GEORGIA BAPTIST COLLEGE OF NURSING
OF MERCER UNIVERSITY
NUR 330 Nursing Care of the Childbearing Family
Unit 3 Holistic Care of the Antepartal Client and Family
Lesson Plan 3.2:
Nursing Process During the Antepartal Period
Lesson Outcomes: Upon completion of this lesson the learner will:
1.
Identify the essential components of a prenatal history and the rationale
for assessment of data. (C2, 7)
2.
Explain common obstetric terminology. (C7)
3.
Relate the physiololgic changes of pregnancy to typical findings on
physical assessment. (C5)
4.
Discuss the components of initial and subsequent prenatal visits and
rationale for assessment. (C8)
5.
Explain the importance of prenatal care to subsequent outcomes of
pregnancy. (C6, 7)
6.
Describe self-care interventions to relieve discomforts of pregnancy. (C2,
3, 8)
7.
Relate specific danger signals of pregnancy to possible causes and need
for reporting to healthcare team. (C7)
8.
Utilize the nursing process to meet needs of the expectant family. (C1, 2)
9.
Relate research findings to care of the expectant family. (C6)
10.
Describe the concept of change as it relates to the expectant family. (C3)
11.
Utilize teaching-learning principles to provide for anticipatory guidance
with the expectant family. (C3, 7)
12.
Identify the nurse's role in providing healthcare to the expectant family
during antenatal period. (C1, 11)
34
Content Outline:
1.
Antepartum assessment: History & psychosocial factors
1.1. Assessment of client’s history
1.1.1 Family health history
1.1.2. Past health history
1.1.3. Menstrual history
1.1.4 History of past pregnancies
1.1.4.1. Common terminology
1.1.4.2. Classification systems – GPA & GTPAL
1.2. Current pregnancy
1.2.1. Calculation of expected date of delivery (EDD) – Naegle’s rule
1.2.2. Physical changes
1.2.3. Psychological changes
1.2.4. Identification of risk factors
1.2.5. Data about significant other
1.3. Other relevant data
1.3.1. Religious/cultural
1.3.2. Occupational/ environmental
1.3.3. Nutritional
1.3.4. Resources and support system
2.
Antepartum Assessment: Physical examination
2.1. Head and neck
2.2. Chest and heart
2.3. Breast
2.4. Skin
2.5. Extremities
2.6. Abdomen
2.6.1. Fundal height -- McDonald's Rule
2.6.2. Fetal heart tones
2.7. Pelvic examination
2.7.1. Speculum
2.7.2. Bimanual examination
2.7.3. Approximation of pelvic adequacy
2.8. Role of nurse in physical assessment
3.
Antepartum Assessment: Laboratory data
3.1. Blood work
3.2. Urine testing
3.3. Cultures/smears
35
4.
Monitoring during subsequent prenatal visits
4.1. Fundal height
4.2. Fetal heart tones & fetal movement
4.3. Other assessment data
4.4. Comparison with previous data
5.
Nursing diagnosis
6.
Planning and implementing interventions; evaluating care
6.1. Anticipatory guidance
6.2. Relief of common discomforts of pregnancy
6.2.1. Specific discomforts
6.2.2. Education for self-care
6.3. Identification & reporting of danger signs in pregnancy
6.4. Consideration of cultural/religious beliefs
6.5. Nursing considerations
7.
Health promotion and maintenance
7.1. Activity, prenatal exercise, and rest
7.2. Nutrition
7.3. Hygiene
7.4. Clothing
7.5. Sexual activity
7.6. Substance exposure/abuse & fetal/neonatal outcomes
7.6.1. Alcohol
7.6.2. Tobacco
7.6.3. Caffeine
7.6.4. Over-the-counter medicines
7.6.5. Other drugs
7.7. Other concerns
7.7.1. Travel
7.7.2 Employment
7.7.3 Illness in pregnancy
8.
Preparation for childbirth
9.
Preparation for newborn
9.1. Plans for infant feeding
9.2. Resources for infant care
9.3. Preparation of siblings
36
Teaching/Learning Activities:
1.
2.
Lecture & discussion
Selected media
Critical Thinking Focus:
1.
Utilize the nursing process to meet the needs of expectant families during
experiences in clinical settings providing prenatal care.
2.
Develop creative strategies to meet the learning needs of perinatal clients of
varying ages, socioeconomic, and cultural backgrounds.
3.
Outline a teaching plan for a nulliparous client experiencing common
discomforts of pregnancy.
Required Readings:
Murray, S. S., & McKinney, E. S. (2006). Foundations of maternal-newborn nursing
(4th ed., pp. 127-148, 223-238, 600-607). Philadelphia: W. B. Saunders.
Suggested Readings:
Draper, L. (2006). Pregnant women in the workplace: distinguishing between normal
and abnormal physiologic changes. AAOHN Journal, 54(5), 215-223.
Moos, M. K. (2006). Prenatal care: limitations and opportunities. JOGNN, 35(2), 278285.
Tillett, J., Kostich, L. M., & VandeVusse, L. (2003). Use of over-the-counter
medications during pregnancy. Journal of Perinatal and Neonatal Nursing,
17(1), 3-18.
Polomero, V. (2007) Marriage in the transition to parenthood: How can perinatal
education help? Or can it? International Journal of Childbirth Education,
22(2), 21-24.
Worzer. L. (2004). Stress and sleep deprivation in pregnancy. International Journal
of Childbirth Education, 19(1), 16-18.
"LP3-2AnteNP"
37
5/99 KH
Revised: 5/00 EL; 1/01 EL; 5/01 EL; 5/02 EL; 6/03 SKR; 12/05RML, 12/06 SLS, 12/07 SLS
Reviewed:!2/04RML
38