PRACTICAL NURSING DEPARTMENT
PN 2002
Nursing of Mother and Infant
Credit Hours:
Schedule:
Two
Monday 8:00-10:00
Friday
8:00-10:00
8 weeks
Course Instructor: Jennifer Harmon, BSN, RN
PN Program
Office #: 391-3260
E-Mail:
jharmon@northark.edu
Spring 2014
SYLLABUS ACKNOWLEDGEMENT
Course:
___Nursing of Mother and Infant and Clinical II__________
Semester:
___Spring 2014__________________________________
I acknowledge by signing below that I have received the syllabus for the course indicated
above. I have reviewed the syllabus and understand the objectives of this course. Further,
I understand how my performance will be evaluated and how my final grade will be
determined. I am aware of my instructor’s office hours, and I know how to contact him or
her for help with and/or clarification of course contents or procedures.
_______________________________________________
(Student Signature)
_______________________________________________
(Date)
PRACTICAL NURSING PROGRAM
Course Title:
Nursing of Mother and Infant
Course Number:
PN 2002
Course Credit &
Time Allotment:
Course
Instructor:
Course
Description:
Rationale:
Audience for
the Course:
Course
Outcomes:
2 semester credit hours
Monday
8:00-10:00
Friday
8:00-10:00
8 Weeks
Jennifer Harmon, BSN, RN
This course introduces the principles of caring for the child-bearing
family. Content includes prenatal, labor, delivery and postnatal care of
the mother and infant. Concepts from Basic Nursing, Nutrition and
Pharmacology are integrated into the course as related to the nursing
care of the mother and infant.
January Class Pre-requisites: PN 1012, 1001, 1005, 1010, 1003, BIOL
1434 or 2214 and 2224. Co-requisites for Summer Semester: PN
2004, 2003.
August Class Pre-Requisites: PN 1001, 1003, 1005, 1010, 1012, BIOL
1434 or 2214 and 2224. Co-requisites for Spring Semester: PN 2004,
2008, 2012, 2014.
The purpose of this course is to introduce the students to the care of
the child-bearing family.
PN Program students who have successfully completed the first
semester of the PN Program including Fundamentals of Anatomy and
Physiology.
Upon successful completion of this course, the student will be able to:
1.
Analyze the physiologic, psychosocial and spiritual needs of
maternal/child patients with appropriate nursing interventions and
expected outcomes by utilizing the nursing process and critical
thinking skills. (Measured by analysis of case study and clinical
evaluation).
Course
Outcomes:
(continued)
2.
3.
4.
5.
6.
7.
8.
9.
Course Text:
Course
Resources:
Methods to
Facilitate
Learning:
Course Content:
Incorporate cultural and growth and development influences to
promote comprehensive care to maternal/child patients.
(Measured by case study and clinical evaluation).
Evaluate safety aspects to assure a safe environment and effective
care of the maternal/child patient. (Measured by case study and
clinical evaluation).
Distinguish between therapeutic and non-therapeutic
communication skills to facilitate effective interactions with
maternal/child patients, peers, faculty and health personnel.
(Measured by case study, classroom interactions and clinical
evaluation).
Employ legal and ethical responsibilities to enhance effective
decision-making when providing care to the maternal/child patient.
(Measured by case study, post-conference discussion and clinical
evaluation).
Justify the use of caring and professional behaviors to provide
comprehensive patient care to the maternal/child patient.
(Measured by post-conference discussion and clinical evaluation).
Integrate pharmacological and nutritional aspects appropriate to the
care of the maternal/child patient. (Measured by case study).
Analyze the organization, priority setting, and delegation of patient
care assignments in the maternal/child setting to provide safe
effective care. (Measured by patient assignment activity and clinical
evaluation).
Incorporates evidence-based practice to provide effective patient
care. (Measured by Patient Assignment Activities and Clinical
Evaluation).
Introduction to Maternity and Pediatric Nursing by Gloria Leifer.
Study Guide to Accompany Introduction to Maternity and Pediatric
Nursing by McKinney and Rosner.
Northark, Campus Libraries
Videos
The instructor will utilize a variety of teaching strategies to actively engage
the student to enhance learning and critical thinking including Lecture,
PowerPoint Presentations, Case Studies, Critical Thinking Exercises,
Games, Student response systems (clickers), muddiest point, one minute
papers, think-pair-share, fish bowl, etc.
Unit I:
Overview of Maternity Care
Human Reproductive Anatomy and Physiology
Prenatal Care
Prenatal Development
Prenatal Care
Complications During Pregnancy
2
Course Content:
(continued)
Course
Evaluation:
Unit II:
Labor and Birth Process
Nursing Care
Pain Management
Complications During Labor and Birth
Unit III: Postpartum Care
Family, Mother and Newborn Care
Complications Following Birth
Unit IV: The Newborn
The Term Newborn
Pre-Term and Post-Term
Congenital Malformations
A.
Unit Examinations
Test I: Chapters 1-4 Leifer
Overview of Maternity Care
Human Reproductive Anatomy & Physiology
Prenatal Care
Test II: Chapters 5-8 Leifer
Maternity Care
Labor and Birth
Test III: Chapters 9-11 Leifer
Postpartum Care
Women’s Health Care
Test IV: Chapters 12-14 Liefer
The Newborn
Test V: Comprehensive Final Exam
B.
Course Grade:
Completion of Miscellaneous Homework and Assignments (pop
quizzes, individual and group reports, study guide assignments,
etc.)
Unit Examinations
Homework Assignments
Comprehensive Final
35%
15%
50%
Refer to the Practical Nursing Student Handbook and semester
schedule for policies concerning daily assignments, tardiness, makeup work, dress code, academic integrity, student responsibilities and
ADA Statement.
3
Attendance:
It is the student’s responsibility to discuss any absences and the
possibility of make-up work with the instructor as soon as possible.
Students are expected to attend all class meetings and officially
withdraw from courses they are no longer attending. Instructors will
not withdraw a student from this course. Each tardy or absence
from class will be rounded to an hour or hours. A student may miss 4
hours of theory (classroom hours) for PN 2002 – Nursing of Mother
and Infant.
Final Note:
The stated schedule, assignments, and procedures in this course are
subject to change in the event of extenuating circumstances. Students
will be notified verbally or in writing of changes by the instructor.
4
OBJECTIVES
Upon completion of this course, the student will be able to:
A. OVERVIEW, ANATOMY & PHYSIOLOGY AND PRENATAL CARE
1. Contrast present-day concepts of maternity and child care with those of the
past.
CONTENT
A. Overview, Anatomy & Physiol-
ogy and Prenatal Care
5
1. The Past, Present and Future
a.
Past
1.
Europe
2.
United States
a) Government Influences
b)
Children’s Bureau
c)
White House Conferences
d) International Child of the Year
e)
Public Health Department
b.
Present
1.
Maternity Care
a)
Cultural Considerations
2.
Child Care
3. Health Care Delivery System
4.
Advanced Practice Nurse
5.
Nursing Process
6.
Critical Thinking
c.
Future
1.
Health Care Reform
2.
Healthy People 2010
3.
Documentation
4.
Community-Based Nursing
LEARNER ACTIVITIES
BEFORE CLASS:
Read: Leifer, Chapters 1-4.
DURING CLASS:
Lecture.
Complete and discuss critical thinking
questions in study guide, chapters 1-4.
Critical Thinking:
Caring for an Undernourished Preg nant Woman
OBJECTIVES
2. Review the anatomy & physiology of
the human reproductive system.
3. Describe the process of gametogenesis in human reproduction.
CONTENT
LEARNER ACTIVITIES
Read: Leifer, Chapter 2.
2. Anatomy and Physiology
a.
Puberty
1.
Male
2.
Female
b. Male Reproductive System
c. Female Reproductive System
d. Female Reproductive Cycle and Menstruation
e. Physiology of the Sex Act
1.
Male
2.
Female
3. Cell Division and Gametogenesis
6
4. Explain human fertilization and implan- 4.Fertilization
tation.
a.
Sex Determination
b. Tubal Transport of the Zygote
c. Implantation of the Zygote
5. Analyze fetal development and matura- 5. Fetal Development
tion of body systems.
a.
Cell Differentiation
b. Prenatal Developmental Mile-
stones
6. Summarize the development and func- 6. Accessory Structures of Pregnancy
tions of the placenta, umbilical cord,
a.
Placenta
and amniotic fluid.
b.
Umbilical Cord
7. Compare fetal circulation to circulation after birth.
7. Fetal Circulation
8. Differentiate the similarities and differences on the two types of twins.
8. Multifetal Pregnancy
Read: Leifer, Chapter 3.
OBJECTIVES
9. Investigate prenatal care for a normal
pregnancy.
10.Differentiate among the presumptive,
probable, and positive signs of pregnancy.
11.Describe the physiological changes
during pregnancy.
7
12.Analyze nutritional needs for pregnancy and lactation.
13.Evaluate the importance and limitations of exercise in pregnancy.
CONTENT
LEARNER ACTIVITIES
9. Goals of Prenatal Care
Read: Leifer, Chapter 4.
a.
Prenatal Care
b. Role of the LPN
c. Determining the Estimated Date of Delivery
10.Signs of Pregnancy
a.
Presumptive
b.
Probable
c.
Positive
11.Normal Physiological Changes in Pregnancy
a.
Reproductive System
b.
Respiratory System
c.
Cardovascular System
d.
Gastrointestinal System
e.
Urinary System
f. Integumentary and Skeletal Systems
12.Nutrition for Preganncy and Lactation
a.
Weight Gain
b.
Nutritional Requirements
c.
Recommended Dietary Allow-
ances
d. Recommended Dietary Intake
e. Special Nutritional Considerations
f. Nutrition During Lactation
13.Exercise During Pregnancy
a.
Elevated Temperature
b.
Hypotension
c.
Cardiac Output
d.
Hormones
e.
Other Factors
OBJECTIVES
CONTENT
14.Demonstrate patient education includ- 14.Evidence-Based Practice for
ing evidence-based practice related to Common Discomforts in Pregnancy
common discomforts of pregnancy.
15.Justify the nursing support of emotional changes that occur in a family
during pregnancy.
15.Psychological Adaptations to Preg-
nancy
16.Apply the nursing process in developing a prenatal teaching plan.
LEARNER ACTIVITIES
Complete a teaching plan for discomforts of
pregnancy, include evidence-based practice
for 3.
16.Prenatal Education
17.Calculate the expected date of delivery.
8
B. MATERNITY CARE, LABOR & BIRTH B. MATERNITY CARE, LABOR & BIRTH
1. Explain the use of fetal diagnostic tests 1. Assessmsent of Fetal Health
in women with complicated pregnancies.
2. Summarize antepartum complications, their treatment and their nursing care.
3. Analyze the management of concurrent medical conditions during pregnancy.
2. Antepartum Complications
3. Pregnancy Complicated by Medical Conditions
a.
Diabetes Mellitus
b.
Heart Disease
c.
Anemia
d.
Infections
4. Recognize environmental hazards that 4. Environmental Hazards
may adversely affect the outcome of
a.
Bioterrorism
pregnancy.
b.
Substance Abuse
c. Trauma During Pregnancy
BEFORE CLASS:
Read:Leifer, Chapters 5-8.
DURING CLASS:
Lecture.
Videos: “Normal Labor and Delivery” - 25
“Cesarean Section” - 25
Complete Critical Thinking Questions in
Study Guide, Chapters 5-8.
Elsevier Case Study - PN Gestational Diabetes
OBJECTIVES
CONTENT
5. Incorporate psychosocial nursing
5. Effects of a High-Risk Pregnancy on interventions for the woman who has a the Family
high-risk pregnancy and for her family. a. Disruption of Usual Roles
b. Financial Difficulties
c. Delayed Attachment to the Infant
d. Loss of Expected Birth Experi-
ence
6. Compare the advantages and disad 6. Child Bearing Settings
vantages for each type of childbearing a.
Hospital
setting: hospital, free-standing birth
b. Free-Standing Birth Center
center, and home.
c.
Home
9
7. Analyze specific cultural beliefs the
nurse may encounter when providing
care to a woman in labor.
8. Correlate how the four P’s of labor
interrelate to result in the birth of an
infant.
9. Categorize the normal processes of
childbirth: Premonitory signs, mechanisms of birth, and stages and phases
of labor.
10.Determine appropriate nursing care
and responsibilities for the intrapartum
patient, including the woman in false
labor and the woman having a vaginal
birth after a cesarean birth (VBAC).
7. Cultural Beliefs
8. Four P’s
a.
Powers
b.
Passage
c.
Passenger
d.
Psyche
9. Normal Process of Childbirth
a.
Premonitory Signs
b. Mechanisms of Birth
c. Stages and Phases of Labor
10.Nursing Care and Responsiblities
a.
False Labor
b.
Vaginal Birth
c.
Cesarean Birth
11.Explain the care of the newborn imme- diately after birth.
11.Care of the Newborn
LEARNER ACTIVITIES
OBJECTIVES
12.List the common types of classes offered to child-bearing families.
CONTENT
LEARNER ACTIVITIES
12.Types of Prenatal Classes
10
13.Describe factors that influence a wom- 13.Factors that Influence Comfort Dur-
an’s comfort during labor.
ing Pregnancy
a.
Physical Factors
b.
Psychosocial Factors
14.Evaluate the methods of childbirth
14.Methods of Childbirth Preparation
preparation.
a.
Dick-Read
b.
Bradley
c.
Lamaze
15.Analyze nonpharmacological methods 15.Nonpharmacological Methods
a.
Relaxation
Research pain management during labor
of pain management using evidencebased practice for labor, including the b.
Skin Stimulation
using evidence-based practice.
nursing role for each.
c.
Positioning
d.
Diversion
e.
Breathing
16.Explain each type of pharmacological 16.Pharmacological
pain management, including the nurs- a. Local Infiltration
b.
Pudendal Block
ing role for each.
c.
Epidural Block
d.
Subarachnoid Block
e.
General Anesthesia
f.
Narcotics
17.Obstetric Procedures
17.Evaluate the nurse’s role in each oba.
Amnioinfusion
stetric procedure.
b.
Amniotomy
c. Induction or Augmentation of Labor
d.
Version
e. Episiotomy and Lacerations
OBJECTIVES
CONTENT
LEARNER ACTIVITIES
11
f. Forceps and Vacuum Extraction Births
g.
Cesarean Birth
18.Recognize factors that contribute to an 18.Abnormal Labor
abnormal labor.
a. Problems with the Powers of Labor
b. Problems with the Fetus
c. Problems with the Pelvis and Soft Tissues
d.
The Psyche
e. Abnormal Duration of Labor
19.Differentiate:
19.Differentiate premature rupture of
a. Premature Rupture of Mem-
membranes, preterm labor and probranes
longed labor.
b.
Preterm Labor
1) Signs of Impending Preterm Labor
2)
Tocolytic Therapy
3)
Stopping Preterm Labor
c.
Prolonged pregnancy
20.Emergencies During Childbirth
20.Analyze the nurse’s role in caring for
a. Prolapsed Umbilical Cord
women having emergencies during
b.
Uterine Rupture
childbirth.
c.
Uterine Inversion
d. Amniotic Fluid Embolism
C.POSTPARTUM CARE
C. POSTPARTUM CARE
1. Adapting Care to Specific Groups 1. Analyze specific cultural beliefs that
the nurse may encounter when provid- and Cultures
a. Nursing Considerations for
ing postpartum and newborn care.
Specific Groups of Patients
b. Cultural Influences on Postpar-
tum Care
BEFORE CLASS:
Read:Leifer, Chapters 9-11.
DURING CLASS:
Lecture.
Complete Critical Thinking questions in
Study Guide, Chapters 9-11.
OBJECTIVES
CONTENT
12
2. Postpartum Changes in the Mother
2. Recognize postpartum changes in
Reproductive System
maternal systems and the nursing care a.
b.
Cardiovascular System
associated with those changes.
c.
Urinary System
d.
Gastrointestinal System
e.
Integumentary System
f.
Musculoskeletal System
g.
Immune System
h. Changes After Cesarean Birth and Adaptation of Nursing Care
3. Emotional Care
3. Explain the emotional needs of posta.
Mothers
partum women and their families.
b.
Fathers
c.
Siblings
d.
Grandparents
e.
Grieving Parents
4. Care of the Newborn, Phase 2
4. Describe nursing care of the normal
a. Admission Care of the Newborn newborn.
to the Postpartum or Nursery Unit
b.
Hypoglycemia
c.
Screening Tests
d.
Skin Care
e.
Security
f.
Bonding and Attachment
g.
Daily Care
5. Integrate appropriate nursing interven- 5. Infant Nutrition
Breastfeeding
tions to promote optimal infant nutrition a.
1) Choosing Whether to Breastbased on evidence-based practice.
feed
2)
Physiology of Lactation
3) Assisting the Mother to Breastfeed
4)
Preventing Problems
LEARNER ACTIVITIES
Elsevier Case Study - PN Post-Partum
Using evidence-based practice, discuss how to prevent and treat various
problems encountered by breast-feeding mothers.
OBJECTIVES
6. Plan appropriate discharge teaching
for the postpartum woman and her
infant.
CONTENT
5)
Special Breastfeeding Situa-
tions
6) Storing and Freezing Breast Milk
7)
Maternal Nutrition
8)
Weaning
b.
Formula Feeding
1) Types of Infant Formulas
2)
Preparation
3)
Feeding the Infant
6. Discharge Planning
a.
Postpartum Self-Care Teaching
b. Newborn Discharge Care
13
7. Identify the six categories of complica- 7. Complications Following Birth
tions following birth.
a.
Shock
b.
Hemorrhage
c.
Thromboembolic Disorders
d.
Puerperal Infections
e. Subiivolution of the Uterus
f.
Mood Disorders
8. Analyze signs and symptoms for each 8. Signs and Symptoms
postpartum complication.
9. Identify factors that increase a wom
an’s risk for developing each complication.
9. Risk Factors
10.Explain nursing measures that reduce
a woman’s risk for developing specific
postpartum complications.
10.Nursing Measures
LEARNER ACTIVITIES
OBJECTIVES
11.Summarize the medical management
of postpartum complications.
12.Plan general and specific nursing care for each complication.
CONTENT
11.Medical Management
12.Nursing Process
13.Preventive Health Care for Women
a.
Breast Care
b.
Vulvar Self-Examination
c.
Pelvic Examination
14.Menstural Disorders
14.Distinguish each menstrual disorder
a.
Amenorrhea
and its care.
b. Abnormal Uterine Bleeding
c. Menstrual Cycle Pain
d.
Endometriosis
e. Premenstrual Dysphoric Disorder
15.Differentiate each gynecological infec- 15.Gynecological Infections
a. The Normal Vagina
tion in terms of cause, transmission,
b. Toxic Shock Syndrome
treatment, and care.
c.
Sexually-Transmitted Diseases
d. Pelvic Inflammatory Disease
16.Compare the various methods of birth 16.Family Planning
Temporary Contraception
control, including side effects and con- a.
b.
Permanent Contraception
traindications of each method.
c.
Emergency Contraception
17.Investigate possible causes and treat- d. Unreliable Contraceptive Methods
17.Infertility Care
ment of infertility.
a. Social and Psychological Implica-
tions
b.
Factors Affecting Infertility
c. Factors Influencing Infertility
d. Evaluation of Infertility
e. Therapy for Infertility
13.Explain aspects of preventive health
care for women.
LEARNER ACTIVITIES
14
OBJECTIVES
CONTENT
15
f. Outcomes of Infertility Therapy
g. Legal and Ethical Factors in Assisted Reproduction
h. Nursing Care Related to Infertility Treatment
18.Prepare a teaching plan for the woman 18.Hormone Replacement Therapy
on hormone replacement therapy.
a. Side Effects & Contraindications
b.
Complementary Regimens
c. Therapy for Osteoporosis
19.Explain the medical and nursing care
19.Menopause
of women who are nearing or have
a.
Physical Changes
completed menopause.
b. Psychological and Cultural Varia-
tions
c.
Treatment Options
d. Nursing Care of the Menopausal Woman
20.Analyze the medical and nursing care 20.Reproductive Tract Disorders
of women with pelvic floor dysfunction a. Pelvic Floor Dysfunction
or problems related to benign growths 1)
Vaginal Wall Prolapse
in the reproductive tract.
2)
Uterine Prolapse
3) Management of Pelvic Floor Dysfunction
4) Nursing Care of the Woman with Pelvic Floor Dysfunction
5)
Urinary Incontinence
b. Other Female Reproductive Tract Disorders
1)
Uterine Fibroids
2)
Ovarian Cysts
LEARNER ACTIVITIES
OBJECTIVES
CONTENT
D. THE NEWBORN
1. Nursing Assessment
1. Summarize the physical characteristics a. Reflexes
Head
and nursing assessment of the normal b.
c.
Visual Stimuli
term newborn.
d.
Hearing
e.
Sleep
f.
Pain
g.
Conditioned Responses
h. Neonatal Behavioral Assessment Scale
i.Respiratory System
j.Apgar Scale
k.
Circulatory System
l.Providing Warmth
m. Obtaining Vital Signs
n.
Musculoskeletal System
o.
Lengthand weight
p.
Genitourinary System
q.
Integumentary System
r.
Gastrointestinal System
2. Maintaining Warmth
2. Specify four methods of maintaining
the body temperature of a newborn.
D. THE NEWBORN
16
3. Analyze the cause and appearance of
physiological jaundice in the newborn.
3. Physiological jaundice
4. Explain the following skin manifestations in the newborn: lanugo, vernix
caseosa, mongolian spots, milia, acrocyanosis, desquamation.
4. Skin Manifestations
a.
Lunugo
b.
Vernix Caseosa
c.
Mongolian Spots
d.
Milia
e.
Acrocyanosis
f.
Desquamation
LEARNER ACTIVITIES
BEFORE CLASS:
Read:Leifer, Chapters 12-14.
DURING CLASS:
Lecture.
Complete Critical Thinking questions in
Study Guide, Chapters 12-14.
Elsevier Case Study - PN Healthy
Newborn
OBJECTIVES
5. Investigate methods of preventing
infection in newborns.
CONTENT
5. Preventing Infections
6. Differentiate between the preterm and
the low-birth-weight newborn.
6. Preterm and Low-Birth Weight New-
borns
7. List three causes of preterm birth.
7. Causes of Preterm Births
17
8. Analyze problems of preterm birth and 8. Nursing Process
the nursing goals associated with each a.
Nursing Diagnosis
problem.
1)
Impaired Gas Exchange
2)
Risk of Hypothermia
3) Risk for Impaired Skin Integ-
rity
4)
Alteration in Nutrition
5)
Safety
a)
Infection
b)
Bleeding
6)
Potential for Complications
9. Feeding Preterm vs. Full-Term
9. Contrast the techniques for feeding
preterm and full-term newborns.
10.Explain the symptoms of cold stress
and methods of maintaining thermoregulation.
11.Discuss two ways to help facilitate
maternal-infant bonding for a preterm
newborn.
12.List three characteristics of the postterm infant.
10.Maintaining Thermoregulation
a.
Incubator
b.
Radiant Heat
c.
Kangaroo Care
11.Maternal Child-Bonding
a.
Provide Stimulation
b.
Reduce Noise
c. Coordinate Care for Discharge
12.Postterm Newborn
LEARNER ACTIVITIES
OBJECTIVES
13.Explain the classifications of birth defects.
14.Outline the nursing care for the infant
with hydrocephalus.
15.Analyze the preoperative and postoperative nursing care of a newborn with
spina bifida cystica.
CONTENT
13.Classification of Birth Defects
a. Malformations Present at Birth
b.
Metabolic Defects
c.
Blood Disorders
d.
Chromosomal Abnormalities
e.
Perinatal Damage
14.Hydrocephalus Nursing Care
a.
Preoperative
b.
Postoperative
15.Spina Bifida Nursing Care
a.
Preoperative
b.
Postoperative
18
16.Differentiate between cleft lip and cleft
palate.
16.Cleft Lip and Cleft palate
17.Recognize the early signs of dislocation of the hip.
17.Dislocation of Hip
a.
Limited Abduction
18.Summarize the dietary needs of an
infant with phenylketonuria.
18.Phenylketonuria Dietary Needs
19.Analyze the care of the newborn with
Down Syndrome.
19.Down Syndrome
20.Outline the causes and treatment of
hemolytic disease of the newborn
(erythroblastosis fetalis).
20.Hemolytic Disease
a.
Causes
b.
Treatment
21.Devise a plan of care for an infant receiving phototherapy.
21.Phototherapy
a.
Nursing Process
LEARNER ACTIVITIES