BSN 3 - Nierves, Ivy Jane N. (Ncm-114-Older-Adult)

Republic of the Philippines
Biliran Province State University

(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
NCM 114- OLDER ADULT
NAME OF STUDENT: IVY JANE N. NIERVES BSN 3 DATE:

____________________
ACCORDING TO THE SECRETARY OF HEALTH THE PHILIPPINES RENEWED ITS

COMMITMMENT TO THE INTERNATIONAL BY BOOSTING UNIVERSAL HEALTH
CARE THROUGH FOURMULA ONE PLUS. F1 PLUS IS THE COUNTRY’S HEALTH
SECTOR STRATEGY TO ACHIEVE ITS TARGET FOR THE PHILIPPINES
DEVELOPMENT PLAN BY 2020, THE SUSTAINABLE DEVELOPMENT GOAL BY 2020,
AMBISYON NATIN 2040. THE F1 PLUS FRAMEWORK GUIDES THE
IMPLEMENTATION OF NATIONAL SAFE MOTHERHOOH PROGRAM IN ITS EFFORT
TO CHANGE THE LANDSCAPE OF MATERNAL AND NEWBORN CARE SERVICE
PROVISION TOWARDS SAFER PREGNANCY AND CHILDBIRTH.
NURSE A IS ASSIGNING AT BARANGAY MATIYAGA AND HAS HIS ROUTINE
PRENATAL EVERY 2ND AND 4TH FRIDAY OF THE MONTH. HE ASSESS CAREFULLY,
GIVE HEALTH EDUCATION AND RECORD IT IN THEIR MATERNAL AND CHILD
BOOK. THE CHECK UPS MEANT TO IDENTIFY, PREVENT AND TREAT POTENTIAL
HEALTH PROBLEMS AND PROMOTES HEALTHY LIFESTYLE.
 DEFINE ANTENATAL CARE (ANC?
ANSWER:
Systematic supervision (examination and advice) of a woman during pregnancy is
called antenatal (prenatal) care. The supervision should be regular and periodic in
nature according to the need of the individual. Actually prenatal care is the care in
continuum that starts before pregnancy and ends at delivery and the postpartum
period. Antenatal care comprises of:
• Careful history taking and examinations (general and obstetrical)
• Advice given to the pregnant woman
 RISK ANC IS A METHOD OF CLASSIFYING PREGNANT WOMEN BASED ON
PRE-DETERMINED CRITERIA. WHOSE PREGNANT WOMEN WILL BE
CLASSIFIED AS LOW RISK? HIGH RISK?
ANSWER:
The high risk approach intended to classify pregnant women as “low risk” or “high
risk” based on predetermined criteria and involved many ANC visits.
High Risk: Pregnant women under 17 or over 35 are considered high-risk
pregnancies. Being pregnant with multiple babies. Having a history of complicated
pregnancies, such as preterm labor, C-section, pregnancy loss or having a child
with a birth defect. A family history of genetic conditions.
Ground Floor Administration Building, Main Campus, P. Inocentes St., P.I. Garcia, Naval, Biliran Province, Philippines 6560
Tel. (053) 507-0082‫ ן‬Telefax. (053) 507-0082
SUC Level III-A (Per DBM-CHED Joint Circular #B dated June 21, 2007
Website: www.bipsu.edu.ph ‫ ן‬Email: op@bipsu.edu.ph ‫ ן‬Facebook: www.facebook.com/WowBiPSU
#WoWBiPSU!

Low Risk: A pregnancy that has no maternal or foetal complications is considered

to be a low risk pregnancy. Most pregnancy complications can easily be detected
and prevented with routine prenatal care.
 FOCUSED ANC IS AN INDIVIDUALIZED GOAL ORIENTED ANC THAT ALOWS

THE HEALTH TEAM TO PROVIDE SPECIFIC EVIDENCE-BASED
INTERVENTION TO WOMEN CARRIED OUT AT CERTAIN CRITIVAL TIMES IN
THEIR PREGNANCY. WHAT IS THE ESSENTIAL ELEMENTS COMPROMISE
TO PROVIDE FOCUSED ANC?
 ANSWER:
The essential elements of a focused approach to antenatal care
• Identification and surveillance of the pregnant woman
and her expected child
• Recognition and management of pregnancy-related
complications, particularly pre-eclampsia
• Recognition and treatment of underlying or concurrent
illness
• Screening for conditions and diseases such as anaemia,
STIs (particularly syphilis), HIV infection, mental health
problems, and/or symptoms of stress or domestic
violence
• Preventive measures, including tetanus toxoid
immunisation, de-worming, iron and folic acid,
intermittent preventive treatment of malaria in
pregnancy (IPTp), insecticide treated bednets (ITN)
• Advice and support to the woman and her family for
developing healthy home behaviours and a birth and
emergency preparedness plan to:
o Increase awareness of maternal and newborn
health needs and self care during pregnancy and the
postnatal period, including the need for social support
during and after pregnancy
- Promote healthy behaviours in the home,
including healthy lifestyles and diet, safety and injury
prevention, and support and care in the home, such
as advice and adherence support for preventive
interventions like iron supplementation, condom use,
and use of ITN.
- Support care seeking behaviour, including
recognition of danger signs for the woman and the
Tel. (053) 507-0082‫ ן‬Telefax. (053) 507-0082
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newborn as well as transport and funding plans in

case of emergencies
- Help the pregnant woman and her partner prepare
emotionally and physically for birth and care of their
baby, particularly preparing for early and exclusive
breastfeeding and essential newborn care and
considering the role of a supportive companion
at birth
- Promote postnatal family planning/birth spacing
 WOMEN WITH NO UNDERLYING MEDICAL PROBLEMS SHALL REQUIRE

HAVING AT LEAST 4 ANC VISIT. WHAT IS THE SPECIFIC INTERVAL PERIOD?
ANSWER: A recent multi-country randomised control trial led by the WHO and a
systematic review showed that essential interventions can be provided over four
visit at specified intervals, at least for healthy women with no underlying medical
problems.
- First visit 8-12 weeks, Second visit 24-26 weeks, Third visit 32 weeks, Fourth
visit 36-38 weeks.
 NURSE A PROVIDES THE 8 PREGNANT WOMEN A WRITTEN BIRTH PLAN AT

THEIR FIRST ANC VISIT. NURSE A ENSURES THE IDENTIFICATION OF THE
ELEMENTS INSIDE THE PLAN. IDENTIFY AND EXPLAIN THOSE 10
ELEMENTS INSIDE THE MOTHER AND CHILD BOOK?
ANSWER:
1. Facility of Place of Birth – the preferred hospital or home facility for giving birth.
Appropriate facility for catering emergencies.
2. Skilled Provider or Attendant – choosing who will assist and attend during birth.
3. Funds and Transportation (both can be used for emergencies) – funds from
savings or other means for emergency. Transportation must be reliable, accessible
especially for odd hours or during emergencies.
4. Decision making – who will make decisions and will accompany the mother to
hospital during birth or emergency. Identify someone who will take care of her
family on her absence.
5. Blood donor – who will be the mother’s donor when emergency happens.
6. Needed items – clean clothes for the baby and mother including other essential
belongings.
7. Labor Preference – include any preferences for labor. For example, do the mothers
want to walk around freely? Does she want to use a birthing stool, ball, or chair?
Would she like to take a warm shower or bath?
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8. Delivery references – there are many options to consider for the baby’s birth. If
mother is planning on a vaginal birth, would she prefer not to have an episiotomy
unless it’s medically necessary? Does she want a mirror to see the baby’s birth?
Would the mother like her partner to cut the umbilical cord? If mother needs a C-
section, who would she like to accompany her in the delivery room?
9. Pain medications – pain management during labor is an important consideration.
Mother may not plan to have an epidural, but she could change her mind during
labor. Or she may know that she definitely want to have an epidural if possible. As
defining birth plan, mother must ask her doctor about options for pain relief as well
as any questions she have about them. These could include breathing or
massage.
10. Feeding and Care in the Hospital – once baby’s born, mother need to think about
feeding and care. For example, does she prefer breastfeeding or formula feeding?
Would she like her baby in the hospital room with her at all times, or would she
prefer the baby stay in the nursery sometimes? Is it OK for the medical staff to
offer her baby a pacifier or sugar water? If the baby is a boy, would she like them
circumcised at the hospital? (Sugar water may be used at time of circumcision.)
This also include mother’s plan for vitamins and vaccinations.
 MOTHER AND CHILD BOOK SHALL USE NOT ONLY TO PREPARE FOR BIRTH
BUT ALSO PROVIDE INFORMATION AND TO LEARN ABOUT PREGNANCY
AND CHILD CARE. WITH THE AID OF THE MOTHER AND CHILD BOOK
NURSE A SHOULD BE ABLE TO INFORM, EDUCATE AND GIVE THEM
ADVICE. GIVE THE 8 IMPORTANT THINGS THAT WILL BE INCLUDED IN
HEALTH PROMOTION TO ALL THOSE PREGNANT WOMEN.
ANSWER:
1. Exercise- extreme exercise has been associated with lower birth weight but
moderate exercise is healthy during pregnancy. It can help prevent circulatory
stasis in the lower extremities. It can also offer general feeling of well-being. From
some women, teaching about exercise focuses on helping them realize the need
for exercise and urging them to get enough. Others may need to be cautioned to
restrict exercise or participation in contact sports.
2. Self-care needs- pregnancy is not an illness, few special care measures other than
common sense about self-care are required. Many women have heard different
warnings about what they should or should not do during pregnancy, so they may
need some help separating fact from fiction so that they can enjoy their pregnancy
unhampered by unnecessary restrictions.
Tel. (053) 507-0082‫ ן‬Telefax. (053) 507-0082
#WoWBiPSU!

3. Employment- changes in public assistance laws that encourage women to seek

employment have led to more women working during pregnancy than ever before.
Unless a woman’s job involves exposure to toxic substances, lifting heavy objects,
other kinds of excessive physical strain, long periods of standing or sitting, or
having to maintain body balance, there are few reasons a woman cannot continue
to work throughout pregnancy.
4. Perineal hygiene- most women have an increased vaginal discharge during
pregnancy and may desire to cleanse with a douche. Douching is contraindicated
during pregnancy. The force of the irrigating fluid could cause it to enter the cervix
and lead to infection. In addition, douching alters the pH of the vagina, leading to
an increased risk of of bacterial growth.
5. Bathing- tub baths were restricted during pregnancy because it was feared that
bath water would enter the vagina and cervix and contaminate the uterine
contents. Further, it was believed that hot water touching the abdomen might
initiate labor. Because the vagina normally is in a closed position, however, the
danger of tub bath water entering the cervix is minimal. During pregnancy,
sweating tends to increase because a woman excretes waste products for herself
and a fetus. She also has an increase in vaginal discharge. For these reasons,
daily tub baths or showers are now recommended. Women should not soak for
long periods in extremely hot water or hot tubs as heat exposure for a lengthy time
could lead to hyperthermia in the fetus.
6. Clothing- women have a multitude of clothing options to wear during a pregnancy.
Recommend loose-fitting, comfortable garments. Caution women to avoid tight-
fitting items such as garters, girdles with panty legs and knee-high stockings during
pregnancy. These items impede lower-extremity circulation. Suggest wearing
shoes with a moderate to low heel to minimize pelvic tilt and possible backache.
7. Breast care- a few precautions during pregnancy are helpful to prevent breast
discomfort. A general rule is for a woman to wear a firm, supportive bra with wide
straps to spread breast weight across the shoulders. A woman may need to buy a
larger bra halfway through pregnancy to accommodate her increasing breast size.
If she plans on breastfeeding her newborn, she might choose bras suitable for
breastfeeding so she can continue to use them after the baby’s birth. Teach her to
wash her breasts with clear tap water (no soap, because that could be drying and
cause nipples to crack) daily to remove the colostrum and reduce the risk of
infection.
8. Sleep- the optimal condition for body growth occurs when growth hormone
secretion is at its highest level-that is, during sleep. This plus the overall increased
metabolic demand of pregnancy, appears to be the physiologic reason that the
pregnant women need an increased amount of sleep or at least need rest to build
new body cells during pregnancy.
Tel. (053) 507-0082‫ ן‬Telefax. (053) 507-0082
#WoWBiPSU!

JFARROGANTE, LPT, RN, MAN
Tel. (053) 507-0082‫ ן‬Telefax. (053) 507-0082
#WoWBiPSU!

BSN 3 - Nierves, Ivy Jane N. (Ncm-114-Older-Adult)

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Republic of the Philippines

Biliran Province State University

School of Nursing and Health Sciences

NCM 114- OLDER ADULT

NAME OF STUDENT: IVY JANE N. NIERVES BSN 3 DATE:

ACCORDING TO THE SECRETARY OF HEALTH THE PHILIPPINES RENEWED ITS

Biliran Province State University

School of Nursing and Health Sciences

Low Risk: A pregnancy that has no maternal or foetal complications is considered

 FOCUSED ANC IS AN INDIVIDUALIZED GOAL ORIENTED ANC THAT ALOWS

Biliran Province State University

School of Nursing and Health Sciences

newborn as well as transport and funding plans in

 WOMEN WITH NO UNDERLYING MEDICAL PROBLEMS SHALL REQUIRE

 NURSE A PROVIDES THE 8 PREGNANT WOMEN A WRITTEN BIRTH PLAN AT

Biliran Province State University

School of Nursing and Health Sciences

Biliran Province State University

School of Nursing and Health Sciences

3. Employment- changes in public assistance laws that encourage women to seek

Biliran Province State University

School of Nursing and Health Sciences

JFARROGANTE, LPT, RN, MAN

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