COURSE TITLE: Nursing Care of the Childbearing Family Practicum

CREDIT HOURS: Credit 4 (0-12)

ALLOCATION OF TIME: 12 Hours Per Week

PLACEMENT IN CURRICULUM: Senior Year, Fall Semester

CO-REQUISITES: Nursing 500

This is a nursing practice course with emphasis on providing nursing care to selected childbearing and pediatric clients. Opportunities are provided for the learner to apply the nursing process to enhance normal growth and development, and maintain health in acute and ambulatory settings.

Patricia Price-Lea, PhD, RNC  HYPERLINK "pricelea@ncat.edu"
pricelea@ncat.edu

Sonja Wilson, Ed.D., RN  HYPERLINK "wilsons7@ncat.edu"
wilsons7@ncat.edu

Susan Wilson, Ed.D., RN  HYPERLINK "wilsonsn@ncat.edu"
wilsonsn@ncat.edu

Joan Smith, MSN, RNC  HYPERLINK "nevadasmiff@msn.com"
nevadasmiff@msn.com

At the completion of this course, the student will be able to:

1. Use the nursing process to achieve mutually agreed upon priorities and goals with the childbearing/childrearing families.
2. Apply standards of practice to develop a safe plan of care.
3. Influence families in understanding and coping with developmental and situational crises during childbearing/childrearing.
4. Develop proficiency in psychomotor skills.
5. Collaborate with nurses and others in nursing resources to provide care to childbearing/childrearing families.
6. Use research findings in current practice.
7. Demonstrate client advocacy.
8. Demonstrate responsibility and accountability for nursing care actions.

1. Health Promotion in Child Health
2. Nursing Care of Infants and Toddlers
3. Nursing Care of Preschoolers and School-Age Children
4. Nursing Care of Adolescents

1. Nursing Care of the Antenatal Client
2. Nursing Care of the Intrapartal Client
3. Nursing Care of the Postpartal Client
4. Nursing Care of the Neonate

1. Client care assignments
2. Demonstration of nursing skills
3. Pre and post conferences
4. Nursing prescriptive plans (weekly)
5. Ambulatory rotations

1. Clinical evaluation tool for Nursing 501 Satisfactory (S)/Unsatisfactory (U)

2. Nursing prescriptive plan(s) S/U

3. Ambulatory rotations (follow-up and evaluation) S/U

Students need to satisfactorily complete all of the above to receive a satisfactory grade for Nursing 501.

Final evaluation of clinical performance is rated as "Satisfactory" or "Unsatisfactory". A "Satisfactory" clinical evaluation is required in order to successfully complete Nursing 501. Four (4) semester hours will be awarded and also requires successful completion of the co-requisite of Nursing 500.

1. Clinical agencies
2. LAC

Nursing students are required to use only books and articles that are current (less than five years old).

The term "current" may be defined by faculty as longer than five years in special situations.

Students absent in excess of three (3) clinical days will be required to withdraw from the course(s) or receive an "F" for the course(s)

Students who are absent more than three (3) clinical days in any eight (8) weeks or longer clinical course will receive a failing final grade. Exception(s) will be made for absences in cases of a documented illness, participation in university related activities, death of an immediate family member or other emergencies.

Students who are in excess of ten (10) minutes late for clinical will be considered tardy. Three tardies will be considered an absence.

Whenever possible a student should consult with the instructor prior to an absence on the day of an examination or other required work. Arrangements for make-up should be agreed upon at that time (University student Handbook, 1999). Students who do not take an examination at the scheduled time will receive a 10% reduction of the grade obtained on the make-up examination. Make-up examination grade will not be reduced for absences due to a documented illness, participation in university related activities, death of an immediate family member or other emergencies. Unless prior arrangements for make-up examination have been made the student must petition for make-up examination on the first day of return to class (University Student Handbook, 1999).

Student Name:____________________________________________________________________

Year____________ Semester____________________________________________

Ratings are based on observations of student performance and written assignments by the faculty member. Graded evaluations will be conducted at midterm, at the end of the semester, and may also be conducted at any time deemed necessary or desirable by the student and/or faculty member. All evaluation conferences will be documented using this form. An action plan for improvement will be developed at midterm and at the discretion of the faculty members at any time to address areas needed improvement. Final evaluation of clinical performance is rated as "satisfactory" or "unsatisfactory". A "satisfactory" clinical evaluation is required in order to successfully complete Nursing 501.

In order to receive a satisfactory rating, the student must, by the end of the semester, demonstrate satisfactory completion of the following:

1. Clinical criteria and performance expectations.
2. Ambulatory clinical expectations.

SATISFACTORY(S) – Ability to meet all clinical criteria and expectations.

MUST IMPROVE (MI) – Performance is unsatisfactory at midterm and must demonstrate improvement to the satisfactory level of competence to receive a passing grade in clinical.

UNSATISFACTORY (U) – Unable to meet all clinical criteria and expectations.

At Midterms, the only options are SATISFACTORY(s) or MUST IMPROVE.

After the Midterm Evaluation and at the end of the semester, if the student is not meeting the criteria, the RATING TERM BECOMES UNSATISFACTORY.

Students will demonstrate consistently, behaviors as follows but not limited to:

• Delivers nursing care in a timely manner.
• Organizes care in a way which reflects priorities.
• Adheres to agency policies and procedures.
• Upon arrival to the unit and when leaving the unit, reports to nurse assigned to patients.
• Communicates effectively with the RN assigned to the patient.
• Obtains supervision of and authorization of faculty for the performance of procedures.
• Seeks assistance when needed.
• Provides for patient safety (side rails, bed position, call bell).
• Makes competent clinical judgments.
• Promptly reports changes in patient’s physical and emotional condition to faculty and to assigned staff.
• Responds quickly and effectively to sudden changes in patient condition.
• Checks the patient’s medical record frequently for changes in orders.
• Documents care given and/or not given.
• Adheres to procedures for medication administration.
• Demonstrates knowledge of specific drugs to be administered.

• Reports as assigned time to clinical experiences and post conferences.
• Demonstrates adequate preparation for clinical.
• Works with peers and agency staff in professional manner.
• Dresses in appropriate professional attire.
• Maintains professional interactions with others in patients/families.
• Turns in assignments when due.
• Uses appropriate nursing terminology in reporting, documenting, and conferencing.
• Notifies faculty when leaving clinical areas.
• Arranges for coverage when off the clinical unit for any reason.
• Demonstrates knowledge of nursing standards of care.
• Adheres to policies and procedures found in N.C. A&t School of Nursing Student Handbook.
• Notifies faculty when there is a need to be late or absent from clinical activities.
• Accepts constructive criticism and praise in a professional manner.
• Utilizes feedback appropriately to correct and/or improve performance.
• Demonstrates caring behaviors with patients and families.

11/96; Revised 7/98; Reviewed 12/99; 5/00

U S U S

1. Clinical Performance CriteriaMidtermMidtermFinalFinalIncorporate concepts of family dynamics when applying the nursing process for the childbearing family.

1. State roles of family members Analyze family relationships
2. Identify family strengths and limitations and their impact on situational and maturational crises.

1. Use the Nursing Process to plan, implement and evaluate care to meet the needs of members of the childbearing family.

1. Collects data in four adaptive modes: 1) physiological; 2) self-concept; 3) interdependence; 4) role function.
2. Analyze data consistently to formulate nursing diagnosis for client/family including growth and developmental level of childbearing family.
3. Formulate short term/long term client/family goals, which include growth and development.
4. Devise a nursing care plan of care to guide intervention specific to needs of client/family.
5. Implement nursing interventions based on:

1. Scientific principles and rationales
2. Research findings
3. Developmental stages
4. Legal guidelines

1. Evaluate if child/family goals have been achieved.
2. Modify nursing interventions based on evaluation of child/family goals.

1. Assumes the role of the advocate when caring for the childbearing family.

1. Acts as a beginning advocate for the child/family.

Identify resources to the agency and the community to meet the needs of the child/family as indicated.

Evaluation Tool for Nursing 501: Nursing Care of the Childbearing Family Practicum

U S U S

2. Clinical Performance CriteriaMidtermMidtermFinalFinalProvide client/family teaching on appropriate level.

1. Assumes responsibility and accountability for nursing care actions.

1. Apply standard of care for child/family.
2. Consistently demonstrates professional behavior.
3. Adheres to safety guidelines of the agency and the School of Nursing.
4. Uses therapeutic communication skills in interacting with: 1) client/family; 2) members of the health team.
5. Evaluate own performance objectively.

______________________________________________________________________________________

Midterm Evaluation Date_______________ Midterm S or MI

Faculty Comments: Faculty Signature_____________________________

Student Comments: Date________________ Student Signature____________________________

Final Evaluation Date_______________ Final S or MI

Faculty Comments: Faculty Signature_____________________________

Student Comments: Date________________ Student Signature____________________________

Grade = Pass Fail (Circle one.)

• Use the nursing process to achieve mutually agreed upon priorities and goals with the childbearing family.
• Apply standards of practice to develop a safe plan of care.
• Influence families in understanding and coping with developmental and situational crises during childbearing.
• Develop proficiency in psychomotor skills.
• Collaborate with nurses and others in using community resources to provide care to childbearing families.
• Use research findings in and evaluation of current practice.
• Demonstrate client advocate.
• Demonstrate responsibility and accountability for nursing care action.

Each unit has specific objectives yet addresses all course objectives as listed above.

• Perform general family assessment
• Perform physical, psychosocial, environmental, and cultural assessment of the family
• Accurately state a diagnosis of actual and/or potential needs/alterations
• Incorporate individual and family strengths into care plan for the childbearing family.
• Specify scientific rationale for nursing actions concerned with the childbearing individual and family
• Initiate mechanisms for appropriate consultation referral to community resources and follow-up for the childbearing family

1. Nursing Care and the Family (Adaptive modes: Role function, self-concept, interdependence)

1. Assessment

1. Family Identification

1. Composition
2. Social history
3. Community and neighborhood

1. Individual and Family Data

1. Health history
2. Family dynamics

1. Family Strengths

1. Ability to maintain health life style
2. Ability to provide for family’s physical, emotional, spiritual and cultural needs
3. Child-rearing practices and discipline
4. Communication
5. Support, security and encouragement
6. Growth-producing relationships
7. Responsible community relationships
8. Self-help and accepting help
9. Flexibility of family functions and roles
10. Crises as a means of growth
11. Family unity, loyalty and intra-family cooperation

1. Analysis/Nursing Diagnosis, e.g., Family processes, productive; Coping, effective family; Family functioning, satisfactory

 

2. Planning

1. Set goals, e.g. adequate family coping patterns; open communication patterns; and responsible childbearing practices
2. Set priorities

1. Implementation, e.g. coordinate care with others including community resources; client/family teaching; and discharge planning.
2. Evaluation, e.g., client/couple discusses options available; mutually participates in the decision-making process; family is coping effectively; and family is functioning satisfactorily.

Pre and Post conferences

Clinical assignment

Interview assigned client and family using family assessment guide

Skills: Interviewing techniques

• Identify physiological parameters of growth.
• Plan care to maintain and enhance growth and development.
• Serve as client advocate.

1. Factors which influence growth

1. Assessment

1. Genetic pattern
2. Nutrition
3. Environment

1. Analysis/Nursing Design

1. Knowledge deficit related to nutritional needs at various ages
2. Altered growth patterns related to child abuse

1. Planning

1. Establishment of goals

1. Promote normal growth and development
2. Maintain a safe environment

1. Implementation

Graph height, weight, etc. in well-child clinic or head start program

Observe nutritional counseling during WIC visit at child/youth clinic

Review text: Chapter 7 Physical and Developmental Assessment of the Child

• Assess growth and developmental patterns of individuals and families.
• Interpret data from laboratory and integral assessment.
• Accurately state a diagnosis of the actual and or potential needs/alterations.

• Incorporate all available resources into the plan of nursing care.

• Incorporate individual and family strengths into care plan for child and family.

• Specify scientific rationale for nursing actions concerned with the child and family.

• Initiate mechanisms for appropriate consultation, referral to community resources and follow-up.
• Performs appropriate anticipatory guidance for families with infants.
• Uses principles of parent education.
• Perform specific skills safely, efficiently and effectively
• Document all actions performed in care of clients/families
• Evaluate the progress of the client/family as a basis for revising

1. Review development of the urinary system.
2. Factors impairing the function of the urinary system.

1. Nutritional intake
2. Digestion/absorption abnormalities

1. Nursing Process and the infant with fluid and electrolyte imbalance (Adaptive modes: role function, physiological interdependence and self-concept)

1. Assessment

1. Etiology/pathophysiology. Nausea/vomiting, diarrhea, fever, congenital malformations.
2. Subjective data

1. Health history

1. Nutritional intake
2. Digestion
3. Absorption
4. Elimination
5. Family hx
6. Medical hx

1. Objective data

1. Physical examination

1. Skin
2. Abdomen

1. Developmental assessment
2. Diagnostic studies

B. Analysis/Nursing Diagnosis

1. Alteration in nutritional intake related to congenital malformation.
2. Potential disturbance in meeting developmental task related to failure to thrive.

C. Planning

1. Establishment of goals

1. To maintain and retain fluid and electrolyte balance.
2. To enhance growth and development.

1. Implementation of priorities

D. Implementation

1. Provide support related to emotional responses of family.
2. Initiate parent teaching related to measures to enhance growth and development.

E. Evaluation

1. Reassessment of nursing care actions i.e., what is the infant’s fluid status?
2. Plan modification as needed.

A parent/teaching plan.

Skills: Weight, length, head and abdominal circumference.

.Applies current research in planning care for child/family.

Pre and post conference

Assigned client in outpatient and /or hospital setting

Review text: Chapter 21, Family Centered Care of the Child

During Illness & Hospitalization

Read: Textbook, Chapter 1

Measure specific gravity of urine.

Methods of collecting urine specimen.

PRIOR TO CLINICAL:

View: "Physical Assessments of Infants"

Read: Textbook, pp. 38-50

Review text: Chapter 10, Helth Promotion of the Infant and Family

Developmental assessment of assigned client.

• Perform physical, psychosocial, environmental and cultural assessment of the toddler with respiratory dysfunction.
• Interpret data from laboratory and diagnostic test performed.
• Accurately state a diagnosis of actual and or potential needs/alterations.

• Incorporate all available resources into the plan of nursing care.
• Incorporate individual and family strengths into care plan.
• Specify scientific rationale for nursing actions concerned with the toddler client.
• Initiate mechanisms for appropriate consultation, referral to community resources and follow-up.
• Perform appropriate anticipatory guidance for family with a toddler.
• Use principles of teaching.
• Perform specific skills safely, efficiently, and effectively.

1. Review normal respiratory function.
2. Common respiratory tract alterations.
3. Nursing process and the toddler client with respiratory dysfunction. (Adaptive modes: role function, physiological interdependence and self-concept).

1. Assessment

1. Etiology/pathophysiology e.g., asthma, RSV, Cystic Fibrosis.
2. Subjective data

1. Health History

1. Behavioral response to respiratory distress.
2. Neonatal history
3. Family history

1. Objective data

1. Physical assessment of chest

1. Auscultation
2. Percussion

1. Diagnostic studies, e.g. respiratory function test

B. Analysis/Nursing Diagnosis

1. Alteration in comfort related to anxiety of client/family.
2. Anticipatory guidance related to measures which decrease transmission of respiratory tract infections.

C. Planning

1. Establishment of goals

1. Facilitate transportation of 02 to body cells.
2. Preventive measures using anticipatory guidance.

D. Evaluation

1. Reassessment of nursing actions e.g. auscultation of chest.

Skills:

1. Assess breath sounds
2. Pulmonary hygiene

Pre and Post conferences

Assigned pediatric client

Collaborate with team members to plan and manage care activities for assigned clients.

Review text. Chapter 14, Health Problems of Toddlers

Tingley, S. (2000). Care of the patient with cystic fibrosis. Advance for Nurses (Jan. 2000), 11-13.

• Perform physical, psychosocial, environmental, and cultural assessment of the preschool/school-aged client.
• Interpret data from laboratory and diagnostic tests performed in preschool/school-aged period.
• Accurately state a diagnosis for actual and or potential needs/alterations.

• Incorporate individual and family strengths into care plan for preschool/school-aged clients.
• Specify scientific rationale for nursing actions concerned with the preschool/school-aged client.
• Provide appropriate anticipatory guidance for family with preschool children.
• Use principles of teaching/learning.
• Performs skills safely, efficiently, and effectively.
• Document all actions performed in care of the preschool/school-aged client.
• Evaluates the progress of the child and family as a basis for revising the nursing care plan.

1. Nursing Process and the Pre-school/School-aged Client (Adaptive Modes)

1. Assessment

1. Etiology/pathology

1. Blood dyscrasia
2. Common surgical conditions

1. Subjective data

1. Emotional status
2. Energy level
3. Developmental level

1. Objective data

1. Physical screening

1. Eye
2. Dental
3. Skeletal
4. Cognitive

1. Diagnostic studies/nursing implications
2. Well child assessment

1. Analysis/Nursing Diagnosis

1. Knowledge deficit
2. Alteration in family processes
3. Altered thought processes

1. Planning

1. Establishment of goals

1. Preparation for procedures.
2. Fear relieved and general comfort reestablished.

1. Implementation

1. Provide education about physiologic changes.
2. Provide comfort measures.
3. Diversion therapy.

1. Evaluation

1. Reassessment of nursing actions, e.g. reduction of fear and enhance development.

Pre and post conferences

Assigned pre-school clients in acute care or ambulatory settings.

Review text: Chapters 13 & 14, Information Related to Preschoolers

Nursing care plan

Attend unit reports (shift report, family care conference and discharge planning).

Prepare child and family for procedures.

Post conference. Develop plan of care sharing research findings with health team members.

Review text: Chapter 15: Health Promotion of the School Age Child; Chapter 17:Information Related to School Age Children

• Perform physical and behavioral assessment of the adolescent.
• Interpret data from laboratory and diagnostic tests performed on adolescent.

• Accurately state a diagnostic for actual or potential need/alteration.
• Incorporate individual and family strengths into care plan for adolescent.
• Specify scientific rationale for nursing actions concerned with the adolescent.
• Initiate mechanisms for appropriate consultation/referral to community resources and follow-up.
• Use principles of teaching specific to the family with an adolescent.
• Perform skills safely, efficiently, and effectively.
• Document all actions performed in care of the adolescent with written record.
• Evaluate the progress of the adolescent client as a basis for revising the nursing care plan.

1. Review development of the musculoskeletal and reproductive systems.

1. Alteration in hormonal level
2. Behavioral alteration
3. Common alterations e.g., scoliosis and osteomyelitis

1. Factors influencing developmental changes.

1. Family interaction
2. Peer pressure
3. Physiological changes
4. Environment

1. Nursing Process and the Adolescent (Adaptive modes: role function, physiological interdependence and self-concept)

1. Assessment

1. Etiology and Pathology
2. Subjective data: Health hx, body image
3. Objective data: Physical assessment (posture), Musculoskeletal; Diagnostic studies/Nursing implication, e.g. Hematology – Hbg and Hct

1. Analysis/Nursing Diagnosis

1. Potential for altered development
2. Ineffective hormonal regulation

1. Planning

1. Establishment of goals

1. Provide support for the adolescent transition to adulthood.
2. Provide freedom from trauma such as injury or infection.

1. Prioritize goals

1. Implementation of nursing action

1. Ensure continuous assessment and protection against infection or trauma, in case of an emergency.
2. Promote socialization and peer interaction.

1. Evaluation

1. Reassessment of nursing actions, e.g., family/peer communication, positive self-image.

Skills:

1. Teach auto safety measures.
2. Perform scoliosis screening of adolescent.
3. Demonstrate appropriate discharge teaching.

Charting

Field trip to rehabilitation areas, e.g., support group physical therapy, education unit.

Hohenhaus, S.M. (2000). Nursing in a crime scene. Advance for Nurses (Jan. 2000), 21-22.

• Obtain general, reproductive, and pregnancy histories from individuals and families.
• Conduct interviews to elicit individuals and family’s understanding of pregnancy.
• Interpret data from laboratory and diagnostic tests used in the antenatal period.
• Accurately state a diagnosis of the actual and or potential needs/alternations.
• Discuss issues related to home care of the antenatal client.

• Incorporate all available resources into the plan of nursing care.
• Incorporate individual and family strengths into care plan for antenatal client.
• Specify scientific rationale for nursing actions concerned with the antenatal client.
• Initiate mechanisms for appropriate consultation, referral to community resources and follow-up.
• Performs appropriate anticipatory guidance for antenatal clients.
• Use principles of teaching.
• Perform specific skills safely, efficiently and effectively.
• Document all actions performed in care of antenatal client with written records.
• Evaluate the progress of the antenatal client as a basis for revising the nursing care plan.
• Develop a realistic time plan for achievement of the childbearing family’s goals that is consistent with feedback.

1. Assessment

1. Etiology and Pathophysiology
2. Subjective Data

Health history, e.g., family history; medical history; sexual and obstetrical history; present pregnancy; perceptions concerning pregnancy; patterns of coping and interacting

3. Objective Data

1. Physical Assessment, e.g. palpate uterus; examine breasts
2. Diagnostic studies/nursing implications, e.g., urinalysis

1. Analysis/Nursing Diagnosis, e.g. Potential for anxiety related to the expected course of pregnancy; disturbance in self-concept (potential)
2. Planning

1. Establishment of goals, e.g. express feelings openly; negative feelings about self-concept are recognized as temporary.
2. Implementation of priorities.

1. Implementation, e.g. provide support related to emotional responses or problems; initiate discussions related to woman’s self-concept; client/couple teaching.
2. Evaluation, e.g. client/couple verbalizes facts related to the antenatal period; expectant mother verbalizes concerns about her changing body and demonstrates a positive self-image by maintaining an overall satisfactory appearance.

View: "Assessment of the antenatal client"

Pre and post conferences

Assigned antenatal client in outpatient and/or hospital setting.

Ambulatory experiences packet readings and follow-up evaluation

Nursing care plan

Develop and implement a teaching plan

Skills: Vital signs, fetal heart tones, antenatal and postnatal assessment

Screening: Early detection, measurements and tests; AFP, GTT, Rho-Gam-prenatal; selected lab and diagnostic tests

Charting

Read: (1)Barton, J. (1997), When your patient is pregnant: A Guide for the medical surgical nurse, AJN, 97(3), pp. 16F-16J.

(2) Kopelman, L. (2000). Back on the job. Advance for Nurses (Jan. 2000), 18-19.

(3). Breen, O. (2000). DVT: What every nurse should know. RN, 63(4), 58-63.

• Perform physical, psychosocial, environmental and cultural assessment of the intrapartal client.
• Interpret data from laboratory and diagnostic test performed in the intrapartal period.
• Accurately state a diagnosis of actual and/or potential needs/alterations.

• Incorporate all available resources into the plan of nursing care.
• Incorporate individual and family strengths into care plan for intrapartal client.
• Specify scientific rationale for nursing actions concerned with the intrapartal client.
• Initiate mechanisms for appropriate consultation, referral to community resources and follow-up.
• Performs appropriate anticipatory guidance for intrapartal clients.
• Use principles of teaching.
• Perform specific skills safely, efficiently and effectively.
• Document all actions performed in care of intrapartal client with a written record.
• Evaluate the progress of the intrapartal client as a basis for revising the nursing care plan.

1. Nursing Process and the Intrapartal Client (Adaptive modes: Physiologic, self-concept, interdependence)

1. Assessment

1. Etiology and Pathophysiology
2. Subjective data

Health history, e.g. prenatal record

3. Objective data

1. Physical assessment, e.g. vaginal discharge; cervical dilatation; uterine contractions; ROM
2. Diagnostic studies/nursing implications, e.g. fetal/maternal monitoring

1. Analysis/Nursing Diagnosis, e.g., comfort, alteration in, related to uterine contractions/bedrest; relaxation pattern, ineffective.
2. Planning

1. Establishment of goals, e.g. control over discomfort; support person(s) participates in supporting relaxation.

1. Implementation

1. Provide comfort measures.
2. Work through a number of contractions noting effectiveness of method of relaxation. If none used, introduce techniques.
3. Client/family teaching.

1. Evaluation, e.g. discomfort is minimized; client and fetus are free of side-effects from analgesic drugs, if administered; appropriate breathing/relaxation techniques are maintained.

Nursing care plan

Videos: Labor & Delivery: The LDR M087;Techniques for Supporting the Labor…;Cesarean Delivery M088l Labor & Delivery Augmentation M086; The Bonding Birth Experience; Universal Precautions

Skills:

1. Assessment of uterine contractions
2. Identify normal fetal monitor tracings
3. Monitor fetal heart tones
4. Measure vital signs and blood pressure
5. Use Leopold’s Maneuvers
6. Assess vaginal discharge
7. IV therapy
8. Catheterization
9. Charting

Pre and post-conference

Assigned intrapartal client

Corrine, Lietalk, (1998), The unheard voices of women: Spiritual interventions in maternal child health. MCN, 17 (3), pp. 141-145.

Keith, C., Lewallen, T., & Layton, J. (2000). Holistic caring for the PIH patient. Advance for Nurses, 2(8), 8-10.

• Perform physical, psychosocial, environmental and cultural assessment of the postpartum client.
• Interpret data from laboratory and diagnostic test performed in the postpartum period.
• Accurately state a diagnosis of actual and/or potential needs/alterations.

1. Assessment

1. Etiology and Pathophysiology
2. Subjective Data

Health History, e.g. labor and delivery record

3. Objective Data

1. Physical Assessment, e.g. vital signs; fundus/lochia; perineum, bladder; breasts; legs; bowels, psychological factors
2. Laboratory studies/nursing implications, e.g. Hb/Hct, CBC, UA

1. Analysis/Nursing Diagnosis, e.g. knowledge deficit; alteration in comfort: pain

 

2. Planning

1. Establishment of goals, e.g. effective parent education; pain relieved and general comfort reestablished.

3. Implementation, e.g. provide education about physiologic changes, infant care, etc., provide comfort measures.
4. Evaluation e.g. client verbalizes understanding of physiologic changes after delivery; client uses appropriate interventions to manage discomfort and verbalizes lessening of discomfort.

Pre and post conferences

Assigned postpartum clients

Nursing care plan

Skills:

1. Eight point check
2. Patient teaching

Documentation

Russell, R. & Champion, V. (1996). Health beliefs and social influence in safety practices of mothers with preschool children. Image, 28 (1), pp.59-64.

Pyle, D.M. (1999). Pre-eclampsia. Advance for Nurses, (Dec. 27, 1999), 20-21.

• Perform physical, neurologic and behavioral assessment of the neonate.
• Interpret data from laboratory and diagnostic test performed on the neonate.
• Accurately state a diagnosis of actual and/or potential needs/alterations.

• Incorporate individual and family strengths into care plan for neonate.
• Specify scientific rationale for nursing actions concerned with the neonate.
• Initiate mechanisms for appropriate consultation, referral to community resources and follow-up.
• Performs appropriate anticipatory guidance for neonatal clients.
• Use principles of teaching.
• Perform specific skills safely, efficiently and effectively.
• Document all actions performed in care of neonatal client with a written record.
• Evaluate the progress of the newborn client as a basis for revising the nursing care plan.

4. Nursing Process and the Neonate (Adaptive modes: physiologic, interdependence, and role function)

1. Assessment

1. Etiology and Pathophysiology
2. Subjective Data

Health History, e.g. apgar scoring

3. Objective Data

1. Physical Assessment, e.g. neurological testing
2. Behavioral assessment, e.g. Brazelton Neonatal Behavioral Assessment (BNBAS)
3. Diagnostic studies/nursing implications, e.g. Guthrie inhibition assa

1. Analysis/Nursing Diagnosis, e.g. gas exchange, alteration in (potential); body temperature, alteration in (potential)
2. Planning

1. Establishment of goals, e.g. provide support for the infant’s transition from intrauterine to extra-uterine life; provide freedom from trauma such as injury and infection.
2. Identification of priorities

1. Implementation, e.g. ensure continuous assessment and protection against infection or trauma, and care in case of an emergency; stabilizes newborn’s temperature.
2. Evaluation e.g. respiratory rate remains WNL; no signs of respiratory distress occur; temperature remains WNL; Infant is free of signs of cold stress or hyperthermia.

Nursing care plan

Skills:

1. Assess gestational age
2. Teach bottle feeding/breastfeeding/burping techniques
3. Perform and teach care of genitalia
4. Perform and teach holding and carrying techniques
5. Teach infant safety measures
6. Demonstrate proper newborn thermo-regulation techniques
7. Maintain airway of neonate
8. Administer oral and parenteral medications
9. Assess vital signs
10. Perform physical screening of neonate
11. Demonstrate appropriate discharge teaching, charting
12. Handout: Descriptive
13. Maternity campus lab (Handouts)

Documentation

Varnell, M. (2000). Sudden infant death syndrome. Advance for Nurses, (Jan. 24, 2000), 14-15.

Krisher, R. (2000). Computerized charting in your future. Advance for Nurses, 2(7), 8-10.

Forback, C. (2000). The laboratory at the bedside. Advance for Nurses, 2(7), 26.

Revised 7/30/96 PPL/SH/pl; 6/23/97 SH/SW/pl; 7/98 SW/lfb; 12/99PPL/ppl; 5/00PPL

NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY

SCHOOL OF NURSING

Student’s Name___________________________________

Family’s Name ___________________________________

Date _________________________

I Identifying Date

1. Family Composition:

Number of ages and names of family members

1.

2.

3.

(Use last page if more room is needed)

2. Family Form:
3. Culture
4. Religious Orientation:
5. Social Class Status:

Occupation:

6. Social Class Mobility:
7. Social History
8. Stressful Situations:

1. Environmental Data

1. Home:
2. Safety:
3. Health Care:

1. Family Structure:

 

 

 

 

 

2. Family’s Developmental Task(s)

Identified Family Problems (List according to priority):

Goals of Care:

Family’s Plan of Care:

Additional Items;

Ambulatory Objectives for Maternity

Evaluation of Ambulatory Experience(s)

Ambulatory Objectives for Child Health

NPP (Nursing Prescriptive Plan) Requirements

Clinical Assessment Tool

Handouts

Family APGAR Questionnaire

Double ABCX Model (Family Adaptation Mode)

Assessing My Culture (C. Jackson)

Family Strength Index

Family Crossword Puzzle

Checklist for Violence Prevention (2 pages front/back)

Study questions for Labor and Delivery

To evaluate your understanding of this content answer the following questions in the space provided.

When do Braxton-Hicks contractions occur?

Which physiologic events and maternal behaviors characterize the active phase (mid phase) of the first stage of labor?

How does maternal behavior change during the second and third stages of labor?

What is the primary activity during the fourth stage of labor?

How should the nurse intervene if the client’s blood pressure drops during labor or delivery?

What are the six (6) mechanisms of labor?

Which fetal characteristics affect labor?

How does the maternal respiratory system respond during labor>

What are three (3) advantages of external electronic fetal monitoring?

What are four (4) disadvantages of internal electronic fetal monitoring?

What are the three (3) phases of a uterine contraction?

What causes variable decelerations of fetal heart rate?

When is a cesarean delivery indicated?

Readiness for induction depends on which factors?

What methods can be used to induce labor?

How should the nurses manage a client with a prolapsed umbilical cord?

What is the most common tocolytic agent?