NURS3608 Family Developmental Stressors Fall 2004

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Note: These Self-Study Modules are designed to help students become familiar with terminology or interventions unique to maternal-child nursing. Students’ knowledge of this content will be tested on the last day of clinical preparation (see class schedule). Each student is expected to carry a copy of the completed pertinent Self-Study Module during their clinical practicum. SELF-STUDY MODULE I: Clinical Orientation Guide for ANTEPARTUM/POSTPARTUM I. REQUIRED ACTIVITIES: A. Readings: Pillitteri, A. (2003). Maternal & child health nursing: Care of the childbearing and childrearing family (4th ed.). Philadelphia: Lippincott Williams & Wilkins. B. Audiovisuals: View VC 780; "Postpartum Assessment"; VC 1076 “Breastfeeding” (Medla) VC 1001 Importance of Fatherhood C. Be prepared to perform postpartum physical examination on the first day of your clinical experience. II. STUDENT OBJECTIVES: By the completion of this module, the student should be able to: A. Define the following terms as applicable during the antepartum period: amniocentesis nonstress test amniotic fluid index oligohydramnios antibody parity antigen preterm labor biophysical profile polyhydramnios clonus tocolysis fundal height ultrasound gravida B. Define the following terms as applicable during the postpartum period: after pains lochia boggy uterus perineal lacerations breast engorgement postpartum blues colostrum postpartal chill CVA tenderness postpartum depression diastasis recti REEDA episiotomy uterine involution Homans’ sign uterine atony C. Collect information and demonstrate knowledge of the following medications frequently prescribed for antepartum/postpartum patients to include specific purpose, actions, usual dosages, routes, contraindications) and nursing responsibilities: acetaminophen (Tylenol) magnesium sulfate (MgSo4) crystals Dermoplast magnesium sulfate (MgSo4) intravenous dibucaine (Nupercainal) ointment meperidine (Demerol) docusate sodium (Colace) methylergonovine maleate (Methergine)

Be prepared to perform these on the first day of your clinical experience. Obtaining fetal heart tones (FHTs)/fetal movement count 4. Postpartum Maternal assessment: . 1. 1. Describe the following specialized skills/teaching in the antepartum/postpartum clinical area. Antepartum: blood typing: ABO and Rh Papanicolaou smear Rh antibody screen or titer (indirect Coombs) red blood cell count (RBC) glucose tolerance test. Briefly describe the following commonly seen conditions in patients during the antepartum/postpartum periods. Teaching regarding postpartum experiences: parent . Postpartum: postpartum hemorrhage (PPH) puerperal infection mastitis F. Assistance with breastfeeding 6.infant interaction self care breastfeeding infant care 7. or 1 hr glucose loading rubella antibody test (HAI titer) gonorrhea/chlamydia/syphilis/HIV tests urinalysis Group B streptococcus screen VDRL/RPR/FTA hepatitis screen 2. Measure fundal height 3.NURS3608 Family Developmental Stressors Fall 2004 ferrous sulfate or gluconate promethazine (Phenergan) hydrocodone/acetaminophen (Lortab) Rh immune globulin (RhoGAM) hydroxyzine hydrochloride (Vistaril) rubella vaccine ibuprofen terbutaline (Breathine) lanolin vitamin E magnesium hydroxide (MOM) zidovudine (AZT) 2 D. Antepartum: multiple pregnancy gestational diabetes (GDM) pregnancy induced hypertension (PIH) preeclampsia /eclampsia 2. Calculate estimated date of birth or delivery (EDB or EDD) using Nagele’s rule 2. Postpartum: hemoglobin & hematocrit (H&H) platelet count prothrombin time/partial thromboplastin time (PT/PTT) E. Identify the significance of the following laboratory work for the antepartum/postpartum patient (include normal ranges where applicable): 1. Provision of perineal care 5.

usual dosages. C/S incision) CVA Tenderness perineum for: REEDA. Philadelphia: Lippincott Williams & Wilkins. REQUIRED ACTIVITIES: A. A. actions. baseline fetal heart rate range variable decelerations variability late decelerations bradycardia internal vs. the student should be able to: A. routes. hemorrhoids. Collect information and demonstrate knowledge of the following medications frequently used in labor and delivery to include specific purpose. episiotomy. (2003). Readings: Pillitteri. superficial lacerations reflexes clonus Homan's Sign 3 SELF-STUDY MODULE II: Clinical Orientation Guide for LABOR & DELIVERY I. external fetal monitoring tachycardia early decelerations . bowel sounds. B. II. List and briefly define the stages and phases of labor. Define the following terms in relation to fetal monitoring. Define the following terms related to uterine contractions: duration frequency intensity intrauterine pressure catheter (IUPC) tocotransducer (TOCO) C. STUDENT OBJECTIVES: By the completion of this module. B. VC 1095A & B “Understanding Birth”. Maternal & child health nursing: Care of the childbearing and childrearing family (4th ed. contraindications and nursing responsibilities: butorphanol (Stadol) misoprostol (Cytotec) calcium gluconate morphine sulfate (MSO4) carboprost (Hemabate) nalbuphine (Nubain) ephedrine naloxone (Narcan) fentanyl (Sublimaze) oxytocin (Pitocin) Lactated Ringer’s (IV fluids) E.).NURS3608 Family Developmental Stressors Fall 2004 breasts uterine fundal height & position abdominal assessment: (diastasis recti. D. Differentiate true labor and false labor to include Braxton Hicks contractions. Audiovisuals: View VC 655 Fetal Monitoring. lochia.

). Identify the nurse’s responsibility in the legal documentation for: time of birth and delivery of placenta. K. J. C. M. Discuss the importance of maternal elimination and fluid intake during the intrapartum period. O.NURS3608 Family Developmental Stressors Fall 2004 accelerations F. Outline the nursing care for the laboring woman. Apgar score and newborn’s weight. S. fetus and family. N. Discuss the nursing care of a laboring woman with epidural/spinal anesthesia. Newborn physical assessment . 4 Q. NJ: Prentice Hall Health. H. D. Identify the significance of meconium stained amniotic fluid. Identify six comfort measures for the laboring woman and give a rationale for each. Duell. REQUIRED ACTIVITIES: A. L. Smith. Outline the care of a woman experiencing a C/S. (2004). Bathing an infant b. P. Maternal & child health nursing: Care of the childbearing and childrearing family (4th ed. Readings and Workbook 1. R. SELF-STUDY MODULE III: Clinical Orientation Guide for Newborn Nursery I. Explain in detail how to determine the Apgar score and times it is assigned. Clinical nursing skill: Basic to advanced skills (6th ed). B. Philadelphia: Lippincott Williams & Wilkins. newborn and maternal identification.. & Martin. 2. a. A. Describe the nursing assessment and care of a patient during the 4th stage of labor. Pillitteri. Define the following terms in relation to the intrapartum period: abruptio placenta Leopold’s maneuvers amnioinfusion vaginal delivery (SVD) amniotomy/amniohook placenta previa Cesarean section (C/S) uterine atony G. Discuss the care of the laboring woman after the membranes have ruptured. Define the following terms in relation to progress of labor: dilation station effacement I. Upper Saddle River. (2003). Discuss four priority interventions for immediate care of the newborn (first ten minutes) after birth.

retractions (intercostal. wheezing/rhonchi k. hip clicks and dislocated hips . Be prepared to perform a gestational age assessment (Ballard) and physical assessment on the first day of your clinical experience in Newborn Nursery. petechiae 2. Define the following terms: 1. d. mottle/mottling k. The Skin: a. pseudomenstruation h. Genitalia and rectum: a. VC 1096 Providing Newborn Care 2. epispadias c. Respiratory: a. erythema toxicum f. g. II. active precordium b. ductus venosus e. Heart: a. Newborn care. hymenal/vaginal tag e. crackles j. meconium g. nasal flaring c. transient tachypnea i. plethoric j. brachial plexus injury e. VC 671. Audiovisuals: Videos: 1. uric acid crystals i. polydactyly b. vernix caseosa b. Gestational Age Assessment (1991) Purdue University 3. cyanosis h. surfactant g. hypospadias b. foramen ovale f. periodic breathing b. VC 258 Bathing the newborn 4. VC 894. Physical Assessment of the Normal Newborn – good review prior NBN assignment C. acrocyanosis g. e. diaphragmatic respirations 3. anal fissures d. expiratory grunt d. STUDENT OBJECTIVES: By completion of this module the student should be able to: A. xiphoid cartilage d. syndactylism f. Infant urine specimen Using the infant radiant warmer Suctioning infant with bulb syringe Using a pediatric oxygen face mask Using an Oxygen Hood 5 B. substernal. sternal) e. Extremities: a. VC 677. f. respiratory distress syndrome (RDS) h. jaundice (pathologic and physiologic) i. circumcision 5. Mongolian spots c. hydrocele d. lanugo d. milia e.NURS3608 Family Developmental Stressors Fall 2004 c. ductus arteriosus 4. murmurs c.

nonshivering thermogenesis b. ear tags. suck d. neutral thermal environment c. 6. IUGR g. side effects. Moro e. cephalhematoma h. tracking d. red reflex 9. convection e. VLBW f. rooting c. vitamin K 6. Reflexes: a. triple blue dye 7. lambdoid. molding f. Babinski g. macroglossia d. plantar 6 8. Gestational Assessment a. conjunctivitis b. Face: a. dextrostix 5. electrolytes. hepatitis B immune globulin (HBIG) 4. tubercles c. posterior) i. Eye: a. AGA b. macrognathia e. sutures (coronal. sagittal. differential. Ears: a. gentamicin 3. caput succedaneum g. septic work-up . Identify normal laboratory findings in the newborn and relate abnormalities to pathologic conditions: 1. walking reflex f.NURS3608 Family Developmental Stressors Fall 2004 c. conduction 11. squamosal) 7. glucose. subconjunctival and retinal hemorrhages c. ampicillin 2. gestational age assessment tool (Ballard) B. Epstein's pearls c. adverse affects. LBW d. oxygen C. cleft lip and cleft palate b. Head. Neck. LGA d. calcium 2. SGA c. clubfoot 6. radiation e. pits 10. palmar b. Thermoregulation a. Know the following common drugs used in the clinical area in terms of the purpose. and nursing responsibilities: 1. Simian creases f. fontanel (anterior. magnesium level and reticulocyte count 7. complete blood count. position b. erythromycin ophthalmic ointment 5. evaporation f. hepatitis B vaccine 8. contraindications.

Review stages of psychosocial and cognitive development according to Erikson and Piaget (Pillitteri. STUDENT OBJECTIVES: By completion of this module the student should be able to: A. NJ: Prentice Hall Health B. 20-21) . VC 1039 Pediatric Medication: Principles and Calculations II. Maternal & child health nursing: Care of the childbearing and childrearing family (4th ed. F. Describe family-centered care (Pillitteri. p. Describe oralgastric (OG) tube placement in a newborn. p.). 2003. performing routine neonatal care: a) cleaning scalp and face g) obtaining a urine specimen from a urine b) feeding and diapering collection bag c) umbilical cord care h) obtaining chemstrip accu check. Clinical nursing skill: Basic to advanced skills (6th ed). (2003). Identify common problems and appropriate interventions with newborns: hypoglycemia. 2003. including blood out (Pillitteri. B. Duell. RBC antibody screen (direct Coombs or direct antiglobulin) 7 8. taking vital signs 2. Smith. B. p. S. Pillitteri. Upper Saddle River. 2003. 733). Describe development care for a high-risk newborn or ICN graduate (Pillitteri. List signs and symptoms of child abuse. G. 2.NURS3608 Family Developmental Stressors Fall 2004 3. C-reactive protein (CRP) (see lab reference) D. head to toe physical assessment of the NB: a) obtaining anthropometric measurements b) assessing the fontanels c) assessing neonatal reflexes d) performing Ortolani's maneuver 4. Describe concept of playroom in Pediatrics. p. & Martin. preventing heat loss in a neonate 5. A. hypothermia and hyperbilirubinemia E. Readings and Workbook 1. dextrostix d) suctioning with a bulb syringe serum glucose for blood sugar and/or e) giving an IM injection hematocrit f) performing a heel stick i) rectal temperature j) administration of eye ointment SELF-STUDY MODULE IV: Clinical Orientation Guide for Intermediate Care Nursery and Pediatrics I. assessing gestational age using Ballard assessment tool 3. Videos: 1. 744745) C. 782-787) and age appropriate nursing implications. E. guiac stool 9. Philadelphia: Lippincott Williams & Wilkins. C. bilirubin & Coombs test 4. D. REQUIRED ACTIVITIES: A.. Review documentation of intake and output for neonate and pediatric patients. D. Describe common skills performed in the newborn clinical area 1. 2003. (2004).

Beats per minute Br . . . Collect information and demonstrate knowledge of the following medications frequently used in pediatrics to include specific purpose.R. .H.Uterine Contraction C/S .D.O.L.Estimated date of birth EDC .Estimated blood loss Eff.Estimated fetal weight ELF . . allergic A.Elective low forceps F.Femur length Grav .R. .Costovertebral angle Cx . .H.Bag of water B. usual dosages (mg/kg and usual schedule).NURS3608 Family Developmental Stressors Fall 2004 8 H.Gravida ICN . contraindications and nursing responsibilities: acetaminophen suppository gentamicin sulfate albuterol glycerin suppository allopurinol methylprednisolone sodium succinate (Solu-Medrol) aminophylline metoclopramide hydrochloride (Reglan) ampicillin montelukast (Singulair) caffeine mupirocin (Bactroban) cefotaxime sodium (Claforan) phenobarbital codeine phenytoin digoxin theophylline fosphenytoin sodium vancomycin hydrochloride furosemide zinc oxide ABBREVIATIONS frequently found in maternal/child and/or pediatric health records (Provided for student information only.T.Estimated date of delivery EFM .T. .Estimated date of confinement EDD .P. routes. .Cesarean Section CVA .M. actions. use of abbreviations in documentation is discouraged due to errors in communication): Ab .Fetal heart tones F. or cms.O.R.L.W.B.Biparietal diameter B.M.Effacement E. . .Intensive Care Nursery . List normal ranges for vital signs in pediatrics I.W.cervix D&C .P.Artificial rupture of membrane B.F.centimeter or centimeters Contr or UC . .Delivery Room EDB .Fetal heart rate F.L. .External Fetal Monitor E.Allergies.Bilateral tubal ligation cm.Breast B. .Abortion ALL: .Dilation and Curettage D.

has borne more than one viable fetus Newborn nursery Normal spontaneous delivery No known drug allergies Nulliparous. edema.O.NURS3608 Family Developmental Stressors Fall 2004 Inc.G. has produced one infant Prolonged rupture of membranes (>24 hrs. appearance Rupture of membranes Recovery Room Spontaneous abortion Station Scalp Electrode Small for gestational age Spontaneous rupture of membranes Therapeutic abortion Term intrauterine pregnancy tocodynamometer termination of pregnancy Ultrasound Vaginal Exam long-term variability ABSENT 0-2 BPM Minimal = 3-5 BPM Average to moderate = 6-25 BPM Marked = greater than 25 BPM Short Term Variability.R.L. S.p.P.R. O. P. P.M.A. ecchymosis.B.ab IUFD IUPC LBR L&D L. never having borne a child Obstetrics Operating Room Parity Penicillin Pregnancy Induced Hypertension Postpartum tubal ligation Postpartum Presenting part Prolonged preterm rupture of membranes (>24 hrs. Absent Late deceleration early deceleration variable deceleration 9 STV Late decel Early decel VAR decel - .P.) Redness.T.A.H. TAB TIUP TOCO TOP US VE LTV Incomplete abortion Intrauterine fetal demise Intrauterine Pressure Catheter Labor Birthing Room Labor and Delivery Large for gestational age Last menstrual period Magnesium Sulfate Missed abortion Multipara. <37 wks) Primipara. p.I.G. PPROM Primip PROM REEDA ROM R. SE or FSE S. LMP MgSO4 Missed ab Multip NBN NSVD NKDA Nullip O.R. Para PCN P. Present. drainage. SAB Sta.

JW. & VF: 7/04 10 .NURS3608 Family Developmental Stressors Fall 2004 Revised by SGW.

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