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RARITAN VALLEY COMMUNITY COLLEGE

ACADEMIC COURSE SYLLABUS

 

NURSING THE CHILDBEARING FAMILY

Nurs 125

I.  Overview

    A.  Semester Credit Hours: 4

    B.  Weekly Contact Hours: Lecture 4.  Clinical Laboratory 12

    C.  Prerequisites:  Foundations of Nursing, Nursing of Adults I, and Anatomy and Physiology I and II.      Principles of Microbiology

         Corequisites:    Trends in Nursing and Elective

    D.  Catalog Description:  

 II.   Basic Course Information

A.      Course Number and Title: Nurs 125 – Nursing of the Childbearing Family

B.       Sponsoring Department:  Health Science Education

C.       Semester Credit Hours: 4

D.      Weekly Contact Hours:  Lecture -  4.  Clinical Laboratory – 12

E.       Prerequisites:  Foundations of Nursing , Nursing of Adults I (or Nursing Transitions), Psychiatric Mental

      Health Nursing , Anatomy and Physiology I and II, Principles of Microbiology.

F.   Co-requisites:    Trends in Nursing and free elective

  III.  Catalog Description:

      The course focuses on nursing care during the Childbearing experience and  considers the health needs of mothers, newborns, and supportive networks in the local and global community.  Addresses  normal events of    childbearing, common problems of mothers and infants, and common complications that occur  to mothers and infants during the childbearing cycle.  Students develop clinical skills in labor and delivery and postpartum units, newborn nurseries, and prenatal clinics.  The nursing process is the vehicle for responding to human needs and evidenced wellness states.  A service learning experience and/or honors section is optional.  Four lecture hours and  twelve clinical hours.  A satisfactory clinical evaluation and a theory grade of “C” is  required for  progression in the program.

Useful Websites:

  1. http://www.depressionafterdelivery.com

  2. http://www.radiantmother.com

  3. http://www.preemieparentsupport.com 

IV   Course Objectives :  Upon successful completion of the course, a student should be able to:

Function As a Provider of Care

1. Integrate holistic human needs in the provision of a safe and effective care environment.

            1.1.   Provide direct and basic care and comfort that meets holistic human needs  for families during the Childbearing Cycle.

            1.1. a.  Assess client’s needs considering cultural, environmental, physical, psychosocial, and spiritual factors in the local and global community.

1.1. b.  Differentiate specific parameters of normal physiologic/psychological changes from alterations in wellness.

1.1.c      Formulate likely nursing diagnosis (e.g. pain during labor, potential for hypothermia in neonate,  ineffective breastfeeding related to maternal discomfort)

1.1.d.  Design outcome objectives that are measurable, specific, individualized and have a target date for achievement.

1.1.e   Plan specific nursing actions to achieve these outcome objectives.

1.1.f.  Defend nursing actions with scientific rationale.

1.1.g. Evaluate expected outcomes and nursing actions and recommend on going course of action.

1.1.h. Prioritize nursing actions when providing direct care to clients and families.

 

            1.2.  Demonstrate caring behaviors when delivering basic care and comfort measures

            1.3.  Implement safety and infection control measures to reduce risk potential

    2.  Employ critical thinking in clinical decision making when maintaining physiologic and psychosocial integrity.

      2.1.  Use critical decision making accurately in solving problems as a provider of care with individuals and families during the childbearing cycle.

      2.2.  List and discuss clinical problems and formulate possible solutions during clinical practice and post conference.

      2.3.  Accurately evaluate changes in health care status, report to staff and faculty in a timely manner.

3.  Collaborate appropriately with members of the health care team for the effective provision of care.

        3.1.  Communicate effectively with clients, families and health team members.

        3.1.a.  Establish therapeutic relationships with clients through effective communication to foster resolution of problems, to impart knowledge and to answer questions.

                  3.1.b.  Give complete and accurate reports on assigned client(s) to health team members.

                  3.1.c.  Aid with establishment of parent infant attachment.

                  3.1.d.  Analyze the effectiveness of interpersonal interactions.

                  3.1.e.  Utilize therapeutic communications skills when counseling clients and families.

                                            

3.2.  Consult and report information to health care team members effectively and in a timely manner.

4.   Construct therapeutic interventions when using the nursing process.

4.1.  Apply knowledge of pharmacotherapeutics  and medications commonly used  (classification, dosage, side effects, nursing implications, and client responses) and administer medications safely.

          4.2.  Evaluate nutritional needs, including multicultural aspects, and participate in therapeutic  interventions during the childbearing cycle to assist the client in maintaining wellness.

    4.3.  Demonstrate competence in psychomotor skill competencies and hygienic care based on scientific

           principles to provide  safe, effective, and comfortable care.

 

5.  Integrate principles of growth and development across the lifespan in the promotion and

      maintenance of health.

 

 5.1.  Outline client and family developmental levels and tasks to be accomplished.

 

6.  Utilize teaching/learning principles to improve outcomes when caring for clients at

     different levels of wellness.

         6.1.  Use client health teaching as a means of promoting behaviors which improve or maintain the

                   quality of health and life.

                 6.1.a.  Provide anticipatory guidance regarding changes and the needs of mothers, infants, fathers, and siblings at home.

                   6.1.b.  Teach correct principles, procedures and techniques of self care and infant care practices to mothers and to family members.

                   6.1.c.  Evaluate the infant care skills of parents.

                6.1.d.  Evaluate own role as teacher.

7.      Utilize and maintain established hospital and ANA clinical practice standards when planning and delivering care.

Function as a Manager of Care                                                                                          

8.  Synthesize concepts of community based care in the promotion and maintenance of health.

     8.1.  Describe community based health care agencies that are  needed to achieve expected outcomes.

 8.2.  Prepare a discharge plan to facilitate the hospital to community transition of  clients/families.

9.  Integrate concepts of health care delivery systems in the contemporary society to deliver effective care.

    9.1.  Manage the care of individual, groups, and families through direct or delegated care.                                 

9.1.a  Collect assessment parameters (data) and utilize them to assess the client(s).

9.1.b. Collect and assess subjective and objective data related to maternal and fetal health, including laboratory and diagnostic test results.

9.1.c. Distinguish specific manifestations indicative of pathophysiology.

9.1.d. Interpret data collected from clients, staff, and medical records to plan and implement nursing care.

9.1.e. Examine unusual financial, psychosocial, or physical constraints that prevent the family from caring for the infant

9.1.f. Critique your reactions to clients/families and identify how your reactions affect your assessment and  interaction. multicultural aspects of the local and global community in relationship to the childbearing cycle when planning  and managing client care

      9.1.g. Synthesize knowledge of multicultural aspects of the local and global community in relationship to the childbearing cycle when planning  and managing client care

      9.1.h. Validate your assessment through collaboration with family and health team members.

      9.1.i.  Formulate an individualized plan of care for the client/family by using the nursing process, assessment data, and revisions of the standard plan of care.

      9.1.j.  Distinguish which objectives were/weren’t met.

      9.1.k. Evaluate one’s own ability to manage client care.

      9.1.l. Analyze one’s own ability to utilize the problem solving approach.

  10.  Employ concepts of current trends in health care when planning and delivery client care.

       10.1.  Demonstrate knowledge and skills necessary to evaluate the health care delivery system.

        10.2.  Appraise the client’s ability to gain access to and utilize the health care delivery system and act as an advocate for the client/family.

        10.3.  Utilize research findings in approaching clinical problems

11.  Utilize appropriate communication techniques within the organizational structure and with clients and groups.

      11.1.  Consult with health team members/faculty when situation is beyond current knowledge or experience to identify practice limitations and seek assistance as necessary.

       11.2.  Examine adaptive responses which promote movement toward wellness or assist with adapting to limitations and handicaps in the neonate, or to acceptance of fetal-neonatal loss through the use of appropriate verbal or nonverbal communication skills.

 Function as a member within the profession of nursing

12.  Employ ethical behaviors, based on the Code of Ethics for Nurses, when providing care.

12.1. Critique ethical and legal issues which arise in this area of practice to explore such issues in clinical and classroom settings.

13.  Implement caring behaviors which respect the values, customs, and culture of diverse  populations.

    13.1.  Practice multicultural sensitivity when planning and providing care and counseling.

14.  Engage in activities for professional development, self growth, and life-long learning.

      14.1. Assess personal and professional strengths /limits and demonstrate evidence of self awareness  and self growth.

15.  Demonstrate accountability by following the legal guidelines for professional practice in the Rules and Regulations of the New Jersey Board of Nursing .

V.  Topical Outline                                                                                                                                 A. Introduction to Nursing the Childbearing Family

                 B.  Normal Pregnancy

                 C.  Normal Labor and Delivery

                  D.  Normal Newborn

                   E.  Maternal Complications

                               1.  Antepartal

                                2.  Intrapartal

                                 3.  Postpartal

                      F.  High Risk Newborn

                      G.  Fertility Management

                      H.  Adolescent Pregnancy and Age Related Concerns

VI.  Teaching Strategies:  

Lecture, Discussion, Video Cassettes, student presentations (contraception), nursing care plans, ethical dilemma paper (decision case model), optional study guides, anatomical models in nursing learning laboratory..

VII.  Papers, Examinations, and other Assessment Instruments

  A.  Clinical Performance:  will be evaluated as satisfactory or unsatisfactory on the basis of observed  performance and progress.  Clinical practice must be satisfactory or excellent for the student to successfully complete the course.

  B.  Grade Determinants  All are requirements and must be completed satisfactorily to PASS the       course.                           

     Ethical Dilemma Paper                                                                     5%

     Other written clinical work (required prior to final exam)                     P/F

     Quizzes (3)                                                                                       45%

    Final Examination                                                                               50%

    Total                                                                                                 100%

                                                                                                                                                                                                 

  C.     Criteria for Grading

D           60 to 74.99 (may not progress in nursing program)

           75  to 77.49 

 C+         77.5  to 79.99

 B-             80 to 87.49

B+          87.5 to 89.99

A            90 to 100

POLICY:  There will be no rounding up of  grades.

VIII.  Required Texts and Materials

       Textbooks:

       Lowdermilk, D. and Perry, S. (2004). Maternity and Women's Health Care. Mosby: St. Louis , Missouri .

       Lutz, C. and  Przytulski, K.  (1997) Nutrition and Diet Therapy. 3rd edition.  F.A. Davis. Phila. , Pa.

        Course Syllabus, Course Calendar, and Clinical Packet are available in College Book Store.  The Course Calendar and the Course Syllabus are available on line.

IX.  Resources

         Audiovisual/Articles:  Supplemental audiovisual materials.

        Study Guides: Optional study guides in course syllabus.

        Course Coordinators are available in their offices during office hours for review and/or remediation

        Models of Human Anatomy and the pelvis are available in the Learning Laboratory

        The course coordinators are available during their office hours for remediation.  Anyone who scores

        below 80% for his/her final grade is required to complete a remediation assignment within 2 weeks of course completion.

        Computer Lab:  NCLEX RN Review questions, Access to Internet resources

X. Limitations to Practice

           Licensure for the practice of professional nursing is regulated by the New Jersey Board of Nursing.

          Limitations to NCLEX-RN testing, licensure, and professional practice may occur for substance

           abuse/alcohol abuse or violations and conviction of any state or federal law involving moral turpitude

         or relating adversely to the nursing profession.  The nursing department chairperson or the Board of

          Nursing may be consulted for clarification of this area.

XI.  Student input is welcomed as part of the ongoing evaluation process.  Student representatives or individual students are encouraged to relay communication between his/her clinical group and the faculty members for the Nursing  the Childbearing Family course.

 

XII.  WITHDRAWAL/APPEAL:  The procedure for appealing an academic grade is available in Online, the

      Student Handbook .   You must continue to attend classes during the appeal process.If you wish to withdraw,

       please contact the department chairperson and the counseling center.  Students  may apply for up to one year

       Leave of Absence by completing the appropriate form which is available in the Counseling Center.
               

 

 

Course Requirements

Class Attendance

As per college policy, students are expected to attend all classes.  You are permitted an absence of ONE 6 hours clinical day and ONE 2 hour class lecture.  If  any excesses of these limits occur,  it is expected that the student will seek a conference with the appropriate clinical instructor or course coordinator to determine methods for the student to follow to successfully complete clinical objectives.  A critical incident report which outlines specific steps that the student must follow will be completed at the time of the conference.  A copy of this report will be sent to the course coordinator.  Students who do not seek a conference with the clinical instructor within one week after accumulation of 6 or more hours of clinical absence will be considered for administrative withdrawal from the program.  LATENESS:  A student will be marked absent if  he/she arrives more than 1/2 hour late to either class or clinical.   Students who are absent for more than two class periods will receive a 2 point reduction in their final class grade for each day that he/she is late.  If the instructor is notified appropriately of unavoidable circumstances, special consideration can be given.

 Course Policy - Quizzes

Quiz dates are provided on the course calendar.  Students are expected to take quizzes on the dates scheduled.  Only if students are absent from classes on the day of the quiz for illness or other serious reason,  will they be permitted to take the make-up quiz.  Students must call or leave a message with the department secretary or on the instructor’s voice mail prior to 10 AM on the day they are absent from class.  Make-up quizzes are to be arranged at the convenience of the lab assistant and must be completed as soon as possible, BEFORE the end of the next class day.  Students who fail to comply with this policy will receive a 0 for the quiz.  ONLY ONE make-up quiz is permitted per module.

The final exam for this module may not be taken until all the quizzes and course work have been satisfactorily completed by the student.

Written Requirements  -  Pass/Fail

1.  Preparation to safely administer medications commonly used in this clinical specialty is needed.

     A knowledge of generic name, dosage, routes of administration, pharmacological action, use, side

    effects,  and nursing implications is expected for the following medications:   Betamethasone, Methergine, Oxytocin,  Phytonadione, Rhogam, Promethazine, , Rh(D) Immune Globulin, Rubella vaccine, Magnesium Sulfate (IM and IV), Brethine, Dilaudid,  Percoset, Erythromycin (Ilotycin) Ophthalmic Ointment, Varicella Zoster Immunoglobin, , and Dulcolax.

    When assigned to labor and delivery, be prepared to answer questions related to the following medications:  Prostaglandin E, Prostin Gel, Cervidil, Sodium Bicarbonate, Narcan (Naloxone Hydrochloride), Butorphanol Tartrate(Stadol), Hemabate

2.  Two completed gestational age assessments on 2 newborns

3.  One completed maternal infant attachment tool. 

4.  One Labor and Delivery Study Guide.

5.  Postpartum Assessment Study Guide.

6.  Discharge Assessment Tool

7.  Care Plans:  A STANDARDIZED style care plan will be completed during the module on:

                                a.  a normal newborn infant

                                b.  a postpartum mother, either normal spontaneous vaginal delivery or caesarian section

                                c.  a mother who is experiencing labor

 

COMMUNITY   EXPERIENCES

1.  Childbirth/Parenting  Education  Classes -  Required that you attend at least 1 class

2.  Home Visit - Recommended.  MUST get permission of (1) the mother, and (2) clinical instructor.

       MUST visit in groups of 2 students.  Any potential health problems must be reported toclinical instructor and documented.  Complete home visit assessment form and this may substitute for a clinical day, if all other clinical objectives have been met.

3.        Morristown Memorial Hospital or St. Peter’s Medical Center - Neonatal Intensive Care Unit - sign up in class during first week.  Complete NICU form.  You will receive a compensation day for this experience, unless it occurs on a regularly assigned clinical day.

Written Requirement - Graded  -  ETHICAL  DILEMMA

Many complex ethical dilemmas exist  in Nursing of the Childbearing Family.  This assignment is designed to help students understand some basic beliefs about the issues, and  develop the skills to critically analyze approaches to resolving dilemmas.  This assignment is worth 5 points toward the final grade.

 The student will prepare a brief paper which investigates a relevant dilemma in the field of Nursing of the Childbearing Family. Begin with presenting  a hypothetical or actual case study, from your readings or experience.

 The format should include factors affecting ethical decision making, moral theories and frameworks, moral principles, and your own personal position on the issue they have selected

The format which MUST be used  is the ethical dilemma decision tree model.  This assignment will be graded by the following criteria:

   

ETHICAL DILEMMA PAPER GRADE  

  Total possible points Your score
Overall Scholarship: clear presentation of ideas, grammar, syntax, clarity of work, spelling. References must be from professional journals, unless otherwise approved; within last 5 years.

1.0

 
Complete data base.

1.0

 
Identify the ethical conflict created by the problem.  A dilemma exists when there is a need to choose between alternative actions that conflict with human needs or the needs of others.  Identify the choices and the ethical principle underlying  each choice.  EX. Not telling the truth takes away one's autonomy.

0.75

 
Outline the various courses of action.              

0.75

 
Determine the possible outcomes of the suggested actions.

0.75

 
Determine who owns the problem and who should make the decision.

0.25

 
Define the obligations of the nurse.

0.25

 
State your own personal course of action and the ethical principle underlying your choice. (Refer to Foundations text for underlying principles).

0.25

 
TOTAL

5.0

 

REFER TO SYLLABUS FOR DATE THAT FOCUS PAPER IS DUE.  1 POINT WILL BE DEDUCTED FOR EACH  LATE DAY.   Selected  papers may be presented on final class day. 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  

RARITAN VALLEY COMMUNITY COLLEGE

Course Evaluation - Maternity Nursing

 

Date:

Your evaluation assists with the development and revision in the course.  Please complete and submit at or before the final exam.

 

Please evaluate as poor, fair, good, very good the lecture and course calendar.

 

Content      

 Lecture                                                                   Course Calendar                                                                                  

 

1.  Introduction. to Maternity Care

 

2.  Pregnancy

 

3.  Labor and Delivery

 

4.  Post-Partum

 

5.  Complications of the Childbearing Cycle

 

6.  Newborn

 

7.  High Risk Newborn

 

8.  Fertility Management

 

II.  Videotapes

 

                  List those videotapes that were most helpful.

 

                  List those videotapes that were least helpful.

 

III.  Was the  course calendar useful? 

 

IV.  What did you gain from doing the ethical focus paper?

 

V.  Were you able to meet your clinical objectives satisfactorily.

 

                  Name the hospital that you were assigned to. 

                       _______________________________

                  1.  L and D

 

                  2.  Newborn Care

 

                  3.  Postpartum Care

 

VI.  What did you gain from the NICU experience?

 

VII.  Other suggestions.  Please use the other side of this page.

                                                                                                                                                                                                                                                                                                                        Unit 1                                                                                                                                                                                                                                                                                                                                                                                                                             

INTRODUCTION TO NURSING OF THE CHILDBEARING FAMILY

Concepts:

Current  trends and issues in Maternal-Newborn nursing practice are introduced, as well as the current roles of maternity nurses.  Pertinent statistical data and its significance are presented.  After reviewing statistics and contemporary practices, the unit focuses on selected theories related to family structure, development, and functioning.  Genetics, human sexuality, conception, and fetal development are reviewed.  This content provides a foundation for considering the needs and care required by a family  during the childbearing cycle.

Objectives:  The student will

1.   Summarize  evolving trends and issues in maternal-newborn nursing practice.

2.  Recognize the importance of the family  as a unit during the childbearing experience.

3.  Identify the main features and developmental stages of a family.

4.  Describe the various family structures in contemporary society.

5.  Identify social, economic, and cultural factors that influence family dynamics.

6.  Define common statistical tools related to maternal-newborn care and the ways these are used  to evaluate and implement change in health care delivery.

7.  Describe the components and development of  human sexuality.

8.  Identify and respect personal differences related to human sexuality.

9.  Describe the anatomy and physiology of the male and female reproductive systems.

10. Describe the characteristics and principles genetic disorders.

11. Describe and processes of conception and fetal development.

12.  Distinguish the differences between fetal and adult circulation.

  Unit II

Normal Pregnancy

Concepts:  Pregnancy is a time of profound change, both physical and emotional.  This period impacts not only on the woman but on her relationships with others.  This unit incorporates essential knowledge about changes of normal pregnancy.  The student is guided in understanding how these changes affect the woman, physiologically, emotionally, nutritionally, and socio-culturally.  The father, siblings, grandparents, and others who form a significant part of the mother’s support system are also considered,  This understanding forms the basis of utilizing the nursing process in caring for expectant families in the micro and macro community.

Objectives:  The student will

1.  Describe physiological changes that occur during pregnancy in the mother and the fetus.

2.  Understand the physical impact of pregnancy upon the woman and her family.

3.  Identify and describe presumptive, probable, and positive signs of pregnancy.

4.  Describe and utilize information on nutritional requirements during pregnancy.

5.  Relate the danger signs of pregnancy and alterations in wellness to their possible causes.

6.  Discuss values of various types of health care available during the antepartal period.

7.  Discuss basic information the nurse should provide to help the expectant family carry out appropriate self care.

8.  Teach comfort measures to the pregnant women in relation to:  rest and activity, clothing, hygiene, and minor discomforts.

9.  Describe communication and teaching skills that nurses utilize in providing antepartal education.

10.  Describe tests and procedures utilized to assess fetal status, including indications, contraindications, client teaching and preparation, predictive values of each, risk factors, and nursing interventions.

11.  Describe possible teratogenic effects of drug and alcohol on the fetus.

 

Unit III

Normal Labor and Delivery

(A mother’s meditation following the birth of her child:  I celebrate and welcome the new life that has come into mine.  Together we share in our private miracle.  I am filled with wonder and amazement.  After all this time of waiting, you are here.  Hello, dear child!)

Concepts:  The phenomena of labor and delivery is the climax of the entire childbearing cycle.  The intensity of  the physical and psychological  experience is unique to each family unit.  The maternity nurse must understand the physiological and psychological changes that occur during labor in order to assess, plan, and implement nursing care for the childbearing unit during the normal process of labor.  There is much variation among women in their reaction to the birth process and in their need for support during this critical experience.

Objectives:  The student will

1.  Discuss the relationship of the fetus to the pelvis during the normal process of labor.

2.  Explain the effect of the passageway, the passenger, the powers, and the psyche on the progress of labor.

3.  Describe the mechanism of labor (also known as the cardinal movements)

4.  Explain the difference between true and false labor.

5.  Identify the premonitory signs of labor.

6.  Discuss nursing assessments that maintain and or promote well-being of the mother and fetus during the birth process.

7.  Utilize knowledge of various methods of childbirth education in providing nursing care.

8.  Identify behavioral and physical changes that occur in each phase or stage of labor

9.  Acquire a beginning knowledge of  electronic fetal monitoring techniques used during the labor process.

10. Discuss nursing interventions appropriate for each stage of labor and delivery.

11.  Identify assessment of needs and care for the normal newborn infant immediately after delivery.

12.  Discuss the management of discomfort associated with labor and delivery.

13.  Describe and compare alternative birthing settings and care providers for childbirth.

 

Unit IV

The Postpartal Period

Concepts:  This unit focuses on the normal physiological adjustments which occur post-partally as well as the psychological changes which usually occur.  Students gain a normative nursing diagnosis, goals, and plans for intervention.  Bonding theory as well as a review of essential postpartum teaching provides students with knowledge on which to base nursing intervention.  Content previously introduced related to various family structure, interaction, and roles and the socio-cultural factors which effect life-style and adjustment to change are integrated into this unit.

Objectives:

1.  Describe physiological changes that occur in the puerperium.

2.  Identify the psychological changes of the postpartum period:  Taking In Phase, Taking Hold Phase.

3.  Discuss assessment and nursing management of  the postpartal family.

4.  Assess and utilize health teaching as related to the total family unit, and give anticipating guidance to parents.

5.  Utilize other members of the health team and outside agencies as indicated for a better transition  from hospital to home care.

6.  Summarize factors that influence the development of parent infant attachment.

7.  Identify specific measures of assessing parent-infant attachment.

8.  Describe possible approaches to follow-up care for the childbearing family.

                                                                                                                                                                 

Unit V

Normal Newborn        

Concepts: To begin life as a physiological, independent human being, the infant must rapidly assume responsibility for all major body functions.  The extrauterine adaptation of the newborn infant is far more complex than previously recognized.  The nurse must be aware of these biopsychosocial adjustments to effectively meet health needs of the newborn and his or her family.  Parent education, a second major area of nursing responsibility involved helping family members learn to care for its newest member.

Objectives:  The student will

1.        Describe physiological changes which take place in the newborn during the transition from  intrauterine to extrauterine life.

2.  Appraise characteristics of the newborn’s appearance, recognizing possible abnormalities of defects in structure.

3.  Determine the gestational age and neurological  maturity of various newborn infants.

4.  Identify normal reflexes present in the newborn.

5.  Identify and understand sensory and motor behavior of the neonate.

6.  Describe and utilize information on nutritional requirements during the neonatal period.

7.  Utilize comfort measures in caring for the newborn infant.

8.  Identify infants who are in the “high-risk” category utilizing available information and observational skills.

9.  Explain what is meant by a safe, comfortable environment.

10.  Understand and evaluate methods of infection control utilized in caring for the newborn.

11.  Assess and utilize health teaching about the newborn while working with parents as they indicate need and readiness.

12.  Discuss phototherapy and guidelines for parent teaching.

13. Explain circumcision:  purposes, methods, post-operative care and teaching, controversy.

14.  Review the physiology of lactation - breast development, stages of lactation, and maternal breastfeeding reflexes.

15.  Discuss breastfeeding and formula-feeding in relation to advantages, care of breasts, diet and  fluids, infant responses, and infant-related and maternal-related concerns.

16.  Explore culture aspects of breastfeeding.

17.  Utilize other members of the health team as indicated for a safe transition from hospital to home care.

   

Unit VI

Complications of the Childbearing Cycle          

Concepts:  The  maternity cycle is usually a normal experience for the childbearing unit.  The nurse’s role is to help the mother maintain her health throughout pregnancy, labor, and puerperium.  However, there are maternal conditions that predispose a mother and infant to an alteration in wellness resulting in an atypical response to pregnancy.  The maternity nurse is challenged to provide sound care that meets the unique maternal and fetal needs presented by these conditions.

Objectives:  The student will

1.  Identify the effects of pre-existing health deviations on pregnancy.

2.  Describe the major health disorders associated with pregnancy.

                a.  hypertensive states and maternal infections

                b.  hemorrhagic disorders

                c.  endocrine, cardiovascular, medical and surgical conditions

                d.  psychosocial conditions complicating pregnancy

3.  Identify nursing interventions for the various complications of pregnancy.

4.  Identify complications which can occur during  the intrapartal period and appropriate nursing   interventions for each.

5.  Identify nursing interventions for a mother experiencing premature labor and for a mother having a cesarean birth.

6.  Describe common postpartal complications and appropriate nursing interventions for each.

7.  Identify the psychosocial impact of complications during the childbearing cycle on the mother and her family unit.

Unit VII

The High Risk Newborn

Concepts:  The high risk infant is susceptible to increased mortality and morbidity due to a variety of factors.  By identifying high risk infants and implementing appropriate interventions as early as possible, potential consequences can be avoided or minimized.  All high risk infants share many similar problems.

The neonate with alterations from wellness requires specialized care and management.  Objective observations about the infant’s behavior must be evaluated and interpreted so that appropriate intervention can be instituted quickly.  An understanding of normal physiology, pathophysiology, and clinical observations form the foundation for effective nursing care.

Objectives:  The student will

1.  Identify and describe the characteristics and unique needs of the SGA, AGA, LGA neonate.

2.  Define the characteristics of the preterm neonate.

3.  Identify the physiological difference between a preterm infant and a full-term infant.

4.  Explain the effects of selected maternal health problems on the high risk neonate.

5.  Discuss the special needs of  support required for the family experiencing the crisis of  delivering a  high risk infant.

6.  Compare and contrast the various types of respiratory distress in the newborn based on clinical  manifestations.

7.  Discuss the components of nursing care for a newborn with respiratory distress syndrome.

8.  Differentiate between physiological jaundice and pathological jaundice and describe nursing management for each.

9.  Describe circumstances that must be present for the development of Rh and ABO incompatibility.

10.  Identify nursing responsibilities in phototherapy and exchange transfusion procedures.

11.  Discuss selected metabolic abnormalities including cold stress and hypoglycemia, and their effects on the neonate.

12.  Explain the theories, clinical manifestations, and nursing management of  necrotizing enterocolitis.

13.  Describe the clinical manifestations and nursing management of selected neonatal complications(intracanial hemorrhage, sepsis neonatorum, and  infectious diseases).

14.  Identify the nursing actions necessary to support family members dealing with the birth of an at-risk infant.

15.     Describe how the nurse helps meet the special needs  of family members experiencing loss and grief.

 

Unit VIII  

Fertility Management

Concepts:  This unit  explores fertility and infertility, two distinct but complimentary areas on the reproductive health spectrum.  It begins with contraceptive health care and then moves to health care for women and partners experiencing impaired fertility. Regarding contraceptive methods,  the unit stresses respect the couple’s right to decide about contraception based not only on contraception knowledge but also such factors  as culture, religion, sexual practices, and personal preferences.

Objectives:  The student will

1.  List common causes of  impaired fertility  and their treatments.

2.  Discuss ethical problems related to assisted reproductive technology.

3.  Compare and contrast the contraceptive methods available in the United States and discuss the mechanism of action, side effects, adverse reactions, pros and cons and effectiveness of  each method. 

4.  Discuss the alternatives available to a woman experiencing an unplanned pregnancy.

 

Unit  IX

The Expectant Family - Age Related Concerns

Concepts:  Age at the time of pregnancy may be a factor in a woman’s adjustment, both physically and psychologically.  This unit explores the special needs and concerns of  pregnant adolescent and of women who become pregnant after age 35.

Objectives:  The student will

1.  Discuss the incidence and cost of adolescent pregnancy.

2.  Compare and  contrast the developmental tasks of adolescence and of pregnancy.

3.   Identify common parental reactions to adolescent pregnancy.

4.  Discuss the nutritional concerns and needs of the pregnant adolescent.

5.  Describe factors that have contributed to the increased incidence of pregnancy in women over age 35.

6.  Relate the use of  the nursing process to the provision of effective care  for the older expectant couple.

 

  Authored by H. Jones

Last Update:1/15/04