NUR 099 (Nursing Seminar 1)

STUDENT ACTIVITY SHEET BS NURSING / FOURTH YEAR

Session # 5

LESSON TITLE: OBGYN NURSING PART

Materials:
2 LEARNING OUTCOMES:
Book, pen and notebook, index card/class list
Upon completion of this lesson, the nursing student can:

1. Prepare the family for childbirth and parenting through patient References:
education;
2. Apply the nursing skills learning in facilitating the labor and Pillitteri, A. (2009). Maternal & Child Health
delivery of the mother; Nursing: Care of the Childbearing & Childrearing
3. Assist the woman recover during the postpartum period and Family (6th Edition). Lippincott Williams & Wilkins
promote the mother and infant’s well-being.

LESSON PREVIEW/REVIEW (5 minutes)

MAIN LESSON (55 minutes)

I. Preparing the family for childbirth and parenting

a. Childbirth education
b. The childbirth plan
c. Methods to manage pain in childbirth
d. The birth setting
e. Alternative methods of birth
f. Women with unique needs
II. Nursing care of a family during labor and birth
a. Theories of labor
b. The components of labor
c. The stages of labor
d. Maternal and fetal responses to labor
e. Measuring progress in labor
f. Maternal and fetal assessments during labor
g. The care of the woman in the 4 stages of labor
h. The woman with unique concerns in labor
III. Nursing care of a postpartal family
a. Psychological changes of the postpartal period
b. Physiologic changes of the postpartal period
c. Nursing care of a woman and family during the first 24 hours after birth
d. Nursing care of a woman and family in preparation for health agency discharge
e. Nursing care of a postpartal woman and family with unique needs

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CHECK FOR UNDERSTANDING (25 minutes)
You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct answer and
another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You are given 25 minutes
for this activity:

Multiple Choice

SITUATION: Baby James, an 8-hour old newborn is admitted to the NICU because of low APGAR Score. His mother had a
prolonged second stage of labor.

1. Which of the following is the most important concept associated with all high-risk newborn?
A. Support the high-risk newborn's cardiopulmonary adaptation by maintaining adequate airway
B. Identify complications with early intervention in the high risk newborn to reduce morbidity and mortality
C. Assess the high risk newborn for any physical complications that will assist the parent with bonding
D. Support mother and significant others in their request toward adaptation to the high risk newborn
ANSWER:
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2. Which of the following would the nurse expect to find in a newborn with birth asphyxia?
A. Hyperoxemia
B. Acidosis
C. Hypocapnia
D. Ketosis

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3. When planning and implementing care for the newborn that has been successfully resuscitated, which of the following would be
important to assess?

A. Muscle flaccidity
B. Hypoglycemia
C. Decreased intracranial pressure
D. Spontaneous respiration

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4. When assessing the head of the newborn’s head, the nurse has observed for swelling and the appearance of the head is as though it
appears like a cone. Which of the following terms must the nurse note on her chart?
a. Caput succedaneum
b. Molding
c. Cephalhematoma
d. Craniosynostosis

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5. For this newborn who is experiencing birth asphyxia, which of the following would be the most appropriate nursing
diagnosis?
a. Imbalanced nutrition: less than body requirements
b. Risk for hypothermia
c. Ineffective breathing pattern
d. Impaired gas exchange

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SITUATION: Rhea, a 32-year-old primigravida at 39-40 weeks AOG was admitted to the labor room due to hypogastric and lumbo-
sacral pains. Internal examination revealed a fully dilated, fully effaced cervix. Station 0.

6. She is immediately transferred to the DR table. Which of the following conditions signify that delivery is near?
a. A desire to defecate
b. Begins to bear down with uterine contraction
c. Perineum bulges
d. All of the above

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7. Artificial rupture of the membrane is done. Which of the following nursing diagnoses is the priority?
a. High risk for infection related to membrane rupture
b. Risk for injury related to prolapsed cord
c. Alteration in comfort related to increasing strength of uterine contraction
d. Anxiety related to unfamiliar procedure

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8. Rhea complains of severe abdominal pain and back pain during contraction. Which two of the following measures will be MOST
effective in reducing pain?
a. Rubbing the back with a tennis ball and effleurage
b. Guided imagery
c. Proper breathing techniques
d. Offer warm compresses

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9. Lumbar epidural anesthesia is administered. Which of the following nursing responsibilities should be done
immediately following procedure?
a. Reposition from side to side
b. Administer oxygen
c. Increase IV fluids as indicated
d. Assess for maternal hypotension

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10. Which is NOT the drug of choice for epidural anesthesia?

a. Sensorcaine
b. Xylocaine
c. Ephedrine
d. Marcaine

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RATIO:

SITUATION: Mocha, a 27-year-old mother is at G4P3 at full term gestation is brought to the ER after a gush of fluid passes through
her vagina while shopping at the supermarket.

11. Mocha is brought to the emergency room. The fetal heart tone (FHT) is noted to be 116 beats per minute. Which of the
following actions should the nurse do first?

a. Monitor FHT every 15 minutes

b. Administer oxygen inhalation
c. Ask the charge nurse to notify the obstetrician
d. Place her on the left lateral position

ANSWER:
RATIO:

12. Nurse Jhunela checks the perineum of Mocha. Which of the following characteristic of the amniotic fluid would cause an alarm
to the nurse?

a. Greenish
b. Scanty
c. Colorless
d. Blood tinged

ANSWER:
RATIO:

13. Mocha asks nurse Jhunela, "Why do I have to be on complete bed rest? I am not comfortable in this position." Which of the
following response of the nurse is most appropriate?

a. Keeping you on bed rest will prevent the possibility of cord prolapse
b. Completed bed rest will prevent more amniotic fluid to escape
c. You need to conserve your energy so you will be strong enough to push later during the delivery
d. Let us ask your obstetrician when she returns to check on you

ANSWER:
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14. Mocha wants to know how many fetal movements per hour is normal, the correct response of nurse Jhunela would be

a. Twice
b. Thrice
c. Four times
d. 10-12 times

ANSWER:
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15. Upon examination by the obstetrician, he charted that Mocha is in the early stage of labor. Which of the following is true in
this state?

a. Self-focused
b. Effacement is 100%
c. Lasts for 2 hours
d. Cervical dilatation of 1-3 cm

ANSWER:
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SITUATION: Baby boy Berlin was delivered spontaneously following a term pregnancy. Apgar scores are 8 and 9 respectively.
Routine procedures are carried out.

16. When is the APGAR Score taken?

a. Immediately after birth and at 30 minutes after birth

b. At 5 minutes after birth and at 30 minutes after birth
c. At 1 minute after birth and at 5 minutes after birth
d. Immediately after birth and at 5 minutes after birth

ANSWER:
RATIO:

17. The best way to position a newborn during the first week of life is to lay him

a. Prone with head slightly elevated

b. On his back, flat
c. On his side with his head flat on bed
d. On his back with head slightly elevated

ANSWER:
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18. Baby boy Berlin has large sebaceous glands on his nose, chin, and forehead. These are known as
a. Milia
b. Lanugo
c. Hemangiomas
d. Mongolian spots

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19. Baby boy Berlin must be carefully observed for the first 24 hours for?
a. Respiratory distress
b. Duration of cry
c. Frequency of voiding
d. Range in body temperature

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20. According to the WHO, when should the mother starts breastfeeding the infant?

a. Within 30 minutes after birth

b. Withing 12 hours after birth
c. Within a day after birth
d. After infant’s condition establishes

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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the
correct answer and correct/additional ratio in the space provided.
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LESSON WRAP-UP (10 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you track how
much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Strategy: CAT Muddiest Point

After the instructor finished wrapping up today’s lesson, have each student respond to this question: “In today’s session, what was
least clear to you?” This technique will help you determine which key points were missed by the students. Next, have them record this
in a piece of paper. After answering the question, station yourself at the door and collect the paper as students depart from the room.
Respond to students’ answer during the next class meeting or as soon as possible

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