duty
c. Damage
b. Full disclosure
c. Understanding information
d. Voluntary
9. How does a long statute of limitations for lawsuits involving a newborn relate to nursing documentation?
11. A nurse reacts with anger because a woman has not had prenatal care because she does not see pregnancy as an illness
that requires health care. The nurse’s reaction demonstrates:
a. Cultural diversity.
b. Fatalism.
c. Predestination.
d. Ethnocentrism.
12. Explain how differing communication characteristics of various cultural groups affect nursing communication.
a. Decision making
b. Eye contact
c. Touch
e. Time orientation
Check Yourself
1. Notations written on a fetal monitor strip:
a. Are a legal part of the chart.
b. Should be kept for 7 years.
c. Replace all client documentation on labor flow sheets.
d. Provide adequate documentation of labor nursing care.
2. A nurse is morally opposed to abortion at any time during pregnancy. Which statement best describes the nurse’s
responsibility related to this belief?
a. The nurse cannot accept employment in any agency that may provide abortion services.
b. The nurse may decline to participate in abortion but must care for women after the procedure.
c. The nurse must make this position known before being employed at an agency that provides
abortions.
d. The nurse must provide the same care for women undergoing abortion procedures as for any other woman.
Developing Insight
1. In your clinical setting, talk with the staff about ethical dilemmas they have experienced. How were the dilemmas
resolved? What policies are in place to help nurses deal with ethical dilemmas?
2. Examine consent forms used in your agency for vaginal and cesarean births, circumcision, and anesthesia.
3. What is your agency’s chain of command if a physician’s response to a nurse’s request for instruction is inadequate
or inappropriate?
4. Look up the latest statistics for the poverty rate on the Internet. How does the rate of poverty differ among various
racial groups? Does the incidence of poverty differ when a household is headed by one person rather than two? If the
household is headed by one person, do rates differ between those headed by women and those headed by men? Does
age make a difference in these statistical numbers? Can you support the reliability of statistics from the Internet site
that you chose?
LEARNING ACTIVITIES
_ Feedback loop a. Imaginary line dividing the upper (false) pelvis from the lower
(true) pelvis
_ Linea terminalis
b. Involuntary release of seminal fluid from the penis during sleep
_ Nocturnal emission
0. Small ridges or folds of tissue in the female vagina and on the
_ Perineum male scrotum
_ Rugae d. Collective term for all the female external reproductive organs
6. What factors cause the average male to be taller than the average female at physical maturity?
7. Explain the importance of each type of uterine muscle (myometrial) tissue. Where is each type primarily located?
a. Longitudinal fibers
i. Importance
ii. Location
11
Copyright © 2019, Elsevier Inc. All rights reserved.
12 Chapter 3 Reproductive Anatomy and Physiology
ii. Location
c. Circular fibers
1. Importance
ii. Location
9. What is the difference in the time when the immature female and male gametes are formed?
a. Female gametes
b. Male gametes
10. Match each structure with its function (a—j). Some letters may be used more than once; other letters may not be used
at all. What is the structure that is described by any answer that you do not choose?
Sertoli cells j. Discharge milk into the ductal system of the breast
Skene’s glands
Copyright © 2019, Elsevier Inc. All rights reserved.
Chapter 3 Reproductive Anatomy and Physiology 13
b. Ovulatory phase
c. Luteal phase
b. Secretory phase
c. Menstrual phase
13. Why might a man who usually wears very tight underwear have a problem with infertility?
Labefing
1. Label each of the external female reproductive structures.
4. Label each muscle and muscle group of the female pelvic floor.
Check Yourself
1. The gender of an infant will be female unless:
a. Two X chromosomes are received from the mother.
b. The short arm of the Y chromosome is received from the father.
c. Conception occurs during the last half of the female reproductive cycle.
d. The mother’s ovary produces testosterone early in pregnancy.
The layer of uterine muscle that is most active during labor is composed of which type of the following fibers?
a. Longitudinal
b. Interlacing
c. Circular
The layer of uterine tissue that responds to cyclic changes in hormones secreted by the pituitary gland is the:
a. Perimetrium.
b. Myometrium.
c. Endometrium.
Conditions that cause the fallopian tubes to be narrower than normal may result in:
a. Excessive cramping and bleeding during menstruation.
b. Increased likelihood of pregnancy during each cycle.
0. More rapid propulsion of the ovum through the tube.
(1. Implantation of a fertilized ovum within the tube.
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.