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TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Fall 2011
COURSE SYLLABUS ............................................................................................................. 1-14
CALENDAR
Maternal-Neonatal Nursing Made Incredibly Easy ................................................................. 15
Week 1
1. Orientation, Contemporary Maternity Care, Growth & Development and the
Menstrual Cycle .......................................................................................... Week 1 Page 1-2
2. Transitions through Pregnancy: Physical Changes, Signs and Symptoms ..... Week 1-Page 3
Week 2
3. Transitions: Conception, Fetal Development, Assessment Care and Nutrition through
Pregnancy and Lactation .............................................................................Week 2-Page 4-5
4. Health Promotion: Putting it all Together ....................................................... Week 2-Page 6
Week 3
5. The Transition of Labor & Birth: Needs, Care and Comfort Measures ......Week 3-Page 7-8
6. Intrapartal Assessment and Care of Mother and Fetus ................................... Week 3-Page 9
7. Friedman’s Curve (Partogram) ..................................................................... Week 3-Page 10
8. Categories of Presentation ............................................................................. Week 3-Page 11
Week 4
9. Postpartum Transition, Nursing Assessment/Care and High Risk Postpartum
Complications; Maternal/Newborn Death .............................................Week 4-Page 12-13
10. Postpartum Assessment and Care; Contraception ....................................... Week 4-Page 14
Week 5
11. Normal Newborn Transition after Birth: Assessment, Needs, Care .......Week 5-Page 15-16
12. Health Promotion: Parental Teaching & Infant Nutrition.......................Week 5-Page 17-18
Week 6
13. Health Promotion for High Risk Problems during Pregnancy................Week 6-Page 19-20
14. Health Promotion/Prevention for High Risk Psychosocial Populations ...... Week 6-Page 21
Week 7
15. Risky Transitions through Labor & Delivery; Risky Transitions for the
Newborn ..................................................................................................Week 7-Page 22-23
16. FACE Wrap-up .......................................................................................... Week 7-Page 247
Hospital Orientation
1. Orientation to Hospital Clinical Experience ..................................................Hospital-Page 1
2. Orientation Study Guide ................................................................................Hospital-Page 2
Obstetric and Women’s Health Clinics
3. Obstetrical Clinical Observation Experience .................................................Hospital-Page 3
4. Assessment of the Prenatal Woman ........................................................... Hospital-Page 4-6
Labor and Delivery
5. Labor & Delivery Hospital Clinical Experience ........................................ Hospital-Page 7-8
6. Labor & Delivery Study Guide ......................................................................... Hospital 9-13
Labor & Delivery Forms
a. Demographic Data Collection
b. IV Fluids and Medications
c. Nursing Diagnosis Sheet
d. Friedman’s Curve (Partogram)
e. Self Evaluation Form
i
Postpartum
7. Postpartum Hospital Clinical Experience.............................................. Hospital-Page 15-15
8. Postpartum Study Guide ..............................................................................Hospital-Page 16
9. Nine-point Postpartum Assessment ....................................................... Hospital-Page 17-18
Postpartum Forms
a. Demographic Data Collection
b. Health Assessment/Functional Patterns
c. IV Fluids and Medications
d. Nursing Diagnosis Sheet
e. Nursing Care Plan
f. Generic Postpartum Care Plan
g. Self Evaluation Form
h. Nursing Plan of Care and Evaluation Criteria
Norman Newborn
10. Newborn Nursery .................................................................................. Hospital-Page 19-20
11. Normal Newborn-Nursery Study Guide ............................................... Hospital-Page 21-24
12. Triple Dye ...................................................................................................Hospital-Page 25
13. Normal Newborn-Nursery Assessment Guide...................................... Hospital-Page 26-28
Newborn Forms
a. Demographic Data Collection
b. Health Assessment/Functional Patterns
c. IV Fluids and Medications
d. Nursing Diagnosis Sheet
e. Nursing Care Plan
f. Nursing Plan of Care and Evaluation Criteria
g. Self Evaluation Form
Neonatal Intensive Care Unite
14. Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) Clinical
Observation ................................................................................................Hospital-Page 29
15. Special Care Nursery (SCN) or Neonatal Intensive Care Unit (NICU) Study
Guide .................................................................................................... Hospital-Page 30-31
NICU Forms
a. Demographic Data Collection
b. IV Fluids and Medications
c. Self Evaluation Form
Multiple Clients
16. Care of Multiple Clients .............................................................................Hospital-Page 32
17. Abbreviated Care Plan for Multiple Client Week.................................... Hospital –Page 33
Multiple Client Forms
a. Demographic Data Collection
b. Health Assessment/Functional Patterns
c. IV Fluids and Medications
d. Nursing Care Plan
e. Nursing Plan of Care and Evaluation Criteria
ii
f. IV Fluids and Medications
g. Nursing Diagnosis Sheet
h. Nursing Care Plan
i. Nursing Plan of Care and Evaluation Criteria
j. Self Evaluation Form
k. Abbreviated Care Plan for Multiple Client Week
l. Demographic Data Collection for Multiple Clients
m. Nursing Diagnosis Sheet
n. Nursing Diagnosis Sheet (newborn)
o. Care Map and Evaluation Criteria
p. Self Evaluation Form
Performance Evaluation Profile
17. Student Performance Evaluation Profile
Competency Guidelines
18. Competency-Apical Newborn Heart Rate
19. Clinical Skills Opportunities Record
Family and Community Education Poster and Paper Project
20. Face Project Preparation, Presentation and Summary Paper .......................... Face-Page 1-2
21. Face Learning Needs for Assigned Population ................................................... Face-Page 3
22. Goals (Health Promotion) ................................................................................... Face-Page 4
23. Face Poster Implementation & Evaluation Grading Criteria .......................... Face-Page 5-6
24. Face Poster Critique Grade Sheet .......................................................................Face-Page 7
25. Face Individual Participation Rating ............................................................ Face-Page 8-10
iii
I. PLACEMENT: Level 3 - Nursing Curriculum
II. CREDIT HOURS: Three (3). The credit hours are allocated as follows:
1.75 credits - Theory classes (195 minutes each for 7 weeks)
Unit Exams (60 minutes each for 3 weeks; 45 minutes for 1 week)
Comprehensive Final (2 hours for 1 week)
1.25 credits - Clinical Practicum/Learning Activities
Learning Activities Laboratory (1.25 hours each for 7 weeks)
Clinical Practicum (6 hours each for 5 weeks, 4 hours for 2 weeks)
Ambulatory Community Experience (6 hours, 2 hours each for 3 weeks)
Collaborative Exam (30 min each for 4 weeks)
III. COURSE PREREQUISITES:
NURS 1457 Nursing of Adults with Major Health Disruptions
NURS 1421 Nursing Issues and Perspectives 2
BIO 2164 Microbiology
PSY 2023 Developmental Psychology
IV. COURSE COREQUISITES:
POS 1113 American Federal Government
NURS 2433 Nursing Care of Children and Their Families
NURS 2453 Nursing Promotion for Quality of Life
V. COURSE CATALOG DESCRIPTION:
Nursing care of mothers and newborns during the childbearing transition is the focus of this
course. Emphasis is on the physiological care of the mother and infant and psychosocial
transition of the family. The concepts of transition, growth and development, and health
promotion are explored within the roles of manager and provider of care while being a
member within the discipline of healthcare. Pharmacologic principles and interventions are
applied to specific client populations. Community is viewed as a part of the environment,
and the psychosocial adaptation of the entire family is examined.
VI. COURSE OUTCOMES:
At the end of this course, the students will be able to:
A. Roles
 Demonstrate an understanding of the theoretical principles essential to the roles of
the ADN (care provider, care manager and member of the healthcare team) in the
care of the childbearing family.
 Implements the roles of the ADN when providing holistic care for the childbearing
family of varying ages, developmental levels, values, ethics, groups and cultures.
2
B. Client Needs
 Implement nursing skills/competencies and evaluates the delivery of evidence based
care of the childbearing family according to standards of practice, licensure laws,
and professional responsibilities.
C. Communication
 Communicate effectively with the childbearing family in a caring and therapeutic
manner consistent with cultural expectations and phases of pregnancy.
 Communicate effectively with faculty, agency staff and peers through oral, written
and technological communication routes.
D. Critical Thinking
 Utilize critical thinking to implement the nursing process through functional health
patterns, teaching/learning principles and developmental concepts in order to develop
and implement nursing plans of care for the childbearing family.
VII. COURSE OVERVIEW:
NURS 2423 will provide the student with knowledge and skills needed to provide nursing
care for the childbearing family, the concepts of 1) transition, 2) growth and development
and 3) health promotion are emphasized during the course. Theory will be presented via
lecture, Powerpoint, overheads, question and answer sessions, group discussions and
examples of theory application. The Learning Activities Laboratory includes skill
demonstration, skill practice, simulations, films, games, puzzles, case studies, group
discussions, role playing and individual project presentations. Hospital clinicals include
experiences in labor and delivery, postpartum, newborn nursery, intensive care nursery and
in community clinics providing care to women and families during the childbearing phase
of life. A teaching project will be completed in teams at assigned community locations.
Nursing Informatics will be integrated into the course. The student will be expected to
utilize the concepts and principles acquired from prerequisite nursing courses, TCC
Nursing Division Conceptual Framework, nutrition, pharmacology, psychology, anatomy,
and physiology in meeting the basic needs of the patient. Self-direction and self-motivation
are expected of the student, along with an ongoing process of self-evaluation throughout
the course.
VIII. NURSING DIVISION:
Associate Dean:
Office No.:
Phone No.:
Office Hours:
Lisa Watkins, RN, MSN
SE Campus SE 8199-A
595-8647
7:30 a.m.-5:00 p.m., M-F
2
IX. INSTRUCTORS:
Dr. Sarah Plunkett,
Course Coordinator
Office: MC 525
Phone: 595-7203
Home: 299-3552
Cell: 855-6513
e-mail: [email protected]
Leslie Guthrie
Office: MC 338
Phone: 595-7387
Cell: 697-7038
Home: 664-2024
e-mail:
[email protected]
Gwenn Hurlbut
Office: MP 252
Phone: 595-7210
Home: 583-1425
Cell:
230-3358
e-mail: [email protected]
Adjunct Instructors:
Donna Frayser
Home: 451-2977
Cell:
381-1533
e-mail: [email protected]
Melanie Ketchum
Cell: 688-3662
e-mail:
[email protected]
Donna Murray
Cell: 520-8264
e-mail:
[email protected]
X. TEXTBOOKS:
Perry, Shannon E. and Hockenberry, Marilyn J., Lowdermilk, D., and Wilson, D. (2010)
(4th ed). Maternal Child Nursing Care, St. Louis, MO. Mosby.
TCC Nursing Packet – NURS 2423 Nursing of the Childbearing Family, Fall 2011
Textbooks from previous nursing courses may be used as information resources.
Optional:
Doenges, Moorehouse, Murr (2010). Nursing Care Plans: Guidelines for Individualizing
Client Care Across the Life Span. ISBN 978-0-803-62210-4
Piotrowski, K. & White, A. R.(2010) (4th ed). Study Guide to Accompany Maternal Child
Nursing Care, Mosby, ISBN 978-0-323-07237-3
Holloway, B.W. and Moredich, C. (2011) (2nd ed). OB/GYN Peds Notes: Nurses Clinical
Pocket Guide, FA Davis, ISBN 978-0-8036-2332-3
Helpful Websites:
www.neonatology.org
www.postpartum.net
www.awhonn.org
www.mededppd.org
www.medela.com
www.perinatalweb.org
www.nann.org
www.childbirthconnection.org
www.ncsbn.org (Review NCLEX Blueprint)
www.womensmentalhealth.org
www.mchb.hrsa.gov/pregnancyandbeyond/depression/
http://www.nwlink.com/~Donclark/hrd/bloom.html
XI. TEACHING-LEARNING STRATEGIES:
Teaching-learning activities include a variety of learning opportunities with emphasis
placed on the development of student creativity and critical thinking. Instructional
strategies include classroom presentation, assigned readings, interactive video discs, small
group discussion, audio-visual aids, written assignments, health information technology,
observations, demonstrations, return demonstration, supervised practice, simulations,
supervised clinical experiences, printed handouts, pre- and post-conferences, self-directed
inquiry, and self-evaluation.
XII. SYSTEM FOR STUDENT GRADING AND EVALUATION:
To satisfactorily complete NURS 2423 and to be eligible to continue matriculation in the
Tulsa Community College Nursing Program, the student must earn a cumulative
percentage grade of 75% on exams, a cumulative overall percentage grade of 75%, AND
earn a grade of Satisfactory (S) for all clinical components of this course. Upon achieving a
75% on exams, scores from other work will be added to determine the student’s final grade.
There will be NO ROUNDING, NO EXCEPTIONS. All written work must be
submitted to SAFE ASSIGNMENT in addition to hard copy submitted to their instructor.
Posting of Grades
Exam scores are posted on Blackboard within one week of the original exam. Graded
observation reports, papers/projects, and careplans are generally returned within two weeks
of receipt from the student OR prior to the date that the next one is due (whichever comes
first).
A. GRADING SCALE
Final grades will not be poster per TCC policy, but students can determine their grades
utilizing the following worksheet:
Points Earned
Points Possible
Score exam 1
___________
100
Score exam 2
___________
100
Score exam 3
___________
50
Score exam 4
___________
100
Comprehensive Final Exam
___________
100
Score for FACE project
___________
150
Care plan grade (average score from
four careplans)
___________
100
*Preparation & observation reports
___________
100
*Preparation, Observation Reports & Study Guides (listed as POS in Grade Center)
 2 study guides (Orientation & Postpartum)
at 5 points each
___________
 3 study guides (NN, NICU, L&D) at
10 points each
___________
 3 preparation maps (PP, NN, L&D) at
10 points each
___________
 3 observation reports (OB Clinic, L&D,
NICU) at 10 points each
___________
The percentage scale is as follows:
720-800
640-719
600-639
480-599
479 or less
100-90%
80-89%
75-79%
74-60%
59% or less
=
=
=
=
=
A
B
C
D
F
B. CLINICAL PERFORMANCE
A clinical grade of Satisfactory (S) is determined by earning a satisfactory evaluation
on ALL of the following clinical performance requirements of this course.
1.
2.
3.
4.
5.
6.
7.
Psychomotor Skills Competency Testing
Medication Dosage Computation
Written Care Plans, Postpartum, and Newborn Nursery
1 Newborn Assessment
1 Maternal Postpartum Assessment
Study Guides for Labor & Delivery, Postpartum, Newborn Nursery, & NICU
Observations Reports of Clinical Experiences (labor delivery, NICU,
obstetrical clinic visit)
8. Demonstration of Professional and Nursing Role Behaviors as defined in the Student
Performance Evaluations Profile (SPEP)
XIII. DESCRIPTION OF COURSE REQUIREMENTS:
A. THEORY EXAMINATIONS
A total of four (4) unit examinations will be given to evaluate student acquisition of
theoretical knowledge. Exams will be given at the end of each one or two weeks over the
material covered in the classroom and in the Learning Activities Laboratories.
All
Exams will consist of 25 questions per week of content. Each exam item will be worth
2 points. Three (3) unit exams will have 50 items (2 points each) worth 100 points total
and one (1) unit exam will have 25 items (2 points each) worth 50 points total. Students
will also complete a Comprehensive Final exam at the end of the semester worth 100
points total.
B.
COLLABORATIVE TESTING OPPORTUNITY
Students have the opportunity to earn collaborative points by participating in
collaborative groups after each unit exam. Students may decline to participate in
collaborative exams by signing a wavier at the beginning of the course. Students who
agree to engage in collaborative testing MUST participate in group discussions to receive
group points. A student who declines to participate in collaborations will lose all
participation points for the course.
Hrs.
Presented
1¼
1
1
1 ½*
2¼
1
1 ½*
2¼
1
1 ½*
3¼
1 ½*
3¼
1½
1¾
1½
1 ½*
EXAM BLUEPRINT
Topic
Unit Exams-#
of questions
WEEK 1
1-2
Orientation to Course
Contemporary Maternity Care
7-9
Growth & Development and
7-9
Menstrual Cycle
Physical Changes, Signs &
4-6
Symptoms of Pregnancy
WEEK 2
Conception, Fetal Development,
Assessment & Care Through
14-18
Pregnancy
Nutrition through Pregnancy &
6-8
Lactation
Putting it all together
3-5
WEEK 3
Labor & Birth Process
14-18
Care and Comfort during Labor &
6-8
Birth
Fetal Monitoring
3-5
WEEK 4
Postpartum Transition, Needs
20-22
Assessment and Care
Infertility and Contraception
3-5
WEEK 5
Normal Newborn
20-22
Infant Nutrition & Parental Teaching
3-5
WEEK 6
High Risk Pregnancy Problems – Pre
10-11
Gestational
High Risk Pregnancy Problems 9-10
Gestational
High Risk Social Factors
3-5
WEEK 7
1¼
High Risk Labor and Birth
1½
High Risk Newborn
* Learning Activity Labs
10-13
10-13
Comp Exam #
questions
0
1-2
1-2
1-2
3-4
2-3
1-2
3-4
2-3
1-2
5-6
1-2
5-6
1-2
2-3
2-3
1-2
2-3
2-3
B. FAMILY AND COMMUNITY EDUCATION (FACE)
Each student will be placed in groups of three to five to conduct a teaching project. A
community agency and its population will be provided and the students will develop a
list of learning needs and a teaching plan with a poster and handouts to meet that
learning need. A visit to the agency will be completed during which the students will
implement the teaching plan and evaluate learning. The poster project, handouts and
written report of the FACE experience is worth 150 points of the final grade.
C. SKILLS COMPETENCIES
Students are expected to be able to perform competencies previously passed if needed
for client care. The only new competency that will be documented is a newborn apical
pulse rate. A faculty member will take the rate at the same time as the student. The
student must be able to count the rate within four beats of the faculty.
D. NURSING CARE PLANS
Prior to arrival at the clinical sites each week the student is to complete a Study
Guide to prepare them for the experience with the assigned population of clients.
There will be other paperwork required to be completed during clinical and submitted
as specified in each week’s Learning Map. During the weeks the student is in Labor
and Delivery, Postpartum and Normal Newborn Nursery, prior to arrival for clinical
each student will also complete a Preparation Map for the population of clients they
are assigned for the week. The Preparation Map should contain information for which
the client should be assessed during the clinical time. During the weeks of Postpartum,
Normal Newborn and Multiple Clients, students will utilize the nursing process to
assess and plan care for their assigned client. The preparation maps, observation
reports, and study guides (POS) will be worth up to 100 points total. Each of the four
careplans will be graded separately and then averaged together for one (1) final
careplan score worth up to 100 points total that will appear in the Blackboard
gradebook.
A separate score of 80% or above must be earned for each careplan completed in the
Newborn and Postpartum weeks in order to have the option of completing an
abbreviated (short) assessment and careplan for that area during the week they are
assigned to Multiple Clients. Students are eligible to complete the abbreviated (short)
assessment and careplan for each area where they previously scored 80% or higher. If
a score of 80% or higher is not earned for one (1) or both of the original careplans,
traditional care plan forms and paperwork will be required. Therefore it is
possible that a student may be eligible for both abbreviated (short) versions; one
abbreviated (short) and one traditional; or two traditional careplans during the week of
Multiple Clients.
NOTE: Students must earn a passing exam average (75% or higher) in order to
have clinical grades added to their exam scores to determine the overall course grade.
E. NEWBORN ASSESSMENT
Each student will demonstrate the ability to perform a newborn assessment with
faculty assistance and calculate the nutritional needs of assigned newborn clients.
F. MATERNAL POSTPARTUM ASSESSMENT
Each student will demonstrate the ability to perform a maternal postpartum assessment
with faculty assistance.
G. PERFORMANCE OF PROFESSIONAL BEHAVIORS
Students are expected to demonstrate professional behaviors during all clinical
components of this course. Performance of these behaviors is evaluated by professional
faculty in each assigned clinical setting following each clinical practicum day. A
description of expected behaviors are presented in the STUDENT PERFORMANCE
EVALUATION PROFILE (SPEP). The procedure used to record student
performance on the SPEP is described in the following section of this syllabus entitled
XIV. STUDENT PERFORMANCE EVALUATION PROFILE.
XIV. STUDENT PERFORMANCE EVALUATION PROFILE (SPEP)
The STUDENT PERFORMANCE EVALUATION PROFILE identifies objectives that
reflect desired professional behaviors categorized in the roles of the Associate Degree
Nurse. After the completion of each clinical day, the STUDENT PERFORMANCE
EVALUATION PROFILE is used by the faculty members to record the student’s ability
to demonstrate:



Safe and effective nursing care.
Professional responsibility.
Commitment to learning and self-development.
A cumulative overall evaluation of “Satisfactory” on the STUDENT PERFORMANCE
EVALUATION PROFILE is required to pass the clinical portion of the course and to
progress in the Tulsa Community College Nursing Program.
A. Evaluation of student performance will be based on how consistently performance
objectives are met. A summary of student performance is computed weekly.
B. If performance of a clinical practicum objective is consistently demonstrated by the
student, achievement of the objective is “Satisfactory.” A check-mark is placed
beside that objective on the STUDENT PERFORMANCE EVALUATION
PROFILE.
C. When a student demonstrates excellence in the performance of a particular objective,
a plus sign (+) is placed beside that objective on the STUDENT PERFORMANCE
EVALUATION PROFILE.
D. If a student is unable to demonstrate consistent performance of a particular objective,
or an objective is not applicable during a certain week, or if the student’s performance
of an objective is not observed by the faculty, one of the following symbols is
recorded on the STUDENT PERFORMANCE EVALUATION PROFILE:
I
N
NA
O
=
=
=
=
Objective inconsistently met
Objective not met
Objective not applicable for that week
Objective not observed by instructor
E. If a student receives an “I” in a specific objective and does not show improvement in
the performance of that objective in the current clinical rotation in subsequent weeks,
the student may receive an “N” for that objective.
F. Some of the clinical performance objectives are considered critical to satisfactory
nursing practice and are designated by a star (*). If a student does not satisfactorily
meet a critical objective, he/she will receive an “N” for that objective and may
receive a “U” for that clinical day.
G. If the student earns an “N” for three or more clinical performance objectives; the
student’s grade for that clinical day may be recorded as a “U,” indicating
unsatisfactory performance.
H. When a student consistently demonstrates achievement of clinical objectives and
All critical objectives with fewer than three “N’s” for that clinical day, clinical
performance is satisfactory and an “S” is recorded for that day’s clinical grade.
I. If the student earns a “U’ for any clinical day, a counseling form documenting student
performance and recommendations for improvement is composed by the clinical
instructor(s) and discussed with, and signed by, the student. A copy is placed in the
student’s permanent file.
J. If two days of unsatisfactory performance in the clinical practicum is achieved during
the semester, then the student is placed on probation. Three clinical days of
unsatisfactory clinical performance during the semester constitutes failure of the
clinical practicum for NURS 2423. (Refer to the TCC Nursing Program Handbook for
more information regarding 2U’s = Probation and unsatisfactory clinical
performance.)
K. The student is expected to demonstrate improvement during the clinical practicum a
and should strive to have all objectives evaluated as being satisfactorily met by the
end of the semester.
XV. POLICIES AND PROCEDURES FOR NUR 2423, NURSING OF CHILDBEARING
FAMILIES
The student in NURS 2423, Nursing of Childbearing Families, is responsible for knowing
and complying with all of the policies published in the current edition of the Student Code
of Conduct and Policy Handbook for TCC, and the TCC Nursing Program Student
Handbook. The student should review both policy books periodically during the
semester.
In addition, the student is responsible for complying with the following policies and
procedures specific to NURS 2423. These statements apply to theory class, learning
activities laboratory, clinical practice and all other scheduled course activities.
A. ATTENDANCE
Professional learning responsibility includes attendance and contribution to class or
conference discussions. Students are expected to attend theory class. Attendance at all
other course activities is REQUIRED.
Learning activities laboratories, the FACE project and clinicals experiences must be
made up to meet course objectives. It is the responsibility of the student to contact the
course coordinator or clinical instructor ASAP to make arrangements for make-up.
B. EMERGENCIES OR ILLNESS
In the event of an emergency or illness notify the TCC Nursing Division Office
(595-7188) prior to any scheduled clinical practice, activities laboratory, faculty
appointment, or examination. Leave your name, phone number and scheduled time
for the activity. It is the responsibility of the student to contact faculty to arrange a
make-up time for the activity missed.
A student who has a fever of 99.8F or higher, an upper respiratory infection, a GI
disturbance, or any type of infectious condition should not attend clinical practice. If
this occurs, the student should follow the procedure outlined for a clinical practicum
absence.
C. ABSENCE OR NON-ATTENDANCE
1. Theory
If a student is unable to attend class, it is the responsibility of that student to
obtain handouts that were distributed, obtain class notes and acquire other pertinent
information/announcements that were made in their absence.
2. Clinical Practicum (ATTENDANCE IS MANDATORY)
If a student is unable to attend a scheduled clinical practicum experience, the TCC
Nursing Division, faculty and clinical facility/unit must be notified of the absence at
least one (1) hour before the clinical experience is scheduled to begin. A student
missing more than 8 hours may be unable to meet the Clinical Performance
Objectives for the course. It is the responsibility of that student to contact the clinical
instructor immediately after the absence to arrange for clinical make-up time.
All missed clinical time must be made up before the end of the semester. Clinical
practicum make-up time may be scheduled on evenings or weekends depending on
the availability of clinical experiences.
3. Learning Activities Laboratory
ATTENDANCE IS MANDATORY for assigned Learning Activities Laboratory
classes. If students are unable to attend their scheduled class, the NURS 2423
Coordinator must be contacted to schedule make-up time for learning activities.
Make-up should be completed prior to the next exam to foster expected learning for
the exam.
4. Scheduled Examinations
Students are to take ALL examinations as scheduled. Theory examinations are
computer graded. The computer printout is the official score for the exam.
Students must notify the Nursing Division Office and the respective Course
Coordinator prior to missing any scheduled exam.
The Course Coordinator may request a written explanation from the student to
determine if the absence will be excused. (Missing an exam for work is not a
valid excuse).
Students failing to notify the Nursing Division Office prior to missing an
examination are considered “No Call-No Show’ and may receive a zero“0” for that
exam.
Unavoidable absences will be considered on an individual basis. Make-up exams
may be taken in the “Testing Center” (MC 1018). All make-up exams must be
scheduled with the respective Course Coordinator and must be completed within
one week of the original examination date. The make-up exam may be different
from the original exam. In the event a student misses more than two exams per
course OR level (whichever comes first), 10% of the points possible will be
deducted from any subsequent missed examinations. This includes the final exam.
D. WRITTEN ASSIGNMENTS SUBMITTED AFTER ESTABLISHED DUE DATE
All written assignments are required and must be submitted on the established
date and at the assigned time. Late assignments may not be accepted resulting in a
“0” for the assignment. It is the responsibility of the student to notify the instructor as
soon as they realize the assignment will be late. Serious, extenuating situations
concerning late work may be considered at the discretion of the faculty on an individual
basis.
If the assignment is accepted, it will have 10% of the assigned value deducted for each
day the assignment is late. If assignment is over 7 days late, it will not be accepted
unless arrangements have been made with the course coordinator. Since all written
assignments have a weighted value, late assignments can result in failure NUR 2423.
E. UNSAFE NURSING PRACTICE AND UNPROFESSIONAL CONDUCT
If a student demonstrates unsafe nursing practice or unprofessional conduct as defined
and described in the TCC Nursing Program Student Handbook, faculty will impose
any one or more of the sanctions identified.
Students attending clinical experiences off campus (hospital, FACE, OB Clinic
observations) are expected to dress in a professional manner as specified by
instructors, and need to comply with the regulations as stated in the TCC Nursing
Program Student Handbook. In addition to the requirements of nails being short and
clean, no acrylic nails and/or nail polish is allowed.
Since students may observe or do procedures requiring a surgical scrub, or be in areas
requiring a scrub prior to care of clients, stricter regulation of nails is required to
maintain a maximum level of sanitation.
F. PREPARATION FOR SCHEDULED LEARNING EXPERIENCES
1. Theory
Classes are designed to assist students to synthesize information into a nursing
framework.
To optimize learning it is imperative that students prepare for class.
Preparation includes:
a. Identifying correct date and theory class topics from the printed course calendar.
b. Locating the corresponding Theory Learning Map, which is available in the
Learning Resource Packet.
c. Reviewing expected learning outcomes, read and complete preparation materials
in order to answer the Critical Thinking Questions.
2. Clinical Practicum
A student reporting to the clinical area unprepared or demonstrating unsatisfactory
conduct and/or appearance may be dismissed for that day at the discretion of the
instructor. An unsatisfactory weekly performance will be recorded on the student’s
PERFORMANCE EVALUATION PROFILE. To make up the missed clinical time,
the student must make arrangements with the clinical instructor.
3. Clinical Learning Activities Laboratory
Students are expected to come to class prepared to practice and discuss specific
skills. The Learning Map corresponding to each Learning Activities Laboratory
will guide student preparation. The faculty role in this laboratory is to assist
students to clarify and validate information, and verify competent performance of
skills.
G. TAPING OF CLASSES
Students may audiotape classes with the consent of the instructor and peers. Consent
to tape, duplicate or transcribe is for the use of currently enrolled students only. Taping
and selling tapes for profit is considered unprofessional conduct.
H. PRESENCE OF CHILDREN IN THE CLASSROOM OR CLINICAL FACILITY
It is TCC policy that children are not permitted in any classroom or laboratory.
Unattended children are not permitted in any TCC building. Children are also not to
accompany a student to or be left unattended at any clinical practicum facility.
I. PAGE RS OR CELLULAR PHONES
No cellular phones, headsets or pagers are permitted to be used in any classroom or
clinical practicum. If cell phones or pagers are carried, the paging signal must be
inaudible. In an emergency situation, a student can be contacted through the campus
police office (595-7263). No electronic devices of any kind are allowed during testing.
Instructors will provide a calculator if needed.
J. TCC POLICIES/INFORMATION SHEETS (attached)
XVI. Policies Related to Federal Law
ADA Policy
STUDENTS WITH SPECIAL NEEDS: Students with documented disabilities are
provided academic accommodations through the disabled Student Resource Center
(918-595-7115) or Resource Center for the Deaf and Hard of Hearing (918-595-7428/
TDD-TYY 918-595-7434).
If any student is in need of academic accommodations from either, it is the student’s
responsibility to advise the instructor so an appropriate referral can be made no later than
the first week of class. Students my also contact the disabled Student Services Office
directly at the telephone numbers indicated. ACADEMIC ACCOMMODATIONS
WILL NOT BE PROVIDED UNLESS APPROPRIATE DOCUMENTATION IS
PROVIDED TO THE DISABLED STUDENT SERVICES OFFICES TO SUPPORT
THE NEED.
FERPA Policy
TCC adheres to the Federal mandates under the Family Educational Rights and Privacy
Act (1974), in which students are endowed with certain privacy of information rights in
relation to grades and educational activities. For further details, contact the Dean of
Student Services at 595-7148
XVII. Tulsa Community College Policies and Information:
A. Student Code of Conduct: prohibited activities
Refer to current copy of Student Policies and Resources Handbook (Student Code of
Conduct)
B. Schedule Adjustment/Refund Deadlines
Refer to copy of current catalog
C. Refund policy: Refer to copy of current catalog
D. Complete Withdrawal/Drop a class
Refer to copy of current catalog
E. Student complaints—procedure for filing
Refer to current copy of Student Policies and Resources Handbook
F. Authority for Student discipline
Refer to current copy of Student Policies and Resources Handbook
G. Types of Student Discipline
Refer to current copy of Student Policies and Resources Handbook
H. Student Organizations:
A complete list is available in Student Activities Office, room SA236, X7271
Student Nurses’ Association Advisors:
Linda Lyons-Coyle
[email protected]
Gretchen Hrachovec
[email protected]
Janet Jackson
[email protected]
Mary Helen Freter
[email protected]
Lisa Gerow
[email protected]
I. Communication
MyTCC is the official electronic communication tool used by Tulsa Community
College. Each student is provided with an e-mail account, which is used by the
college to communicate with students. You may access the site at
http://MyTCC.tulsacc.edu.
Your user name is your eight digit student ID number. Your password is the PIN
you use to access the Student Web. (Your PIN is initially set as month date and year
of birth, using leading zeroes and the last two digits of the year of birth. It is
strongly recommended that you change your PIN the first time you access the
Student Web.)
If you wish to forward mail from MyTCC you may do so easily. Open the mail
channel by clicking on the e-mail icon in the upper right-hand portion of the
welcome screen, or the e-mail icon at the bottom of the e-mail channel. Once the
e-mail channel opens, click on the options tool at the top of the screen. On the
left-hand side of the window that opens, click on Settings. The bottom option
allows you to forward e-mail to another account. Be aware that MyTCC does not
retain a copy of forwarded mail. If you change or close the account to which you
have forwarded mail you will have no record of communications sent by TCC.
J. Nurses Christian Fellowship
Advisors: Leslie Guthrie
Lisa Watkins
[email protected]
[email protected]
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Maternal-Neonatal Nursing Made Incredibly Easy
By Springhouse Corporation
This program is installed on several black, Non-Internet computers on the Mentoring room in the
Computer Lab, MP 200. To utilize this resource for learning:
1.
2.
3.
4.
5.
6.
7.
8.
Click on Programs
Click on Maternal-Newborn Nursing Made Incredibly Easy
Pick either: Endless Lecture, Tedious Textbook Torture or Problem Patient
Pick on or two categories, dependent upon the lecture for the week
Pick at least 25 questions
Answer questions
Print Results when game over
If required to do this as part of your Learning Enhancement Program prescription, bring game
results of at least 75% to the Learning Enhancement Representative for the course..
Topics by Week:
Week 1
The Reproductive System and Genetics
Week 2
Antepartum Care
Week 3
Intrapartum Care
Week 4
Postpartum Care and Family Planning
Week 5
Neonatal Care
Week 6
High Risk Antepartum Care
Week 7
High Risk Intrapartum Care and High Risk Neonatal Care
Gwenn Hurlbut, Testing Coordinator and Learning Enhancement Representative (for NURS
2423).
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 1
Orientation & Theory
Topic: Orientation, Contemporary Maternity Care, Growth & Development and the Menstrual Cycle
Learning objectives
Preparation Resources
Critical Thinking Questions
1. Discuss the scope of maternity nursing
2. Identify biostatistical terminology utilized for the
childbearing population.
3. Examine the Healthy People 2010 goals and
interventions for maternity nursing.
4. Compare and contrast different theoretical
approaches for working with childbearing families.
5 Discuss the impact of community, family and culture
on the childbearing family.
6. Discuss family function and dynamics that
contribute to the well being of its members and
society.
7. Identify some common cultural beliefs & practices of
ethnic groups commonly encountered in Tulsa:
Hispanic, African-American, Asian American, and
Native American.
8. Discuss vulnerable populations, barriers to their
receiving health care and anticipatory guidance to
promote their health.
9. Compare and contrast the three levels of
prevention for health care of the childbearing
family and community.
10. Discuss the benefits of preconception counseling
and care.
11. Identify the nurse’s role in assessing a client’s
sexual health.
12. Explain the structures and functions of the male/
female reproductive systems.
Wong, Perry, Hockenberry,
Loudermilk & Wilson chapters
1-5; Ch 6 (pp. 86-96 only); Ch
40 (pp. 1105-1117).
www.childbirthconnection.org
1. Describe some of the many different
settings in which a nurse may provide
maternity care.
2. Who is our client?
3. What functions do families provide?
What happens when these functions
are not provided? What family forms
make a child more or less vulnerable?
4. In planning care for a Hispanic, Arabic
Native American or Asian family what
would I need to consider?
5. If I were caring for a client who is
culturally different from myself & I knew
nothing about that culture what actions
would I take to be culturally competent?
What resources would be beneficial?
6. If given anatomical pictures or structural
descriptions, could you explain the
function of the male and female
reproductive structures?
7. What is the purpose of the proliferation
of tissue lining the uterus? It is
regulated by what hormones?
8. Most sexual dysfunction occurs during
which phase of the sexual response.
Terminology
1. Androgens
2. Binuclear family
3. Birth rate
4. Endometrium (uterine)
cycle
5. Estrogen
6. Extended family
7. Family development
theory
8. Family stress theory
9. Family systems theory
10. Fertility rate
11. Homosexual family
12. Hypothalamic-pituitary
(brain) cycle
13. Infant mortality rate
14. Levels of prevention
15. Low birth weight
16. Maternal mortality rate
17. Menarche
18. Menopause
19. Neonatal mortality rate
20. Nuclear family
Week 1-Page 1
Learning Activities
1.
2.
3.
4.
5.
Reading assignment
Didactic presentation
Visual aides
Student discussion
Handout
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Clinical Practicum Learning Map
13. Identify the male/female hormones produced during
sexual maturation.
14. Identify the sign and milestones of puberty.
15. Identify the 3 interrelated components of the female
reproductive system.
16. Identify and discuss the release of hormones at the
phases of the menstrual cycle.
17. Describe common conditions associated with
menstruation.
18. Identify the four (4) phases of the sexual response.
21. Ovarian (egg) cycle
22. Perinatal mortality rate
23. Preconception
counseling
24. Progesterone
25. Prostaglandins
26. Reconstituted family
27. Testosterone
28. Single parent family
29. Very low birth weight
07/2011 NURS 2423
Week 1-Page 2
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 1: Lab
Topic: Transitions Through Pregnancy: Physical Changes, Signs & Symptoms
Functional Health Pattern: Health Perception Management, Sexual-Reproductive
Learning objectives
Preparation Resources
Critical Thinking Questions
1. Discuss pregnancy testing.
2. Explain the maternal anatomic and physiologic
adaptations to pregnancy.
3. Differentiate among presumptive, probably, and
positive signs of pregnancy.
4. Identify the maternal hormones produced during
menstruation and pregnancy and discuss the
major effects on pregnancy and lactation.
5. Discuss obstetric terminology and obstetrical
abbreviation for GTPAL and GP.
Wong, Perry, Hockenberry,
Loudermilk & Wilson, chapter
10
1. Be prepared to discuss the common
anatomic/physiologic changes that
occur during pregnancy and lactation.
2. Describe to a peer how women and
their families might perceive/experience
the physiologic and anatomic transitions
associated with pregnancy and lactation.
07/2011 NURS 2423
Terminology
1. Ballottement
2. Braxton Hicks contraction
3. Chadwick’s sign
4. Chloasma
5. Fertilization
6. Funic souffle
7. Goodell’s sign
8. GP
9. GTPAL
10. Hegar’s sign
11. Human chorionic
gonadotropin (HCG)
12. Lightening
13. Linea Nigra
14. Luteinizing hormone
15. McDonald’s sign
16. Physiologic anemia
17. Signs of pregnancy
18. Striae gravidarum
19. Telangiectasia
20. Term
21. Uterine souffle
22. Viability
Week 1-Page 3
Learning Activities
1. Reading assignment
2. Didactic presentation
3. Visual aides
4. Student discussion
5. Handout
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 2: Theory
Topic:Transitions: Conception, Fetal Development, Assessment Care and Nutrition through Pregnancy & Lactation
Functional Health Pattern: Health Perception Management, Value-Belief, Sexual-Reproductive, Nutrition-Metabolic
Learning objectives
1. Identify the role of genetics in conception
2. Identify/discuss the components & process of
conception
3. Define twinning
4. Describe the process of fertilization
5. Discuss intrauterine, embryonic, fetal growth/
development.
6. Describe development, structure and functions
the placenta/umbilical cord.
7. Describe the effects of teratogens on
embryonic and fetal growth/development.
8. Discuss health assessment of the pregnant
woman and fetus.
9. Discuss prenatal diagnostic tests.
10. Compare and contrast the stages of
psychological transition the childbearing
family progresses through during pregnancy.
11. Discuss the use of antenatal diagnostic tests
in assessing fetal well-being.
12. Discuss teaching for self-care related to
discomforts of pregnancy during the 1st, 2nd,
and 3rd trimesters.
13. Examine the role of nutrition in the outcome
of a pregnancy.
14. Compare recommended nutritional needs
during pregnancy, postpartum, and lactation.
Preparation Resources
1. Wong, Perry, Hockenberry,
Loudermilk & Wilson,Ch
8-9; chapter 17, (p. 427-FHR);
Ch 11-12; Ch 31 (Family and
Medical Leave Act-last
paragraph p. 819 only); Ch 33
(G/D pp. 842-848 only).
Terminology
1. Alpha Fetoprotein Test (AFP)
2. Amniotic Fluid Index (AFI)
3. Amniotic Fluid Volume (AFV)
4. Anemia
5. Biophysical profile
6. Body mass index (BMI)
7. Calories (K cal)
8. Chorionic Villi Sampling (CVS)
9. Contraction Stress Test (CST)
10. Daily fetal movement kick
count
11. Developmental tasks
12. Diet history
13. Doppler ultrasound
14. Energy
15. Estimated date of birth (EDC,
EDB, EDD)
Week 2-Page 4
Critical Thinking Questions
Learning Activities
1. When/where does fertilization usually occur?
2. What are the components of the initial, ongoing
and follow-up antepartum assessments?
3. How could the antepartum assessment be
structured/adjusted to meet individual client
needs in various healthcare settings?
4. How is teaching-learning theory utilized in
preparing clients for the changes of pregnancy
and the prevention identification of high risk
signs/symptoms?
5. What are the nursing implications for prenatal/
antenatal diagnostic tests?
6. When would you use a NST or an OCT? What
degree/type of client support would be
needed?
7. Intake of what substances would increase a
pregnant woman’s risk of poor nutrition?
8. How would you alter your teaching about
nutrition between the following pregnant
women?
a. First pregnancy
b. Third pregnancy
c. 16-year-old
d. 25-year-old
9. Describe dietary substitutions appropriate for a
pregnant client who has lactose intolerance.
1. Reading assignment
2. Didactic presentation
3. Visual aides
4. Student discussion
5. Handout
15. Explain recommended weight gain during
different stages of pregnancy based on prepregnant weight.
16. Give examples of food sources of the nutrients
required for optimal maternal nutrition during
pregnancy/lactation.
17. Discuss dietary problems and recommendations
for some cultural food patterns and alternative
eating patterns.
07/2011 NURS 2423
16. Fetal gestational age (compare
to chronological age)
17. Fetal Heart Rate (FHR)
18. Fundal height
19. Intrauterine growth restriction
(IUGR)
20. Kegel exercise
21. Lactose intolerance
22. Last Menstrual Period (LMP)
23. Lecithin/sphingomyelin (L/S)
ratio
24. Morning sickness
25. Nagele’s rule
26. Nipple stimulation (CST)
27. Non-Stress Test (NST)
28. Pelvic tilt
29. Pica
30. Preterm labor
31. Round ligament pain
32. Supine hypotension
33. Teratogen
34. 1st, 2nd, 3rd, trimesters
35. Twinning
Week 2-Page 5
10. What recommendations would the nurse
make for a pregnant client who is a
vegetarian?
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 2: Lab
Topic: Health Promotion: Putting it all Together
Functional Health Pattern: Health Perception Management; Nutrition-Metabolic
Learning objectives
1. Incorporate the nursing process,
assessment data and information about
maternity care to analyze and plan care for
case study client.
2. Complete simulation of:
a. Postpartum client assessment
b. Normal Newborn assessment
c. Admission bath to newborn
Preparation Resources
1. Wong, Perry, Hockenberry,
Loudermilk & Wilson,
Review Ch 12.
2. Complete and bring to class
case study
3. Also bring to class:
a. Nine-Point Postpartum
Assessment (in packet)
b. Normal Newborn Nursery
Assessment Guide (in
packet).
4. View: “Nursing Assessment of
the New Family” in MP 200 on
Computers in Rows B, E, & G.
Watch sections entitled “Nursing
Assessment of the Postpartum
Patient” and “Nursing
Assessment of the Newborn”.
07/2011 NURS 2423
Week 2-Page 6
Critical Thinking Questions
1. If I were caring for a maternity family, would I
be able to identify what assessment data is
needed at specific times?
2. Identify problems and risk factors?
3. Be able to provide needed care to optimize the
family’s health?
Learning Activities
1.
2.
3.
4.
5.
Reading assignment
Visual aides
Student discussion
Handout
Lab Simulation
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 3: Theory
Topic: The Transition of Labor & Birth: Needs, Care and Comfort Measures
Learning Objectives
1. Identify the 4/5 P’s that affect the labor and
birth process.
2. Differentiate true vs. false labor.
3. Identify the7 cardinal movements or
mechanisms of labor.
4. Identify the 4 stages of labor and birth.
5. Discuss the physiology of maternal/fetal
responses to the labor and birth process.
6. Identify and discuss the nurse’s role in
providing bio/psycho/social/spiritual care for
the childbearing family during the four
stages of labor and birth.
7. Identify indications for common selected
procedures on the childbearing woman.
8. Discuss the nurse’s role during selected
common procedures on the childbearing
woman.
9. Identify potential complications in labor and
birth.
10. Describe the nurse’s role & responsibilities
during labor and birth complications.
11. Identify factors that contribute to
discomfort during the labor and birth process
12. Discuss perceptions, values, beliefs, factors
that may influence the client’s choice of
pain control.
13. Compare & contrast childbirth preparation
Methods
14. Identify non-pharmacologic and
pharmacologic interventions to assist the
client in maintaining adequate pain control,
pathophysiology, and how they work.
Preparation Resources
Wong, Perry, Hockenberry,
Loudermilk & Wilson: Ch 15-16;
Chapter 17 (open glottis to discourage
valsalva- p. 437 only); Chapter 18;
Chapter 19 (Induction of Labor–
Augmentation of Labor, p. 502-510)
Terminology
1. After pains
2. Agonist-antagonist compounds
3. Amniotomy
4. Analgesia
5. Anesthesia
6. Ataractics
7. Attitude
8. Bag of waters
9. Baseline FHT
10. Bishop Score
11. Biparietal diameter
12. Biophysical profile
13. Bloody show
14. Bradley method
15. Cervical ripening
16. Crowning
17. Dick-Read method
18. Dilation
19. Effacement
20. Effleurage
21. Endorphins
22. Engagement
23. Epidural block
24. Epidural block patch
25. Episiotomy
26. False Labor
Week 3-Page 7
Critical Thinking Questions
1. Look at a diagram of the newborn’s head.
Can you label the suture lines & fontanel’s
(Refer to p. 377, Fig. 15-1).
2. Visualize the female bony pelvis and how
the fetus relates to it at different stages of
labor and birth. How might these processes
affect the mother and fetus? (Refer to
p.380, Fig15-5 and 15-6).
3. Think about the processes of cervical
effacement & dilation and how they relate
to the 4/5 P’s. If you were the L/D nurse
what concepts would you need to
understand to make quality judgments in
caring for mother and fetus? (Refer to
p. 384, Fig15-11).
4. What information is essential to rule out
false labor?
5. What assessment data is critical to know
upon admission to the L/D unit?
6. Can you identify common nursing
diagnoses and standard interventions
provided for all childbearing families
through the 4 stages of the labor and birth.
7. What is the nurse’s role in promoting
family
bonding/attachment?
8. A client has been in labor for 20 hours and
is dilated to 5 cm. Assessment shows mom
and baby are not displaying distress.
9. A laboring client is dilated to 8 cm and is
tolerating labor well. With each contraction
you notice that she closes her eyes & does
slow, controlled breathing. Are there any
interventions that might help this client?
Learning Activities
1. Reading Assessment
2. Didactic presentation
3. Visual aides
4. Student discussion
5. Handout
27. Fontanels
28. Gate-control theory
29. Gynecoid pelvis
30. Hyperventilation
31. Induction
32. Labor stages
33. Labor phases of stage I (latent, active,
transition)
34. Lamaze, psychojprophylactic method
35. Lie (longitudinal, transverse)
36. Local anesthetic
37. Local infiltration anesthesia
38. Low spinal (saddle) block anesthesia
39. Mechanisms (Cardinal movements of
labor)
40. Molding
41. Narcotic analgesic
42. Neonatal narcosis
43. Nitrazine test
44. Nuchal cord
45. Open glottis pushing (exhalation breathing)
46. Opiate antagonist
47. Paracervical block
48. Placenta
49. Placental separation
50. Position
51. Presentation (cephalic, breech, shoulder)
52. Presenting part
53. Pudendal block
54. Referren pain
55. Regional analgesia
56. Regional block
57. Resting tonus (uterus)
58. Somatic pain
59. Station
60. Systemic analgesia
07/2011 NURS 2423
Week 3-Page 8
10. A laboring mother is dilated to 2 cm and
begging for her epidural block. What would
you tell the client? What interventions might
help this client?
11. A laboring mother is checking into the
maternity unit. Upon admit assessment, she
is found to be dilated to 9 cm &completely
effaced. She has prepaid for an epidural
block. What should you do?
12. A laboring mother checks into the
maternity unit, dilated to 6 cm. She did
not have prenatal care, and she has not
tolerating contractions well, and screams
through each contraction. How will you help
the client through the labor and birth
process?
13. Consider each of the types of pain control
methods. Compare and contrast the nursing
for each.
Terminology Continued:
61. True Labor
62. Uterine contract
63. Valsalva maneuver
64. Visceral pain
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 3: Lab
Topic: Intrapartal Assessment and Care of Mother and Fetus
Maternal assessment--labor progress, Friedman’s Curve/Partogram, vaginal examination
Fetal assessment--Leopold’s Maneuver, fetal monitoring (application, explanation, & interpretation)
Functional Health Pattern: Health Perception management, Activity-exercise, cognitive-perception, sleep-rest, coping-stress
Learning Objectives
1. Describe the nurse’s role in assessment of
FHT on the fetal monitor during labor and
the newborn’s HR at birth.
2. Discuss assessment of a Fetal Heart Rate
(FHR) baseline and uterine contraction pattern
on fetal monitors.
3. Distinguish between the following FHR
patterns, causes and implications:
acceleration, bradycardia, tachycardia,
variability, and decelerations (early, late and
variable).
4. Discuss fetal assessment including the
Leopold’s Maneuver. Identify the location of
fetal heart rate.
5. Discuss and demonstrate fetal monitoring
application techniques and appropriate patient
teaching.
6. Observe a birthing simulation.
7. Practice assessment of cervical dilation on
cervical dilation simulation trainers and .
practice documenting the mother’s labor
progress on a Friedman’s Curve (Partogram).
07/2011 NURS 2423
Preparation Resources
1. Wong, Perry, Hockenberry,
Lowdermilk & Wilson:
Read Ch 17; review Ch 18.
2. Handout
Terminology
Accelerations
FHR Baseline
Bradycardia
Decelerations: Early, Late,
Variable
5. Electronic Fetal
Monitoring
(EFM)
6. External monitoring
7. Fetal position
8. Fetal scalp blood sample
9. Friedman’s Curve
10. Hypoxemia
11. Hypoxia
12. Intermittent Auscultation
13. Internal Fetal Scalp
electrode
14. Intrauterine pressure
catheter (IUPC)
15. Leopold’s maneuver
16. Partogram
1.
2.
3.
4.
Week 3-Page 9
Critical Thinking Questions
You are a labor & delivery nurse assigned to a
laboring client who planned on a home
delivery with a midwife. After 36 hours of
labor the client had only dilated to 2 cm despite
strong uterine contractions. At that time the
midwife advised the family to go to the
hospital for possible medical intervention.
After planning a natural birthing experience the
client verbalizes dissatisfaction with the
assessment procedures and is crying as you are
placing the external fetal monitor. What would
you do to soothe and reassure the client?
Terminology continued
17. Tachycardia
18. Tocotransducer
19. Ultrasound transducer
20. Variability
1.
2.
3.
4.
Learning Activities
Reading Assignment
Didactic presentation
Visual aides
Student participation in
simulation/static manikin
demonstrations in stations
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Friedman’s Curve (Partogram)
Summary: (What?)
Analysis: (Why?)
07/2011 NURS 2423
Week 3-Page 10
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Figure 15-9 Categories of Presentation
07/2011 NURS 2423
Week 3-Page 11
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 4: Theory
Topic: Postpartum Transition, Nursing Assessment/Care & HIGH RISK Postpartum Complications; Maternal/Newborn Death
Functional Health Pattern: Health Perception Management, Nutrition-Metabolic, Elimination, Role-Relationship, Activity-Exercise, Value-Belief,
Coping-Stress Tolerance, Self-Concept, Self Perception, Sexual-Reproductive, Sleep-Rest
Learning objectives
1. Identify priorities of maternal care during the
4th stage of labor and birth.
2. Describe bio-psycho-social changes a woman
goes through during the postpartum period.
3. Discuss head-to-toe assessment
BUBBLEHER) of the postpartum client.
4. Compare and contrast the nursing needs of a
client experiencing a vaginal versus c-sec
delivery. Identify expected norms for vs.
uterine involution, lochia flow and peri care for
both vaginal and c-sec delivery.
5. Discuss common deviations from normal PP
findings and potential etiology.
6. Identify non-pharmacologic & pharmacologic
measures to promote comfort/healing for the
PP client. Discuss indication for use of
medications commonly administered after
birth (i.e., for pain, hemorrhage, bowel
function, nutrition and infection).
7. Summarize nursing diagnoses, goals and
interventions for common high-risk-biophychosocial PP problems.
a. postpartum hemorrhage
b. hemorrhagic shock
c. postpartum infection
d. mastitis
e. inversion of the uterus
f. subinvolution of the uterus
g. thromboembolic disease
Preparation Resources
Wong, Perry, Hockenberry,
Loudermilk & Wilson: Ch 20-23;
Chapter 41 (p. 1164-1168 only); and
Ch 26 (p. 694-700).
Terminology
1. Afterbirth pains
2. Anticipatory grief
3. Bitter sweet grieving
4. BUBBLEHER
5. Constructive reminiscence
6. Couplet care
7. Cystocele
8. Diastasis recti abdominis
9. Endometritis
10. Engorgement (breast)
11. Fundus
12. Genital fistula
13. Hemorrhoids
14. Involution of fundus
15. IUFD
16. Lactation suppression
17. Lochia (rubra, serosa, alba)
18. Mastitis
19. Neonatal death
20. Oxytocic medication
21. Perineum (and care of)
Week 4-Page 12
Critical Thinking Questions
1. A first time mother asks how she can tell
if her body is making a normal transition
back to the pre-pregnant state. Plan and
explain the teaching you would
implement.
2. Describe how you would implement and
teach your PP client about infection
control during the PP period.
3. When assessing a woman’s fundus, 2
hours PP you note vaginal bleeding is
occurring in spurts. What further
assessment would be indicated? What
nursing actions would be indicated?
4. Compare and contrast assessment and
care of the breasts for the breast feeding
versus the bottle feeding mother. What
teaching would you include for each?
5. What parameters would you use to
distinguish risk for early PP hemorrhage?
6. Three hours after a vaginal delivery, the
mother’s VS are P=114, RR=32,
BP=84/49. The client is lethargic and her
skin is cool and clammy. What is
happening? What other assessment data
should be gathered? What nursing
actions are indicated?
7. You are assigned to give PP care to a
mother who was induced for IUFD due to
cord accident at 39 weeks.
Learning Activities
1. Reading assignment
2. Didactic presentation
3. Visual aides
4. Student discussion
5. Handout
h. UTI
i. constipation
j. postpartum depression
k. postpartum bereavement
8. Discuss anticipatory guidance for the family
family experiencing parenting a newborn with
health problems and/or maternal/newborn
death.
07/2011 NURS 2423
22. Persistent postpartum PIH
23. Puerperium
24. Puerperal infection
25. Postpartum depression
26. Postpartum hemorrhage
27. Rectocele
28. REEDA scale
29. Retained placenta
30. RHD-immune globulin
(RhoGAM)
31. Roller-coaster effect of grieving
32. Rubella vaccine
33. Sitz bath
34. Stillbirth
35. Subinvolution
36. Uterine atony
37. Uterine displacement
38. Uterine inversion
39. Uterine prolapse
Week 4-Page 13
How will you give nursing care and support
the family emotions? How can you facilitate
the grieving process for this family. What is
important to include on a periatal loss
checklist?
8. Identify support groups and services
available in your local community to assist
families who have experienced a maternal/
newborn loss.
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 4 Lab
Topic: Postpartum Assessment and Care; Contraception
Functional Health Pattern: Health Perception Management. Role-Relationship, Sexual-Reproductive
Learning objectives
1. Identify common causes of infertility and
possible treatments
2. Compare & contrast reproductive alternatives
for couples experiencing infertility.
3. Compare and contrast different methods of
contraception.
4. Discuss ethical, legal, cultural and religious
considerations of infertility, contraception and
elective abortion.
5. Complete simulation of postpartum care,
including but not limited to:
a. Assessment
b. Problem identification
c. Planning and prioritization of Care
d. Collaboration to implement appropriate
intervention
e. Evaluation of Effectiveness of Care
07/2011 NURS 2423
Preparation Resources
Wong, Perry, Hockenberry,
Loudermilk & Wilson Ch 5 (p.
80-85 only); Ch 7 (129-156).
Terminology
1. Amenorrhea
2. Basal body temperature
(BBT)
3. Calendar method
4. Cervical cap
5. Cervical mucous method
6. Coitus interruptus
7. Condom
8. Contraception
9. Depo-Provera
10. Diaphragm
11. Elective abortion
12. Fertile period
13. Fertility awareness methods
14. Induced abortion
15. Infertility
16. Intrauterine device (IUD)
17. Kegel exercises
18. Oral hormonal
contraceptives
19. Post coital contraception
20. Postpartum blues
21. Predictor test for ovulation
22. Sibling rivalry
Week 4-Page 14
Critical Thinking Questions
1. Discuss with a peer reproductive
alternatives for couples experiencing
infertility
2. Discuss with a peer the ethical, legal and
cultural infertility treatment, contraception
and abortion considerations of fertility
management
3. Plan the teaching you would give about
contraception to the following clients:
a. a 16-year-old who just had her first baby
b. 30-year-old mother of 4
c. Catholic couple
23.
24.
25.
26.
27.
28.
29.
30.
31.
Terminology continued
Spermicide
Spinnbarkeit
Spontaneous abortion
Sterilization
Subdermal implants
Therapeutic abortion
Tubal ligation
Vasectomy
Warm lines
1.
2.
3.
4.
5.
Learning Activities
Reading assignment
Didactic presentation
Visual aides
Student discussion
Handout
Date: Week 5: Theory
Topic: Normal Newborn Transition after Birth: Assessment, Needs, Care
Functional Health Pattern: Health Perception Management, Activity-Exercise, Nutrition-Metabolic, Elimination, Cognitive-Perceptual, Sleep-Rest,
Coping-Stress
Learning objectives
Preparation Resources
Critical Thinking Questions
Learning Activities
1. Describe the biologic system changes during
1. Wong, Perry, Hockenberry,
1. What is the APGAR score? Explain when it 1. Reading assignment
the neonate’s transition to extrauterine life.
Loudermilk & Wilson, Ch
is done and what it tells us regarding the
2. Didactic presentation
2. Identify and discuss the nurse’s role in
24-25; Chapter 48 (p.1442outcome of the neonate.
3. Visual aides
stabilizing the neonate and promoting transition
1453).
2. Why is thermoregulation a priority in
4. Demonstration
to extrauterine life.
2. In MP 200 D, view
neonatal care? How is NTE promoted to
5. Student discussion
3. Identify and discuss components of the NB
“Management of the Newborn
avoid hypo/hyperthermia in the neonate?
6. Handout
admission/shift assessments and what the data
Experience” (take your
3. A new mother states that her baby’s hand/
may reveal regarding “at risk” status of the NB. headphones).
feet are blue an she worries that her baby
4. Recognize common variations of expected
3. In MP 200, view Nursing
must be cold. Explain your response to this
normal physical findings in the neonate.
Assessment of the New Family:
parent and document this rationale.
5. Identify potential NB risk factors and discuss
“Nursing Assessment of the
4. What is the importance of observing a
how they may compromise oxygenation,
Newborn” and “Gestational Age
newly circumcised infant void? How will
thermoregulation, CNS function, F&E balance,
Assessment of the Newborn”
you
elimination, and growth/development.
(Rows B, E, & G) (take your
teach circ care to the family and what will
6. Identify and discuss factors that influence
headphones).
you have them monitor to be sure that the
sensory/perceptual functioning of the neonate.
3. www.BallardScore.com
healing process is taking place?
7. Describe normal NB patterns of behavior during 4. In the LRC at Media Reserve
5. The nurse is assessing a 2-hour old infant
the first periods of reactivity and the 6 sleepDesk: Comprehensive Newborn
with a blood sugar of 35 mg/dl whose temp
wake states.
Assessment RJ 251 .P5 2006
is unstable despite servo control under the
8. Discuss use of the Ballard gestational age
1105389
radiant warmer. What is the priority for
assessment tool for evaluating the NB. Identify
care and why?
the best time to perform this assessment.
Terminology
9. Discuss the purpose of circumcision, various
1. Acoustic (glabellar) blink
methods, nursing care and parent teaching.
2. Acrocyanosis
3. AGA
4. APGAR score
5. Apnea
6. Arm recoil
7. Babinski reflex
8. Ballard (Dubowitz) tool
9. Brick dust spots
10. Brown fat
11. Caput
12. Cephalohematoma
Week 5-Page 15
Terminology continued
13. Cephalocaudal development
14. Circumcision
15. Cold Stress
16. Crossed extensor
17. Ductus Arteriosus
18. Ductus Venosus
19. Epstein’s pearls
20. Erythema toxicum
21. Fencing/archer reflex (tonic
neck)
22. Fetal circulation
23. Foramen ovale
24. Galant/trunk incurvation
reflex
25. Grunting (expiratory)
26. Guthrie test (PKU)
27. Habituation
28. Harlequin sign
29. Heel to ear
30. Hyperbilirubinemia
31. Insensible water loss (IWL)
32. Kernicterus
33. Lanugo
34. Large for gestational age
(LGA)
35. Low birth weight (LBW)
36. Macrosomia
37. Magnet reflex
38. Milia
39. Molding
40. Mongolian spots
41. Moro/startle reflex
42. Nasal flaring
43. Neonatal resuscitation
protocol (NRP)
Week 5-Page 15
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
Terminology continued
Neutral thermal environment
(NTE)
Neutral thermal zone (NTZ)
Non-shivering thermogenesis
Ortolani’s Maneuver
Ophthalmia neonatorum
Palmar grasp reflex
Plantar grasp reflex
Popliteal angle
Postmature/posterm/postdates
Premature
Prone crawl
Protective environment
Pseudomenstruation
Pulse oximetry
Red reflex
Retractions
Rooting reflex
Scarf sign
Six sleep-wake states of
Newborn
Small for gestational age
(SGA)
Square window
Stepping reflex
Sucking reflex
Subconjuctival hemorrhage
Telangiectatic Nevi (storkbites)
Term
Vernix caseosa
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 5: Lab
Topic: Health Promotion: Parental Teaching & Infant Nutrition
Functional Health Pattern: Health Perception Management, Nutrition-Metabolic, Elimination, Role-Relationship
Learning objectives
1. Be prepared to role play and/or teach the
following information:
a. current recommendations for feeding infants.
b. factors to be considered when choosing a
method of newborn feeding.
c. advantages, disadvantages & contraindications
for breastfeeding; include the action of specific
factors in human milk that protect the infant
against infection.
d. the relationships between the newborn’s
neurologic development and feeding readiness
cues.
e. explain newborn sucking behavior and its
influence on the breast-feeding process
f. maternal and infant signs of successful milk
transfer during breast-feeding, and changes
in human milk composition from the beginning
to the end of a feeding.
g. nursing assessments and interventions to
facilitate a breast-fed baby’s latching on and
feeding effectively. Include how a mother’s
milk supply is increased to meet her baby’s
needs.
h. signs of adequate intake in the breast-fed
infant.
i. the effects of maternal intake of substances
and medications on the breastfeeding infant.
j. nursing assessments & interventions to assist
the mother who is feeding her newborn
formula. Explain why it is important for the
baby to be held during bottle-feeding.
Preparation Resources
1. Wong, Perry, Hockenberry,
Loudermilk & Wilson, Ch
26; Ch 36 (p. 972-976 only)
2. Review Ch 25, (p. 669- 676
Discharge Planning and
Teaching)
Terminology
1. Active alert
2. Alternate breast feeding
3. Areola
4. Colostrum
5. Crying
6. Deep sleep
7. Demand feeding
8. Drowsy
9. Engorgement
10. Feeding readiness cues
11. Growth spurts
12. Inverted nipple
13. Lactation consultant
14. Lactiferous sinuses
15. Lactogensis
16. Latch on
17. Let-down reflex
18. Light sleep
19. Mastitis
20. Milk ejection reflex (MER)
21. Milk glands
22. Milk transfer
23. Monilial infections
Week 5-Page 17
1.
2.
3.
4.
Critical Thinking Questions
A woman gives birth to a health 7-lb. 13 oz.
baby girl. The nurse suggests that the
woman place the infant to breast within 15
minutes after birth. Explain the rationale for
this nurse’s actions. If the newborn were not
put to breast at this time, when is the next
best time to do this?
A new mother recalls from prenatal class
that she should try to feed her newborn
daughter when she exhibits feeding
readiness cues rather than waiting until her
baby is crying frantically. Based upon this
data, for what behaviors should the mother
observe?
A postpartum woman telephone the
physicians office about her 4-day old baby.
She is not scheduled for a weight check
until the baby is 10 days old, and she is
worried about how well the breast-feeding
is going. What would you, the nurse, ask or
tell the mother? What additional data might
you need? In additional to verbal
communication, what other intervention(s)
might you do?
What information do you give a new parent
about their infant’s home care regarding
bathing, dressing, temperature regulation,
crying, and safety.
Learning Activities
1. Reading assignment
2. Didactic presentation
3. Visual aides
4. Student discussion
5. Handout
2.
3.
4.
5.
k. advantages and disadvantages of bottle
feeding, including information about preparing
and feeing formula.
Recognize the influence of cultural values on
infant care, especially feeding practices.
Describe the physiologic mechanisms of
lactation.
Calculate nutritional needs by newborn’s weight
Identify and explain components of teaching
about infant care that would be completed in
preparation for discharge home.
07/2011 NURS 2423
24.
25.
26.
27.
28.
29.
30.
31.
Nipple confusion
Oxytocin
Plugged milk duct
Prolactin
Quiet Alert
Rooting reflex
Shut down
Supply-meets-demand
system
Week 5-Page 18
Date: Week 6: Theory
Topic: Health Promotion for High Risk Problems During Pregnancy
Functional Health Pattern: Health Perception Management, Role-Relationship, Activity-Exercise, Nutrition-Metabolic, Elimination,
Sexual-Reproductive
1.
2.
3.
4.
5.
6.
7.
8.
9.
Learning objectives
Discuss the pathology, assessment, treatment,
and nursing care of pregnant women with
diabetes including maternal and fetal risk and
complications associated with pregestational
and gestational diabetes.
Explain the effects of thyroid and maternal
phenylketonuria disorders on pregnancy.
Describe the effects of various heart disorders
on pregnancy, including their implications for
nursing care.
Discriminate among the four major types of
anemia associated with pregnancy with
regards to signs, treatment, and implications
for pregnancy.
Discuss the care of pregnant women with
gastrointestinal disorders.
Discuss the care of pregnant women with
neurologic disorders.
Discuss the care of pregnant women with
autoimmune disorders.
Discuss care of the pregnant woman with
Human Immunodeficiency Virus, including
neonatal implications and ramifications on the
childbearing family.
Discuss care of the pregnant woman with
a. hypertensive disorder
b. preeclampsia
c. severe preeclampsia
d. HELLP syndrome
e. eclampsia
07/2011 NURS 2423
Preparation Resources
Wong, Perry, Hockenberry,
Loudermilk & Wilson Ch 13-14
Terminology
1. Acquired Immuno-Deficiency
Syndrome AIDS)
2. Adult respiratory distress
syndrome (ARDS)
3. Battledore cord insertion
4. Cardiac decompensation
5. Congenital heart defects
6. Diabetes mellitus
7. DIC
8. Eclampsia
9. Ectopic pregnancy
10. Eisenmenger Syndrome
11. Folic Acid deficiency
anemia
12. Gestational diabetes
mellitus (GDM)
13. Gestational trophoblastic
disease
14. Glucose tolerance test (GTT)
15. Glycosylated hemoglobin
(HgbAlc)
16. HELLP syndrome Virus
(HIV)
17. Human Immuno-Deficiency
Virus (HIV)
18. Hydatidiform mole
19. Hyperemesis gravidarum
Week 5-Page 18
1.
2.
3.
4.
5.
6.
Critical Thinking Questions
How does the care of the pregnant client
with diabetes mellitus differ from the care
of the client who is not diabetic?
What teaching is needed for a pregnant
client who is HIV positive?
Consider the effects of a thyroid disorder
on the body and the changes that occur in
the different stages of pregnancy and birth.
What are the problems that may occur in
the pregnant client with a thyroid disorder?
What nursing interventions would facilitate
a positive pregnancy outcome?
Consider the effects of a hypertensive
disorder during the different stages of
pregnancy and birth. What are the
problems that may occur and what nursing
interventions would facilitate positive
pregnancy outcome?
What are the pros and cons of
pharmacologic interventions vs. nonpharmacologic intervention in the care and
treatment of a pregnant woman with a
hypertensive disorder?
Why do some women experience
hyperemesis gravidarum? What
interventions decrease the symptoms?
Learning Activities
1. Reading assignment
2. Didactic presentation
3. Visual aides
4. Student discussion
5. Handout
Suggested Videos:
1. View “Diabetes in
Pregnancy”, RG 951.C74,
1992, Vol. 5, 1097918,
TCC/LRC/Metro
2. View “Pregnancy Induced
Hypertension,” RG 951.
C74, 1992, Vol. 6,
1097920,
TCC/LRC/Metro
10. Explain the effects of hyperemesis
gravidarum on maternal/fetal well being.
11. Discuss care for the woman with hyperemesis
gravidarum.
12. Identify and discuss hemorrhagic disorders of
pregnancy; including early versus late
pregnancy bleeding.
a. miscarriage
b. incompetent cervix
c. ectopic pregnancy
d. hydatidiform mole
e. placenta previa
f. placenta abruption
g. cord/placenta variations
h. DIC
13. Discuss care of the pregnant woman with a
TORCH infection or STI.
14. Discuss nursing implications for care of the
pregnant woman requiring surgery or trauma
care.
15. Explain the care of pregnant women with
pulmonary disorders.
07/2011 NURS 2423
20. Hyperthyroidism
21. Hypertrophic
cardiomyopathy
22. Hypoglycemia
23. Hypothyroidism
24. Incompetent cervix
25. Infarct (cord/placenta)
26. Intrauterine growth
restriction
(IUGR)
27. Iron deficiency anemia
28. Ketoacidosis
29. Large for gestational age
(LGA)
30. Macrosemia
31. Marfan syndrome
32. Miscarriage
33. Mitral Valve Prolapse (MVP)
34. Peripartum cardiomyopathy
35. PIH
36. Placental abruption
37. Placenta previa
38. Preclampsia
39. Pregestational diabetes
mellitus (type I; type II)
40. Sickle cell anemia
41. Small for gestational age
(SGA)
42. Subacute bacterial
endocarditis
43. Succenturiate placenta
44. Thalassemia
45. TORCH infection
46. Velamentous cord insertion
Week 5-Page 18
7. How can you quickly distinguish
between the signs and symptoms of
placenta previa and placental abruption?
8. What special nursing considerations
and/ or interventions are needed in care
of the pregnant woman with a TORCH
infection or STI? Surgery or trauma?
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 6 Lab
Topic: Health Promotion/Prevention for High Risk Psychosocial Populations
Functional Health Pattern: Health Perception Management, Nutrition-Metabolic, Elimination, Role-Relationship, Activity-Exercise, Value-Belief,
Coping-Stress Tolerance
Learning objectives
1. Identify social factors that increase health
risks for women during their childbearing
years.
2. Identify the psychological, physical and
sociological risks faced by the pregnant
adolescent.
3. Identify useful interventions to be used
when caring for a pregnant adolescent.
4. Identify the psychological and
sociological
risks faced by a substance abuser.
5. Identify the physical effects to the mother
and newborn of substance abuse.
Discuss when and how to assess for
substance abuse.
6. Identify factors that place a woman at risk
for being abused by her spouse-partner,
and the roles and responsibilities of the
nurse when caring for these women
07/2011 NURS 2423
Preparation Resources
Wong, Perry, Hockenberry, Loudermilk
and Wilson: Ch 3 (p. 28-34); Ch 4(p. 5764); Ch 11 (p. 252-253 and p. 260-261);
Ch 13 (p. 328-333); Ch 40 (p. 11361145).
Terminology
1. Cycle of violence
2. Domestic violence
3. Early adolescence
4. Emancipated minors
5. Family violence
6. Fetal Alcohol Effect (FAE)
7. Fetal Alcohol Syndrome (FAS)
8. Late adolescence
9. Middle adolescence
10. Substance abuse
Week 6-Page 21
Critical Thinking Questions
1. How would you feel if you were a labor
and delivery nurse, and your laboring
client was bring verbally abusive. Would
you feel differently if your client tested
positive for cocaine?
2. You have a laboring client who is dilated
to 2cm and is screaming for pain
medication with each contraction.
Would
a history of substance abuse make any
difference to you?
1.
2.
3.
4.
5.
Learning Activities
Reading Assignment
Didactic presentation
Visual aides
Student discussion
Handout
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Theory Learning Map
Date: Week 7 Theory
Topic: Risky Transitions Through Labor & Delivery; Risky Transitions for the Newborn
Functional Health Pattern: Health Perception Management, Nutrition-Metabolic, Elimination, Role-Relationship, Activity-Exercise, Value-Belief,
Coping-Stress Tolerance
Learning objectives
1. Identify and discuss common maternal/
fetal complications of:
a. labor and birth.
b. selected high risk procedures
2. Discuss medical, behavioral, and
environmental risk factors related to
preterm labor and birth.
3. Identify self-care/nursing care and
pharmacological interventions utilized to
prevent and/or stop preterm labor.
4. Describe maternal/fetal risks associated
with:
a. postdate labor and birth.
b. forceps
c. vacuum extraction
5. Discuss indications for and nursing care
of the woman having a cesarean section.
6. Discuss indications & nursing care of the
woman having an abortion.
7. Identify and describe techniques used for
interruption of pregnancy.
8. Identify and discuss nursing care of the
newborn with hematologic problems such
as Rh and ABO incompatibility.
9. Differentiate various types of jaundice and
nursing care to prevent complications.
10. Differentiate early/late sepsis of the
newborn.
Preparation Resources
1. Wong, Perry, Hockenberry,
Loudermilk & Wilson: Ch 7
(p. 156-159 abortion); Ch
14 (p. 350-354 miscarriage);
Also Read Ch 19, and 27-28.
2. Review Ch 17.
3. In LRC View: Fetal Abuse: The
Effects of Drugs and Alcohol RG
580.D76 F48 1997
Terminology
1. ABO incompatibility
2. Amnioinfusion
3. Amniotic fluid embolism
4. Anencephaly
5. APT test
6. Battledore placenta
7. Bishop score
8. Biophysical profile
9. Cephalopelvic disproportion
(CPD)
10. Cesarean section
11. Circumvallate placenta
12. Cleft lip/palate
13. Club foot
14. Coombs test
15. Cord blood gas
16. Cord prolapse
17. Developmental/Kangaroo care
18. Diaphragmatic hernia
dysfunctional labor
Week 7-Page 22
Critical Thinking Questions
1. Describe the impact of preterm labor,
dystocia, and postdate pregnancy on the
pregnant woman and her family.
2. What are the nursing implications of
tocolytic agents?
3. What is the nurse’s role in prevention/
management of the woman in preterm
labor?
4. According to AWHONN, what is the
priority/standard of care for nursing
interventions during labor complications?
5. Infants of diabetic mothers are considered
high risk for certain clinical conditions.
What are some of these conditions and
implications for nursing care?
6. There is a high index of suspicion for
prenatal substance abuse. What is the
L/D nurse’s responsibility in providing
care for this mother/fetus during the labor
and birth process?
7. A laboring mom is being prepared for an
emergency c-sec due to prolapsed cord.
What are the nurse’s responsibilities in
this situation?
8. A pregnant woman was admitted for
induction of labor at 43 weeks gestation
with a definite EDC.
1.
2.
3.
4.
5.
Learning Activities
Reading assignment
Didactic presentation
Visual aides
Student discussion
Handout
Suggested videos:
Available in the LRC at the
Media Reserve Desk:
1. Matria Healthcare
Presents: Focus on
Preterm Labor RG
649 m281998
1106572
2. Comprehensive
Newborn
Assessment RJ 251
.P5 2006 1105389
3. Fetal Abuse: Effects
of Drugs & Alcohol
RG 580 .D76 F48
1997
11. Discuss the nurse’s role in the prevention
and treatment of newborn infection.
12. Relate the consequences of selected
maternally transmitted infections to nursing
care of the newborn (i.e., syphilis, gonorrhea,
herpes, chalamydia, HIV).
13. Describe the impact of maternal diabetes on
the newborn and related nursing care.
14. Describe nursing care of the newborn
experiencing substance withdrawal (i.e.,
drugs, alcohol).
15. Describe nursing care of the newborn
experiencing cardio respiratory complications
16. Describe immediate care of the newborn with
major (life-threatening) birth anomalies.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
07/2011 NURS 2423
Dystocia
Epispadius
Esophageal atresia
Exchange transfusion
External cephalic version
Fetal alcohol effects (FAE)
Fetal alcohol syndrome (FAS)
Fetal pulse oximetry
Fetal scalp pH
Forceps
Gastroschisis
Gavage feed
Hemolytic disease of the
newborn
Hip dysplasia
Hyperbilirubinemia
Hydrocephalus
Hypoglycemia
Hypo/hyperthermia of the
newborn
Hypo/hypertonic uterine
dysfunction
Hypospadius
IDDM protocol
Imperforate anus
Internal version cephalic/
podalic)
Intrauterine growth restriction
(IUGR)
Isoimmunization
Kernicterus Kleihauer-Betke
test
Macrosomia (LGA)
Mechanical ventilation
Meconium aspiration (MAS)
Meconium staining
Microcephaly
Multifetal pregnancy
Myelomeningocele
Neural tube defects
Week 7-Page 23
A NST in the obstetrician’s office revealed a
nonreactive tracing. Upon AROM, thick
meconium fluid is noted. The nurse caring for
the newborn should anticipate what
characteristics and why? What are
appropriate nursing interventions?
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
Terminology continued
Nuchal cord
Oligohydramnios
Omphalocele
Oxytocin/pitocin
Pathologic jaundice
Persistent pulmonary hypertension of the
newborn (PPHN)
Phimosis
Phototherapy
Physiologic jaundice
Placenta acreta, increta, percreta
Placental infarcts and calcifications
Polyhydramnios
Postdate
Preciptous labor and birth
Preterm labor and birth
Premature rupture of membranes (PROM)
Prolapsed cord
Respiratory distress syndrome (RDS)
Sepsis neonatorum
Shoulder dystocia
Spina bifida
Succenturiate placenta
Tetanic contraction
Tocolysis
TORCH infections
Uterine dysfunction
Uterine rupture
Vacuum extraction
V-BAC
Velamentous placental insertion
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Date: Week 7: Lab
Topic: FACE Wrap-up
Functional Health Pattern: Health Perception Management, Role-Relationship, Activity-Exercise, Nutrition-Metabolic, Elimination,
Sexual-Reproductive
Learning objectives
1. Identify and discuss the high risk population
you served. Give the demographics of the
high-risk psychosocial populations to whom
your teaching project was presented.
2. Identify common nursing diagnoses for the
childbearing family in the community
environment you encountered.
3. Display and briefly explain your poster
project and handouts.
4. Briefly report on your OB clinic visit.
07/2011 NURS 2423
Preparation Resources
Critical Thinking Questions
Wong, Perry, Hockenberry,
Loudermilk and Wilson
Review chapters 2, 3, 31,
33-34.
1. What high risk psychosocial population did
your FACE clients fit? How did this effect
your plans to teach? What factors have
been instrumental in the evolution of the
agency where you presented your poster
session?
2. What nursing diagnosis did you develop
and what did you teach?
3. What Community agencies/resources did
you find most helpful in developing the
poster project for your FACE clients? How
did that agency evolve?
4. What is something you learned while
completing the project?
5. What would you change if you were to do it
again?
Terminology
Share any new terminology
identified in relationship to
your FACE client.
Week 7-Page 24
Learning Activities
1.
2.
3.
4.
Reading assignment
Visual aides
Student discussion
Each FACE group will give
a brief presentation (about
5 minutes) to the class by
discussing the Learning
Objectives.
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Clinical Practicum Learning Map
Date: Week 1
Topic: Orientation to Hospital Clinical Experience
Functional Health Patterns: All
Learning Objectives
1. Verbalize and/or demonstrate the location of the
following areas/items in the hospital or unit:
Hospital: Assigned parking area, assigned
clinical units, snack shop/cafeteria, chapel,
library, x-ray, admitting, and visitor facilities.
Unit: Medication administration area or cart,
Policy and Procedures manuals, Fire and Safety
procedures and equipment code buttons,
kitchen or snack storage area, clean linen area,
clean equipment storage, dirty linen area, trash
containers, restrooms, staff lounge, client
charts, crash cart, blanket warmer.
2. Verbalize or demonstrate the use of the
following hospital technology: beds, room
lighting, warmer, stirrups, computer systems.
3. Discuss the unit safety and security procedures.
4. Observe the physical exam of a postpartum
client and a newborn. If possible look, listen,
and feel assessment components.
5. Become familiar with agency charting and be
able to locate information needed for client care
and clinical paperwork.
Preparation Resources
1. Complete Orientation Study Guide.
2. Bring to clinical and be prepared to
discuss during pre- or postconference.
3. Bring BUBBLEHER assessment
Guide from PP section
4. Bring Newborn Assessment Guide
and Newborn Reflexes Assessment
Guide from NB section.
Critical Thinking Questions
How is care in the labor and
delivery nursery/post partum
units different than care you have
seen and/or given in other
hospital units?
Learning Activities
Role playing
Cooperative learning
Problem solving
Practical application
activities
5. Complete required hospital
HIPAA and patient charting
training. Location and time
TBA
1.
2.
3.
4.
Written Assignments
Submit the clinical study guide
to the instructor at beginning of
clinical.
07/2011 NURS 2423
Hospital-Page 1
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Orientation Study Guide (5 points)
1. Look up and briefly write-up the following medications used in maternity care. Identify
indications for use, usual dosage, desired effects, side effects and nursing considerations. Be
sure to get information that pertains to maternity care. (use own drug books if no pages
noted & cite reference)
Rubella vaccine, (Rubivax, Meruvax) (p. 241, 752, 546, 984, 987, 1060):
RhoGAM (RhIgG) (p. 547):
Ferrous Sulfate (Iron):
Colace:
Magnesium Sulfate (p. 343-347 & 493-496):
Hospital-Page 2
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Orientation Study Guide Cont.
2. Look up the normal ranges of the following lab values for these client populations. Note
differences in references ranges, when found. Most from text. Refer to Lab Values book for
others.
1. Hemoglobin (mother, p. 220; newborn
p. 657)
2. Hematocrit (mother, p. 220; newborn
p. 657)
Non-Pregnant
Pregnant
Newborn
_______g/dl
_______g/dl
_______g/dl
_______%_
__________%
_______%_
Hgb ________
Hct _________
3. Anemia (p. 219)
4. Glucose (refer to gestational diabetes)
a. Before meals or fasting (p. 220)
b. 2 hour post prandial (p. 220)
_________mg/dl
_______mg/dl
________mg/dl
_______mg/dl
c. Newborn, 1 day (p. 657 ot 1755)
___________
5. Bilirubin (refer to hyperbilirubinemia)
a. Total (p. 1753)
b. Direct (“conjugated”) (p. 1753)
___________
6. Magnesium (serum) therapeutic level for
treatment of Preterm Labor and/or PIH
( p.344, 495)
7. Intolerable Adverse Magnesium Level
(p. 495)
_____________
______________
8. Calcium, adult & total serum from cord ( p.
1754)
______________
9. Coombs test (refer to hemolytic disease of
the newborn; Hint: the desired result is not
a number value. Circle correct answer.)
a. direct (newborn) (p. 767)
b. indirect (mom) (p. 767)
___________
___________
Hospital-Page 2
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Topic: Obstetrical Clinical Observation Experience – BRING THIS FORM WITH YOU
Learning objectives
Preparation Resources
Critical Thinking Questions
1. Shadow staff to observe and assist with prenatal,
1. Review Assessment of the
Does this resource make
postpartum and women’s health care of clients. Become
Prenatal Woman
maternity care available to the
familiar with a community resource available to provide
2. Review Wong, Perry and
targeted pregnant population
health care during the childbearing stage of life. Sites
Hockenberry, Ch 3.
of Tulsa?
TBA.
3.In LRC at Media Reserve
2. Utilize staff to answer the following questions:
Desk, View: Matria Healthcare
a. Describe the history of this facility. How it was
Presents: Focus on Preterm
established, how long in operation, and who it serves.
Labor RG 649 m28 1998
b. Who is the targeted client population served at this
1106572
clinic?
c. How do clients make their first appointment at the
clinic?
d. What methods of reimbursement do clients use to
pay for their health care?
e. Analyze communication patterns observed during
nurse-client and/or physician resident/ client interactions.
f. What assessment parameters did the nurse or
physicians use to determine the client’s health status?
g. What type of planning is utilized in providing care
for the client?
h. What types of documentation are utilized in the
client’s record?
i. What multidisciplinary services are available to
clients?
j. Discuss one critical incident that you observed that
made a distinct impression on you. Describe your feelings
about the incident and how it might impact your approach
to clients and the nursing care you will deliver.
k. Discuss your impressions, general reactions and
feelings about your introduction to obstetrical clinics.
07/2011 NURS 2423
Hospital-Page 4
Learning Activities
Submit summary of observation
experience to clinical instructor.
This paper will include a
discussion of Learning Objective
#2, a-j. and the critical thinking
question. It need not be typed,
but must be legible to receive a
satisfactory evaluation.
Written assignment
Submit by 4:30 p.m. on Friday
following the clinical experience
unless instructed otherwise by
instructor.
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Assessment of the Prenatal Woman
(Review prior to Obstetrical Clinical Observation)
Possible Nursing Diagnoses Related to Prenatal Care:
1. Alteration in comfort related to nausea/vomiting from increased estrogen levels, decreased
blood sugar, or decreased gastric motility.
2. Alteration in comfort related to heartburn due to pressure on the cardiac sphincter from
enlarged uterus.
3. Activity intolerance related to fatigue and dyspnea secondary to pressure from the enlarging
uterus on the diaphragm and increased blood volume.
4. Alteration in bowel elimination related to constipation from decreased gastric motility and
pressure from the uterus on the lower colon.
5. Potential disturbance in self-concept related to the effects of pregnancy on biologic and
psychosocial patterns.
6. Potential knowledge deficit of the effects of pregnancy on the body systems, fetal growth and
development, nutritional requirements, psychosocial domain, and changes in the family unit.
Nursing Objectives in the First Prenatal Visit:
1. Determine factors in the client’s, partner’s, and family’s past history that may affect the
pregnant woman’s prenatal course, pregnancy outcome, and long-term health.
2. Assess the client’s past and present physical and emotional health.
3. Establish early rapport that will grow as the nurse and the pregnant woman together set
priorities for prenatal care and related problems.
Collecting Prenatal Health History:
(The health history is a brief biography and should elicit the following information)
1. Past medical history
2. Current medical history and review of systems
3. Sexual history
4. Gynecologic history
5. Obstetric history
6. Occupational and recreational history
7. Family medical history
8. Social and cultural history
9. Developmental history
10. Partner’s past medical history
11. Partner’s current medical history
12. Partner’ sexual history
13. Partner’s occupational and recreational history
14. Partner’s family medical history
Hospital-Page 5
Danger Signs During Pregnancy
The client should contact her health care provider if the following signs or symptoms occur:
1. Vaginal bleeding
2. Edema of the face and hands
3. Continuous and severe headache
4. Blurring or dimness of vision
5. Abdominal pain
6. Persistent vomiting
7. Cessation of fetal movement
8. Chills or fever
9. Painful urination
10. Fluid escaping from vagina
11. Dizziness when not supine
Risk Factors
Obtained from the initial and episodic histories. Risk factors can be divided into personal, life
style, health, and past history factors and include:
Maternal Risk Factors:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Low socioeconomic status
Low educational level
High parity (>4)
Age <16 or >35 years of age
Nullipara 35 or >35 years of age
Multipara 40 or >40 years of age
Pregnancy within 3 months of previous birth
Pre-pregnant weight <100 lbs. or >200 lbs.
Short stature (<5 feet)
Maternal Life-Style Factors:
1.
2.
3.
4.
Inadequate nutrition
Smoking
Alcohol use
Addicting drug use
Maternal Health Factors:
1.
2.
3.
4.
5.
6.
Anemia
Multiple gestation
Hemorrhage in present pregnancy
Preterm rupture of membranes
Sickle cell disease or trait
Diabetes mellitus or gestational diabetes
Hospital-Page 6
7. Cardiac disease
8. Kidney disease
9. Hypertension
10. Thyroid disease
11. TORCH infections (toxoplasmosis, rubella, CMV, Herpes Type II)
12. Syphilis, gonorrhea, chlamydia
13. Tuberculosis
14. Tumors (malignant or premalignant)
15. Epilepsy
16. Mental retardation
17. Psychiatric disorder
Maternal Past History Factors:
1.
2.
3.
4.
Cephalopelvic Disproportion (CPD)
Cesarean birth
Prolonged labor
Reproductive tract anomaly (incompetent cervix, cervical or uterine malformation, tubal
occlusion or malformation, ovarian mass, endometriosis)
5. Diabetes mellitus (including gestational diabetes)
6. Anemia
7. Hemorrhage
8. Bleeding or clotting disorder
9. Drug or alcohol abuse
10. Pregnancy induced hypertension (PIH)
11. Preterm birth (2 or more)
12. Abortion (2 or more consecutive spontaneous)
13. Term stillbirth (2 or more)
14. Previous infant with:
a. Rh or ABO incompatibility
b. Birth defect(s)
c. Mental retardation
d. Metabolic disorder
e. Macrosomia (at least 9 lbs. or 4032 g)
07/2011 NURS 2423
Hospital-Page 7
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Clinical Practicum Learning Map
Topic: Labor & Delivery Hospital Clinical Experience
Learning Objectives
Preparation Resources
1. Compare labor of assigned intrapartum client
observed to the normal physiology of labor.
Chart client’s labor on Partogram (Friedman’s
Curve).
2. On IV Fluids and Medications Sheet identify
the medications and anesthesia administered
by staff to assigned intrapartum patient.
3. Discuss the nurse’s role in recovery of the
mother and the newborn in the first one to two
hours after delivery (Stage IV).
4. Maintain physical safety of assigned patients.
a. Perform a surgical aseptic hand scrub at
the beginning of clinical day.
b. Maintain medical asepsis during patient
care.
c. Recognize and maintain sterile fields in the
delivery room.
5. Provide physiological comfort of assigned
client
a. Recognize mother’s reaction to each
phase of labor.
b. Assist with relaxation and breathing
techniques.
c. Provide appropriate comfort measures
during each stage of labor.
6. Observe/implement to intrapartum client,
psychomotor competencies as opportunity
presents:
a. Admission of a patient to the L & D unit.
b. Abdominal or perineal prep and enema (if
used).
1. View “Crosstraining for Obstetrical
Staff and “Intrapartum Care,” RG
951. C74; 1992 Vol. 2, 1097915,
TCC/LRC/Metro
2. View CD-ROM “Managing the
Experience of Labor and Delivery,”
MP 200. Bring headphones to be
able to listen to program.
3. Complete the L/D “Preparation
Map.” Bring to clinical and be
prepared to discuss. Identify the
common physiological and
psychosocial assessment that
. would be collected on a client
during the labor and delivery
. process.
4. Complete a Labor & Delivery
Study Guide. Bring to clinical and be
prepared to discuss.
Continued on next page
Hospital-Page 8
Critical Thinking
Questions
Refer to the Critical
Thinking Questions on
Theory and Learning
Activities Laboratory
Maps for Week 3.
Learning Activities
1.
2.
3.
4.
5.
Observation
Cooperative Learning
Problem Solving
Practical Application Activities
Assist assigned RN with client
care
Written Assignments
1. Submit clinical study & preparation
map to instructor at the beginning of the
clinical experience.
2. Submit assigned paperwork &
Observation Report to instructor’s office
or instructor’s mail box in Nursing
Division office by 4:30 p.m. on Friday
following clinical experience unless
instructed otherwise by instructor.
a. Refer to green Guidesheet for
direction for completion of
paperwork
b. Demographic Data Collection
Sheet
c. Complete a Partogram with
analysis to meet learning
objective #1.
d. IV Fluids & Medications sheet
to meet learning objective #2.
e. On Nursing Diagnosis Sheet,
identify 3 physiologic and
psychosocial diagnoses and
supporting data experienced by
your assigned laboring client
concept map.
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
c. Application and use of fetal monitoring
equipment.
d. Identify a normal fetal monitoring strip and
deviations from normal.
e. Intravenous infusion therapy.
f. Nursing care during the fourth stage of
labor
g. Catheterize/insert Foley catheter.
h. Maintain communication with the
professional staff regarding progress of
intrapartum clients.
i. Observe/assist with immediate care of the
newborn and transfer to the nursery.
07/2011 NURS 2423
f. Show assessment data to
complete your preparation
concept map.
g. Typed observation report
addressing learning objective
#3.
h. Self-Evaluation form
Hospital-Page 9
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Labor & Delivery Study Guide
1. Identify the four stages of labor and what is occurring during that time. (Stages of Labor,
p. 387-388). There are many interventions for which the nurse is responsible. Name
at least 5 of the most important interventions to protect the safety, security and
comfort of the mother and newborn. (Chapter 18, p. 443-485)
Stage
1st Stage
2nd Stage
3rd Stage
4th Stage
2.
Definition & Events
Nursing Interventions
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
List the cardinal movements (mechanisms) of normal labor & delivery. (p. 388-390)
a.
b.
c.
d.
e.
f.
Hospital-Page 10
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
3. Identify the following presentations and positions: LOA, LOP, transverse, vertex, and breech.
(p. 378-379)
Hospital-Page 10
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
4. Look up the following medications used in labor & delivery. Identify indications for use,
usual dosage, route, adverse affects and nursing considerations. Be sure to get only information
that pertains to labor and delivery care.
Terbutaline Sulfate (Brethine) (p. 495):
Betamethasone (p. 496):
Prostaglandin (PGE2, Prepadil, Cervidil) (p. 507):
Misoprostol (Cytotec) (p. 506):
Oxytocin (Pitocin):
a. during labor, (p. 507-510):
b. postpartum (p. 525-526):
Butorphanol Tartrate (Stadol) (p. 408):
Nalbuphine (Nubain) p. 408):
Naloxone Hydrochloride (Narcan) (p. 409):
Meperidine (Demerol) (p. 407):
Fentanyl (Sublimaze) (p. 408):
Bupivacaine (p. 412):
Hospital-Page 10
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
5. Analyze the following monitor tracings. Identify the requested information for graphs a through e.
(chapter 17)
a.
Fetal
Heart
Tones
Uterine
Activity
Frequency ________________________Duration ________________________
Baseline Fetal Heart rate range_______________ Variability _______________
Pattern _____________________
Reassuring _____ or Non-reassuring _____
Significance_______________________________________________________
Possible causes_____________________________________________________
Nursing actions required______________________________________________
b.
Fetal
Heart
Tones
Uterine
Activity
Frequency ________________________Duration ________________________
Baseline Fetal Heart rate range_______________ Variability _______________
Pattern _____________________
Reassuring _____ or Non-reassuring _____
Significance_______________________________________________________
Possible causes_____________________________________________________
Nursing actions required______________________________________________
Hospital-Page 10
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
c.
Fetal
Heart
Tones
Uterine
Activity
Frequency ________________________Duration ________________________
Baseline Fetal Heart rate range_______________ Variability _______________
Pattern _____________________
Reassuring _____ or Non-reassuring _____
Significance_______________________________________________________
Possible causes_____________________________________________________
Nursing actions required______________________________________________
d.
Fetal
Heart
Tones
Uterine
Activity
Frequency ________________________Duration ________________________
Baseline Fetal Heart rate range_______________ Variability _______________
Pattern _____________________
Reassuring _____ or Non-reassuring _____
Significance_______________________________________________________
Possible causes_____________________________________________________
Nursing actions required______________________________________________
07/2011
Hospital- Page 14
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
e.
Fetal
Heart
Tones
Uterine
Activity
Frequency ________________________Duration ________________________
Baseline Fetal Heart rate range_______________ Variability _______________
Pattern _____________________
Reassuring _____ or Non-reassuring _____
Significance_______________________________________________________
Possible causes_____________________________________________________
Nursing actions required______________________________________________
07/2011
Hospital- Page 14
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Data Collection
Student’s Name: ________________________________________________ Date:
EDB: ___ Del. Date:______ Del. Time:
___ Gestation of Pregnancy ____wks ___days
Bag of water:# of Hrs ruptured ___Color: ____ Route of delivery: __Vag __ P or __R C-section
Mother’s Age: __________ Race: __________ Religion :_____________ Marital Status:
Gravida: ___ Para: ___ GTPAL: _____________________________ Blood Type:
Rubella Status: ___________ GBS status: _______ EBL: _______ Hct: _______ Hgb:
Allergies: _________________________________ Diet:
Medications Taken at Home:
Cultural/Spiritual Traditions for new mom/new baby:___________________________________
______________________________________________________________________________
Erikson’s Developmental Level Expected (Maternal):
Actual:
Behavioral Evidence of Actual Level:
Infant’s Gender _____ APGARS: 1 min ____ 5 min ____ Blood Type ______ Coombs
Weight __________ Length __________ Feeding Method
Infant’s Gestation At Birth: (weeks)_______(days)______/7
Vital Sign Range
Mother
Previous Day
Temperature
Pulse
Respirations
Blood Pressure
Pain Rating
Day of Care
XXXXXXXXXX
Infant
Previous Day
Day of Care
XXXXXXXXXXX
Describe the mother’s delivery and/or surgical procedure(s) to mother. Include
information about labor progress when admitted to hospital, complications, length of
labor, length of pushing, pain management: What, When, Effectiveness.
Use back of page.
07/2011
Hospital- Page 14
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
IV Fluids and Medications
P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear, Spinal, Epidural
Med/Route Frequency,
Dosage Prescribed
(Routine and PRN)
07/2011 NURS 2423
Frequency & Dosage Taken
Reason Prescribed for
THIS Client and Nursing
Implications
Hospital-Page 17
Client’s Response to Medication
(if seen)
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Priority #
Key Problem
Refer to p. 441; and 458-459
for common nursing
diagnoses utilized among
laboring patients
Priority #
Key Problem
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis
(problem/etiology)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Reason for Needing Health
Care
(Medical Diagnosis/
Surgical Procedure)
Priority Assessments:
Priority #
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis (problem/
etiology)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Hospital-Page 18
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Friedman’s Curve (Partogram)
Summary: (What?)
Analysis: (Why?)
Hospital-Page 18
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Self Evaluation Form
New Terms
Definition (cite references)
My learning goals are:
Achieved
Strengths:
Not Achieved
Challenges:
Knowledge:
Knowledge:
Skills:
Skills:
Attitudes:
Attitudes:
Hospital-Page 18
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Topic: Postpartum Hospital Clinical Experience
Learning Objectives
1. Assess a newly delivered mother and
provide nursing care appropriate for this
client.
2. Complete demographic data collection
form with information from assigned
client
and family.
3. Utilize nursing process to implement and
evaluate provided generic nursing care
plan.
4. Utilize nursing process to develop and
implement a nursing diagnoses specific to
assigned client (must be different than
generic careplan)
5. Communicate & collaborate appropriately
with client, staff, physicians and fellow
students to provide care for client and
family.
6. Safely administer prescribed medications,
with supervision, if appropriate.
7. Appropriately use hospital forms to chart
assessment and care.
Preparation Resources
1. In MP 200 (Rows B, E, & G), View
“Nursing Assessment of the New
Family: Nursing Assessment of the
Postpartum Patient” (bring your
headphones).
2. Complete and bring to clinical the
Postpartum Study Guide. Be
prepared to discuss the information
at preconference.
3. Complete the postpartum
Preparation Map. Bring it to clinical
and be prepared to discuss. Look at
common physiologic and psycho –
social-spiritual problems a new
mother would be at risk of
developing.
4. Review the generic PP careplan
provided by your instructor. Be
prepared to individualize,
implement and evaluate for your
assigned client.
Hospital-Page 21
Critical Thinking Questions
Refer to Critical Thinking
Questions on Theory and
Learning Activities
Laboratory Maps for Week 4.
Learning Activities
Role Playing
Cooperative Learning
Problem Solving
Practical Application Activities
Student Presentations
Written Assignments
Client Care
Written Assignments
1. Submit clinical study guide and PP
preparation map to instructor at the
beginning of the clinical experience.
2. Submit assigned paperwork to
instructors office or instructor’s mail
box in Nursing Division office by
4:30
p.m. on Friday following clinical
experience unless instructed
otherwise by instructor.
a. Refer to green Guidesheet for
directions for completion of
paperwork.
b. Completed post-partum
assessment tool on assigned client
c. Complete IV Fluids & Medication
Sheet with all postpartum
medications ordered for your
d. Complete Nursing Diagnosis sheet
with at least three diagnoses and
supporting data specific to your
assigned client.
Continued on Next Page
1.
2.
3.
4.
5.
6.
7.
e. Individualize, implement and evaluate
generic care plan provided by instructors.
f. Formulate one new care plan for one of
the priority diagnoses listed on the Nursing
Diagnosis sheet. This should be a
diagnosis different than the generic care
plan, and have different interventions.
There should be at least 5 interventions,
including one teaching intervention. This
care plan is to be implemented and
evaluated during clinicals.
g. Complete self evaluation form.
h. Include Nursing Plan of Care & Evaluation
Criteria Grade Sheet.
07/2011 NURS 2423
Hospital-Page 22
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
POSTPARTUM STUDY GUIDE
1.
List the nine areas to be assessed in the postpartum check.
2.
Describe the timeframes and positions of the uterus during normal uterine involution: (p.
525)
a. Immediately after delivery:
b. 12 hours post delivery:
c. 24 hours post delivery:
d. Beyond 24 hours post delivery:
e. 6 days post delivery:
3.
What is “Sub-Involution”? (p. 525)
07/2011 NURS 2423
Hospital-Page 23
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
4.
Describe the physiology of lactation. (p. 682-684)
5.
Look up the following medications used in maternity care. Identify indications for use,
usual dosage, desired effects, and nursing considerations. Use your textbook and
medication book to find information that pertains to maternity care. (Use your own
drug books)
Dermoplast Spray (Benzocaine, Americane)
Mepergan fortis:
Tylox/Percocet/Darvocet:
Phenergan:
Methergine Maleate
Depo Provera
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Ergonavine
Hemabate Prostin
Duramorph
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Nine-point Postpartum Assessment
(BUBBLEHER ASSESSMENT – PLEASE REVIEW)
Before beginning, be sure that the mother had emptied her bladder and that she is lying in a supine
position on a flat bed. Explain each procedure to her and inform her of your findings. Remember to use
Universal Blood and Body Fluid Precautions.
1. Breasts:
Gently palpate each breast. What is the contour? Are the breasts full, firm, tender, shiny? Are the
veins distended? Is the skin warm? Does the patient complain of sore nipples and are her breasts so
engorged that she requires medication?
If you feel nodules in the breasts, they may be there because the ducts were not emptied at the last
feeding. Stroke downward towards the nipple, then gently release the milk by manual expression. If
the nodules remain, notify the doctor.
Take this opportunity to explain the process of milk production, tell her what to do about
engorgement, show her how to perform self-breast examinations, and answer any questions she may
have about breastfeeding.
2. Uterus:
Palpate the uterus. It should be firm and should decrease approximately one fingerbreadth below the
umbilicus each day. Have the patient feel her uterus as you explain the process of involution.
If the uterus is not involuting properly, check for infection, fibroids, and lack of tone. Unsatisfactory
involution may also result if there is retained placenta or if the bladder is not completely empty.
3. Bladder:
Inspect and palpate the bladder simultaneously while checking the height of the fundus. Bladder
distention should not be present after recent emptying. When it does occur, a pouch over the bladder
area is observed, resistance is felt upon palpation, while at the same time, the mother usually feels a
need to urinate. An order from the physician is necessary so that catheterization may be done.
Infection of the urinary tract must be prevented from occurring. This is why it is imperative that the
first three postpartum voidings be measured and should be at least 150cc. Frequent small voidings,
with of without pain and burning, may indicate infection or retention. If voidings are frequent and
large, explain the diuresing process to the mother. Talk to the mother about proper perineal care.
Explain that she should wipe from front to back after voiding and defecating. This helps prevent
urinary tract infection and is a hygienic principle that pertains to females of all ages.
4. Bowel Function:
Question the patient daily about movements. She must not become constipated. If her bowels have
not functioned by the second postpartum day, you may want to start her on a mild laxative.
Encourage her to drink extra fluids and to select fruits and vegetables from her menu.
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5. Lochia:
Assess the amount and type of lochia on the pad in relation to the number of postpartum days. For the
first three days, you should find a very red lochia similar to the menstrual flow. During the next few
days it should become watery of serous, and on the tenth day, it should become thin and colorless.
Notify the doctor if the lochia looks abnormal in color or quantity, if it has an unusual odor or
contains clots other than small shiny ones. Inform the mother about what changes she should expect
in the lochia and when it should cease. Tell her when the next menstrual period will probably begin
and when she can resume sexual relations. You may also want to discuss family planning at this time.
6. Episiotomy:
Although episiotomies are routine don’t overlook the importance of inspecting them thoroughly. Use
a flashlight if necessary for better visibility. To determine if the wound is healing properly, check for
infection inflammation and suture sloughing. Is the surrounding skin warm to the touch and does the
patient complain of unusual discomfort? You should notify the doctor if any occur.
Also check the rectal area. If hemorrhoids are present, the doctor may want to start the patient on a
sitz bath and local analgesic medication.
Most postpartum patients-especially those who are mothers for the first time-will have questions
about the stitches, “When will they be removed?” “Will they pull out during bowel movements?”
Reassure her as you answer these questions and other questions she may have regarding pain,
cleanliness, and coitus. Use REEDA scale to help you assess.
7. Homan’s Sign:
Press down gently on the patient’s knee (legs extended flat on the bed) and ask her to flex her foot.
Pain or tenderness in the calf is a positive Homan’s sign and an indication of thrombophlebitis. The
physician should be notified immediately.
8. Emotional Status:
Throughout the physical assessment, notice and evaluate the mother’s emotional status. Does she
appear dependent or independent? Is she elated or despondent? What does she say about family
support? Are there other nonverbal clues? Explain to her and to her family that she may cry easily for
awhile and that her emotions may suddenly shift from high to low.
These changes are normal and are probably caused by the tremendous hormonal changes occurring
in her body and by her realization of the new responsibilities that accompany each child’s birth.
9. Respiratory System:
Listen to breath sounds in all lobes of the lungs. Lung sounds should be clear. The longer the client
has been confined to bed, the higher the risk of atelectasis. While client is confined to bed, remind
them to turn, cough and deep breath every one to two hours while splinting their abdomen. As soon
as is medically indicated, get client up and ambulating.
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Demographic Data Collection
Student’s Name: ______________________________________________ Date:
Assigned to: Mother: _____ Infant______
EDB: ______ Del. Date: ______ Del. Time:
___
Route of delivery: Vaginal ___ Primary C-sec. ___ Repeat C-sec. ___ Gestation ____ weeks & ______ days
Mother’s Age: _______ Race: ________ Religion :________________ Marital Status:
Gravida: ___ Para: _____ GTPAL: ____________________ Blood Type:
______
EBL: _______
Rubella Status: ____________ GBS status: _______ Hct: pre-delivery____post_____ Hgb: pre____post_____
Bag of water: ____Assisted ____ Spontaneous Rupture
# of hours ruptured _______; Color: __________
Allergies: ___________________________________ Diet: ________________________________________
Medications Taken at Home: _________________________________________________________________
Cultural/Spiritual Traditions for new mom/new baby: _____________________________________________
Erikson’s Developmental Level Expected of Mother: ______________________________________________
Behavioral Evidence of Actual Level:
Infant’s Gender ________ APGARS: 1 min _____ 5 min ______ Blood Type _______ Coombs __________
Weight __lb.__oz ______gm Length _____in______cm Feeding Method
Frequency of feedings occurring
Amount taken or time at breast feeding
Erikson’s Developmental Level Expected of Newborn: _____________________________________________
Behavioral Evidence of Newborn’s Developmental Level _________________________________________
Vital Sign Range
Mother
Previous Day
Temperature
Pulse
Respirations
Blood Pressure
Pain Rating
Infant
Day of care
XXXXXXXXXX
Previous day
Day of care
XXXXXXXXXXX
Describe the delivery and other surgical procedure(s) to mother and surgical procedures to the newborn.
Include information about labor process: when labor began, when admitted to hospital, complications,
length of stages, length of pushing. Also include pain management: What, When, Effectiveness. If any
surgical procedures performed on infant, describe what, why and how. Use back of page.
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Health Assessment/Functional Patterns
Instructions: In each pattern include client’s strengths, limitations, and pertinent factors influencing
health. Highlight abnormal data.
Health Perception Management Pattern
Parents
Activity-Exercise Pattern
Mother
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Elimination Pattern
Mother
Infant
Nutritional-Metabolic Pattern
* Complete for both clients, even if you are not assigned to that member of the family
Mother
Infant
*Pre-pregnant weight _______ *Height
*Baby’s weight
*Weight at delivery
*Type of feeding
*Weight gain during pregnancy
Caloric needs per day
Needs feedings of ________ oz q _________ hours
Actual frequency of feedings____________________
Amount taken or time at breast__________________
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Cognitive Perceptual Pattern
Mother
Infant
Sleep-Rest Pattern
Mother
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Sexual Reproductive Pattern
Mother
Infant
Coping – Stress Tolerance Pattern
Mother
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Self Perception Pattern
Parents
Role Relationship Pattern
Parents
Value-Belief Pattern
Parents
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P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear
Med/Route, Frequency,
Dosage Prescribed
(Routine and PRN)
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Frequency & Dosage Taken
Reason Prescribed for
THIS Client and Nursing
Implications
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Client’s Response To Medication
(if seen)
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Nursing Diagnosis Sheet
Priority #
Key Problem
I don’t know how this fits
with the problems???
Priority #
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or negative
assessment data, pertinent history)
Reason For Needing Health
Care
(Medical
Diagnosis/Surgical
Procedure)
Priority Assessments:
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
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Priority #
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Nursing Care Plan
Student: _________________________________________________________ Mother: _____________________ Infant: _____________________
Nursing Diagnosis: ________________________________________________________________________________________________________
Goal: ___________________________________________________________________________________________________________________
Specific Outcomes: (AEB Behaviors to Measure Goal Achievement) ________________________________________________________________
________________________________________________________________________________________________________________________
Nursing Intervention
1.
Scientific Rationale and Source
1.
Implementation (I) and Evaluation (E) of
Client’s Response to Intervention
1. I
E.
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Nursing Intervention
Scientific Rationale and Source
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Implementation and Evaluation of Client’s
Response to Intervention
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Nursing Intervention
Scientific Rationale and Source
Evaluation of Goal Achievement: (Met, Not Met, Partially Met); and,
Specific Outcomes (AEB Behaviors to Measure Goal Achievement):
Date:
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Shift Time:
Signature:
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Implementation and Evaluation of Client’s
Response to Intervention
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Self Evaluation Form
New Terms
Definition (cite references)
My learning goals are:
Achieved
Strengths
Challenges
Knowledge:
Knowledge:
Skills:
Skills:
Attitudes:
Attitudes:
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Nursing Plan of Care and Evaluation Criteria
Points Deducted
I. ASSESSMENT (35%)
_______ 1. Collects and documents data relevant to bio/psycho/social/spiritual health of clients
_______ 2. Compares assessment data to norms for assigned client population
_______ 3. Documents assessment data appropriately in agency record
_______ 4. Demonstrates appropriate knowledge, use of medical terms, abbreviations, symbols
________5. Identifies need for client education
_______ 6. Identifies indications for and effects of prescribed medications
_______ 7. Determines appropriate client problem and prioritizes
II. NURSING DIAGNOSIS (10%)
_______ 1. Supports nursing diagnosis with assessment data related to anatomy and physiology.
_______ 2. Supports nursing diagnosis with client specific assessment data
III. PLANNING (20%)
_______ 1. Utilizes standards of nursing care to reflect nursing interventions that are realistic and
relevant
_______ 2. Identifies scientific rationale for each nursing intervention
_______ 3. References scientific rationale for each nursing intervention
_______ 4. Interventions planned to provide client/family education
IV. IMPLEMENTATION OF INTERVENTIONS (15%)
_______ 1. Implements and/or modifies written plan of care as appropriate for client’s condition
_______ 2. Utilizes other health care providers to promote client’s health status, (if needed)
_______ 3. Provides appropriate information to meet educational needs of client
V. EVALUATION (20%)
_______ 1. Develops appropriate client-centered outcome (goal) in specific, measurable terms
_______ 2. Evaluates client response to planned nursing interventions
_______ 3. Evaluates attainment of client outcome (goal)
_______ 4. Explains evaluation of goal
______Total points deducted
Student scored ___________ of 100 possible points
Deductions: 0. Meets expectations, work legible, correct terminology wording & spelling
1. Needs improvement with legibility, terminology, wording or spelling
2. Work good, needs more specific data
3. Work good, but incomplete
4. Needs improvement in application of nursing process
5. Unsatisfactory
Instructor___________________________________________________________ Date ________________ NOTE:
Students making below 75 need a faculty consultation prior to submitting next care plan.
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GENERIC POST PARTUM CARE PLAN
Student: _________________________ Mother: x Infant:____ Date of Care: ________Delivery Time/Date____
Nursing Diagnosis: Risk for infection. Risk factors broken skin integrity with possible entrance of pathogens 2nd to episiotomy or cesarean
Delivery, drains from C/S, placental site, vaginal exams, *PROM, needle sticks from epidural, IV starts & lab work, breast feeding, urinary
catheterization
Goal: Client will be free of signs & symptoms of infection throughout hospital stay
Specific Outcomes (AEB Behaviors to measure goal achievement):
1.) VS are WNL--T 97.6-100.3, P 60-100, R 12-24, BP-100 to 150/60 to 89
2.) Incision (episiotomy or C/S) &/or nipples WNL for REEDA.
3.) Lab values WNL, & H&H above 10 & 32, leukocytosis, sedimentation rate
4.) Lochia: heavy mod light, no abnormal bleeding or odors
5.) Uterus contracting WNL, with no unusual tenderness
6.) Client ambulating freely, providing self & newborn care by the end of the clinical shift
Nursing Intervention
Scientific Rationale and Source (APA)
I. Implementation; B. Evaluation of
Client’s Response to Intervention
1. Review prenatal, labor & birth record for evidence of any
risk factors for infection (episotomy, lacerations, skin
tears, cesarean delivery incision, prolonged rupture of
membranes, (*PROM), temperature of 100.4, maternal
history of immunosuppression, DM, catheterization,
internal fetal monitoring, multiple vaginal exams after
ROM, epidural, retained placental fragments, breast
feeding).
1. To ascertain whether the perineum or abdomen had
areas of broken skin integrity exposed to infectious
agents during labor, delivery, C/S surgery, or recovery
of the new mother. Risks include antepartal factors
and intrapartal factors (Wong, p. 668-669).
1. I
2. Assess and monitor vital signs (include the 5th vital
sign for pain) every 4 hours or more frequently in
unstable or within 24 hours of delivery.
2. Infections manifested by temp. >38.3°C (101°F) after
the first 24 hours. Pulse-tachycardia with fever or
marked bradycardia or blood pressure-hypotension or
hypertension (Wong, 2005, p. 668-669). Increased
pain after pain has been controlled or continued pain
may indicate local infection (Green & Wilkinison, 2004,
p. 445.
2. I
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E
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3. Assess and monitor fundal tone and locations. Teach
client about expected descent of fundus
Scientific Rationale and Source (APA)
3. Failure of the uterus to contract normally (deviated
From midline, boggy, remains above umbilicus after 24
hours) may be because of retained placental fragments
which may lead to infection (Wong, 2005).
4. Assess and monitor any areas where skin integrity has
been broken (episiotomy, placental site, lacerations,
abrasions, breasts, /S abd. Incision, etc.).
4. Broken skin integrity is a portal of entry for pathogens.
Redness swelling, increase pain or purulent drainage
may indicate the presence of infection after the 1st 24
hours in the perineum (Green & Wilkinson, 2004, p.
445).
5. Have all health care providers practice good hand
washing techniques, clean areas with appropriate
antiseptic prior to breaking barriers of skin integrity
such as IV insertions, drawing lab work, incisions for
C/S, episitomy, epidural naesthesia & wear gloves.
5. Pathologic organisms are primarily spread from person
to person by the hands. Antiseptic treatment to prevent
the spread of pathogens from dirty to clean areas of
breasts or perineum will help spread infection. (Green &
Wilkinson, 2004, pp. 41 & 446).
6. Change bed linens, disposable pad and draw sheets
frequently. Teach the client that walking barefoot brings
germs back into the bed.
6. One important means of preventing infection is
maintenance of a clean environment to prevent the
spread of infection. (Wong, 2005, p. 609-610).
7. Assist client with pericare after first voiding & teach client
to continue pericare (rinsing perineal area from front to
back with water or antiseptic squirted from bottle) with
each elimination or pad change until lochial discharge
completely stopped. Reinforce teaching and assess
client’s understanding & compliance if this teaching has
already been done. Also insist C/S client with pericare
while unable to do so in bed or up to commode by using
the same method and cleaning the bed.
7. Cleansing perineum will remove a warm, moist medium
for growth of pathogens and promote healing and
prevent infection. (Green & Wikinson, 2004, p. 439;
446)
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A. Implementation; B. Evaluation of
Client’s Response to Intervention
3. I
E
4. I
E
5I
E
6. I
E
7. I
E
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8. Teach client to wipe or blot from front to back after each
elimination.
9. Teach client to change perineal pads with each
elimination.
10. Assess and monitor lochia flow, color, & amount.
Teach client about the normal lochia flow expected
during the post partum period.
11. Administer antibiotics if ordered (list medication
and action). Teach mom the importance of taking
medication as prescribed when going home.
12. Monitor abdominal incision for S/S of infection if
cesarean delivery.
13. Assess for nutritional status and promote good
nutrition.
07/11 NURS 2423
Scientific Rationale & Source (APA)
8. Prevents spread of fecal contaminants and other
bacteria to the episiotomy/laceration or vagina.
“…to avoid transferring E. Coli from the rectum to the
vagina and urinary tract. (Green & Wilkinson, 2004,
p. 439).
9. To prevent cross-contamination from the rectum to
the vagina or urethra. Proper care of the episiotomy
site and perineal area prevents infection. (Wong,
2005, p. 462)
10. Continued flow of lochia may indicate endometritis
(infection) if associated with fever, pain, or abdominal
tenderness (Wong, 2005, p. 447). Foul smelling
lochia is an indication of Infection and detection early
could prevent systemic infection (Green & Wilkinson,
2004, p. 445).
11. Management of endometritis consists of intravenous
broad spectrum therapy (Wong, 2005, p. 507).
Compliance with drug therapy is necessary to
eliminate the infectious organism completely (Green
& Wilkinson, 2004, p 508).
A. Implementation B. Evaluation of
Clients Response to Intervention
8. I
E
9. I
E
10. I
E
11. I
E
12. Erythema warmth and mild swelling at the incision
indicates inflammatory response (Green & Wilkinson,
2004, p. 495)
12. I
13. Intake of adequate protein and calories is essential
for tissue healing and repair. Malnutrition predisposes
to infection (Green & Wilkinson, 2004, p. 495
13. I
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14. Teach the S/S of infection that should be
reported.
Scientific Rationale & Source (APA)
14. Client instruction will aid in early recognition of
infection (Green & Wilkinson, 2004, p. 480)
A. Implementation B. Evaluation of
Clients Response to Intervention
14. I
E
Evaluation of Goal Achievement: (Met, Not Met, Partially Met); and,
Specific Outcomes (AEB Behaviors to Measure Goal Achievement):
Date:___________________Shift Time:______________________Signature:__________________________________________
Green, C. & Wilkinson, J. (2004). Maternal Newborn Nursing Care Plans. St. Louis: Mosby.
Wong, D., Hockenberry, M. Perry, S., Lowdermilk, D., & Wilson (2006) Maternal Child Nursing Care, 34rd Ed. St. Louis: Mosby
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Theory Learning Map
Topic: Newborn Nursery
Learning objectives
1. Assess a newly delivered infant and
provide nursing care personalized to
this newborn and his/her family.
2. Complete Demographic Data
Collection Form utilizing information
from assigned client.
3. Utilize nursing process to implement
and evaluate provided generic
nursing care plan.
4. Utilize nursing process to develop
and implement a nursing diagnosis
specific to assigned client. (Must be
different than generic careplan).
5. Communicate and collaborate
appropriately with client, staff,
physicians, and fellow students to
provide care for the client an family.
Preparation Resources
Critical Thinking Questions
1. Wong, Perry, Hockenberry,
Loudermilk and Wilson, chapters
25-28
2. In the LRC at Media Reserve
Desk: View Comprehensive .
Refer to the Critical Thinking
Questions on the Theory and
Learning Activities Laboratory
Maps for Weeks 5 & 7.
. Newborn Assessment RJ 251 .P5
. 2006 1105389
3. In MP 200 D, view .
. “Management of the Newborn .
. Experience” (take your
. headphones).
4.In MP 200, view Nursing
Assessment of the New Family:
. “Nursing Assessment of the
. Newborn” and “Gestational Age
. Assessment of the Newborn”
. (Rows B, E, & G) (take your
. headphones).
5. www.BallardScore.com
6. Complete the Newborn Nursery
Study Guide. Bring it to clinical
and be prepared to discuss.
7. Complete the newborn
Preparation map. Bring it to
clinical & be prepared to discuss.
Look at common variations in
transition to extrauterine life a
newborn would be at risk of
developing.
6. Review the generic NB careplan
provided by your instructor. Be
prepared to individualize,
implement and evaluate for your
assigned client.
Learning Activities
1.
2.
3.
4.
5.
Role Playing
Cooperative Learning
Problem Solving
Practical Application Activities
Written Assignment of Client Care
Competency
Apical Fetal Heart Rate: Student and Faculty will
count the newborn apical fetal heart rate
simultaneously for one minute, the student/faculty
counts must be within four beats.
Written Assignments
1. Submit clinical study guide and Preparation
Map to instructor at the beginning of the clinical
experience
2. Submit assigned paperwork to instructor’s
office or instructor’s mail box in Nursing
Division office by 4:30 p.m. on Friday following
clinical experience unless instructed otherwise
by instructor:
a. Refer to green Guide sheet for directions for
completion of paperwork.
b. Completed newborn assessment tool on
assigned client.
c. Complete IV Fluids and Medication Sheet
with all medications ordered since birth for
your assigned client.
d. Complete Nursing Diagnosis sheet with at
least three diagnoses specific to your
assigned client.
e. Individualize, implement and evaluate
generic care plan provided by instructors.
Continued on Next Page
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f. Formulate one new care plan for one of the
priority diagnoses listed on the Nursing
Diagnosis sheet. This should be a different
diagnosis than the generic care plan, and have
different interventions. There should be at least
5 interventions, including one teaching
intervention. This care plan is to be implemented
and evaluated during clinical
g. Complete self evaluation form
h. Include Nursing Plan of Care and Evaluation
Criteria Grade Sheet
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Normal Newborn-Nursery Study Guide
1. a. What is the purpose of the Ballard exam? (Figure 25-1, p. 645, p. 650)
_________________________________________________________________
b. Identify 2 sections of the Ballard tool:
_____________________________________________________________
________________________________________________________________
2. Describe the following characteristics on an AGA term newborn.
a. Skin characteristics (p.615, 628-629)
b. Breast bud size (p. 619)
c. Male genitalia (p. 618-619)
d. Female genitalia (p. 618)
3. Umbilical vessels consist of ___________________ and _______________ (p. 633)
4. What five characteristics of the newborn does the Apgar system evaluate? (p. 643-644)
a.
b.
c.
d.
e.
5. Describe the characteristics of the newborn’s respirations. ( p. 627)
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6. List three types of normal infant stools in sequence. (p. 614)
a.
b.
c.
7. Describe the difference between a normal bottle-fed stool and normal breast-fed stool. (p.614)
a. Bottle
b. Breast:
8. The caloric requirement for a newborn is ____ Kcal/kg/day or ____Kcal/lb/day. With this
information, calculate the 24-hour caloric requirement for an 8-pound newborn. The newborn
needs ________________ per day
9. What immunoglobulin is passed through breast milk and provides some passive
immunity for the newborn? (p. 684)
10. What is the normal elimination pattern per 24 hours for a newborn? The newborns should
have ___ wet diaper(s) and ______ stool(s) within 24 hours of birth, _______ wet
diaper(s) and ______ stool(s) by day 3, and ______ wet diaper(s) and ______________ stool(s)
after day 4. (p. 685)
11. Describe nursing care after circumcision. What care is done differently for a baby
circumcised by the Plastibell method? (p. 755)
12.
What discharge instruction for circumcision for care should a nurse give a new mother?
(p. 669 Patient Teaching Box)
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13. What discharge instructions would the nurse give a new mother about care of a male infant
who has not been circumcised? (p. 675, Home Care Box)
14.
Describe routine umbilical cord care for the newborn. (p. 675, Home Care Box)
15.
Describe phenylketonuria (PKU) ( p. 777, 658)
a. Symptoms:
b. Cause:
c. Timing of lab work:
d. Treatment:
16.
655)
Describe physiological jaundice of the newborn. What is Kernicterus? (p. 653-654 &
.
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17.
On the diagram below: Label the suture lines, fontanels. ( p. 377) When do the anterior
and posterior fontanels usually close? (P. 376)
18.
Describe the differences between: (pp. 615-616.)
a. caput succedaneum
b. cephalohemtoma.
19.
List the normal range of vital signs for a newborn. (pps. 626-627, 1762)
a. Axillary temperature in both Fahrenheit and Centigrade:
b. Pulse
c. Respiration
d. Blood pressure
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20. Healthy newborn admission medications: Identify and write up indications, implementation
information, side effects, and nursing implications for usage of the following medications in the
newborn. If injectable also note preferred size of needle and injection site.
Erythromycin (Ilotycin): ( p. 649)
Vitimin K: Aquamephyton (Konakion) (p. 649)
Hepatitis B Vaccine ( p. 663)
(rev) 6/06/11 newborn nursery study guide
Childbearing 2011-2012
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Normal Newborn-Nursery Assessment Guide
(PLEASE REVIEW)
Immediate stabilization requires nurse to assess and support:
Temperature (*dry and *warm infant)
Airway (sniff *position and *suction, mouth then nose)
Breathing (*stimulate to cry)
Circulation (heart rate and color)
Note APGAR at 1, 5 & 10 minutes, VS, clamp cord. Weight and measure, do footprints and
secure ID bands.
*American Heart Association & American Academy of Pediatric Resuscitation Guidelines.
1. GENERAL:
a. Note posture, tone, level of activity, presence of moro reflex.
b. Note proportion and symmetry.
c. Note oversize. Measure body length from back of crown to heel with tape measure flat on
bed beneath or next to infant.
d. Note cry.
e. Note behavior, level of consciousness (LOC), self-consoling/regulation behaviors,
habituation. Note transition through the 6 sleep/wake states (deep sleep, light sleep,
drowsy, quiet alert, active alert, crying). Check blood sugar levels according to hospital
protocol.
f. Axillary temperature.
2. SKIN:
a. Note color. Check for pallor, cyanosis, plethora, jaundice, circumoral/circumorbital
cyanosis.
b. Note texture, turgor, capillary refill, warmth, dryness, presence of vernix/lanugo.
c. Note the presence of rashes, birthmarks or lesions. Check for erythema toxicum, milia,
telangiectatic nevi, Mongolian spots, strawberry hemangioma, nevus flammeus,
ecchymosis, petechia, café au lait spots.
3. HEAD:
a. Note the shape and symmetry.
b. Palpate the skull…Note the presence, shape and size of the fontanels and the relationship
of the sutures. Check for molding, cephalohematoma, caput succedaneum, forcep and/or
scalp lead marks.
c. Measure head circumference (frontal-occipital circumference, FOC).
d. Ears…Note the position, shape, attachment and presence of pits or skin tags
.
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e. Eyes…Note size of eyes and orbits, position, characteristics of iris, cornea, sclera,
conjunctiva and lids. Reactivity of pupils, presence of red reflex and range of motion.
Note Glabellar (acoustic or tactile blink) reflex. Note epicanthal folds, Brushfield’s spots,
strabismus, circumorbital cyanosis.
f. Nose…Note the shape, size, symmetry and patency.
g. Mouth…Note symmetry, shape, size, characteristics (lips and hard/soft palate intact),
rooting, sucking and gag reflexes.
h. Neck…Note shape, symmetry, range of motion, presence of masses. Note Fencing (tonic
neck) reflex.
4. THORAX/CHEST:
a. Note size, shape, symmetry, and palpate clavicles for fractures.
b. Breast…Note presence of breast tissue (buds), location on chest and presence of any
nipple discharge (witch’s milk). Measure chest circumference at nipple line.
c. Heart…Note rate, rhythm, PMI, auscultate heart sounds (anteriorly and posteriorly), note
presence of any murmur or thrill. Perform 9 pulse-site check.
d. Lungs…Note the characteristics of breath sounds bilaterally as well a anteriorly and
posteriorly, respiratory effort and rate.
5. ABDOMEN:
a. Note shape, bowel sounds, circumference (at umbilicus), softness, color, and presence of
visible bowel loops, defects or masses, diastasis recti.
b. Umbilical cord…Note the color, number of vessels, size and presence of any odor or
drainage, presence of Wharton’s jelly or umbilical hernia. NOTE: cord clamps are
usually removed upon hospital dismissal.
c. Liver…May be palpated 1-2 cm below right costal margin.
d. Spleen Tip…May be palpated at the left costal margin.
e. Bladder…May be palpated above the symphysis pubis. Should void within 12-24 hours of
birth. Normal urinary output is 1-2cc/kg/day or 6-10 wet diapers/day after feedings
established. Note presence of uric acid crystals (brick dust)- a pinkish color from the urine
on the diaper.
f. Kidneys…Lower in infants and may be palpated in the retroperitoneal space.
g. Gastric Aspirate…Normally cloudy-white and rarely exceeds 25 cc.
6. GENITALIA: Appropriate for stated gender???
a. Male…Note position of meatus and testes, characteristics of scrotum (i.e. hypospadius,
chordee, episadius, hydrocele, micro-penis).
b. Female…Note characteristics of labia and clitoris, presence of discharge (pseudomenses),
masses or hymenal tag.
7. ANUS
a. Note position, patency and presence of “anal wink” to R/O imperforate anus.
b. Stools…Note time of first stool, color, amount, odor and consistency.
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8. SPINE
a. Note alignment, intactness, presence of masses, pilondial cyst/dimple, tuft of hair.
b. Note Galant (trunk incurvation) reflex.
7. EXTREMITIES:
a. Arms/Legs…note symmetry, ROM, color, pulses and temperature. Note moro, startle,
prone crawl and crossed extensor reflexes.
b. Hips…Note ROM and Ortolani’s Maneuver, not if buttock creases are even.
c. Hands/Feet…Note number of digits (syndactyly, polydactyly), posture, crease patterns
(Simian creases), palmer/plantar grasps and Babinski reflexes bilaterally. Note
acrocyanosis or club foot. Note stepping and magnet reflexes.
Ongoing assessments: If no abnormalities are noted in the initial assessment then the primary emphasis
in follow-up assessments should focus on:
1. Vital Signs
2. Changes in Color
3. Changes in Activity
4. Changes in Respiratory Effort
5. Feeding Ability (suck/swallow/breath coordination), frequency, intake.
6. Elimination Patterns
7. Family Bonding
8. Family providing basic infant care (feeding, bathing, dressing, holding)
9. Daily weight
10. Security precautions (ID bands, hospital protocol)
11. Teaching for home care (cord, care, circ care, normal G&D, follow-up care, immunizations,
car seat safety)
12. Newborn hearing screening
13. Lab work at appropriate times (PKU/Guthrie, Bili)
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Demographic Data Collection
Student’s Name: ______________________________________________ Date:
Assigned to: Mother: _____ Infant______
EDB: ______ Del. Date: ______ Del. Time:
___
Route of delivery: Vaginal ___ Primary C-sec. ___ Repeat C-sec. ___ Gestation ____ weeks & ______ days
Mother’s Age: _______ Race: ________ Religion :________________ Marital Status:
Gravida: ___ Para: _____ GTPAL: ____________________ Blood Type:
______
EBL: _______
Rubella Status: ____________ GBS status: _______ Hct: pre-delivery____post_____ Hgb: pre____post_____
Bag of water: ____Assisted ____ Spontaneous Rupture
# of hours ruptured _______; Color: __________
Allergies: ___________________________________ Diet: ________________________________________
Medications Taken at Home: _________________________________________________________________
Cultural/Spiritual Traditions for new mom/new baby: _____________________________________________
Erikson’s Developmental Level Expected of Mother: ______________________________________________
Behavioral Evidence of Actual Level:
Infant’s Gender ________ APGARS: 1 min _____ 5 min ______ Blood Type _______ Coombs __________
Weight __lb.__oz ______gm Length _____in______cm Feeding Method
Frequency of feedings occurring
Amount taken or time at breast feeding
Erikson’s Developmental Level Expected of Newborn: _____________________________________________
Behavioral Evidence of Newborn’s Developmental Level _________________________________________
Vital Sign Range
Mother
Previous Day
Temperature
Pulse
Respirations
Blood Pressure
Pain Rating
Infant
Day of care
XXXXXXXXXX
Previous day
Day of care
XXXXXXXXXXX
Describe the delivery and other surgical procedure(s) to mother and surgical procedures to the newborn.
Include information about labor process: when labor began, when admitted to hospital, complications,
length of stages, length of pushing. Also include pain management: What, When, Effectiveness. If any
surgical procedures performed on infant, describe what, why and how. Use back of page.
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Health Assessment/Functional Patterns
Instructions: In each pattern include client’s strengths, limitations, and pertinent factors influencing
health. Highlight abnormal data.
Health Perception Management Pattern
Parents
Activity-Exercise Pattern
Mother
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Infant
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Elimination Pattern
Mother
Infant
Nutritional-Metabolic Pattern
* Complete for both clients, even if you are not assigned to that member of the family
Mother
Infant
*Pre-pregnant weight _______ *Height
*Baby’s weight
*Weight at delivery
*Type of feeding
*Weight gain during pregnancy
Caloric needs per day
Needs feedings of ________ oz q _________ hours
Actual frequency of feedings____________________
Amount taken or time at breast__________________
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Cognitive Perceptual Pattern
Mother
Infant
Sleep-Rest Pattern
Mother
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Infant
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Sexual Reproductive Pattern
Mother
Infant
Coping – Stress Tolerance Pattern
Mother
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Infant
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Self Perception Pattern
Parents
Role Relationship Pattern
Parents
Value-Belief Pattern
Parents
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P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear
Med/Route, Frequency,
Dosage Prescribed
(Routine and PRN)
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Frequency & Dosage Taken
Reason Prescribed for
THIS Client and Nursing
Implications
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Client’s Response To Medication
(if seen)
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Diagnosis Sheet
Priority #
Key Problem
I don’t know how this fits
with the problems???
Priority #
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or negative
assessment data, pertinent history)
Reason For Needing Health
Care
(Medical
Diagnosis/Surgical
Procedure)
Priority Assessments:
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
1 NURS 2423
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Priority #
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Care Plan
Student: _________________________________________________________ Mother: _____________________ Infant: _____________________
Nursing Diagnosis: ________________________________________________________________________________________________________
Goal: ___________________________________________________________________________________________________________________
Specific Outcomes: (AEB Behaviors to Measure Goal Achievement) ________________________________________________________________
________________________________________________________________________________________________________________________
Nursing Intervention
1.
Scientific Rationale and Source
1.
Implementation (I) and Evaluation (E) of
Client’s Response to Intervention
1. I
E.
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Nursing Intervention
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Scientific Rationale and Source
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Implementation and Evaluation of Client’s
Response to Intervention
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Intervention
Scientific Rationale and Source
Evaluation of Goal Achievement: (Met, Not Met, Partially Met); and,
Specific Outcomes (AEB Behaviors to Measure Goal Achievement):
Date:
07/11 NURS 2423
Shift Time:
Signature:
Hospital –Page 62
Implementation and Evaluation of Client’s
Response to Intervention
TCC Nursing Program
NUR 2423 Nursing of Childbearing Families
Self Evaluation Form
New Terms
Definition (cite references)
My learning goals are:
Achieved
Strengths
Challenges
Knowledge:
Knowledge:
Skills:
Skills:
Attitudes:
Attitudes:
07/11 NURS 2423
Not Achieved
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Nursing Plan of Care and Evaluation Criteria
Points Deducted
I. ASSESSMENT (35%)
_______ 1. Collects and documents data relevant to bio/psycho/social/spiritual health of clients
_______ 2. Compares assessment data to norms for assigned client population
_______ 3. Documents assessment data appropriately in agency record
_______ 4. Demonstrates appropriate knowledge, use of medical terms, abbreviations, symbols
________5. Identifies need for client education
_______ 6. Identifies indications for and effects of prescribed medications
_______ 7. Determines appropriate client problem and prioritizes
II. NURSING DIAGNOSIS (10%)
_______ 1. Supports nursing diagnosis with assessment data related to anatomy and physiology.
_______ 2. Supports nursing diagnosis with client specific assessment data
III. PLANNING (20%)
_______ 1. Utilizes standards of nursing care to reflect nursing interventions that are realistic and
relevant
_______ 2. Identifies scientific rationale for each nursing intervention
_______ 3. References scientific rationale for each nursing intervention
_______ 4. Interventions planned to provide client/family education
IV. IMPLEMENTATION OF INTERVENTIONS (15%)
_______ 1. Implements and/or modifies written plan of care as appropriate for client’s condition
_______ 2. Utilizes other health care providers to promote client’s health status, (if needed)
_______ 3. Provides appropriate information to meet educational needs of client
V. EVALUATION (20%)
_______ 1. Develops appropriate client-centered outcome (goal) in specific, measurable terms
_______ 2. Evaluates client response to planned nursing interventions
_______ 3. Evaluates attainment of client outcome (goal)
_______ 4. Explains evaluation of goal
______Total points deducted
Student scored ___________ of 100 possible points
Deductions: 0. Meets expectations, work legible, correct terminology wording & spelling
1. Needs improvement with legibility, terminology, wording or spelling
2. Work good, needs more specific data
3. Work good, but incomplete
4. Needs improvement in application of nursing process
5. Unsatisfactory
Instructor___________________________________________________________ Date ________________ NOTE:
Students making below 75 need a faculty consultation prior to submitting next care plan.
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GENERIC NEWBORN CARE PLAN
Student: _________________________ Mother:
Infant: x Date of Care: ________Delivery Time/Date________
Nursing Diagnosis: Risk for infection. Risk factors include broken skin integrity with possible entrance of pathogens secondary to
cutting of umbilical cord, presence of bacteria in vagina, injections, and needle stick from lab work.
Goal: Client will be free of signs & symptoms of infection
Specific Outcomes (AEB Behaviors to measure goal achievement):
1. VS --T. 97.6-99.0, P. 100-160, R. 20-60. 2. Areas of broken skin integrity (scalp electrode site, umbilical stump, circumcision site, injection of &
lab draw sites) WNL for REEDA, 3. Lab values (if assessed WNL) 4. No purulent drainage from eyes 5. Infant displays no lethargy or jitteriness
Nursing Intervention
Scientific Rationale & Source (APA)
1. Review maternal OB record for risk factors that
would predispose infant to infection, which may
be acquired transplacentally, via the ascending
route or at delivery (e.g., Group B strep positive,
HIV positive, active herpes lesion on mother,
Premature or Prolonged Rupture of Membranes
[PROM or PPROM])
1. S/S maternal infection during the week prior to
delivery and presence of infectious disease all
predispose the infant to infection (Donges &
Moorehouse, 1999, 457).
2. Practice good hand washing techniques, before
and between handling infants. Clean areas with
appropriate antiseptic prior to breaking barriers
of skin integrity, such as IV insertion, drawing lab
work
2. To remove pathogens & prevent transfer to newborn
and other newborns (Green & Wilkinson, p. 541).
3. Wear gloves for any contact with amniotic fluid,
blood, urine, stool or other body secretions and
wash hands after removing gloves. Bathing,
diapering and changing linens is required to
remove contaminated fluids
4. Monitor vital signs including skin temperature
as appropriate ( q. 15 min. x 4, until stable and
WNL, q 30 min. x 2, 1 hr after first bath, & every
8 hrs until discharge from the hospital
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Implementation & Evaluation of Client’s Response to
Intervention
1. I
E
2. I
E
3. These are sources or pathogens transferable to
infants or staff on the newborn skin. When the
newborn’s skin is cleansed and dirty items removed,
it provides a cleaner environment. (G. & W. p. 540)
4. Aids in recognizing developing infections (D. & M.,
p. 458). The temperature may be subnormal or
elevated with an infection in a newborn (G. & W., p.
540)
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3. I
E
4. I
E
Nursing Intervention
Implementation & Evaluation of Client’s
Response to Intervention
Scientific Rationale & Source (APA)
5. Teach parent, siblings & visitors about hand
washing techniques to use before handling
infant.
5. Minimizes the chance that pathogens will be
transmitted ( G. & W., pg. 541)
6. Assess skin integrity (i.e., fetal scalp electrode
site, birth trauma, umbilical cord, circumcision of
penis (on males).
6. Loss of skin integrity provides a portal of entry for
pathogens and the infant has passive immunity at
birth and the system is immature (G. & W., p. 540).
6. I
7. Determine newborn’s gestational age by EDB
(Estimated Date of Birth) and Ballard score
(Maturational Assessment of Gestational Age)
7. Transfer of immunoglobulin E & G ( Ig E & Ig G)
antibodies via the placenta increases significantly in
the last trimester, providing passive immunity to
some pathogens. (D. & M., p. 458)
7. I
8. Encourage early breastfeeding as appropriate
and teach the parent the benefits in prevention of
infection.
8. Colostrum & breast milk contain high amounts of
secretory IgA, which provides a form of passive
immunity as well as macrophages and lymphocytes
that foster local inflammatory response, (D. & M.,
p. 458)
8. I
9. Administer eye prophylaxis in the form of
erythromycin ointment (Ilotycin) approximately 1
to 2 hrs after birth (after period of parent–infant
interaction).
9. Helps prevent ophthalmia neonatorum caused by
Neisseria gonorrhea (D. & M., p. 448)
9. I
10. Administer topical, oral, perineal, and IM
antibiotics, skin protectants as indicated. (e.g.,
HBIG prophylaxis, topical ointments for diaper
rash).
10. To destroy or eradicate pathogenic organisms.
HBIG immune globulin provides antibodies and
immediate protection (G & W, 1999, p. 451, 542).
10. I
11. Maintain individual equipment and supplies for
each newborn (stethoscope, BP cuff, electronic
thermometer). Treat each crib like a patient’s
room.
11. Help prevent cross contamination of neonate
through direct contact or droplet infection (D. & M.,
p. 458)
11. I
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5. I
E.
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E.
E
E
E
E
E
Nursing Intervention
Scientific Rationale & Source (APA)
Implementation & Evaluation of Client’s
Response to Intervention
12. Teach parent/s to monitor visitors for infectious
illnesses, skin lesions, fever, or herpes. Limit
contact with newborn appropriately.
12. Helps prevent spread of infection to newborn due
to the infant’s immature immune system (D. & M.,
p. 458).
12. I
13. Assess cord & skin area at base of cord daily
for redness, odor, or discharge. Facilitate
drying through exposure to air by folding diaper
below, & T-shirt above the cord stump. Do cord
care according to hospital policy.
13. Promotes drying & healing, enhances normal
necrosis & sloughing, & eliminates moist medium
for bacterial growth. (D. & M., p. 458).
13. I
14. Teach parent to continue cord care techniques
while in the hospital and at home.
14. To continue the healing, drying and prevention of
pathogens from entering that portal of entry (G. &
W., p. 541).
14. I
15. Administer fluids as ordered & teach parents
the need for adequate fluid intake.
15. Fluid intake helps to prevent dehydration, stasis of
secretions & infections (G. & W., p. 541-2)
15. I
E
16. Teach parents how to assess temperature and
normal expected range.
16. Parental awareness promotes early recognition
and increases likelihood of prompt medical
attention. (D. & M., p. 473)
16. I
17. Teach the parents signs of sepsis & to notify
HCP (e.g., poor feeding, decreased muscle
tone; frequent vomiting; green, watery stools;
fever or hypothermia; fewer than 6 wet
diapers/day after a week, restlessness and
irritability, lethargy).
17. Newborn sepsis can be fatal within a short period
of time (G. & W., p. 548)
17. I
E
E
E
E
E
Evaluation of Goal Achievement: (Met, Not Met, Partially Met); and,
Specific Outcomes (AEB Behaviors to Measure Goal Achievement):
Date:____________________Shift Time:____________________________________Signature:______________________________________________________
Donges, M.E. & Moorhouse, M.F. (1999). Maternal newborn plans of care: Guidelines for individualizing care, 3 rd Ed. Philadelphia: F.A. Davis, Co
Green, C. & Wilkinson, J. (2004). Maternal newborn nursing care plans. St. Louis: Mosby. Wong, D., Hockenberry, M. Perry, S., Lowdermilk, D., &
Wilson D. (2006). Maternal child nursing care, 3rd Ed. St. Louis: Mosby.
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Clinical Practicum Learning Map
Topic: Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) Clinical Observation
Learning Objectives
Preparation Resources
Critical Thinking Questions
1. Identify and briefly discuss the neonatal
pain assessment scale used at the NICU/
SCN where you were assigned.
2. What did you observe the RNs in the NICU
do to implement the role:
a. Provider of Care
b. Role of Manager of Care
c. Member of the Discipline of Health
Care?
3. Discuss your feelings about the experience
and what you learned.
1. Wong, Perry, Hockenberry,
Loudermilk and Wilson Review:
Ch 27-28
2. Complete the NICU/SCN Study
Guide and bring to clinical. Be
prepared to discuss. Refer to
LRC reserve books and
www.neonatology.org
1. Compare/contrast how discharge
planning & developmental care
are provided in the NICU/SCN vs.
the well baby nursery.
2. How does the birth of a
premature/sick neonate impact
the lives of a family (i.e. roles of
parents and siblings; family
finances; coping skills; bonding;
breastfeeding)?
07/11 NURS 2423
Terminology
1. Anencephaly
2. Bladder Exstrophy
3. Choanal Atresia
4. Cleft Lip/Palate
5. Clubfoot
6. Cytologic Study
7. Dermatoglyphics
8. Diaphragmatic Hernia
9. Encephalocele
10. Epispadias
11. Esophageal Atresia/
Tracheoesophageal Fistula
(TEF)
12. Hemolytic Disease
13. Hip Dysplasia
14. Hydrocephalus
15. Hypospadias
16. Imperforate Anus
17. Intraventricular Hemorrhage
(IVH)
Hospital –Page 70
Terminology Continued
18. Microcephaly
19. Minimal Handling Protocol
(MHP)
20. Neonatal Abstinence Scoring
System (FINNEGAN Score)
21. Neonatal Resuscitation Protocol
(NRP)
22. Omphalocele/Gastroschisis
23. Polydactyly
24. Sexual Ambiguity
25. Spina Bifida
26. Syndactyly
27. Teratoma
29. TORCH
30. UAC
31. UVC
Learning Activities
1. Observe/assist assigned RN
with client care as allowed
2. Cooperative Learning
3. Problem Solving
4. Practical Application Activity
Written Assignment
1. Submit clinical study guide to
instructor at the beginning of the
clinical experience.
2. Submit assigned paperwork to
instructor’s office or instructor’s
mail box in Nursing Division
office by 4:30 p.m. Friday
following clinical experience
unless instructed otherwise by
instructor:
a. Demographic Data Collection
Sheet
b. IV Fluids and Medications
Sheet
c. Typed observation report
addressing learning Objective
1-3 and CRITICAL THINKING
QUESTIONS 1-2.
d. Self Evaluation Form
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Special Care Nursery (SCN) or
Neonatal Intensive Care Unit (NICU) Study Guide (10 points)
1. Look up the following medications used in care of the sick newborn. Identify: indications for
use, usual dosage, desired effects, side effects, nursing considerations and submit in writing.
(Refer to LRC reserve books, www.neonatology.org and Ch 25-28, or Google search.
Ampicillin
Gentamicin
Indocin
Curosurf
Survanta
Caffeine Citrate
2. Identify 4 different medical diagnoses or reasons for neonates to be admitted into the NICU/
SCN and briefly discuss the treatment for each diagnosis. (Ch 27)
3. Differentiate chronological age vs. developmental/corrected age. Explain how you would
calculate this for a child born at 34 weeks gestation who is now 33 days old. (p. 726)
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4. Briefly discuss nursing responsibilities/considerations for care of the neonate with an
umbilical arterial catheter (UAC), umbilical venous catheter (UVC) and percutaneously
inserted central catheter (PICC) (www.neonatology.org)
5. What is the purpose of developmental care? What are the nursing considerations? (p.723-727)
6. What is the purpose of Kangaroo Care? What are the nursing considerations? (p.723-725)
(www.neonatology.org)
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Demographic Data Collection
Student’s Name: ______________________________________________ Date:
EDB: ____________ Del. Date: ______________ Del. Time: __________________________
Gestational Age at Birth: _ __weeks &___days Developmental Age Now ___Weeks &___Days
Mother’s Age: _____ Race: _____ Religion :________________ Marital Status:
Gravida: ___ Para: ___ GTPAL: _____________________________ Blood Type:
Rubella Status: ______GBS status: _______ Reason for Admit to NICU:___________________
Cultural/Spiritual Traditions for new mom/new baby:
Erikson’s Developmental Level Expected of baby: _____________________________________
Actual:
Behavioral Evidence of Actual Level:
Infant’s Gender _____ APGARS: 1 min ____ 5 min ____ Blood Type ______ Coombs
Birth Weight ________gms Length __________ Feeding Method
Current Weight:________gms
Describe the mother’s delivery and/or surgical procedure(s) to mother or infant, as
available. Include information about pain management if available: What, When,
Effectiveness. Use back of page if necessary.
Vital Sign Range
Infant
Previous Day
Temperature
Pulse
Respirations
Blood Pressure
Pain Rating
07/11 NURS 2423
Hospital –Page 72
Day of Care
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
IV Fluids and Medications
P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear
Med/Route, Frequency,
Dosage Prescribed
(Routine and PRN)
07/11 NURS 2423
Frequency & Dosage Taken
Hospital –Page 74
Reason Prescribed for
THIS Client and Nursing
Implications
Client’s Response To Medication
(if seen)
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Self Evaluation Form
New Terms
Definition (cite references)
My learning goals are:
Achieved
Strengths
Challenges
Knowledge:
Knowledge:
Skills:
Skills:
Attitudes:
Attitudes:
07/11 NURS 2423
Not Achieved
Hospital –Page 75
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Topic: Care of Multiple Clients
Learning Objectives
1. Assess and provide care specific to two
assigned clients ( a mother & her newborn)
2. Complete Demographic Data Collection Form
utilizing information from assigned clients.
3. Utilize nursing process to develop & implement
care plans for one nursing diagnosis
specifically related to each assigned client
(mom and baby). (Must be different than
diagnoses previously implemented.)
 Optional Care Maps: Students may opt to
complete an abbreviated assessment and
care map (one each for mom and newborn)
if they achieved 80% or above on their PP
and NB careplans.
4. Communicate and collaborate appropriately
with client, staff, physicians, and fellow
students to provide care for the clients and
families.
5. Safely administer prescribed medication, if
indicated.
6. Use hospital forms according to hospital
policy and procedure to chart assessment and
care.
07/11 NURS 2423
Preparation Resources
Critical Thinking Questions
Previous weeks work will
provide adequate preparation
Refer to the Critical Thinking
Questions on the Theory and
Learning Activities Laboratory
Maps for Weeks 3 and 5.
Hospital –Page 76
Learning Activities
1.
2.
3.
4.
5.
Role Playing
Cooperative Learning
Problem Solving
Practical Application Activities
Written Assignment of Client Care
Written Assignments
1. Submit assigned paperwork to
instructor’s office or instructor’s mail
box in Nursing Division office by 9 a.m.
Monday following clinical experience
unless instructed otherwise by instructor.
a. Completed assessment tool on
assigned clients.
b. Individually for mother and newborn
complete the following:
1. IV fluids and Medication Sheet
2. Nursing Diagnosis Sheet specific to
assign client.
3. Complete two traditional careplans:
one for mom & newborn with a
priority diagnosis specific to assigned
mom/nb. Each careplan should have
at least 5 interventions & at least one
teaching intervention. Both careplans
are to be implemented & evaluated
during clinical, OR students who
qualify may opt to do the abbreviated
assessment and concept map (one
each for mom and newborn). See
hospital, page
for instructions.
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Demographic Data Collection
Student’s Name: ______________________________________________ Date:
Assigned to: Mother: _____ Infant______
EDB: ______ Del. Date: ______ Del. Time:
___
Route of delivery: Vaginal ___ Primary C-sec. ___ Repeat C-sec. ___ Gestation ____ weeks & ______ days
Mother’s Age: _______ Race: ________ Religion :________________ Marital Status:
Gravida: ___ Para: _____ GTPAL: ____________________ Blood Type:
______
EBL: _______
Rubella Status: ____________ GBS status: _______ Hct: pre-delivery____post_____ Hgb: pre____post_____
Bag of water: ____Assisted ____ Spontaneous Rupture
# of hours ruptured _______; Color: __________
Allergies: ___________________________________ Diet: ________________________________________
Medications Taken at Home: _________________________________________________________________
Cultural/Spiritual Traditions for new mom/new baby: _____________________________________________
Erikson’s Developmental Level Expected of Mother: ______________________________________________
Behavioral Evidence of Actual Level:
Infant’s Gender ________ APGARS: 1 min _____ 5 min ______ Blood Type _______ Coombs __________
Weight __lb.__oz ______gm Length _____in______cm Feeding Method
Frequency of feedings occurring
Amount taken or time at breast feeding
Erikson’s Developmental Level Expected of Newborn: _____________________________________________
Behavioral Evidence of Newborn’s Developmental Level _________________________________________
Vital Sign Range
Mother
Previous Day
Temperature
Pulse
Respirations
Blood Pressure
Pain Rating
XXXXXXXXXX
Infant
Day of care
Previous day
Day of care
XXXXXXXXXXX
Describe the delivery and other surgical procedure(s) to mother and surgical procedures to the newborn.
Include information about labor process: when labor began, when admitted to hospital, complications,
length of stages, length of pushing. Also include pain management: What, When, Effectiveness. If any
surgical procedures performed on infant, describe what, why and how. Use back of page.
07/11 NURS 2423
Hospital –Page 76
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Health Assessment/Functional Patterns
Instructions: In each pattern include client’s strengths, limitations, and pertinent factors influencing
health. Highlight abnormal data.
Health Perception Management Pattern
Parents
Activity-Exercise Pattern
Mother
07/11 NURS 2423
Infant
Hospital –Page 77
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Elimination Pattern
Mother
Infant
Nutritional-Metabolic Pattern
* Complete for both clients, even if you are not assigned to that member of the family
Mother
Infant
*Pre-pregnant weight _______ *Height
*Baby’s weight
*Weight at delivery
*Type of feeding
*Weight gain during pregnancy
Caloric needs per day
Needs feedings of ________ oz q _________ hours
Actual frequency of feedings____________________
Amount taken or time at breast__________________
07/11 NURS 2423
Hospital –Page 77
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Cognitive Perceptual Pattern
Mother
Infant
Sleep-Rest Pattern
Mother
07/11 NURS 2423
Infant
Hospital –Page 77
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Sexual Reproductive Pattern
Mother
Infant
Coping – Stress Tolerance Pattern
Mother
07/11 NURS 2423
Infant
Hospital –Page 77
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Self Perception Pattern
Parents
Role Relationship Pattern
Parents
Value-Belief Pattern
Parents
07/11 NURS 2423
Hospital –Page 81
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear
Med/Route, Frequency,
Frequency & Dosage Taken
Reason Prescribed for
Client’s Response To Medication
Dosage Prescribed
THIS Client and Nursing
(if seen)
(Routine and PRN)
Implications
07/11 NURS 2423
Hospital –Page 82
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Diagnosis Sheet
Priority #
Key Problem
I don’t know how this fits
with the problems???
Priority #
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or negative
assessment data, pertinent history)
Reason For Needing Health
Care
(Medical
Diagnosis/Surgical
Procedure)
Priority Assessments:
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
07/11 NURS 2423
07/11 NURS 2423
Hospital –Page 39
Hospital –Page 91
Priority #
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Care Plan
Student: _________________________________________________________ Mother: _____________________ Infant: _____________________
Nursing Diagnosis: ________________________________________________________________________________________________________
Goal: ___________________________________________________________________________________________________________________
Specific Outcomes: (AEB Behaviors to Measure Goal Achievement) ________________________________________________________________
________________________________________________________________________________________________________________________
Nursing Intervention
1.
Scientific Rationale and Source
1.
Implementation (I) and Evaluation (E) of
Client’s Response to Intervention
1. I
E.
07/11 NURS 2423
Hospital –Page 85
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Intervention
07/11 NURS 2423
Scientific Rationale and Source
Hospital –Page 85
Implementation and Evaluation of Client’s
Response to Intervention
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Intervention
Scientific Rationale and Source
Evaluation of Goal Achievement: (Met, Not Met, Partially Met); and,
Specific Outcomes (AEB Behaviors to Measure Goal Achievement):
Date:
07/11 NURS 2423
Shift Time:
Signature:
Hospital –Page 87
Implementation and Evaluation of Client’s
Response to Intervention
TCC Nursing Program
NUR 2423 Nursing of Childbearing Families
Self Evaluation Form
New Terms
Definition (cite references)
My learning goals are:
Achieved
Strengths
Challenges
Knowledge:
Knowledge:
Skills:
Skills:
Attitudes:
Attitudes:
07/11 NURS 2423
Not Achieved
Hospital –Page 88
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
TCC Nursing Program
NUR 2423 Nursing of Childbearing Families
Nursing Plan of Care and Evaluation Criteria
Points Deducted
I. ASSESSMENT (35%)
_______ 1. Collects and documents data relevant to bio/psycho/social/spiritual health of clients
_______ 2. Compares assessment data to norms for assigned client population
_______ 3. Documents assessment data appropriately in agency record
_______ 4. Demonstrates appropriate knowledge, use of medical terms, abbreviations, symbols
________5. Identifies need for client education
_______ 6. Identifies indications for and effects of prescribed medications
_______ 7. Determines appropriate client problem and prioritizes
II. NURSING DIAGNOSIS (10%)
_______ 1. Supports nursing diagnosis with assessment data related to anatomy and physiology.
_______ 2. Supports nursing diagnosis with client specific assessment data
III. PLANNING (20%)
_______ 1. Utilizes standards of nursing care to reflect nursing interventions that are realistic and
relevant
_______ 2. Identifies scientific rationale for each nursing intervention
_______ 3. References scientific rationale for each nursing intervention
_______ 4. Interventions planned to provide client/family education
IV. IMPLEMENTATION OF INTERVENTIONS (15%)
_______ 1. Implements and/or modifies written plan of care as appropriate for client’s condition
_______ 2. Utilizes other health care providers to promote client’s health status, (if needed)
_______ 3. Provides appropriate information to meet educational needs of client
V. EVALUATION (20%)
_______ 1. Develops appropriate client-centered outcome (goal) in specific, measurable terms
_______ 2. Evaluates client response to planned nursing interventions
_______ 3. Evaluates attainment of client outcome (goal)
_______ 4. Explains evaluation of goal
______Total points deducted
Student scored ___________ of 100 possible points
Deductions: 0. Meets expectations, work legible, correct terminology wording & spelling
1. Needs improvement with legibility, terminology, wording or spelling
2. Work good, needs more specific data
3. Work good, but incomplete
4. Needs improvement in application of nursing process
5. Unsatisfactory
Instructor___________________________________________________________ Date ________________
NOTE: Students making below 75 need a faculty consultation prior to submitting next care plan.
07/11 NURS 2423
Hospital –Page 89
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
P.O., Sub-Q, IM, IV, Tube, Nasal, Inhalant, Skin Patch, Topical, Rectal, Vaginal, Eye, Ear
Med/Route, Frequency,
Frequency & Dosage Taken
Reason Prescribed for
Client’s Response To Medication
Dosage Prescribed
THIS Client and Nursing
(if seen)
(Routine and PRN)
Implications
07/11 NURS 2423
Hospital –Page 90
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Diagnosis Sheet
Priority #
Key Problem
I don’t know how this fits
with the problems???
Priority #
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or negative
assessment data, pertinent history)
Reason For Needing Health
Care
(Medical
Diagnosis/Surgical
Procedure)
Priority Assessments:
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Nursing Diagnosis: (problem/etiology)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
6/9/05 nursing diagnosis sheet
Childbearing 2006-2007 (spring)
Priority #
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Care Plan
Student: _________________________________________________________ Mother: _____________________ Infant: _____________________
Nursing Diagnosis: ________________________________________________________________________________________________________
Goal: ___________________________________________________________________________________________________________________
Specific Outcomes: (AEB Behaviors to Measure Goal Achievement) ________________________________________________________________
________________________________________________________________________________________________________________________
Nursing Intervention
1.
Scientific Rationale and Source
1.
Implementation (I) and Evaluation (E) of
Client’s Response to Intervention
1. I
E.
07/11 NURS 2423
Hospital –Page 93
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Intervention
07/11 NURS 2423
Scientific Rationale and Source
Hospital –Page 93
Implementation and Evaluation of Client’s
Response to Intervention
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Intervention
Scientific Rationale and Source
Evaluation of Goal Achievement: (Met, Not Met, Partially Met); and,
Specific Outcomes (AEB Behaviors to Measure Goal Achievement):
Date:
07/11 NURS 2423
Shift Time:
Signature:
Hospital –Page 93
Implementation and Evaluation of Client’s
Response to Intervention
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Nursing Plan of Care and Evaluation Criteria
Points Deducted
I. ASSESSMENT (35%)
_______ 1. Collects and documents data relevant to bio/psycho/social/spiritual health of clients
_______ 2. Compares assessment data to norms for assigned client population
_______ 3. Documents assessment data appropriately in agency record
_______ 4. Demonstrates appropriate knowledge, use of medical terms, abbreviations, symbols
________5. Identifies need for client education
_______ 6. Identifies indications for and effects of prescribed medications
_______ 7. Determines appropriate client problem and prioritizes
II. NURSING DIAGNOSIS (10%)
_______ 1. Supports nursing diagnosis with assessment data related to anatomy and physiology.
_______ 2. Supports nursing diagnosis with client specific assessment data
III. PLANNING (20%)
_______ 1. Utilizes standards of nursing care to reflect nursing interventions that are realistic and
relevant
_______ 2. Identifies scientific rationale for each nursing intervention
_______ 3. References scientific rationale for each nursing intervention
_______ 4. Interventions planned to provide client/family education
IV. IMPLEMENTATION OF INTERVENTIONS (15%)
_______ 1. Implements and/or modifies written plan of care as appropriate for client’s condition
_______ 2. Utilizes other health care providers to promote client’s health status, (if needed)
_______ 3. Provides appropriate information to meet educational needs of client
V. EVALUATION (20%)
_______ 1. Develops appropriate client-centered outcome (goal) in specific, measurable terms
_______ 2. Evaluates client response to planned nursing interventions
_______ 3. Evaluates attainment of client outcome (goal)
_______ 4. Explains evaluation of goal
______Total points deducted
Student scored ___________ of 100 possible points
Deductions: 0. Meets expectations, work legible, correct terminology wording & spelling
1. Needs improvement with legibility, terminology, wording or spelling
2. Work good, needs more specific data
3. Work good, but incomplete
4. Needs improvement in application of nursing process
5. Unsatisfactory
Instructor___________________________________________________________ Date ________________
NOTE: Students making below 75 need a faculty consultation prior to submitting next care plan.
07/11 NURS 2423
Hospital –Page 94
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Abbreviated Care Plan for Multiple Client Week
1. Circle or highlight data found for both assigned clients in new and unmarked Preparation
Maps you prepared for your weeks in postpartum and newborn nursery.
2. Complete documentation for your clinical facility and submit with Care Plan as per Newborn
and Postpartum weeks.
3. Complete Demographic Data Collection for Multiple Client’s and Nursing Diagnosis Sheet
for mother and newborn.
4. Complete Nursing Diagnosis Sheets for mother and baby.
5. Complete a care map to show care provided for both the mother and a separate one for the
newborn. The care map should reflect the entire nursing process (ADPIE). This MUST be for
a nursing diagnosis not previously implemented (Infection or the diagnosis used for Newborn
or Postpartum
Assessment: Cue clusters for the identified nursing diagnoses for mother and newborn.
Diagnosis:
List one nursing diagnosis for mother and one nursing diagnosis for the
newborn (actual, at risk and/or wellness). These should be nursing diagnoses
NOT previously planned and implemented.
Plan:
List appropriate nursing interventions for each of the diagnoses for mom and
newborn. Plan the goal with outcomes you hope to achieve. If medications are
prescribed for the problem you identify, list them in your interventions. You do
not have to document rationale for your interventions. Utilize the nursing care
planning criteria (such as the number, number of assessment and teaching) you
have been given.
Implementation: Show the results of your implemented interventions. Be specific!
Evaluation: Show the evaluation of goals and outcomes.
6. Complete a Self Evaluation Form for the week.
7. Turn in Care Map and Evaluation Criteria
07/11 NURS 2423
Hospital –Page 96
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Demographic Data Collection for Multiple Clients
Student’s Name: ______________________________________________ Date:
Gravida: ____ Para:____ GTPAL: _________EDB: ______ Del. Date: ______ Del. Time:
___
Gestation of Pregnancy ____ weeks & ______ days Route: ___ Vag. ___ Primary C-sec ___ Repeat C-sec
Mother’s Age: _______ Race: ________ Religion :________________ Marital Status:
Gravida: ___ Para: _____ GTPAL: ____________________ Blood Type:
______
EBL: _______
Rubella Status: ____________ GBS status: _______ Hct: pre-delivery____post_____ Hgb: pre____post_____
Bag of water: ____Assisted ____ Spontaneous Rupture
# of hours ruptured _______; Color: __________
Allergies: ___________________________________ Diet: ________________________________________
Medications Taken at Home: _________________________________________________________________
Cultural/Spiritual Traditions for new mom/new baby: _____________________________________________
Erikson’s Developmental Level as Expected of Mother and Baby: Yes ________ No_______
Infant’s Gender ________ APGARS: 1 min _____ 5 min ______ Blood Type _______ Coombs __________
Weight __lb.__oz ____gm Length _____in______cm Feeding Method; Breast______Bottle____ Both_____
Baby needs ___________________ every ____________hours to meet it’s nutritional needs.
Baby taking ___________________ every ____________ hours. Meeting Nutritional Needs? ___Yes ___No
Vital Sign Range
Mother
Previous Day
Temperature
Pulse
Respirations
Blood Pressure
Pain Rating
Infant
Day of care
XXXXXXXXXX
Previous day
Day of care
XXXXXXXXXXX
Describe the mother’s delivery and other surgical procedure(s) to mother. Include
information about when labor began, length of stages, length of pushing. Also include
pain management: What, When, Effectiveness. If any surgical procedures performed on
infant, describe what, why and how. Use back of page.
Medications taken by mother. Show dosage, number and times of medications taken. Use back of sheet.
Medictions for newborn beside Vitamin K, Erythromycin, and Hep B.
07/11 NURS 2423
Hospital –Page 97
TCC Nursing Program
NURS 2324 Nursing of the Childbearing Family
Priority #
Key Problem
Nursing Diagnosis Sheet (mother)
I don’t know how this fits
with the problems???
Priority #
Key Problem
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis
(problem/etiology)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Reason For Needing Health
Care
(Medical
Diagnosis/Surgical
Procedure)
Priority Assessments:
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis (problem/
etiology)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data,
pertinent history)
07/11 NURS 2423
Hospital –Page 97
Priority #
TCC Nursing Program
NURS 2324 Nursing of the Childbearing Family
Priority #
Key Problem
Nursing Diagnosis Sheet (newborn)
I don’t know how this fits
with the problems???
Priority #
Key Problem
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis
(problem/etiology)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data, pertinent
history)
Reason For Needing Health
Care
(Medical
Diagnosis/Surgical
Procedure)
Priority Assessments:
Priority #
Priority #
Key Problem
Key Problem
Key Problem
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis
(problem/etiology)
Nursing Diagnosis (problem/
etiology)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data,
pertinent history)
Supporting Data: (positive or
negative assessment data,
pertinent history)
07/11 NURS 2423
Hospital –Page 99
Priority #
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Care Map and Evaluation Criteria
Points Deducted
Mother
Baby
I. ASSESSMENT (35%)
_____ 1. Collects data relevant to bio/psycho/social/spiritual health of clients
_____
_____ 2. Completes demographic data collection sheet
_____
_____ 3. Documents assessment data appropriately on Preparation Concept Map
_____
_____ 4. Documents assessment data appropriately in agency record
_____
_____ 5. Demonstrates appropriate knowledge, use of medical terms, abbreviations,
symbols
_____ 6. Identifies indications for and effects of prescribed medications
_____
_____ 7. Determines appropriate client problem
II. NURSING DIAGNOSIS (10%)
_____ 1. Supports nursing diagnosis with client specific data.
_____
_____
_____
_____ 2. Supports nursing diagnosis with assessment data related to anatomy and
physiology.
III. PLANNING (20%)
_____
_____ 1. Utilizes standards of nursing care to determine nursing interventions
_____
_____ 2. Interventions realistic and relevant to identified nursing diagnosis
_____
_____ 3. Interventions adequate to change problem
_____
_____ 4. Interventions planned to provide client/family education
IV. IMPLEMENTATION OF INTERVENTIONS (15%)
_____
_____ 1. Implements an/or modifies plan of care as appropriate for client’s condition
_____
_____ 2. Utilizes other health care providers to promote client’s health status, PRN
_____ 3. Provides appropriate information to meet educational needs of client
_____
_____
V. EVALUATION (20%)
_____ 1. Develops appropriate client-centered outcome (goal in specific, measurable
terms
_____ 2. Evaluates client response to planned nursing interventions
_____ 3. Evaluates attainment of client outcome (goal)
_____ 4. Explains evaluation of goal
__________ Total points deducted Student scored __________ of 100 possible points for Mother
__________ Total points deducted
Deductions:
_____
_____
_____
_____
Student scored __________ of 100 possible points for Newborn
0. Meets expectations, work legible, correct terminology, wording and spelling
1. Needs improvements with legibility, terminology, wording and spelling
2. Work good, needs more specific data
3. Work good, but incomplete
4. Needs improvement in application of nursing process
5. Unsatisfactory
Instructor ____________________________________________________________ Date __________
07/11 NURS 2423
Hospital –Page 100
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Self Evaluation Form
New Terms
Definition (cite references)
My learning goals are:
Achieved
Strengths
Challenges
Knowledge:
Knowledge:
Skills:
Skills:
Attitudes:
Attitudes:
07/11 NURS 2423
Not Achieved
Hospital –Page 101
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Name _________________________________________CWID _________________________
Student Performance Evaluation Profile
EVALUATION CRITERIA
ROLE AS PROVIDER OF NURSING CARE
1
2
3
4
1. Demonstrates critical thinking in all phases of care.
1.1 Uses systematic method to collect bio-psychosocial, cultural
and spiritual data.
1.2 Validates appropriateness of plan and modifies if needed prior
to implementation of planned care.
2. Display behaviors consistent with scientific principles.
2.1 Performs physical exam using all four techniques
2.2 Accurately performs technical procedures.
3. Demonstrates effective communication patterns.
3.1 Uses communication techniques appropriate to client/family/
significant others.
3.2 Conveys acceptance/empathy/caring when communicating
with clients.
3.3 Incorporates assessment data into client teaching.
ROLE AS MANAGER OF CLIENT CARE
Student displays accountability and responsibility for the
management of:
1. Assigned client care
1.1 Assumes responsibility for completion of care required for
assigned client.
1.2 Organizes client care in an effective manner.
1.3.Completes client care within a specified time.
2. Client safety
* 2.1 Provides safe client environment.
2.2 Seeks guidance as needed to implement client care in a safe
and effective manner (refer to Appendix A of TCC Nursing
Program Student Handbook)
2.3 Identifies and takes appropriate action regarding client’s need
for medication
2.4 Administers prescribed medications using scientific principles.
3. Resource management
3.1 Uses time purposefully in client care situations.
3.2 Utilizes equipment and supplies appropriately.
ROLE AS A MEMBER OF THE DISCIPLINE OF HEALTHCARE
1. Displays nursing role behaviors.
1.1 Collaborates with members of healthcare team to plan and/or
implement client care.
1.2 Communicates pertinent information about the client to other
healthcare professionals.
* 1.3 Demonstrates preparation for clinical learning experiences by
arriving with assigned care plans and study guides.
* 1.4 Submits assignments on time: (“U” for week if incomplete)
Follows instructions/directions for completion of assignment.
2. Functions within the group.
2.1 Individually contributes to group function.
2.2 Contributes effectively within the group.
07/11 NURS 2423
Hospital –Page 102
5
6
7
Area
Wk
Name _______________________________________CWID____________________________
1
2
3
4
5
6
7
Area
Wk
2.3 Communicates effectively within the group.
3. Displays professional behaviors.
3.1 Is punctual for clinical practicum and conferences.
3.2 Demonstrates positive attitude verbally and nonverbally.
3.3 Manages stress in an appropriate and effective manner.
* 3.4 Maintains client confidentiality.
3.5 Utilizes verbal and written instructional comments and
suggestions to increase knowledge and change behavior on
weekly work.
3.6 Seeks guidance as needed to achieve clinical learning
objectives.
3.7 Takes initiative to enhance learning.
3.8 Adheres to professional conduct as stated in the TCC Nursing
Program Student Handbook.
3.9 Adheres to dress code as stated in the TCC Nursing Program
Student Handbook.
Symbols Used in Evaluation
 Object consistently met “Satisfactorily”
+ Exceeded expectations in completion of objective
I Object inconsistently met
N Object not met
NA Object not applicable for this week
O Object not observed by instructor
FORMATIVE EVALUATION
Total I’s
Total N’s
Clinical S/U
# Hrs. absent
Study Guides
Concept Maps
Observation
Reports
Student Initials
Faculty Initials
Date
Care Plan Scores
PP Generic Infection Care Plan
__________
NN Generic Infection Care Plan
__________
MC PP
__________
MC NN
__________
Date
S
U
Competency
Apical Pulse of Newborn
Instructor
Completion for Clinical Objectives:
Student Signature
07/11 NURS 2423
Date
Hospital –Page 103
Faculty Signature
Date
Name _______________________________________CWID____________________________
Date
07/11 NURS 2423
Faculty/Student Comments
** ALL entries are to be signed and dated
Hospital –Page104
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Competency-Apical Newborn Heart Rate
Name ___________________________________________ CWID ___________________
Apical newborn heart rate:
Student and faculty will count the newborn heart rate simultaneously, for one minute. The
student and faculty count must be within four beats of each other.
Instructor signature
07/11 NURS 2423
Date
Hospital –Page 105
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Clinical Skills Opportunities Record
The following list of skills is common to the maternal-newborn area of nursing. Please use this
as a guide for seeking out and keeping track of your hands-on opportunities throughout this
rotation.
P = performed for actual client
O = observed procedure with actual client
CLINICAL SKILL
Wk
1
M
= manikin lab practice only
ONA = opportunity not available
Wk
2
Wk
3
MOTHER
BUBBLE-HER
Fundal Massage
Insert F/C
Remove F/C
Hang PB to Existing IV
Convert IV to Normal Saline/Hep Lock
D/C IV
Remove Staples/Sutures
Set Up Sitzbath
Use Dinamap BP
Use Tympanic Thermometer
Adm IM to Mother
Adm SQ to Mother
Adm PO Meds to Mother
Set Up Breast Pump
Teach/Assist Client with Breastfeeding
NEWBORN
APGAR SCORE
Newborn Admission
Newborn Shift Assessment
BALLARD TOOL
Newborn Reflexes
Bathe Infant
Provide Cord Care (triple dye and/or
alcohol)
Provide Circ Care
Adm IM to Infant
Adm SQ to Infant
Adm Eye Med to Infant
Bottle Feed Infant
Heel Stick for Lab/glucose
Use Digital Axillary Thermometer
Use Suction Equipment (DeLee, Bulb
Syringe)
Insert NG/OG Tube
07/11 NURS 2423
Hospital –Page 106
Wk
4
Wk
5
Wk
6
Wk
7
Comments
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Family and Community Education (FACE) Project
Topic: Face Project Preparation, Presentation & Summary Paper
Learning Objectives
Each group will:
1. Review expectations of FACE project
regarding:
a. Service Learning at TCC
b. Learning Needs for Assigned Population
Worksheet
c. Poster Design Template/Poster Critique
Grade Sheet
d. FACE Poster Implementation and
Evaluation Grading Criteria
2. Identify at least four likely learning needs for
the population of clients at an assigned
community facility. (To be turned in on
Monday of Week 2).
3. Develop an interactive poster presentation/
teaching project for one diagnosis with 3-5
behavioral objectives/goals.
4. Develop an evaluation tool for participants
to complete to measure the effectiveness of
the teaching project. It should include a
section to gather general demographic
information.
5. Identify and incorporate into teaching plan
1-3 community resources that would be
helpful for interactive poster teaching topic.
Obtain handouts from community resources
to distribute during poster presentation.
6. Implement teaching plan via interactive
poster presentation at selected community
facility. (date, time and place TBA).
7. Write a professional paper, one per group,
in APA format, detailing and summarizing
the teaching project. (see FACE grading
criteria)
Preparation Resources
P.H. L. & W.:
1. Review Ch 1-4 (pp.
3-83)
2. Read Ch 30 (pp. 888-894)
Kozier & Erb Fundamentals:
Review “Teaching” Ch 25
(p. 446-467).
Or
Potter & Perry (7th ed)
Review “Client Education”,
Ch 25
In addition to above textbooks,
at least 4 peer reviewed nursing
journal articles must be utilized
to document rationale and must
be cited in the body of the
paper.
Critical Thinking Questions
Learning Activities
1. What high risk psychosocial
population did your FACE clients
fit? How did this effect your plans
to teach? What factors have been
instrumental in the evolution of the
agency where you presented your
poster session?
2. What nursing diagnosis did you
develop and what did you teach?
3. What Community agencies/
resources did you find most helpful
in developing the poster project for
your FACE clients? How did that
agency evolve?
4. What is something you learned
while completing the project?
5. What would you change if you
were to do it again?
Interactive Poster Presentation
Week 1:
Orientation to FACE project. Self
selection of groups
Week 2:
Learning Needs for Assigned
Population submitted by noon
Monday along with articles to support
the learning needs you have
identified for your population of clients
Assignment to be turned in to the
Nursing Division Office by noon.
Weeks 3-4:
a. Students are required to attend a
Poster Preparation session from
2:45 until 3:45 on Tuesday of
Weeks 3 or 4 to work on poster
plans and receive feedback and
guidance from faculty.
b. All members of group must meet
with grading faculty member to
review poster plans prior to
attaching materials to poster
board.
Week 4:
Turn in typed Section 1 of paper,
one per group. Detailed paper
covering the Poster Implementation
& Evaluation criteria, along with
reference articles. Assignment must
be submitted by noon Monday to the
Nursing Division Office.
NOTE: Do NOT Discard Your
Posters when your agency
presentations are completed!
You will need to bring them to class
for your 5 minute Wrap-Up
presentations to the class during
Week 7 Lab.
Continued on next page
07/2011 NURS 2423
Face-Page 1
Week 5:
All members of your group must participate in
the scheduled poster presentation session at
assigned agency. Bring Poster Critique Grade
Sheet and submit to faculty graders.
Week 6:
Work with group to complete Section 2 for final
submission.
Week 7:
a. Section 2 of paper (poster Implementation
and Evaluation) paper addressing grading
criteria due by Lab on Week 7.
b. FACE Individual Participation
Rating sheet must be completed
individually & will be submitted during
Lab on Week 7.
c. Groups should come prepared to give
a 5-minute presentation in response
to Critical Thinking Questions based
on poster presentation, which will be
discussed during Wrap Up Lab
during week 7. Guests may be
invited to Wrap-Up.
8. Debriefing about poster project and
Presentation will take place during Week 7
Wrap-Up Lab.
07/11 NURS 2423
Face-Page 2
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Family and Community Education (FACE) Project
Teaching/Learning Objectives for Assigned Population
Student Names In Group:_________________________________________________________
______________________________________________________________________________
Selected Topic: _________________________________________________________________
State teaching/learning objectives in measureable, behavioral terms using Bloom’s Taxonomy.
See the web resource for more help. (http://www.nwlink.com/~Donclark/hrd/bloom.html) Each
group member should find at least one EBP peer-reviewed journal article and write one
teaching/learning objective that is supported by rationale from the article they select.
Highlight rationale within each article for the corresponding objective and give page
number below from each article where the rationale is highlighted for each objective.
Teaching/Learning Objectives:
Obj 1.
(Rationale/Citation):_____________________________________________________________
______________________________________________________________________________
Obj 2.
(Rationale/Citation):_____________________________________________________________
______________________________________________________________________________
Obj 3.
(Rationale/Citation):_____________________________________________________________
______________________________________________________________________________
Obj 4.
(Rationale/Citation):_____________________________________________________________
______________________________________________________________________________
Date for Presentation:
07/11 NURS 2423
Agency:___________________________________
Face-Page 3
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Catchy-Fun Title
(Focus On Health Promotion)
Topic
(What you are
teaching about)
Actions To Prevent Problem
(These are your specific interventions related to
each specific Teaching/Learning Objective)
Outcomes/Goal
Benefits to Client (What
is in it for the audience?
Why should they do it?)
Risks/ Reasons
(What’s the big risk?
Who is at risk &
why?)
Community Resources
(Where to go for help)
Significance Of
Problem To Assigned
Population (Why
should the audience
care)
Handouts (on table) Must Include:
1. Summary of info about topic being taught.
2. Community resources for clients to obtain
more info.
3. Data collection form that covers:
a. Client demographic information.
b. Questions to assess how well clients
met the teaching/learning objectives.
c.
07/11 NURS 2423
Face-Page 4
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Families
Family and Community Education (FACE) Project
FACE Poster Implementation and Evaluation
GRADING CRITERIA:
Section 1 (85 points total)
_____1. Assessment (25 points):
 Describe the target population expected to be served by your teaching project (expected
ages, gender, education, employment)
 Expected level of knowledge; readiness/hesitation factors for learning about the topic
 Potential Barriers to learning about the topic
 Cite source for rationale supporting teaching need of selected topic for this population
_____2. Nursing Diagnosis (10 points):
 Discuss teaching/learning needs to be addressed by the project.
 What is the nursing diagnosis for this topic (stated as a knowledge deficit)? If you have more
than one then give one diagnosis for each topic.
 Cite source for rationale for this nursing diagnosis as it applies to this population
_____3. Planning (30 points total):
Topics to be taught and methods
 Identify information to be taught via Poster Presentation
 Identify methods to be utilized to teach identified information (be specific)
 At least 4 EBP peer- reviewed journal articles must be utilized to describe and cite
rationale for information to be taught (planned interventions) in the body of the
paper (use APA format). Handouts and/or brochures should also contain rationale.
 Identify 3 to 5 client behavioral outcomes/goals. Goals should be listed in terms of what
the client is expected to do: “At the end of the visit to the poster, _______% of the clients will be
able to
as evidenced by
.” Remember that the outcomes/goals should
correspond directly with each of the 4 identified teaching/learning objectives.
 How will you evaluate if the client (learner) achieves the teaching/learning objectives to meet the
outcomes/goals? (Show evaluation tool you have developed to measure effectiveness of teaching
project. This should also include a section to gather general demographic information).
_____ 4. Poster design and information cleared with faculty before assembly of poster. (5 points)
_____ 5. Reference List (8 points):
 Use at least 4 EBP peer-reviewed journal articles current within the past 5 years.
 In addition, professional internet websites and course textbooks may also be used.
 Submit hard copies of brochures and handouts in back pocket of FACE notebook.
____ 6. APA Format (5 points)
 APA format utilized (obtain and utilize information from APA Documentation Style handout available
in the Writing Center and the LRC )
o Title Page
o Typed and double spaced
o Pages numbered
o Proper spelling, grammar and sentence structure
o Reference page utilizing APA format, references correctly cited
_____7. Include Grade Sheet (2 points)
 A Copy of this Grading Criteria must be submitted with paper. Thank you!
Total for Section 1
/ of 85 points possible
Faculty Grader:__________________________________________________
Face-Page 5
07/11 NURS 2423
Section 2 (65 points)
_____8. Implementation (10 points total):
Written Summary
 Summarize and calculate simple statistics regarding demographics from surveys completed by
visitors to your booth
 Describe specific actions taken (by student nurses) to accomplish each of the goals (refer
back to Kozier & Erb or Potter & Perry).
 Discuss referral agencies that were utilized (you must have at least one).
 How did you overcome any hesitancies/barriers to the participants learning?
_____9. Evaluation (15 points):
 Were the teaching/ learning objectives (expected outcomes/goals, % or degree of proficiency) met?
 Compare and contrast the expected outcomes/goals vs. the actual outcomes/goals (It was expected
that 80% of the clients would list _______________, however ______% were able to list_______)?
 Summarize and calculate simple statistics regarding client learning from surveys completed by
participants who visited your poster.
 Include hard copies of the actual evaluation tools completed by visitors to your poster
_____ 10. Continue APA format (8 points)
a. Typed & double spaced
b. Page Numbering (continue on from first section)
c Proper spelling, grammar, sentence structure
d. Reference page (update for second half as needed)
______11. Include Grade Sheet (2 points)
 A Copy of this Grading Criteria must be submitted with paper. Thank you!
______ 12. Poster Critique (25 points): Refer to Poster Implementation Critique grading sheet
 Submit poster (TRI-Fold, science fair style, available at discount/craft stores)
 Include hard copies of brochures and handouts in back pocket of FACE notebook.
______13. FACE Individual Participation Points (5 points). These will be collected during Week 7
Wrap-Up Lab. Come prepared to submit completed forms at the beginning of Lab.
Total for Section 2
Total
/of 65 possible points
/of 150 possible points _______________%
Students’ Names:
Topic:
______
Agency:
___________________
Faculty Grader:
Date:
07/11 NURS 2423
Face-Page 6
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Family
Family and Community Education (FACE) Project
Poster Critique Grade Sheet
Topic
1.
/5 points
Group members:
Poster Presentation
(Y N) Present
(Y N) Professionally attired
(Y N) Fulfilling specific assigned role
(Y N) Good communication skills
Poster Presentation
(Y N) Present
(Y N) Professionally attired
(Y N) Fulfilling specific assigned role
(Y N) Good communication skills
Poster Presentation
(Y N) Present
(Y N) Professionally attired
(Y N) Fulfilling specific assigned role
(Y N) Good communication skills
Poster Presentation
(Y N) Present
(Y N) Professionally attired
(Y N) Fulfilling specific assigned role
(Y N) Good communication skills
Poster Presentation
(Y N) Present
(Y N) Professionally attired
(Y N)
Fulfilling specific assigned role
(Y N) Good communication skills
2.
/ 5 points
Tri-fold poster neat, eye-catching, visually appealing, creative, clearly labeled, relevant to topic.
/10 points Presentation actively engaged audience. Material/activities:
Visual
(Y N)
Verbal
(Y N)
Written
(Y N)
Hands-on
(Y N)
3.
/ 5 points Appropriate hand-outs available for audience
Faculty Graders:
Date:
07/11 NURS 2423
Face-Page 7
TCC Nursing Program
NURS 2423 Nursing of the Childbearing Families
Family and Community Education (FACE) Project
FACE Individual Participation Rating
Name
Poster Topic
Do not include this form in your group notebook. You will return this completed form at
FACE Wrap-Up during Lab on Week 7, and place it in an envelope provided by the
instructors, and other group members will not see your rating. It will be worth 5 points of
your grade.
Please evaluate each member of your group, including yourself, on individual participation in the
planning, working on and presenting of your Poster project on a 0 to 5 scale, ranging from 0 = no
involvement to 5 = exceptional involvement. Then refer to the section in your student handbook
regarding academic integrity and give a brief description regarding how each group member’s
Knowledge (K), Skill (S), and Attitude (A) respected the TCC Guidelines for Academic Integrity as you
worked together to develop your poster presentation and write your paper.
Member 1: Name
Participation Rating: (circle rating)
0
1
2
3
4
5
Greatest contribution to project:
Ways they demonstrated academic integrity:
Knowledge (K)_________________________________________________________________
Skills (S)
Attitude (A)____________________________________________________________________
Member 2: Name
Participation Rating: (circle rating)
0
1
2
3
4
5
Greatest contribution to project:
Ways they demonstrated academic integrity:
Knowledge (K)_________________________________________________________________
Skills (S)
Attitude (A)____________________________________________________________________
07/11 NURS 2423
Face-Page 8
Member 3: Name
Participation Rating: (circle rating)
0
1
2
3
4
5
Greatest contribution to project:
Ways they demonstrated academic integrity:
Knowledge (K)_________________________________________________________________
Skills (S)
Attitude (A)____________________________________________________________________
Member 4: Name
Participation Rating: (circle rating)
0
1
2
3
4
5
Greatest contribution to project:
Ways they demonstrated academic integrity:
Knowledge (K)_________________________________________________________________
Skills (S)
Attitude (A)____________________________________________________________________
Member 5: Name
Participation Rating: (circle rating)
0
1
2
3
4
5
Greatest contribution to project:
Ways they demonstrated academic integrity:
Knowledge (K)_________________________________________________________________
Skills (S)
Attitude (A)____________________________________________________________________
07/11 NURS 2423
Face-Page 10