College of Nursing Rizal Street, Iloilo City

Course Outline

I-Course Name:

NCM 102

II-Course Description: This course deals with the concept of disturbances and pre-existing health problems of pregnant women and the pathologic changes during intrapartum and post partum periods. This course further deals with the common problems occurring during infancy to adolescent stage.

III-Credit: Clinical)

5 units lecture, 6 units RLE ( 1 unit Skills Lab/ 5 units

IV-Required Number of Hours:

90 lecture hours, 306 RLE hours

V-Prerequisite:

Care of Mother, Child and Family

VI-Course Objectives: At the end of the course and given actual or simulated situations/conditions involving individual client (mother, newborn, and children) and family at risk/ with problem, the student will be able to: 1. Utilize the nursing process in the holistic care of client for the promotion and maintenance of health in community and hospital setting. 1.1Assess with the client his/her health condition and risk factors affecting health. 1.2Identify actual/at risk nursing diagnosis 1.3Plan with the client appropriate interventions for identified problems. 1.4Implement with client appropriate interventions for identified problems. 1.5Evaluate with client the progress of their condition outcomes of care. 2. Ensure a well organized recording and reporting system. 3. Observe bioethical principles and the core values (love of God, caring, love of country and people).

4. Relate effectively with clients, members of health team and others in work situation related to nursing and health.

VII- Course Content: PRELIM I.MOTHER A. High-Risk Prenatal Client a. Identifying Clients at Risk 1. Assessment of risk factors -Prenatal History - Obstetrical History *Type of births -Medical History -Surgical History -Sexual History -Social History -Physical Examination

2. Screening Procedures -Cervical Screen -Sexually Transmitted Infections -TORCH Test Series -Breast Exam

3. Diagnostic tests and laboratory exams -Diagnostic Testing during Early Pregnancy -Diagnostic Test for First Prenatal Visits -Diagnostic Test for Return Prenatal Visits (Second / Third Trimester) -Diagnostic Test during Postpartum

b. Pre-gestational conditions 1. Heart Diseases -Classification -Prognosis -Rheumatic heart disease

(signs and symptoms, management) 2. Diabetes Miletus -Maternal effects -Fetal effects -Newborn effects 3. Substance Abuse -Definition -Substances Commonly Abused -Risk Factors -Problems associated with substance abuse -Barriers to substance abuse 4. HIV/ AIDS -Definition -Etiology -History -Physical Examination -Treatment -Complications -Consultations and referrals -Follow-up 5. RH Incompatibility -Diagnostic test -Preventive vaccine -ABO Incompatibility 6. Iron Deficiency Anemia -Definition -Signs and symptoms -Management

c. Gestational condition 1. Hyperemesis Gravidarum -Causative factors -Complications -Diagnostic -Management

-Nursing Considerations 2. Ectopic Pregnancy -Definition -Nursing care -Management 3. Gestational Throphoblastic Disease (H-mole) -Assessment -Nursing Care 4. Incompetent Cervix -Management -Health teaching - Shhirodkar procedure 5. Abortion -Spontaneous -Habitual -Missed -Induced 6. Placenta Previa -Assessment -Nursing Care 7. Abruption Placenta -Cause -Assessment -General nursing care 8. Premature Rupture of the membranes -Causative Factors -Management -Nursing Considerations 9. Pregnancy-Induced Hypertension -Gestational HPN -Preeclampsia -Eclampsia

B.Nursing Care of the client with high-risk labor & delivery & her Family 1. High Risk Factors

A. Passenger 1. Fetal Accommodation to Passageway -Fetal Lie -Presentation -Position -Attitude -Station -Engagement B. Passageway or pelvic bones and other pelvic structure 1. Maternal Pelvis 2. Landmark -Measurements -Data Base C. Powers of Uterine Contractions D. Placenta 1. Power 2. Psyche 3. Signs of Placental Separation E. Clients psyche or psychologic state 1. Factors that may increase a woman's chance of depression 2. Signs and symptoms of post partum depression

2. Problems of the Passenger 1. Fetal malpositions -Types -Nursing Care -Medical Management 2. Fetal malpresentation 1. Vertex malpresentation a) brow presentation b) face presentation c) sincipital presentation 2. Breech presentation a) types b) maternal risks

c) vaginal evolving of breech d) external/podalic version 3. Shoulder presentation a) Compound presentation 4. Nursing care of client with malpresentation

3. Fetal Distress 1. Causes 2. Signs/ symptoms 3. Nursing interventions 4. Nursing responsibility in fetal monitoring -Intermittent Auscultation -Continuous Fetal Monitoring (External & Internal Fetal Monitoring) 5. Evaluating the baseline fetal heart rate -Changes to Baseline Fetal Heart Rate (Tachycardia, Bradycardia, Variability) -Changes in the Fetal Heart Rate (Accelerations, Decelerations, Early Decelerations, Late Decelerations, Variable Deceleration) 6. Nursing Interventions for Non-Reassuring FHR Pattern 7. Monitoring Contractions

4. Prolapsed Umbilical Cord 1. Causes 2. Risk Factors 3. Clinical Manifestations 4. Nursing Diagnosis 5. Management

3. Problems with passageway 1. Abnormal Size and shape of the pelvis 2. Cephalopelvic Disproportion 3. Shoulder dystocia 4. Nursing Interventions

4. Problems with the powers

1. Dystocia -Causeas, Types, Treament 2. Abnormal Progress of Labor -Medical Care 3. Retraction Rings 4. Premature Labor -Home Management, Hospital Management 5. Precipitate Labor 6. Uterine Inversion 7. Uterine Rupture -Causes, Signs and symptoms 5. Placental Problems 1. Placenta Previa 2. Abruptio Placenta

6. Problems with the psyche factors -psychological changes 1. Inability to bear down -Causes, Nursing Diagnoses, Nursing Intervention 2. Anxiety/ Fear -Causes, Defining Characteristic, Nursing Interventions

C. Nursing Care for the High Risk Post-Postpartal Client 1. Postpartal Hemorrhage A. Early Postpartal hemorrhage -Uterine Atony -Lacerations -Hematoma -DIC B. Late Postpartal hemorrhage subinvolution - Retained Placental Fragments -Hematoma 2. Postpartal Puerperal Infection A. Endometritis (Signs ans Symptoms, Mangaement) B. Wound Infection (Mastitis, Incisional Infection, UTI)

3. Thromboembolic disorders 4. Postpartal psychiatric disorder

D. Care of

couple with problems of infertility

1. Causes of infertility in males and females 2. Diagnostic tests 3. Nursing interventions

MIDTERM II. CHILD A. Nursing care of the high-risk newborn to maturity 1. Problems related to maturity -Prematurity -Postmaturity 2. Problems related to gestational weight -Small for gestational age (SGA) -Large for gestational age (LGA) 3. Acute conditions of the neonates such as: -Respiratory distress syndrome -Meconium aspiration syndrome -Sepsis -Hyperbilirubinemia -Sudden death syndrome (SDS)

B. Common health problems that develop during infancy 1. Intussusception (Signs and Symptoms, Treatment) 2. Failure to thrive -Common Parameters -Approach to a child with FTT -History finding in FTT -3 General Categories (Organic, Nonorganic, Idiopathic) 3. Trisomy 21 -Clinical Manifestation, Physical Manifestations, Prognosis, Possible Nursing Diagnoses

4. Cleft Lip and Cleft Palate -Signs and Symptoms, Nursing Diagnosis, Management 5. Imperforated Anus 6. Hirchsprung's Disease 7. Spina Bifida 8. Hydorcephalus -Mechanisms of Fluid imbalance in Hydrocephalus -Clinical manifestations of hydrocephalus -Manifestations of Hydrocephalus in childhood - Diagnosis, Treatment, Management -Shunting (Complications, Shunt Care) -Sings of CFS infection 9. Otitis Media (Predisposing Factors, S&Sx, Management, 10. Meningitis (Pathophysiology, Diagnostic Test, S&Sx, Management) 11. Febrile seizure (Seizure Activity, Prevention, Management, 12. Autism/ ADHD

C. Health problems common in toddlers 1. Burns 2. Poisoning (Lead, Food, Acetaminophen, Aspirin poisoning) 3. Child abuse (Definition, Legal Duty to Report, Risk Factors) -Physical Abuse, Sexual Abuse -Management 4. Cerebral Palsy

D. Health problems common in preschooler 1. Leukemia 2. Wilm's tumor (nephroblastoma 3. Aasthma 4. Urinary Tract Infection (UTI)

E. Health problems most common in school aged children 1. Ddiabetes mellitus 2. Rheumatic fever 3. Rheumatic arthritis

4. Scabies 5. Pediculosis 6. Impetigo

F. Health problems common in adolescent 1. Scoliosis 2. Bone tumors 3. Accidents (trauma/injury) 4. STD 5. Amenorrhea 6. Dysmenorrhea 7. Obesity 8. Anorexia nervosa, 9. Substance abuse 10. Suicide

SEMI-FINALS III. FAMILY A. The family with health problems 1. Assessment of the family capability to perform health tasks a. Primary assessment b. Secondary assessment 2. Family health problem identification a. Determination of categories of family health problems -Health deficits -Health threats -Foreseeable crisis/stress points -Enhanced capability for health promotion 3. Definition of contributing risk factors -Predisposing factors -Enabling factors -Reinforcing factors 4. Criteria of setting priorities among family health problems: -Nature of the problem -Magnitude of the problem

-Modifiability of the problem -Preventive potential -Salience 5. Tool of analysis -Social determinants of health

B. Planning of individual & family health nursing care 1. Concepts, principles, phases and components in planning family health interventions 2. Programs and services that focus on primary & secondary prevention of communicable and non-communicable diseases a. Examples of DOH programs: -National Tuberculosis Program Direct Observed -Short Course Treatment (NTP-DOTS) -Integrated Management of Childhood Illness (IMCI) -Control of Diarrheal Diseases (CDD) 3. Identification of goal of care for priority problems 4. Parameters for selecting nursing interventions: a. Applicable, appropriate and available to the home community setting b. Promotes client safety, comfort & hygiene c. Standards of care & interventions that address acute and chronic illness 5. Principles of collaboration and advocacy to be considered to ensure continuity of care

FINALS C. Implementation of Individual & Family Health Nursing Care 1. Component of care in acute and chronic illness a. Health promotion b. Disease prevention c. Restorative d. Curative e. Rehabilitative care 2. Bio-behavioral interventions and holistic care for individuals & Family with specific problems in a. Oxygenation b. Fluid and electrolyte balance c. Metabolic and endocrine function

3. Strategies in meeting health problems of family a. Promoting behavior change b. Creating a supportive environment towards healthy lifestyle 4. Principles of behavior change 5. Referral system 6. Concept & principles of collaboration & advocacy

D. Evaluation of progress and outcome of care 1. Methods & tools in evaluating effectiveness of family health interventions 2. Sources of evaluative data 3. Alternative strategies & approaches for specific problems & objectives

E. Ensuring a well organized & accurate documentation & reporting 1. Standard format 2. Legal principles involved in documentation

VII- Evaluation Tool: Graded recitation Paper & Pencil Test: Objective type (enumeration, identification) and Essay Examinations

VIII- References: Maternal and Child Health Nursing Care of the Childbearing and Childrearing Family -Adele Pillitteri, PhD, RN, PNP

IX- Grading System:

Cut off grade is 2.75 FG: PG+MG+SFG+TFG/4x50%+50% of the FE Term Grade= CS + TE Class Standing =30% (QRAP) + 50% Unit/ long test + 20% Conduct (C-A-R-E)