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Transcript
MOHAWK VALLEY COMMUNITY COLLEGE
CENTER FOR LIFE AND HEALTH SCIENCES
NURSING
NU 102
Nursing 2A
Family Centered Maternity Nursing
Spring 2013
Kathleen Capone, BS RN
334 7749
Plumley #226
[email protected]
Janet Fortnam, MS RN
334 7763
Payne Hall #364
[email protected]
Revised 1/2012
1
Course Title:
Nursing 2A-Family Centered Maternity Nursing
Course Credit and Hours:
4 Credits
4 Hours Theory per Week
8 Hours Clinical Practicum per Week
Placement in Curriculum:
Spring 2013 (Time Block: 7 ½ Weeks)
Prerequisites:
NU 101 Fundamentals of Nursing
NU 111 Nursing Pharmacotherapeutics 1
BI 216 Anatomy and Physiology 1
Corequisite:
BI 217 Anatomy and Physiology 2
Course Description:
This course focuses on the physical, physiological, cultural, spiritual, and psychological needs
experienced by the expanding family during pregnancy, labor, delivery, and postpartum periods.
The nursing process, Maslow's Hierarchy of Needs theory, and critical thinking are integrated to
meet the needs of the family in the perinatal cycle. Clinical experiences are provided in general
hospital units and community agencies.
Disclaimer Statement:
The content of this syllabus is subject to change in the event of extenuating circumstances or at
the discretion of the course instructor.
2
Table of Contents
Student Learning Outcomes
p. 4
Disability Statement
Sustainability Statement, DGV Statement
p.5
Essential Functions
p. 6
Teaching Strategies
Clinical Practicum Policy
Civility Statement
Academic Integrity Policy
Email Information
p. 7
Required Texts
Required Materials
p. 8
p. 9
Evaluation Methods (A and B Terms)
Examination dates
Examination Policy
Evaluation Computations
Grading Criteria
pp. 9-13
Mandatory Assignments Related to Clinical
pp. 14-15
Lecture Assignments
pp. 16-25
Exit Skill Competencies
p. 26
Appendices
p. 27
3
Student Learning Outcomes
Upon successful completion of this course, the student will:
1. Demonstrate caring behaviors in family centered environment per standards listed in
clinical evaluation tool.
2. Discuss the family’s response to stress and adaptation during the pregnancy and
Perinatal cycles per post-conference discussion and clinical evaluation tool.
3. Identify actual/potential health care needs of the family during the pregnancy cycle
in collaboration with other caregivers per nursing care plan grading rubric.
4. Relate the health/illness continuum to commonly recurring maternal, fetal, and
newborn disorders as evidenced by weekly written nursing care plans.
5. Utilize therapeutic communication skills related to the care of the family during the
pregnancy and perinatal cycles per standard in clinical evaluation
tool.
6. Assess the cause and effect relationship of the family’s environment during the
pregnancy and perinatal cycles as demonstrated in the nursing care plan.
7. Implement therapeutic nursing interventions for the family during the pregnancy
and perinatal cycle as evidenced by meeting standards per clinical evaluation tool.
8. Apply ethical, legal and professional standards in nursing practice as identified in
the American Nurse’s Association ANA) Code of Ethics, ANA Maternity
Standards of Practice, Pregnant Patient’s Bill of Rights, Associations of Women’s
Health, Obstetric, and Neonatal Nurses (AWHONN) and National Association of
Neonatal Nurses (NANN) Standards and Guidelines and the New York State Nurse
Practice Act as evidenced by meeting standards per clinical evaluation tool.
9. Relate various theories to the family’s growth, development, and maturation during
the pregnancy and perinatal cycles as demonstrated in chart review assignment.
10. Demonstrate critical thinking in formulating a nursing care plan for a client during
the intrapartal, postpartal and perinatal period utilizing Maslow’s Hierarchy of
Basic Human Needs Theory and the nursing process.
11. Identify various leadership styles and management techniques used in the familycentered environment as demonstrated by case study assignment and post-conference
discussion and leadership assignments
12. Compare the roles of health care personnel involved in the care of the family
during the pregnancy and perinatal cycles demonstrated in leadership assignments.
13. Integrate the principles of pharmacotherapeutics in the safe administration of
medications during the pregnancy as demonstrated in administration of medications.
14. Implement a teaching plan for the family during the perinatal cycle as demonstrated in
teaching plan assignment.
15. Demonstrate competency in maternal and newborn data collection, including:
physical assessment, client and family interview, record review, and discussion
with health care team members demonstrated in completion of clinical documentation and
homework assignments.
4
Accommodations for Students with Disabilities
Students are expected to contact the instructor with any information pertinent to success in this
class. Please read the Disabilities Statement located under Institution Services on the MVCC
Blackboard Welcome Page. Also see the information below:
I would appreciate hearing from anyone in the class who has any type of disability (e.g.,
physical, learning, psychiatric, vision, hearing, etc.) which may require some special
accommodation. Please see me during my office hours so that we can discuss your needs.
Before services can begin, you must also contact the Disability Services Office, 792-5644, in
Room 153 of the Academic Building on the Utica Campus. (For classes on the Rome Campus,
students should be referred to the Student Services Office, PC A30, 334-7727). Staff
members will review your documentation, determine your eligibility for accommodations, and
decide what those accommodations will be.
Uncaptioned educational DVDs and/or other uncaptioned audio-visual
materials may be shown in this class. Anyone with a hearing disability should
discuss this with me during office hours.
Sustainability Statement
Mohawk Valley Community College is committed to development and implementation of a
comprehensive sustainability plan. To that end, we are beginning by asking students, faculty, and
staff to actively participate in energy conservation measures and proper recycling on campus.
The blue bins located in classrooms, and offices are for paper and paper products only. All
plastic, metal and glass containers should be placed in the proper recycling bins located in the
hallways. Please remember to empty them before depositing them. Any materials that cannot be
recycled should be place in garbage cans. It is also important to turn off lights and computers
when leaving a room. Together we can make an impact on conserving our resources. Remember
to reduce, reuse and recycle!
Academic Affairs DGV Statement:
A few years ago, MVCC initiated a program titled “Diversity –Global View” (DGV), which
gave each of our graduates a chance to participate in educational experiences designed to
increase awareness of intercultural perspectives. Our goal in doing so was to enhance our
students’ understanding of the realities faced by individuals as a result of their race, ethnicity,
cultural background, gender, sexual orientation, socioeconomic status, academic abilities and
interests, age, religious beliefs, and physical ability. To that end, all graduates who matriculated
into programs in the fall 2008 or more recently, or who have changed their major since 2008, are
now required to complete the DGV components associated with the degree or certificate program
in which they are enrolled.
For more information please visit
http://www.mvcc.edu/students/registration/dgvrequirement.cfm.
Disclaimer-Academic Affairs
“The above procedures and policies are subject to change, in the event of extenuating
circumstances or at the discretion of the instructor.”
5
MVCC ADN Nursing Program Essential Functions
MVCC seeks to provide equal access to its program, services, and activities for people with
disabilities. Therefore, to the extent practicable, the college will endeavor to make reasonable
academic adjustment for an applicant with a disability who is otherwise qualified.
The essential function of a student enrolled into the ADN program requires that the student, with
or without reasonable accommodations, must be able to:
1. Demonstrate the ability to perform essential functions for a maximum of a 10 hour shift.
2. Demonstrate the ability to protect a client when the client is standing and ambulating on
all surfaces with or without the use of assistive devices, including canes, crutches and
walkers.
3. Demonstrate the ability to safely move a client over 100 pounds from one surface to
another using the appropriate level of help.
4. Demonstrate safe body mechanics in the process of all client treatments, including lifting
and carrying small equipment (under 50 pounds) and moving large equipment (over 50
pounds).
5. Demonstrate the ability to manipulate dials on equipment.
6. Demonstrate the ability to coordinate simultaneous motions.
7. Demonstrate the ability to perform occasional overhead extension.
8. Demonstrate the ability to hear blood pressure, heart and lungs sounds with or without
corrective devices.
9. Demonstrate the ability to palpate soft tissue including pulse, muscle and bones.
10. Demonstrate the ability to perform nursing interventions such as sterile procedures,
dressing changes and administer medications (including dosage calculations when
necessary) following infection control procedures.
11. Display adaptability to change.
12. Establish effective relationships with others.
13. Communicate effectively, safely and efficiently in English by:
a. Explaining procedures
b. Receiving information from others
c. Receiving information from written documents
d. Exhibiting appropriate interpersonal skill (refer to ANA Code of Ethics for
Nurses)
e. Analyzing and documenting assessment findings and interventions.
14. Distinguish color changes.
15. Detect an unsafe environment and carry out appropriate emergency procedures including:
a. Detecting subtle environment changes and odors including, but not limited to, the
smell of burning electrical equipment, smoke, and spills.
b. Detect high and low frequency sounds, including but not limited to, alarms, bells,
and emergency signals.
These are the Essentials Functions of the MVCC ADN Nursing Program. If there are any reasons
why you may not be able to perform these functions with or without reasonable accommodations,
you must notify the Associate Dean of Nursing and Allied Health, and your Clinical and/or
Lecture Instructor immediately
6
Teaching Strategies
Lecture; Discussion; Critical Thinking Exercises; Role Playing; Written Assignments;
Demonstrations; Return Demonstrations; Multimedia Presentations; Analysis of Case Studies;
Scenarios; Internet; Computer Instruction
Clinical Practicum Policy
See MVCC Nursing Student Handbook
Civility Statement
Mohawk Valley Community College is committed to civility in and out of the classroom.
Everyone has the mutual right to an environment that is conducive to teaching and learning.
With that commitment in mind, conduct in the classroom is governed by the Student Code of
Conduct which can be found in the Student Handbook and online. MVCC chooses respect for
all college community members and classroom disruptions will not be tolerated.
Academic Integrity Policy
The student cannot:
1. Ask for, give or receive help during tests, examinations, or quizzes or other evaluations
without permission of the instructor.
2. Utilize books, papers, computer-based media or other materials and equipment during
tests, examinations, quizzes or other evaluations without permission of the instructor.
3. Engage in plagiarism by submitting or using as their own another person’s oral, written
or computer-based work. All sources of material must be cited.
Any violation of academic integrity will result in disciplinary action up to and including dismissal
from the MVCC nursing program.
Email
The primary method of communication is transmitted through MVCC email. All students have
email accounts through MVCC Please check email accounts frequently. To access email:
1. Go to www.mvcc.edu
2. Choose “email: Student Access” from drop down box
3. Log in
a. User Name: first initial, last name, day of your birth (ex jfortnam14)
b. Password: last 4 digits of your social security number
7
Required Texts
1. *ATI RN Maternal Newborn Nursing, Ed. 8,Content Mastery Series
2. *Deglin, J., Vallerand, A. & Sanoski, C. (2011). Davis’s drug guide for nurses + resource kit CD-ROM
(12th ed.). Philadelphia, PA: F.A. Davis.
3. Doenges, L., Morehouse, M., & Murr, A. (2010). Handbook of nursing diagnosis: Planning,
individualizing, and documenting client care. (3rd Ed.). Philadelphia, PA: F.A. Davis.
4. Ladewig, P.A.W., London, M.L., & Davidson, M.R. (2010). Contemporary maternal-newborn nursing
care (7th ed.). Upper Saddle River, NJ: Prentice Hall.
5. Ladewig, P.A.W., London, M.L., & Davidson, M.R. (2010). Clinical Handbook for contemporary
maternal-newborn nursing care (7th ed.). Upper Saddle River, NJ: Prentice Hall.
6. *Lynn, P. (2011). Taylor’s clinical nursing skills: A nursing process approach (3rd Ed.).
Philadelphia, PA: Lippincott, Williams, & Wilkins.
7. *Pickar, G.D. & Abernathy, A.P. (2007). Dosage Calculations: A ratio-proportion approach (3rd ed.).
Clifton Park, NY: DELMAR CENGAGE Learning.
8. *Saxton, D. (2008). Mosby’s comprehensive review of nursing for NCLEX-RN examination (19th Ed.). St.
Lois, MS: Mosby Elsevier.
9. *Van Leeuwen, A.,Poelhuis-Leth, D., & Bladh, M. (2011). Davis’s comprehensive handbook of
laboratory and diagnostic tests with nursing implications (4th ed.). Philadelphia, PA: F.A. Davis.
10. *Venes, D. (2011). Taber’s encyclopedia medical dictionary (21st ed.). Philadelphia, PA: F.A. Davis.
Recommended Texts
1. Wittman, Ruth, et al, (2013). Nursing Concept Care Maps for Safe Patient Care, Philadelphia, PA:
F. A. Davis.
2. *Gaglione, T., Zerwekh. J., Claborn, J. C., & Miller, C. J. (Newest Ed.) Memory notebook of nursing:
Pharmacology & diagnostics. Ingram, TX: Nursing Education Consultants.
3. *Zerwekh, J., Claborn, J. C., & Miller, C. J. (Newest ed). Memory notebook of nursing: Volume I
(4th Ed.).
Ingram, TX: Nursing Education Consultants.
4. *Zerwekh, J, Claborn, J.C., & Miller, C.J. (Newest ed). Memory notebook of nursing: Volume II
(Newest Ed.).
Ingram, TX: Nursing Education Consultants.
*Indicates texts purchased for NU 101 or NU 111
8
Required Materials
Each Unit Exam will include Dosage Calculation/Medication Administration questions. The only
calculator permitted to be used during test taking is the designated Nursing calculator purchased from the
MVCC college book store.
The following supplies are required:
Penlight, Pocket Pack, Stethoscope, Bandage Scissors, Name Tag
Dress Code Per Student Handbook.
EVALUATIVE MEASURMENTS
Exams-A Term
Exams
Week
Exam 1
3
Exam 2
5
Exam 3
7.5
Date
Unit
Percent of
Grade
T/R-2/5
M/W-2/6
Units I & II
Prenatal
30%
T/R-2/19
M/W-2/20
Unit III
Intrapartal
T/R-3/12
M/W-3/13
Units IV & V
Postpartum and Newborn
9
30%
40%
Exams-B Term
Exams
Week
Exam 1
3
Exam 2
5
Exam 3
7.5
Date
Unit
Percent of
Grade
M/W- 4/8
T/R- 4/9
Units I & II
Prenatal
30%
M/W- 4/22
T/R- 4/23
Unit III
Intrapartal
M/W-TBA
T/R-TBA
Units IV & V
Postpartum and Newborn
10
30%
40%
Evaluation Methods (continued)

Each unit examination will have 65 questions and must be completed within a 1 ½ hour time
frame.

The student will receive a written Final Clinical Evaluation during the 7th (seventh) week of
clinical. The student must obtain a “Satisfactory” on each of the Standards of Performance at
the Final Clinical Evaluation in order to successfully pass clinical. If the student fails
clinical, they will not be allowed to sit for the Third Unit Exam and the student will receive
an F in NU 102.

In addition, a successful Grade for NU 102 requires the following:
1.
2.
3.
4.
5.
Remediation on ATI exams completed by assigned date
Satisfactory completion of all Pre-Lecture Assignments
Satisfactory completion of all Clinical Assignments
Successful achievement of all skills Competencies
Satisfactory completion of Medication Competency
Examination Policy
See the MVCC Nursing Student Handbook.
11
Medication Competency
The student is required to take a Medication Competency Test on the first lecture day prior to
administering medications in clinical.
The student must achieve a 100 % on the exam. If the student does not achieve 100% the student
may retake the exam twice. The Student must show evidence of remediation with a tutor prior to
retaking each exam.
If the student is unsuccessful in achieving 100% on the second retake the student will receive a
clinical jeopardy, will not be able to administer medications, and will be required to meet with a
tutor and develop a remediation plan. This plan will be submitted to the First Year Coordinator.
Following remediation the student will meet with the Retention Specialist and First Year
Coordinator at which time a decision will be made to determine if the student is safe to administer
medications in the clinical area.
If the student is deemed unable to attain safe status by week four of clinical, the student will be
deemed unsafe for practice in the clinical area and will be unable to proceed in the nursing
program.
All test answers must comply with Rounding Rules Policy (See Appendix A)
12
Evaluation Computations
Exam 1
 65 Questions 1 ½ hours
30%
Exam 2
 65 Questions 1 ½ hours
30%
Exam 3
 65 Questions 1 ½ hours
40%
__________
100%
Grading Criteria
A = 89.5-100
B = 79.5-89.4
C = 74.5-79.5 Passing is a 74.5 %
D = 64.5-74.4
F = <64.9
A minimum grade of “C” is required to pass NU 102: Family Centered Maternity Nursing
13
Clinical Dates
A Term: Clinical begins Tuesday January 22. The last day of clinical is Monday, March 11th.
B Term: Clinical begins Monday March 25. The last day of clinical is Saturday, May11th.
Mandatory Assignments Related to Clinical
Prior to Clinical Orientation:
 Complete online Postpartum Care module. At:
http://www.wildirismedicaleducation.com/courses/309/index_nceu.html
(Note: you do not have to register or pay for the exam unless you want the continuing
education credits)
 Take the test and print it when completed. Must achieve an 80%, may retake test until
achieving 80%
 Bring the completed test and results to clinical orientation and give it to your clinical
instructor.
Prior to 2nd Clinical:
 Complete Maternal and Newborn Medication Sheets from list posted on Blackboard.
Bring them with you to every clinical ( List will be posted on BB)
 Complete Normal Assessment Post-Partum . L&D, and Newborn Prep Sheets -Bring
these completed as directed to clinical and give it to your instructor ( See Appendices B,
C and D )
 Bring Blank Post-Partum, L&D, and Newborn Data Collection Work sheets to
clinical each week (See Appendix E,F, G)


***
View DVD or online Med-Com video from library database: Care of the Postpartum
Patient.
Or
View from reserve on site at the library:
These videos will only be found in the library on each campus.
In Utica it is DVD #178: Part # 8 Postpartum.
In Rome it is RDVD #19: Part #8 Postpartum Assessment.
***
In The Nursing Learning Resource Center Lab (NLRC)

Practice assessing fundal height on the maternal mannequin in lab and utilize all items
set up at the NU 102 Postpartum learning station in the NLRC.

Review fetal development / pregnancy book found on the shelf of the crib.
14

View the newborn assessment video by Janet Fortnam found in both the NLRC and the
library on both campuses and practice assessment skills on the newborn mannequin.

Review info in the binder found in the crib in the NLRC and explore the items found in
the crib.

Review the blue flip chart of normal newborn characteristics found with the crib.
Prior to 3rd Clinical

Case Study #1 due
Be prepared to discuss in post conference in clinical.
 View the following ATI skills videos: Breastfeeding Guidelines, Umbilical Cord Care, and
Maternal and Newborn Discharge Instructions.
 Nursing Care Plan #1 Due per grading rubric ( refer to Nursing Student Handbook)
Prior to 4th Clinical


Case Study #2 due
Be prepared to discuss in Clinical post conference.
Nursing Care Plan # 2 Due
Prior to 5th Clinical:


Leadership Assignment due:
Per Clinical Instructor Approval: Complete one of the following Leadership
Assignments:
a. Case Study #3 in lab and be prepared to discuss in post conference
or
b. Complete alternate Leadership assignment due week 5 of Clinical. (See Appendix H)
Nursing Care Plan # 3 Due
Prior to 6th Week of Clinical:
 Nursing Care Plan # 4 Due
Prior to 7th Clinical
 Chart Review Assignment: Pass/Fail (See Appendix I)
Assignment must be submitted prior to week 7 according to grading rubric. An 80% must
be achieved for pass/fail achievement.
 Nursing Care Plan # 5 Due
Case Studies:
All of the case studies must be completed in the lab. A signature of the lab technician/work
study student assistant is required to verify your presence in the lab.
Viewing of the DVDs: Viewing of the newborn assessment DVD must be verified by a
signature from either the lab technician/work study student assistant or library staff.
15
Mandatory Assignments Related to Lecture




Entire ATI Module must be completed by week 6. Proof of completion transcript is
required to be submitted prior to week 6 lecture class. (The average time it takes to
complete the module is 45 minutes)
ATI Remediation based on focus review generated by the Maternal Newborn
practice exam A & B must be brought to the ATI proctored exam.
ATI Transcript showing evidence of remediation based on the focused review of the
proctored exam Due on day of the Nursing Lecture Final Exam (not able to sit for final
exam without remediation)
Weekly Informal Writing Assignment:
(Due at the beginning of each lecture class)
Student will select 3 learning objectives defined at the beginning of required chapters
assigned in the Ladewig Maternity text book.
Student will write at least one well-developed paragraph for each learning objective
explaining how each objective is met in the text and as it relates to nursing (instructor
may assign objectives or allow student to choose).
All assignments must be submitted prior to lecture for successful completion of course.
Instructor may require student to remediate any assignment for completeness.
16
Lecture Assignments *
* All assignments from Ladewig text
Unit
I
A
Term
Topic
Introduction to
Family Centered
Nursing during the
Pregnancy Cycle
Part I: Intro
Tues or Wed
1/22 or 1/ 1/23
Content
I. Pregnancy and the Family
1. Theory
2. Standards of Practice
3. Cultural/Spiritual Considerations
4. Community and Home Care
5. Ethical/Legal Considerations
Preparation*
Required Reading for
Part I:
Chapter 1
Chapter 2
Suggested Readings for
Review:
Chapter 3 & 4
Ati reading assignment
Chapters 1 & 2
**
Part II: Health
Thur or Mon
1/24 & 1/28
**
II. Health Promotion and Prevention
1. Violence against Women
2. Sexually Transmitted Infections
3. TORCH Infections
4. Environmental and Food Risks
**
Required Reading for
Part II:
Chapter 5 pg 104-109
Chapter 6 pg 119-129
Chapter 16 pg 365-371
ATI reading assignment:
Chapter 8
_____
_______________
B
Term
Part I: Intro
Mon. 3/25
or
Tues. 3/26
________________________________________
_
Follow content per Term A assignments above
Part II: Health
Wed. 3/27
or
Thurs. 3/28
17
__________________
Unit
Topic
II
Prenatal Period
A
Term
Part I: Pregnancy
Tues or Wed
1/29 & 1/30
Or
Thur or Mon
1/31 & 2/4
Content
I. Management and Nursing Care of the
Family during Pregnancy
1. Antepartal Nursing Assessment
2. Management and Nursing Care
a. Psychosocial aspects
b. Physiological changes and
discomforts
c. Prenatal education
d. Nutrition in Pregnancy
3. Pregnancy in Special Populations
a. Adolescent
b. Over 35
Preparation*
Read According to
Topic for Part I
(Required):
Chapter 9
Chapter 10
Chapter 11
Chapter 14
Suggested Reading
for Part I:
Chapter 8
Chapter 12
Chapter 13
ATI videos:
Measuring Fundal
Height
Leopold’s maneuvers
Read ati Chapters:
Chapter 3
Chapter 4
Chapter 5
Chapter 6
**
**
**
Part II: Risks
II. Pregnancy at Risk
1. Pre-gestational
a. Diabetes Mellitus
b. Anemia
c. HIV & AIDS
d. Chronic Conditions
2. Pregnancy Induced Conditions
a. Premature Rupture of the Membranes
b. Preterm Labor
c. Hyperemesis Gravidarum
d. Incompetent Cervix
e. Preeclampsia/Eclampsia
f. Ectopic Pregnancy
g. Rh Sensitization
3. Hemorrhage Conditions
a. Abortion
b. Abruptio Placenta
c. Placenta Previa
d. Hydatiform Mole
18
Read According to
Topic for Part II
(Required):
Chapter 15
Chapter 16
Chapter 21
ATI video:
Danger Signs of
Pregnancy
Read ati Chapters:
Chapter 7
Chapter 9
Chapter 10
Unit
II
_____
B
Term
Follow Assignments as per A term above
Part I: Pregnancy
Mon. 4/1
or
Tues. 4/2
Part II: Risks
Wed. 4/3
or
Thurs. 4/4
19
Unit
III
A
Topic
Exam I: Units I & II
Tue Feb. 5 or Wed
Feb. 6
Intrapartal Period
term
Part I: Labor &
Delivery
Thurs. 2/7
Or
Mon.2/11
Content
I. Management and Nursing Care of
The Family during Labor and Birth
1. Concepts
2. Signs of Labor
3. Stages of Labor
4. Assessment of Mother and Fetus
during Labor
5. Interventions of Labor
6. Pain Management
Preparation*
Read According to Topic
for Part I (Required):
Chapter 14
Chapter 17
Chapter 18
Chapter 19
Chapter 20
ATI videos:
Stages of Labor
Epidural Catheter
Placement
Ati required reading:
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Med-Com Video:
Electronic Fetal
Monitoring (available on
reserve in the library or
via electronic data base)
**
**
**
Part II: Risks
Tues 2/12 & Thurs
2/14
or
Wed 2/13 & Mon
2/18
II. Childbirth at Risk
1. Cephalopelvic Disproportion
2. Polyhydramnios/Oligohydramnios
3. Macrosomia
4. Precipitous Birth
5. Post term
6. Prolapsed Cord
7. Dysfunctional Uterine Contractions
8. Fetal Malposition
9. Fetal Malpresentation
10. Fetal Distress
11. Uterine Rupture
12. Amniotic Fluid Embolism
Read According to
Topic for Part II
(Required):
Chapter 21
Chapter 22
______________________________________
____________________
20
ATI video:
Cesarean Birth
Ati required reading:
Chapter 16
_________________
Follow assignments as per A term above
unit
III
___
B
term
Exam 1: Units 1&2
April 8 or April 9
Part I: Labor &
Delivery
Wed. 4/10
or
Thurs 4/11
Part II: Risks
Mon. 4/15 & Wed.4/17
Or
Tues 4/16 & Thurs
4/18
21
This Page Intentionally Blank
22
Unit
IV
A
Term
Topic
Exam 2: Unit 3
Labor & Delivery
Feb. 19 or Feb. 20
Perinatal Period
Content
I. Management and Nursing Care of
the Newborn
1. Physiologic Responses of the Newborn
2. Nursing Assessment and Intervention
with the Newborn
3. Newborn Nutrition
Part I: Newborn
Thurs. 2/21
or
Mon. 2/25
Preparation*
Required Reading for
Part I:
Chapter 24
Chapter 25
Chapter 26
Chapter 27
ATI videos:
Apgar scoring
Breastfeeding
guidelines
Kangaroo Care
Umbilical Cord Care
Ati required Reading:
Chapter 23
Chapter 24
Chapter 25
ATI video:
Gestational Age
Assessment
**
Part II: Risks
Tues 2/26 &
Thurs 2/28
or
Wed 2/27 & Mon 3/4
**
II. The Newborn at Risk
1. Respiratory Distress Syndrome
2. Hyperbilirubinemia
3. Hypoglycemia
4. IDM
5. SGA/LGA
6. IUGR
7. Preterm
8. Post term
9. Neonatal Infections
23
**
Read According to
Topic for Part II
(Required):
Chapter 28
Chapter 29
ati Required Reading:
Chapter 27
Unit
IV
B
Term
Exam 2: Labor &
Delivery
Mon. April 22
or
Tues. April 23
Follow Assignments as in A term above
Part I: Newborn
Wed. 4/24
or
Thurs. 4/25
Part II: Risks
Mon 4/29 & Wed 5/1
Or
Tues 4/30 & Thurs
5/2
24
Unit
V
Topic
Postpartum Period
A
Part I: Postpartum
Term Tuesday 3/5
or
Wednesday 3/6
Content
I. Management and Nursing Care of
The Family in the Postpartum Period
1. Postpartum Adaptation
2. Nursing Assessment and
Intervention during the Postpartum
Period
Preparation*
Required Reading for
Part I:
Chapter 30
Chapter 31
ATI videos:
Postpartum assessment
Postoperative
assessment
Maternal and Newborn
Discharge Instructions
Suggested Reading for
Part I:
Chapter 32
ati Required Reading:
Chapter 17
Chapter 18
Chapter 19
Chapter 26
**
Part II: Risks
Thurs. 3/7
or
Mon. 3/11
(ATI exam TBA)
____
Unit
V
B
Term
Exam 3: Units IV&V
Tuesday 3/12
or
Wednesday 3/13
__________________
Part I: Postpartum
Mon. 5/6
or
Tues. 5/7
Part II: Risks
Wed. 5/8 or
Thurs. 5/9
Exam Review Monday
5/13 (tentative date)
Time & Place TBA
Exam 3: Units IV&V
TBA: finals week
ATI proctored TBA
**
II. Postpartal Family at Risk
1. Postpartal Hemorrhage
2. Infection
3. Thromboembolic Disease
4. Psychiatric Disorders
**
Read According to
Topic for Part II
(Required):
Chapter 33
ati required Reading:
Chapter 20
Chapter 21
Chapter 22
_______________________________________
Follow content per term A content above
ATI Practice Test A & B: Completed prior to
the proctored exam, Remediation done per
instructions prior to taking the proctored test.
Remediation brought to proctored exam
If a Level 3 is not achieved on the ATI proctored
exam the student is required to remediate
according to the focused review recommendation
following the exam and submit all required
remediated templates due at the Final Exam.(all
hand written)
Remediation must be completed by assigned date
to receive a passing grade for the course.
25
ATI remediation due on TBA
ATI remediation due on final exam day
___________________
Exit Skill Competencies for NU 102
*The following skills are identified as the exit skill competencies for NU 102
Upon successful completion of this course, the student will:
1. Describe Antepartum Assessment
2. Describe Intra-partum Assessment
3. Perform Neonatal Assessment
4. Perform Postpartum Assessment
a. Vaginal Delivery
b. Describe Cesarean Section
5. Demonstrate Dosage Calculation/Medication Administration
6. Manage Care for Two Clients (Mother/Baby Dyad)
7. Provide Health Education to new families.
The student is held responsible for all exit skill competencies from NU 101 and NU 103 (if NU
102 taken in B Term).
*See Skills Competency Packet
26
Appendix A: Rounding Rules for Dosage Calculation, IV Infusion
Whole Numbers:
Dosages in whole numbers should never be followed with a decimal point and zero.
Example:
4 mg PO (Correct)
4.0 mg PO (Incorrect)
Remember:
Basic Rounding: Decimals
Rounding to the nearest tenth:
If the last digit is equal to or > 5 round up. Ex: 1.57 mL= 1.6mL
If the last digit is < 5 round down.
Ex: 1.54 mL= 1.5mL
Rounding to the nearest hundredth:
If the last digit is equal to or > 5 round up. Ex: 0.686mL=0.69mL
If the last digit is < 5 round down.
Ex: 0.543mL = 0.54mL
Converting pounds to kilograms:
Round to the nearest 10th
1 kg = 2.2 pounds
Example: 120 pounds = 54.54 kg = 54.5 kg
Dosage Less than 1 mL
Round at the end of the
problem.
The exception to this rule is when
you are converting pounds to kg.
Always convert to kilograms first
then complete calculation.
Drops (gtt) and Units:
Drops and units are too small to
divide into parts. Always round to
the nearest whole number.
Example: 89.5 = 90
89.4 = 89
Milliliters:
Dosage Less than 1 mL
Calculate to three places
If dosage calculation is in the
then round to the 100th
10th place you must proceed the
and place a zero in front of
decimal with a zero.
the decimal.
Ex: .4 mL= 0.4 mL
Ex: 0.376 = 0.38 mL
.8 mL = 0.8 mL
Ex: 0.563 = 0.56 mL
Greater than 1 mL
If the answer is > 1mL round
to the nearest 10th.
Ex: 1.57 = 1.6 mL
Tablets:
Tablets, as a rule, can be given whole or broken into halves, if scored.
Converting Apothecary to Metric:
Conversion not always equal from grains to milligrams. Grains1 = 60-65mg
Ex:
ASA gr V = ASA 325 mg
Phenobarbital gr ½ = Phenobarbital 30 mg
Nitroglycerine gr 1/200 = Nitroglycerine 0.3 mg (60 divided by 200)
IV Calculations:
Intravenous infusions are calculated in drops per minute (gtt/min) for gravity flow and
milliliters per hour (mL/h) via infusion pump.
Ex: gravity flow – round to nearest whole number. (Formula: Volume of solution X Drop Factor of
tubing divided by time in minutes.) 100 mL X 20 gtts divided by 60 minutes =33.33 = 33 gtt/minute
Ex: IV pump – round to the nearest whole number. 1000 mL to infuse over 12 hrs. 1000 divided by
12 = 83.33 = 83 mL/hour
edited 05/2010
27
Appendix B
Student Name__________________________________________
Clinical Instructor_______________________________________
Lecture Instructor_______________________________________
Normal assessment Clinical Preparation—Labor and Delivery
Directions: Prior to clinical, complete all biological and psychosocial assessment areas, rationale for
assessments, and expected assessment data for normal labor-and-delivery patient. After the clinical day,
complete the worksheet by entering the assessment data on your patient.
Biological Assessment Areas Rationale for Assessments Expected Assessment Data for Low-Risk Labor
Patient:
Biological Assessment Areas
Rational for Assessments
Expected Assessment Data
for low-risk labor patient
1. EDD
2. Parity and history of
prior Pregnancy and
L&D
3. Vital Signs
4. FHR: baseline,
periodic changes,
variability
5. Contraction Pattern
28
Actual Assessment data
6. Cervical and fetal
status:
Dilatation and
effacement
Station and
Position
7. Vaginal Secretions,
Bleeding, amniotic fluid
8. Pain
9. Hydration
Psychological, Cultural
Assessment areas
1. Knowledge and
preparation for labor
and birth
Rational For
Assessment
Assessment Data
2. Expectation for labor
and birth
3. Personal Hygiene and
self-care
4. Coping Style
29
5. Emotional Status
6. Cultural Issues
7. Support person’s
style of support
8. Support person’s
knowledge of labor and
birth
9. Effects of previous
labor and birth
experience on present
experience
10. Interaction between
laboring patient and
support person
11. Role of family and
friends who are present
during labor and birth
30
12. Effects of nursing
interventions
31
Appendix C
Post-Partum Clinical Assessment Prep Worksheet
Name____________________________________________
Clinical Instructor__________________________________
Lecture Instructor__________________________________
(First two columns due prior to each clinical)
Directions: Prior to clinical, complete all biological and psychosocial assessment areas, rationale for assessments,
and expected assessment data for low-risk postpartum woman. After the clinical day, complete the worksheet by
entering the assessment data on your patient.
Physiological Assessment areas
Rational for Assessments
Expected Assessment
Actual
Data for Normal Vaginal
Assessment Data
Delivery
1. Breast
2. Uterus
3. Lochia
4. Perineum, REEDA,
Episiotomy/lacerations/rectum,
hemorrhoids
32
5. Elimination
Bowel:
Bladder:
6. Homan’s Sign
7. Vital Signs
8. Lungs
9. Activity
10. Rest/Comfort
11. Hydration
12. Neurological
13. Lab results
33
Psychosocial
Rational for Assessment
Assessment Areas
Expected Assessment
Data for NVD
1. Maternal phase
2. Concern about infant/infant
care
3. Personal Hygiene: Self-care
4. Self-Concept
5. Recall of labor and birth
experience
34
Actual Assessment Data
6. Cultural Issues
7. Maternal/Infant interactions
8. Paternal/infant interactions
9. Couple interaction
10. Support System
11. Plan for home care
35
12. Effects of nursing
interventions
REF FA DAVIS CO
36
Appendix D
NEWBORN Clinical ASSESSMENT Prep work sheet
Name_____________________________________________________
Clinical Instructor___________________________________________
Lecture Instructor___________________________________________
Directions: Prior to clinical, complete the first two columns.
After the clinical day, complete the worksheet by entering the assessment data on your newborn
patient.
Assessment Data
Rationale for
Assessment
Expected Findings for
Normal Newborn
Neonate
A. General Appearance:
1. Gestational age by
maturity rating
2. Weight
3. Activity
4. Posture
5. Symmetry
6. Temperature
B. Skin
1. Color
2. Coatings (e.g.,
lanugo, vernix)
3. Hydration
Intake:
Void:
Stool:
4. Rashes
5. Bruises
6. Pigmentation
37
Actual Findings
C. Head
1. Circumference
2. Shape
3. Fontanels
4. Eyes
5. Ears
6. Neck
D. Chest
1. Circumference
2. Shape
3. Breast
4. Heart (rate, rhythm,
sound)
5. Respiratory (rate,
effort)
6. Clavicles
E. Abdomen
1. Cord
2. Shape
3. Stools
F. Genitals
G. Skeletomuscular
1. Extremities
2. Spinal column
H. Reflexes
1. Suck and rooting
2. Grasp
3. Moro
4. Babinski
5. Cry
I. Behavior (e.g., periods
of reactivity)
REF FA Davis Co.
38
Appendix E
POSTPARTUM DATA COLLECTION WORKSHEET (Prepared during each clinical and due with care plan)
Name_________________________________ClinicalInstructor________________________________
Lecture Instructor__________________________________________
Maternal Information
Patient initials: ___________ Rm #: ______ Age: _____
Primary language: _________________ Religion: __________
Marital status: _______________ Support person(s): _____________________________
G ____ T ____ P ____ A ____ L ____ Ages of children: ______________________
EDD: __________ Delivery date/time: _____________Method of delivery: __________
Laceration/episiotomy: ____________
Complications of pregnancy: ___________________________
Complications of labor & delivery: ______________________
EBL: _________ mL
Chart Review
Allergies: ____________________
Admission Hgb/Hct: _____________ Postpartum Hgb/Hct:_____________Wbc_________
ABO/Rh: ________ Rubella: _______ HBsAg: _______ GBS: ______________
Baseline vital signs: ___________________________
Physical Assessment: __________________________
BM: ________ Last void time and amount: ____________
Activity level: ________ Diet: ________
Mother/infant interaction: __________________________________________________
Assessment of emotional state: ______________________________________________
Last pain medication: _____________________
39
Complications of postpartum: _______________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Treatments and procedures:
Medications and IV:
Scheduled meds:
PRN meds:
Teaching needs:
Priority client needs:
REF. FA Davis Co.
40
Appendix F
Labor and Delivery Data Collection Worksheet (Prepared during clinical and due with care plan)
Name________________________________________Clinical Instructor_________________________
Lecture Instructor___________________________________________
Patient’s initials: _________________
Maternal History Data
Age: _________ G: _____ T: _____ P: _____ A: _____ L: _____ EDD: ____________
Ethnicity: _________________ Primary language: __________________________
Marital status: _________ Employment: _______________
L&D Admission History
Reason for presenting to unit: _________________________________________
Admission date/time: ______________________________
Membrane status: __________________ Color of fluid: ______________________
Cervical examination: _________________ Onset of labor (date/time):_______________
Maternal vital signs: _________________ Dipstick urine for protein/glucose: __________
Prenatal Record Review
No prenatal care: _______ Comments: _________________________________________
Prenatal care initiated at _____________________ gestation
Vital signs: _______________________________________________________________
Height: __________ Weight: ___________ Weight gain: ___________
Laboratory results:
Hgb: ___________ Hct: __________ ABO/Rh/antibody: ________________
Glucose screening: _____________ Hgb electrophoresis: ________________
Urine c/s: ___________ Toxicology screen, if indicated: _______________
Chlamydia: ___________ Gonorrhea: ____________ GBS: _____________
Hepatitis A, B, and C: ____________________________________
41
Herpes: ______________________ HIV: _____________________
Rubella: ________ Syphilis: _________ PPD: __________ CXR: _________
Other labs: ___________________________________________________
Sonogram results including placental location: ____________________________
Documentation of significant events: _______________________________________________
Substance abuse hx: _________________ Physical violence hx: ____________
Medical and surgical hx, including allergies: _____________________________
Past Ob hx: ________________________________________________________
Type of childbirth education: ________________________________________________
Antenatal Assessment Results, if Indicated
Nonstress test: ______________________ Contraction stress test: ___________________
Biophysical profile (BPP): __________________________
Amniotic fluid index (AFI): _________________________
L&D Labor Documentation Example
Date/Time
Fetal Assessment
Monitor mode
Baseline FHR
Baseline Variability
FHR Pattern
Uterine Activity
Monitor Mode
Frequency of Ctx
Intensity of Ctx
Uterine resting tone
Oxytocin ( mU/min)
Cervical Status
Vaginal Exam by:
Dilatation ( cm)
Effacement (%)
Station
42
Assessments/Interventions
Maternal Position
Activity
Maternal Response to
Labor
Pain Assessment
Partner/Support Person
Epidural/Pain Meds
Maternal Vital Signs
Initials
Delivery Information
Date and time of delivery: _______________________
Length of Labor: _______________
1st stage: _______ 2nd stage: _______ 3rd stage: _______
Type of delivery: ___________ Apgar scores: ________________
Maternal complications:_______________________________________
Newborn complications: ______________________________________
Ref. FA Davis Co.
43
Appendix G
Newborn Data Collection Worksheet (prepared during each clinical and due with care plan)
Name____________________________________ Clinical Instructor_____________________________
Lecture Instructor_______________________________________
Newborn Information
Chart Review
Sex: _____ Birth wt.: _________ Current wt.: __________ Length: ____________
Gestational age: ___________ Apgar scores: ____________
Maternal GBS status: ______________
Maternal blood type: ______________
Newborn blood type: _______ Blood sugar, if indicated: _______
Bilirubin, if indicated: __________ Coombs, if indicated: ___________
Physical Assessment
VS: _________________
Voiding: _______ Stool: _______
Method of feeding: _____________ Last feeding: _____________
Assessment of feeding: _______________ LATCH score: _______________
Treatments and procedures:
Medications/vaccines:
Family teaching needs:
Priority family needs:
REF: FS. Davis Co.
44
Appendix H
Alternate Leadership Assignment
Name______________________________________________________Date____________________
Clinical Instructor____________________________Lecture Instructor__________________________
1) Leadership role assessment
a. Identify the charge nurse and discuss their type of leadership style (refer to your Fundamentals
text) Give specific examples to support your assessment.
b. Include in your assessment:
How many personnel does the charge nurse manage and what are their roles?
What are the responsibilities of the charge nurse on this unit and shift?
Who does the charge nurse report to?
How are assignments determined?
How is patient information communicated to the receiving nurses?
Describe how the charge nurse contributes to the efficiency of the unit?
How did the charge nurse handle any problem or emergent situation?
Describe the charge nurse’s relationship and communication style with staff, physicians and
ancillary personnel.
In general, how does staff respond to the charge nurse’s leadership?
2. Reflect on the role and responsibility of the charge nurse with regard to its significance in the
functioning of the unit.
Include in your response:
The challenges of the charge nurse role.
Any issues or practices that could have been handled differently for a better outcome- explain
why and what you recommend may resolve or improve the situation.
The charge nurse’s particular strengths and areas of needed improvement.
3. Discuss what you have learned that will be helpful to you own practice of nursing.
45
Appendix I
Chart Review Exercise
Name____________________________________________________________
Clinical instructor___________________________________________________
Lecture Instructor___________________________________________________
Section 1: Demographics grading criteria Area 1-7: 50 % - 50 points address each item within each
section.
1. Mother’s initials: in ______ Age: (8 pts.)
2. Father’s initials: Age:
3. Mother’s educational background and type of employment:
4. Father’s educational background and type of employment:
5. Children, names and ages:
6. Other people living with couple and relationship to the couple:
7. Cultural and socioeconomic status:
Section 2: History with Previous Pregnancies (8 pts.)
Number of previous pregnancies: G:_______ P (T:______P:______A:______L:______)
A. Provide the following information for each previous pregnancy (use additional paper if need):
Outcome of each previous pregnancy (list details below for each pregnancy):
Date and year of birth:
Weeks gestation at time of birth (e.g., 38 6/7 wks):
Gender of baby:
Weight of baby:
Health status of baby (at birth and at present):
B. Previous labor and birth experience (list details below for each previous labor and birth): 8 pts.
Overall perception (good/bad, scary, wonderful, etc.):
Length (total labor, active labor, pushing):
46
Spontaneous/induced:
Pain medications used (IV, epidural):
Natural birth interventions used (birthing ball, Jacuzzi, ambulation, etc.):
Birth setting (hospital, birth center, home):
Vaginal birth/cesarean birth/forceps or vacuum assisted birth:
Perineal outcome (intact, laceration, episiotomy):
Complications (bleeding, IUGR, preterm labor, hypertension, gestational diabetes, etc.):
C. Previous postpartum experience (list details below for each previous postpartum experience): 8 pts.
Method of feeding (breast, bottle, both) and how long:
Help at home:
Pain (perineal, breast, uterine cramping/contractions):
Colic:
Infant sleep patterns:
Postpartum blues/postpartum depression:
D. Any other relevant information:
Section 3: History of current pregnancy (8 pts.)
LMP: ________________________ EDB: ______________________
Number of prenatal visits: _______ Planned or unplanned pregnancy: ____________
Common discomforts during pregnancy: ______________________________________
Complications of pregnancy:
Emotional adjustments during the pregnancy:
Relevant social history:
Labs/procedures, medications, other relevant information:
47
Section 4: Summary of Labor and Birth (8 pts.)
Weeks gestation at birth: __________
Type of birth (NSVD, C/S, forceps, vacuum):
Length of labor:
First stage: _______ Second stage: _______ Third stage: ________
Spontaneous vs. induced labor:
Method(s) of pain management:
Date and time of birth: ____________ Apgar scores: ____________________
Complications:
Family/friends present and their role(s) in labor:
Family’s satisfaction with their labor and birth experience:
Other relevant information:
Section 5: Summary of Postpartum Hospitalization (10 pts.)
Vital signs (range):
Postpartum assessment summary:
Labs/procedures, medications, other relevant information:
Patient education provided family responses to birth experience/new baby, plans for help at
home, and any complications, date of discharge, and plans for discharge: Specify how for each area how
this information was provided to the patient during hospitalization?
Section 6: Infant Information (8 pts.)
1. Gestational age at birth
2. Gender
3. Weight and length
4. Skin
5. Fontanels
48
6. Vital signs
7. Method of feeding
8. Blood type
9. Complications
10. Other data (medications, procedures
[e.g., circumcision, IV], labs, etc.)
Section 7: Teaching-Learning
Grade: 50 % - 50 points
Based on your chart review and with your patient’s individual needs in mind (e.g., is this her first
baby, did she have a vaginal or cesarean birth, has she had any complications, is her baby healthy,
how is she feeding her baby, etc.), list five priority teaching-learning needs for your mom-baby
couplet.
Instructions: Provide a detailed response, including the specifics of your plan for teaching per below:
Use the Care Plan template document as a teaching care plan and include a detailed teaching plan for
one of these learning needs.
What are the subjective and or objective assessments? 10%
What is the nursing teaching diagnosis? 10%
What is the long term goal and short term goals? 10%
What are your teaching interventions? 10%
What is your evaluation of the teaching-learning goal? 10%
Submit a blank copy of the Care Plan rubric with your assignment. Your grade will be calculated from the
rubric.
REF: FA DAVIS Co.Completed Form to be submitted to Lecture Instructor at end of week 7
49
NU 102 Lab and Assignment tracking Log Sheet {Use back of form for additional comments)
To be Submitted to Lecture Instructor the Beginning of Week 7
Student Name_________________________________________________________________Date________
Clinical Instructor_______________________________Lecture Instructor_____________________________
Clinical Week Due
1
Time in/out
Title of Lab or Library
Assignment
Grade:
Care of Postpartum pt. online
module test grade: Must achieve
an 80%
Medication Competency
Results 1:
2:
Other
Postpartum Assessment
Clinical Database with
Normal values
(Completed form due the
following week with CP)
1
2
Due each
week
3
/
Newborn Assessment Clinical
Database with
Normal values
(Completed form due the
following week with CP)
Maternal and Newborn
Medications Sheets
Case Study # 1
4
/
Case Study # 2
5
/
6
Grade:
Case Study #3
or Leadership Assignment
ATI Module Completion
Lecture
Care Plan (CP) with two NANDA
Nursing Diagnoses/per rubric
(include appropriate data
collection work sheets)
Pre Lecture Assignment
Lecture
2
Due each
week
2
Exam 1
Exam 2
3, 4, 5, 6 &7
1,2,3,4,5,6,7,
7
Grade:
TBA
TBA
ATI exam
Exam 3
Signature as indicated of
Clinical Instructor, Lab or
Library Assistant
TBA
By week 7
Level:
Chart Review Assignment/ Must
achieve an 80%
ATI Practice Exam
A:
B:
Remediation post practice A and
B exams
Remediation post Proctored exam
Skill Competencies 1-7
Attach graded critical element
sheets
50
Lecture
Lecture
Lecture
51