Lesson Plan Spring 14

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Lesson Plan
NUR 4334 Nursing Care of the Childbearing Family
Spring 2014
Unit Objective
Prerequisites:
These objectives reflect knowledge that you should have obtained
in your Anatomy and Physiology class as a prerequisite to nursing
school and/or in Patho-Pharm II and Human Needs II. If you did
not learn this info, you should spend some time learning it. This
information forms the foundation of all of childbearing. You Will
be tested on this information in this class directly and indirectly!
The Learning activities column identifies areas of the
Lowdermilk text that cover this information. There is also
information in your Patho-Pharm and Human Need texts. I will
provide a VERY brief review during class day 1. However, you are
responsible for knowing this information, even if I do not cover it
in class. If you need more assistance, please schedule an
appointment with your faculty.
Content
I.
II.
III.
IV.
Female reproductive system

Menstrual Cycle
a. Phases
i. Menstrual
ii. Proliferation (follicular)
iii. Secretory
iv. Ischemic
b. Length
Menstruation/puberty &
Menopause/climacteric
Contraception & infertility
Learning Activity
Readings refer to Lowdermilk, 10th ed. Unless
otherwise stated.
Verify your comprehensive understanding of the
reproductive systems and the menstrual cycle.
(Lowdermilk pp: 67-69; Lewis, Ch 51 53)
Text: Ch. 4
Scan & review pp 61-65; read & study pp 67-69;
STUDY/MEMORIZE/UNDERSTAND fig. 4-7, p
68.
Contraceptives:
Lowdermilk Ch. 8 + patho pharm
read pp 169-189; Study Box 8-1, p 171; Teaching
for Self-management, p173, 178-179,180, 187,
Figure 8-8 p 183, signs of potential complications,
p. 183; & 186 and the Nursing Alert boxes.
Identify the physiologic processes involved in the menstrual cycle .

Identify family planning options, advantages and disadvantages of
each, and apply the nursing process to facilitate need fulfillment.
Discuss nursing assessment of woman related to family planning
options
List common causes of infertility.
Describe common diagnoses and treatments for infertility
Induced Abortion pp 189-192. Study Safety alert

box, p 191.
Infertility Ch. 9 scan pp. 194-209
Read:
Box 9-1 Factors Affecting Female Fertility
Box 9-2 Factors Affecting Male Fertility
Box 9-3 Religious and Cultural Considerations
of Fertility
Box 9-5 Summary of Findings Favorable to
Fertility
Table 9-2 Nursing Actionsimpaired
fertility
Medication Guide: Infertility Medication p. 205
Box 9-7 Issues.before treatment p. 206
Table 9-3 Assisted Reproductive Therapies
Scan/review look at pages, identify key words, paragraph headings & subheadings, tables, boxes, diagrams, etc. Read any info that it unfamiliar to you.
Read read the information for general understanding; USUALLY is a supplement to lectures, make sure you understand the material covered.
Study important information. Usually a box, table or diagram that summarizes much of the content of the reading. This should help you recall what you read.
Memorize I use this term only rarely. This is critical, factual information that you MUST know.
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Unit Objective
Lesson Plan
Spring 2014
Content
V.
Differentiate signs and symptoms of common menstrual disorders.

Describe the etiology, clinical manifestations, and nursing and
collaborative management of menstrual problems and abnormal
vaginal bleeding.
Apply the nursing process to facilitate need fulfillment for the
woman with menstrual disorders
pre
Describe the prevention of sexually transmitted infections in

women.
Provide basic intra operative and postoperative nursing care to a
surgical patient.
Identify the competencies outlined in the Essential Competencies
in Genetics and Genomics for all Nurses.
Menstrual Disorders
a. Amenorrhea
b. Dysmenorrhea
c. Premenstrual syndrome (PMS)
d. Endometriosis
e. Alterations in cyclic bleeding
VI.
Health Promotion and STI prevention
VII.
Perioperative nursing
VIII.
Genetics
a. Essential Competencies
b. Gene identification and testing
c. Genotype, phenotype and
karotype
d. Autosomal abnormalities
e. Patterns of transmission
Compare and contrast predictive, presymptomatic and

predispositional testing.
Differentiate genotype and phenotype.
Learning Activity
otherwise stated.
Menstrual disorders: Lowdermilk Ch. 6
Scan pp 119- 141. Read Decision to Use Hormone
Therapy, p. 134.
Health Promotion: Read Anticipatory guidance
for health promotion . . . pp 88 -93; Table 4-3, p 89
Key Points, p. 93
STI
Ch. 7: Scan/ Review pp 143-167; Focus on
symptoms, treatment & pt. teaching for each disease
Perioperative: scan/review
Lewis, 8th ed (Medical-Surgical Nursing Text):
Ch. 18, 19, 20
Genetics: Lowdermilk: Chapters 3
Read essential Competencies . . . p 44; Gene
identification and Testing, p. 45; Factors
influencing the decision . . . p 47. ; Review/Scan p
47-51; Read pp 52-57.
Identify normal chromosome counts in the human.

Define trisomy
Differentiate the inheritance pattern of dominant, recessive and sex
linked conditions.
1/13
Define karyotype
UNIT I ANTEPARTUM
Evaluate contemporary issues and trends in maternity nursing.
Relate the role of culture in caring for childbearing families.
I.
Course Intro/AP
A. Contemporary Issues and Trends
B. Cultural Aspects of Care
C. Health Risks in the Childbearing
years
Lowdermilk:
Ch1: Read:
P. 3, Boxes 1-2 & 1-3; p 4, box 1-4; p.5,
box 1-6
Childbirth Practices pp 7-8;
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Unit Objective
Lesson Plan
Spring 2014
Content
Discuss the impact of pregnancy on family members
D. Psychosocial Aspects in nursing care

of the childbearing family
1. Role Changes
2. Attachment
Summarize psychosocial and behavioral changes that usually occur

as the mother and other family members adapt to pregnancy.
Identify components of a preconception visit and the significance of
each.
Conduct a complete history for a pre-conception visit.
Provide health promotion education for a preconception visit.
Summarize the process of fertilization
Examine the development, structure, and functions of the placenta.
Explain fetal circulation.
Summarize the significant changes in growth and development of
the embryo and fetus.
Recognize major milestones of embryonic and fetal development
and provide appropriate patient education.
II. Preconception Care, Fertilization/

Embryology/Genetics
A. Indicators of ovulation
B. Conditions for fertilization
C. Preconception Care
III.
Antepartum
A. Implantation
B. Fetal Development
1. Embryonic and placental
development
a. Critical periods
2. Germ cell differentiation
3. Teratogens
a. Principles of teratology
Learning Activity
otherwise stated.
Sentinel Events, pp 12-13
Ch. 2 : Read:
Family in Cultural and Community
Context pp 18-19
Box 2-2 p 25;
Table 2-2, pp. 26-27: Traditional Cultural
Beliefs; Childbearing and Parenting
p. 27 culture considerations box
Ch. 4: Read:
pp. 73-78 (Health risks in the childbearing
years)
Chapter 15. Read pp. 330-336
Read:
Preconception care: Ch. 4 p. 70-72
Box 4-1 Components of Preconception Care
Box 4-2 Major Goals of Prenatal Care
Box 4-3 Contraceptive Health Promotion
Read carefully:
Conception and Fetal development Ch. 12
pp.270-288
Study:
Figs 12-6, 12-7, p. 275; Fig. 12-10, p. 277
Table 12-1, pp. 284-286, Milestones in
Human Development before birth, since
last menstrual period
Figure 12-8, p. 276 Sensitive or Critical
periods in Human development
Figure 35-11p. 856, Critical periods in

human embryogenesis
Supplemental reading: Handouts on Blackboard:
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Preconception care
Psychosocial Adaptations to Pregnancy
Fetal Growth and Development
Genetics in Nursing
Differentiate the major organs or tissues arising from each of the

three primary germ layers.
Define teratogen.
Explain the principles of teratology.
List known and strongly suspected human teratogens.
Explain the effects of major teratogens.
Rank, in order of frequency, the major causes of congenital
malformations.
Identify the periods of embryonic/fetal vulnerability for teratogens
and the different effects.
1/27
Develop an individualized teaching plan based on a womans actual

and risk for exposure to specific teratogens
Compare and contrast pregnancy tests (home and laboratory).
Differentiate among presumptive, probable and positive signs of
pregnancy.
Use Naegles Rule to determine the expected date of birth.
Identify criteria used to determine gestational age.
Identify fetal measurements used to date a pregnancy by ultrasound
during each of the trimesters of pregnancy.
Discuss the maternal hormones produced during pregnancy, their
target organs, and their major effects on pregnancy
Document a womans obstetric history using the GTPAL system
A. Anatomy and physiology of

pregnancy
1. Gravida, para, terminology,
GTPAL
2. Pregnancy tests
3. Physiologic adaptations
4. Lab values
5. Diagnosis of Pregnancy
6. EDB; estimation of gestational age
(Naegels rule, Ultrasound, fundal
height, quickening)
A&P:
Read:
o Ch.13: pp. 288-305;
o Ch.15 pp.329-330 I(to adaptation to
pregnancy
o pp. 341-343 (paragraph headings Fetal
Assessment to Health Status);
o Gestational Age Assessment: p. 641
(Gestational age paragraph)
Study:
o Table 13-2 Signs of Pregnancy p.292;
o Fig 13-3, Height of fundus p. 293;
o Table 13-3 Laboratory Values for
Pregnant and Nonpregnant Women p. 299
(memorize normal Hgb & Hct in preg)
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
and the G/P systems.

Supplemental Reading, Handouts on Blackboard:
Diagnosis of Pregnancy
Explain the expected maternal anatomic and physiologic

adaptations to pregnancy.
Compare and contrast common lab values for the healthy adult and
the healthy pregnant woman.
Exercise/Quiz I
Gravida and Para Exercise on Blackboard.
This is a blackboard on line quiz. You will
have one hour to complete the 8 questions.
Each question has 2 correct answers. You
can go forward and backward in the quiz, but
you only have 1 hour. Please have your
Lowdermilk text and review p. 290 before
you open this exercise.
2/3
Explain the importance of nutrition during the childbearing years.
Identify nutritional risk factors during pregnancy.
Provide nutritional counseling to a woman prior to conception.
Examine guidelines for weight gain in pregnancy.
B. Nutrition
1. Nutrient needs during Pregnancy
a. Weight gain
b. Protein
c. Fluid
d. Vitamins and Minerals
2. Pica and cravings
3. Adolescent nutritional needs
4.Nutrition during lactation
Chapter 14
Read
o pp. 307-328
o Read Box 14-1 Food Sources of Folate
p. 309
Study
o Fig 14-2, p 309
o Table 14-1 pp 310-311;
recommendations
o box 14-2, p 311 Wt gain
o Table 14-3 p 313; Daily food guide
o Box 14-5, p 315; Indicators
o box 14-6 , p 317 Ca sources . . .
o Teaching for Self-management: Fe supp
p. 325
o box 14-8, p 326, suggestions
Scan
o table 14-6, pp 326-327 Popular foods
Identify dietary recommendations for energy sources, protein, and

key vitamins and minerals during pregnancy and lactation.
Give examples of food sources which provide the nutrients required
for optimal maternal nutrition during pregnancy and lactation.
Assess nutritional status in pregnancy.
Develop a nursing plan of care for a pregnant woman with pica.
Appropriately refer pregnant women to dietician for nutritional
counseling.
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Compare the dietary needs of pregnant adolescents and mature

pregnant women.
Provide health promotion education for nutrition in pregnancy.
2/3
Outline the patterns of health care used to assess maternal and fetal
health status at the initial and follow up visits during pregnancy.
Identify the purpose of prenatal care.
C. Nursing Care during Pregnancy

1. Prenatal Care
a. Purpose
b. Barriers
c. Patterns
Review the history of prenatal education.

D. Prenatal education
Explain the theoretical basis for childbirth education.
Explain the goals of perinatal education
Compare and contrast prenatal education programs,
including Lamaze, Dick-Read, Bradley Method.
Watch Evolve Video Series: Jarvis Head to toe

exam of the pregnant women (on LRC site)
Compare and contrast the different choices of care providers for

obstetric care in the U.S.
Explain the role and benefits of a doula.
Apply the nursing concept of anticipatory guidance to prenatal
preparation and education.
Evaluate assessment findings of the antepartum woman.
Evaluate risk factors in pregnancy.
Discuss common discomforts of pregnancy, etiology and nursing
assessment and interventions.
Provide patient/family teaching regarding the common discomforts
Nursing Care
Ch 13,
Read:
o Pp 289-291 STUDY terminology &
definitions.
o Read Box 13-1,p 297, BP measurement
o Read pp 336-367
Study:
o Terminology & definitions, pp 2890290
o Table 13-1, p 290 Obstetric history . . .
E. Assessments
1. Initial
2. Followup
3. Lab values
4. Signs of potential
complications
5. Risk assessment
Ch 15
Read
o pp 329-330; 336-367
o table 15-1 Lab tests in prenatal period: p
340
o Box 15-4, HIV screening. p 340
o
Read Teaching for selfmanagement:
Exercise Tips; p 347
Posture and Body; p 348,
Safety During Pregnancy p 349,

Sexuality p 353,
o
Read Box 15-5, p 349,
Conscious relaxation
o
p 356-357, Nursing Care
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Unit Objective
Lesson Plan
Spring 2014
Content
of pregnancy and signs and symptoms of potential complications.
Expected Outcomes
Plans, Interventions and
evaluations
i. Health Promotion and
self management for
discomforts of
pregnancy
ii. Recognition and follow
up of potential
complications
iii. Psychosocial support
c. Variations in Prenatal
Care
a.
b.
Develop a nursing plan of care for an uncomplicated pregnant

woman.
Examine the impact of culture, age, parity, and number of fetuses
on the response of the family to the pregnancy and on the prenatal
care provided.
Provide pt. /family teaching regarding lifestyle choices in
pregnancy (exercise, nutrition, substance abuse, stress management,
etc.)
Identify/counsel a pregnant woman regarding immunization needs
before, during and after pregnancy
2/10
Differentiate among diagnostic techniques for assessment of fetal

well being, including when they are used in pregnancy and for what
purposes.
Evaluate the procedures and results of tests of fetal well being:
MSAFP/triple screen
BPP
NST
CST
Amniocentesis
Chorionic villi sampling
Develop a teaching plan to explain procedural techniques and
implications of findings for MSAFP, Triple Screen, amniocentesis,
chorionic villi sampling and percutaneous umbilical cord blood
sampling to a pregnant woman and her family.
Learning Activity
otherwise stated.
Plan
F.
Assessment of Fetal Wellbeing

a. Daily Fetal Movement Counts
b. Ultrasound
i. Doppler Flood Flow
ii. Amniotic Fluid
Volume/Amniotic Fluid
Index
iii. Biophysical Profile
iv. Amniocentesis
v. Chorionic Villi Sampling
c. Fetal Heart Rate Monitoring
i. Physiology of Fetal Heart
Rate Monitoring
a. NST, CST
Study:
Box 15-3, p 336, Prenatal visit schedule
emergency box, p 341, Supine hypotension
STUDY HARD; practically
memorize Signs of potential complications
p. 342.
o
STUDY HARD: Table 15-2, pp
354-355, Discomforts
o
o
o
Ch. 26
Read
o Pp. 637-649
o Categories of High . . ., box 26-1, p.638
o Specific pregnancy Problems and Related
Risk Factors, box 26-2 p. 639
Ch. 18
Read
o pp. 415-431
o Box 18-2, p. 418 procedure for
intermittent. . .
o Nursing alert, p. 418
o Clinical reasoning exercise, p. 424
o Box 18-7, p. 427, Checklist . . .
o Legal tip, p. 428
o Box 18-8 p. 428 Management of
abnormal. . .
o Box 18-9, p 430, Client and family. . .
o Box 18-10, p 431 Checklist. . .
o
Study
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Unit Objective
Lesson Plan
Spring 2014
Content
Compare and contrast procedures for genetic testing.

Explain the reliability of the findings of diagnostic testing for fetal
well being.
Interpret the results of diagnostic techniques for assessment of fetal
wellbeing.
Explain the basis for fetal heart rate monitoring in labor.
Identify the advantages, disadvantages and contraindications (if
applicable) of different modes of uterine activity and fetal heart rate
monitoring in labor (ua intermittent palpation, tocotransducer,
IUPC; FHR intermittent auscultation, ultrasound transducer, fetal
scalp electrode).
Learning Activity
otherwise stated.
o Box 18-1, p. 416 Three-tier. . .
o Table 18-1, p.416 Normal uterine . . .
o Table 18-2, p 419 External and. . .
o Figs 18-2, 18-3 & 18-4 p. 420
o Fig. 18-5, p. 421
o Table 18-3, p. 422
o Fig. 18-9 & Box 18-3 p. 423
o Fig. 18-10 & Box 18-4 p. 424
o Fig. 18-11 & Box 18-5 p. 425
o Fig. 18-12 & Box 18-6 p. 426
o Fig. 18-13 p 426
o Nursing Process, Electronic Fetal . . . p.
427
o Table 18-4, p. 429 Approximate normal
values. . .
Given an electronic fetal monitor tracing, determine:

Frequency, duration, intensity of contractions and resting tone of
the uterus.
FHR baseline, variability, patterns.
Use NICHD guidelines to identify electronic FHR patterns.
Describe the physiologic basis and nursing implications electronic
FHR patterns seen in labor.
Prioritize nursing interventions for each of the following fetal heart
rate patterns.
Fetal tachycardia
Fetal bradycardia
Early decelerations
Variable decelerations
Late decelerations
Prolonged decelerations
Minimal to absent fetal heart rate variability
Ch 19
Read
o Pp 443-445 (Assessment of uterine
contractions section)
o Nursing alert boxes (2 of them), p. 445
o
Chapter 26:
Read
o pp. 639-652 (start at antepartum testing)
o Box 26-1 Specific Pregnancy Problems
and related Risk Factors p. 639
o Box 26-3 Common Indications for
Antepartum Testing p. 639
o Nursing Alert, p. 640
o Table 26-1 Major Uses for US during
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Pregnancy p. 641
o Clinical reasoning exercise, p 645
o Table 26-4 Summary of Biochemical
Monitoring Techniques p. 646
o Box 26-6 Indications for EFM p. 649
o
Study
o Table 26-2 Biophysical Profile Scoring p.
643
o Table 26-3 Biophysical Profile Mgmt. p.
644
o Figs. 26-10 & 26-11 p. 650
o Box 26-7 Interpretation of NST p. 651
o Fig. 26-12, p. 651
o Figs 26-13 A & B, p 652
o Box 26-8 Interpretation of CST p. 652
Distinguish reassuring and nonreassuring electronic fetal heart rate

patterns in labor.
Trouble shoot common problems with electronic fetal heart rate and
uterine activity monitoring.
Handout on Blackboard:
JOGNN NICHD Terminology
Supplemental Reading, Handouts on Blackboard:
Testing for Fetal Well-Being
Fetal Heart Rate Tracing Interpretation
NCC Applying NICHD terminology
EFM Practice strips and answers
Exercise/Quiz 2: Blackboard quiz on fetal
assessment
2/10
UNIT II: INTRAPARTUM

List the signs of labor.
II.
Intrapartum
A. Labor
Ch. 16
Read
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Unit Objective
Lesson Plan
Spring 2014
Content
Explain the factors that affect the labor process.

Describe the anatomic structure of the head of the term fetus.
Explain the significance of the size and position of the fetal head
during labor and birth.
Given a diagram, identify:
Fetal lie
Fetal presentation
Fetal presenting part
Fetal position
Most likely location to auscultate FHR
Describe the anatomic structure of the bony pelvis.
Describe the various pelvic types and the implications for labor and
delivery.
1.
2.
Diagnosis / Definition
Factor affecting labor 5 Ps
a. Passenger
(size of head, presentation, lie,
attitude, position)
b. Passageway
(bony pelvis, soft tissue)
c. Powers
(primary, secondary)
d. Position
e. Psyche
3.
Process of labor
a. Onset
b. Stages and phases
c. Mechanisms (7 cardinal
movements)
4.
Maternal and fetal
adaptations to labor
Examine the physiologic risks of labor in adolescents.

Summarize the cardinal movements of the mechanism of labor for a
vertex presentation.
Identify the stages and phases of labor.
Explain the maternal and fetal adaptations to labor.

Discuss the causes of pain in childbirth.
Outline adverse effects of pain on maternal and fetal well-being.
Explain the behavioral cues and verbal indicators of pain in the
woman during labor and birth.
Memorize
o Fig 16-1 A&B, p. 370
o Fig 16-2, p 371
o Fig 16-6, p 373
o Box 16-1 p 380 Signs preceding. . .
Supplemental Reading: Handout on Blackboard:
Intrapartum Overview
Explain the phases of second stage labor.

2/17
Learning Activity
otherwise stated.
o pp 369 384
o Fig 16-5 A,B,C
o Fig 16-12
o Clinical reasoning, p. 380
o
Study
o Fig 16-3 A,B,C,D p. 372
o Fig 16-4 p. 372
o Fig 16-7 p. 373
o Fig 16-8, p. 374
o Table 16-2 p 376
o Fig 16-10 A, p 376
o Fig 16-11 A,B,C,D p. 377
o Fig 16-13 A-F, p 381
o Box 16-2, p 383, Maternal physiologic
B. Labor Pain
1. Etiologies
2. Effects of pain
3. Nonpharmacologic pain relief
4. Pharmacologic pain relief
a. Analgesia and sedatives
b. Anesthesia
Ch. 17
Read
o pp. 386- 413
o Cultural considerations, p. 388
o Box 17-1, p. 389 Suggested Measures
o Evidence-based practice, p. 390
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Unit Objective
Lesson Plan
Spring 2014
Content
Explain the theoretical basis of nonpharmacologic pain relief

methods.
Demonstrate breathing and relaxation techniques used for each
stage of labor.
Differentiate between active relaxation, passive relaxation,
distraction and patterned breathing techniques used in childbirth.
Use appropriate nonpharmacologic strategies to enhance relaxation
and decrease discomfort during labor:
Hydrotherapy
Breathing & relaxation techniques
Massage / Effleurage
Environmental control
Positioning
Pressure and counter pressure
Encouragement and support
Differentiate analgesia and anesthesia.
Identify the most common types of obstetric analgesia and
anesthesia.
Analyze pharmaceuticals (systemic analgesics and regional
anesthetics) used to relieve labor pain, including drug classification,
route(s) of administration, therapeutic effects, side effects and
contraindications.
Describe nursing responsibilities during and immediately after the
administration of obstetric analgesia or anesthesia.
Prioritize nursing interventions for complications of regional
anesthetics.
Discuss the use of naloxone (Narcan).
Learning Activity
otherwise stated.
o Box 17-2 p 391, Nonpharamocologic
o Signs of potential complications, p. 400
o Safety alert, p. 401
o Fig. 17-11 A,B,C, p. 403
o Fig. 17-12, p. 404
o Legal tip, p. 408
o Nursing Process, p. 409
o Nursing care plan, p. 410
o Box 17-6, p. 411, Nursing interventions
Study
o Box 17-4, p 398, Pharmacologic
o Medication Guides (2 of them), p. 399
o Medication guide, p. 400
o Fig. 17-8 A&B, p. 401
o Fig. 17-10A&B, p. 402
o Emergency Box, p. 403
o Box 17-5, p. 405 Side effects. . .
o
Memorize
o Box 17-3, p 393, Paced breathing
DVDs: View these them independently in the LRC.
Material on videos may be tested.
DVD on reserve in LRC:

Choices I Childbirth, Vol. 1, Epidural
Anesthesia WO 450 C545 2000
(20 min.)
11
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Pain in Childbirth
Compare and contrast general anesthesia, local anesthesia and

regional anesthesia.
Explain the indications for and nursing care of a patient receiving
an antilogous epidural blood patch.
Develop a nursing plan of care for a laboring woman with an
epidural anesthetic.
Develop a nursing plan of care for a post Cesarean birth patient
with epidural/intrathecal medications and for a post Cesarean
birth patient with patient controlled analgesia.
2/17
Assess the intrapartum family to fulfill human needs.

Distinguish true and false labor.
Use Leopolds Maneuvers to identify:
Fetal lie
Fetal presentation
Fetal presenting part
Fetal position
Most likely location to auscultate FHR
Outline the standard of nursing care for assessment of the woman
and fetus in each stage of labor.
Identify factors that increase a laboring womans risks for
complications during labor and birth. Relate identified risk
factors to specific complications.
Prioritize the factors included in the initial assessment of the
woman in labor.
Based on a womans physical and psychosocial responses, evaluate
C. Nursing Care of the woman and family

in labor
1. Stage I
a. Assessments (admission &
ongoing)
i. Maternal; Assessment
of contractions
ii. Fetal Well Being in
labor
iii.
Psychosocial, cultural and
family Responses
DVDs: View independently in the LRC. Material on videos

may be tested.
High-Touch Nursing Care During Labor

Admission Assessment
(AWHONN, 2006)
WQ39H638, V-1 (37 min)
Ch. 19
Read
o pp. 433-472
o How to Distinguish True Labor from False
Labor Box p. 434
o Procedure: Tests for Rupture of Membranes
p. 437
o Box 19-2 p. 439, Psychosocial
assessment
o Cultural Considerations Box p. 440
o Nursing Process: First Stage of labor pp.
441-442
o Procedure: Leopold Maneuvers p. 443
12
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o Fig 19-5: Supine Hypotension p. 444
o Fig 19-7: Assessment of Uterine
Contractions p. 446
o Fig 19-8: Labor curves (partograms) p. 447
o Box 19-4 EBP to promote, protect and
support normal labor and birth p. 448
o Nursing Care Plan: Labor p. 449
o Table 19-2: Physical Nursing Care During
Labor p. 450
o EBP box, p. 454
o Box 19-6: Guidelines for Supporting the
Father p. 457
the need for a vaginal exam to assess the progress of labor.

Interpret the results of a cervical exam of a laboring woman.
Evaluate the progress of labor.
Evaluate the laboring womans behavioral adaptations to the phases
and stages of labor.
Assess uterine activity using palpation, tocotransducer and IUPC
(adequate?)
Evaluate the fetal response to labor.
Identify the nurses role in promoting the progress of labor.
Prioritize nursing interventions for a woman in each phase of first
stage labor.
Describe the role of activity and positioning in the progress of first
stage labor.
Select appropriate positions for the laboring woman based on
assessment data.
Appropriately respond to increased risks and signs of developing
complications during labor and birth.
Discuss the nurses role in management of pain for the laboring
woman.
Describe the pathophysiology and nursing interventions for
hyperventilation in labor.
Provide and evaluate the effectiveness of patient teaching regarding
analgesia and anesthesia in labor.
b. Interventions - Positioning,
foleys, oxygen, IVs,
coaching
c. Pain Management
o
o
o
o
o
o
Study
Table 19-1, Expected Maternal Progress in
First Stage of Labor p. 439
Fig 19-6:Location of FHTs p. 445
Nursing alert, p. 448
Signs of Potential Complications: Labor p.
448
Box 19-5, p. 455 Common maternal
Emergency Box: Interventions for
Emergencies During Labor p. 459
DVDs:
First Stage Labor Support (AWHONN, 2006)
WQ39H638, V-2 (40min)
13
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Labor Support
Describe symptoms of and nursing interventions for a woman

laboring with a fetus in the OP position.
Coach and support the laboring woman and her partner throughout
labor and birth.
Provide patient and family teaching throughout the labor and birth
process.
Prioritize nursing care for a woman during and immediately after
spontaneous or artificial rupture of the amniotic membranes.
Develop a nursing change of shift report for a woman in labor.
2/17
Develop a safe & comprehensive plan of care for women

experiencing:
Spontaneous labor with and without Epidural anesthesia.
Identify physical and nonverbal signs of second stage of labor for
nursing assessment.
Explain the phases of second stage labor.
Identify normal parameters of second stage of labor.
Compare and contrast various pushing techniques for second stage
labor.
Provide labor support for second stage labor, including teaching
and supporting the womans significant other.
2. Stage II
a. Assessments
i. Maternal
ii. Fetal
b. Interventions
c. Pushing Techniques
d. Positioning

Second Stage Labor Support
AWHONN, 2006
WQ39H638, V-3 (36 min)
Ch 19
Read
o Pp 457 472 as above
o Nursing Process: Second Stage of Labor p.
461
o Box 19-7 Guidelines for Assistance at the
Emergency Birth of a Fetus in the Vertex
Presentation p. 462
o Fig. 19-16 A-E, p. 463
o Box 19-8, pp 468-469 Normal vaginal birth
o Fig 19-23 p 471
o
Study
14
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o Table 19-3 Expected Maternal Progress in the
Second Stage of Labor p. 460
o
2/17
Identify the nursing role in third stage of labor.
3. Stage III
a. Assessments
b. Interventions
Recognize complications in the third stage of labor and provide

appropriate nursing interventions.
Explain the indications for use, therapeutic effects, side effects,
contraindications and nursing implications of medications
administered in third and fourth stages of labor.
2/17
Define labor dystocia; explain 5 causes.

Differentiate hyper and hypo uterine dysfunction in labor and their
management.
Explain:
Precipitous labor
Protracted active phase of labor
Secondary arrest of labor
Prolonged latent phase of labor
Differentiate fetal malposition and malpresentation.
Provide pt/family teaching and coaching for fetal malposition.
Describe management for fetal malpresentation
Distinguish between induction and augmentation of labor and
identify the common modes of each.
Ch. 19
Read
o pp. 471-472 as above
o Nursing Process: Third Stage of Labor p.
472
o Fig 19-24 Third Stage of Labor p. 473
o Fig 19-25, p 473
Inspection of the placenta
4. Alterations in labor patterns and mode of

birth
a. Labor alterations
b. Induction and augmentation
c. Operative vaginal birth
d. Cesarean Births
e. VBAC
Ch 33
Scan
o Figs 33-9 p. 806 & 33-10 A&B, p. 807
o Box 33-10 Selected measures p. 808
Read
o Pp 792 (Dysfunctional labor) 815 (stop
at Postterm)
o Box 33-7: Measures to Reduce Back p.
795
o Figure 33-3 Breech Presentation p. 795
o Figure 33-4 A-G Mechanism of Labor
p. 796
o Legal tip, p. 797
o Nursing Process: Dysfunctional Labor p.
798
o Fig 33-6 External Version p. 799
15
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Describe nursing responsibilities before and after amniotomy.

Describe major precautions to be considered when infusing
16xytocin for induction of labor.
Analyze pharmaceuticals used for labor induction and
augmentation, including drug classification, route(s) of
administration, therapeutic effects, side effects and
contraindications.
Summarize nursing care management for forceps and vacuumassisted birth.
Develop a safe & comprehensive plan of care
for women experiencing labor induction and/or augmentation.
Evaluate the effectiveness of and patient responses to labor
induction / augmentation.
Provide nursing care for a woman with labor induction /
augmentation.
Identify uterine hyperstimulation in labor. Explain how it affects
the fetus.
Prioritize nursing response to uterine hyperstimulation during
induction or augmentation of labor.
Provide nursing care for the intrapartum family undergoing
scheduled and emergent Cesarean Births.
Identify criteria for VBAC.
Explain risks and benefits of vaginal birth after cesarean (VBAC).
Develop a nursing plan of care for a woman undergoing a Cesarean
birth.
Learning Activity
otherwise stated.
o Box 33-8 Indications & Contraindications
for Labor Induction p. 800
o Procedure: Assisting with Amniotomy p.
803
o Safety Alert, p. 803
o Table 33-4 Definitions for Forceps and
Vacuum-Assisted Births p. 806
o Box 33-9: Assisting with Birth p. 807
o Box 33-11 Indications p. 809
o Clinical Reasoning, p. 809
o Figs 33-11 & 33-12: Cesarean Birth; skin
and uterine incisions p. 810
o Legal tip, p. 812
o Teaching for Self-Care: Postpartum Pain
Relief After Cesarean Birth p.813 and
Signs of Postoperative Complications after
discharge p. 814
o Safety alerts (2 of them), p 814
o Box 33-12 Selection Criteria for VBAC p.
815
Study
o Table 33-1: Dysfunctional Labor: Primary
and Secondary Powers p. 793
o Table 33-2: Abnormal Labor Patterns p.
793
o Table 33-3: Bishop score p. 800
o Medication Guidelines: p. 801
Prostaglandin E1; Misoprostol; p. 802
Prostaglandin E2: Cervidil, Prepidil; p. 804
Oxytocin(Pitocin)
o Legal tip, p. 803
o Emergency Box: Uterine Tachysystole
with Oxytocin, p. 805
DVD: Choices in Childbirth, Vol. 2, Induction
16
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
and Augmentation. WQ 440 C545 2000 (17 min)
Identify risks of cesarean births.

Examine advantages and disadvantages for regional and general
anesthesia for cesarean birth.
2/24
2/24
EXAM I
UNIT III: THE POSTPARTUM FAMILY
Explain the nurses role in fourth stage of labor.
Identify factors that increase a laboring womans risks for
complications during recovery. Relate identified risk factors to
specific complications and prioritize nursing interventions.
Prioritize nursing assessments in fourth stage for vaginal and
operative delivery.
Provide family centered nursing care during the fourth stage of
labor.
IV. Postpartum Family

C.
Fourth Stage of Labor
1. Assessments
2. Medical management
3. Nursing care
D.
Postpartum A&P
1. Uterus
2. Lochia
3. Breast
4. Other
Discuss normal postpartum and

apply the nursing process to facilitate need fulfillment.
Describe the anatomic and physiologic changes that occur during
the postpartum period.
Explain characteristics of uterine involution and lochial flow and
describe ways to measure them.
2/24
E.
Differentiate normal and abnormal assessment findings during the
postpartum period. Identify probably causes for deviations
from normal.
F.
Prioritize care for the postpartum patient and family.
Complications
1. Risk factors
2. Medical management/Nursing
Care
Nursing Care
1. Assessment
2. Plan/intervene
Ch 19
Read
o pp472-475
o p. 474 Box 19-9 Assessment during the
fourth stage of labor
Ch. 20
Read
o pp. 478-485
o p. 479, Fig 20-1, Assessment of
involution of uterus after childbirth
o p. 480, Table 20-1, Lochial and
nonlochial bleeding
o Clinical Reasoning p 480
Study
o p. 483, Table 20-2, Vital Signs after
Childbirth
Ch. 21
Read
o pp. 486-506
o p. 488, Table 21-1, Recovery Nurses
Report
o p. 488, Box 21-1, Criteria for Early
Discharge
o p.489, Table 21-2, Postpartum
17
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Unit Objective
Lesson Plan
Spring 2014
Content
Evaluate a patient/family for early postpartum discharge.
a.
b.
Compare and contrast postpartum care for a woman who delivered

vaginally and one who delivered by Cesarean.
c.
Community resources
Discharge teaching for health
promotion
Ev
aluation of care
Develop nursing care plans for a postpartum woman:

Who delivered vaginally, w/o an episiotomy
Who delivered vaginally, w/ an episiotomy
Who delivered by cesarean section w/ epidural/intrathecal
analgesia
Who delivered by cesarean section w/ systemic analgesia
Differentiate baby blues and postpartum depression.
Identify community resources available to postpartum families.
Develop a discharge teaching plan for a vaginal and cesarean birth
patient.
Provide and evaluate discharge teaching to postpartum families.
Explain the influence of culture on postpartum adjustment.
2/24
Describe the integration of the newborn into the family.

Identify parental and infant behaviors that facilitate and those that
inhibit parent-infant attachment.
Provide nursing interventions to facilitate parent-infant attachment.
IV.
1.
2.
3.
4.
5.
6.
Psycho-Social Aspectsj(Mother-Baby)
Attachment
Maternal Role Attainment
Adaptation to parenthood
Sibling adjustment
Grandparents
Learning Activity
otherwise stated.
Assessment and Signs of Potential
Complications
o p. 491, Care Plan: Postpartum CareVaginal Birth
o p. 492, Box 21-2, Interventions for
Episiotomy, Lacerations and
Hemorrhoids
o p. 493, Fig 21-2, Blood loss after birth
o p. 496 Safety alert
o pp. 498 & 499 Nursing alerts (2)
o p. 499 Legal tip
o p. 503 Cultural considerations
o p. 503 Nursing alert
o p 504 Teaching for Self-Management &
Clinical reasoning
Study
o p 493, Nursing alerts (2 of them)
o p. 494, Emergency Box: Hypovolemic
Shock
o p. 494, Fig. 21-3 Palpating fundus
o p. 500, Medication Guide RhoGam
o p. 500, Signs of Potential Complications:
Postpartum Psychosocial Concerns
o
Scan
o p 490 Nursing process
o p. 497, Fig 21-4 PP exercise
Ch. 22
Read
o pp. 507-527
o p. 508, Tables 22-1 & 22-2; Infant
behaviors affecting parental attachment &
Parental behaviors affecting infant
attachment.
18
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Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o P. 513 Nursing care plan
o P. 515 Coping with postpartum blues
o P. 516, table 22-5; early development of
the involved father role
o P 525, box 22-4 Strategies for facilitating
sibling acceptance of a new baby
Study
o P. 509, table 22-3, Examples of parentinfant attachment interventions.
o p. 510, box 22-1, Assessing attachment
behaviors
o p. 22-4 Phases of maternal postpartum
adjustment
DVD:
Nursing Assessment of the New Family, Disc 3,
Nursing Assessment of the Postpartum
patient. WY 157.3 N974 2003. On reserve in
LRC
On-Line Mosby OB Video Skills Series: Located
on the LRC website.
Examine the effect of the following on the transition to parenthood:

age, parity, socioeconomic conditions, social support, culture,
personal aspirations and sensory impairment.
Compare and contrast maternal and paternal adjustment to
parenthood.
Analyze the process of becoming a mother. Identify major
nursing theorists of this concept.
Develop a plan to facilitate parent-infant attachment when one or
both parents are separated from the newborn.
Provide parent teaching to facilitate sibling attachment.
Describe grandparent adaptation to a new family member.
Evolve HESI Case Studies: Obstetric/Maternity:

Postpartum. THIS IS A QUIZ GRADE Due
10/28 by 0800.
3/3
UNIT IV: NEWBORN

Explain the physiologic adaptations that the neonate must make
during the period of transition from the intrauterine to the extra
uterine environment.
Compare and contrast the first and second period of reactivity.
Describe the behavioral adaptations that are characteristic of the
newborn during the transition period.
Explain the mechanisms of thermoregulation in the neonate and the
potential consequences of hypothermia and hyperthermia.
III. Newborn
B. Neonatal Period Intro
C. Transition
D. Physiologic Adaptations to extra
uterine life
1. Respiratory
2. CV
3. Hematopoietic
4. Thermoregulatory
5. Hepatic
6. Integumentary
Ch 19
Read
o p. 467, Immediate Assessments and care
of the newborn
Ch. 23
Read
o pp.528-552
o p. 530, Table 23-1, Characteristics of the
Respiratory System of the Neonate
19
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Differentiate neonatal heat loss via conduction, radiation,

convection and evaporation.
Distinguish stool patterns of neonates.
Learning Activity
otherwise stated.
o p. 531, Table 23-2, Cardiovascular
Changes at Birth
o p. 534, Nursing alert
o Fig 23-3, p 537, Formation and excretion
of bilirubin
o p. 538, Table 23-3 Causes of Unconjugated (Indirect) hyperbilirubinemia
o p. 545, Box 23-2, Clusters of Neonatal
Behaviors in the Brazelton Neonatal
Behavioral Assessment Scale
o pp. 546-549, Table 23-4, Assessment of
Newborn Reflexes
o p. 549, Fig. 23-12 A-F summary of
newborn sleep-wake states
7. Reproductive
8. Skeletal
9. Neuromuscular
E. Behavioral Characteristics
Differentiate caput succedaneum and cephalhematoma.

Recognize newborn reflexes and differentiate normal and abnormal
responses.
Discuss the sensory and perceptual functioning of the neonate.
3/17
F.
Explain the purpose of the Apgar score.
Assign Apgar score to neonate.
Nursing Care
1. Initial Care at birth
a. Risk Assessment/Birth
Preparations
Study
o Fig. 23-2, p. 534. Effects of cold stress
o p. 536, Box 23-1 Changes in Stooling
Patterns of Newborns
o p. 542, Fig. 23-8 A&B
o p. 543 Fig. 23-9 A, B, C
Scan
o p. 540, Fig., 23-4; p. 541, Fig. 23-5 A&B;
p. 542, Fig. 23-6 A&B, 23-7
o p. 544 Figs 23-10 & 23-11 A-D
Exercise/Quiz 3:
HESI case study: Postpartum
Ch. 24
Read
o pp 553-591(to discharge planning
o p. 554, Box 24-1, Assessment of
20
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Provide nursing interventions to a newborn based on Apgar score.

Prioritize immediate care of the neonate at birth.
Explain neonatal resuscitation protocol.
Analyze pharmaceuticals used during the transition period,
including drug classification, route(s) of administration, therapeutic
effects, side effects and contraindications.
Learning Activity
otherwise stated.
Preconception, Prenatal, and Intrapartum
Risk Factors
o p. 554, Box 24-2, Initial Physical
Assessment of the Newborn
o p. 555, Box 24-3, Significance of the
Apgar Score
o p. 555, Box 24-4, Performing a Physical
Examination of the Newborn
o p. 566 Nursing Care plan
o pp. 567-568, Fig 24-1, Estimation of
gestational age
o p. 568, Box 24-5 Maneuvers used
o p. 569 Nursing Process
o p. 570, Procedure: Suctioning with a
Bulb Syringe
o p. 578, Table 24-3, Newborn screening
o p. 581, Fig. 24-12 A-D, Swaddling
o p. 590, Table 24-4
b.
c.
d.
e.
f.
Apgars/ care based on Apgars

Neonatal Resuscitation
Thermoregulation
General Assessment
Medications
i. NRP meds
ii. Antibiotics
iii. Opthalmic ointment
iv. Vit. K
g. Identification procedures
h. Attachment facilitation
Promote attachment of the new family to the neonate at birth.
Study
o pp 556-565; Table 24-2, Physical
Assessment of the Newborn
o p. 570, Signs of potential complications
o p. 572-573, Medication Guides (eye
prophylaxis; Vit. K)
o p. 576 Nursing alert
o p. 577 Box 24-6, Standard Lab. . .
o p. 580, Fig 24-10 Heelstick
o p. 583 Medication Guide (Hep B vaccine)
o p. 584 Medication Guide (Hep B IG)
o p. 584, Fig 24-16 A&B (IM injection)
o p. 588, Box 24-7, Care of the
circumcised
Memorize
21
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o p. 554, Table 24-1, Apgar Score
o
Scan
o EBP p. 571
o P. 576, Fig. 24-8
DVD: On computers in LRC. (Interactive Discs
are also available on reserve if you want to do
an interactive format)
Nursing Assessment of the New Family,
Disc 1: Physical Assessment of the Newborn
and Disc 2, Gestational age Assessment of
the Newborn WY157.3 N974 2003
EVOLVE ON-LINE VIDEO: Head to toe
assessment of the
Supplemental Reading: Handouts on Blackboard:
Circumcision
Newborn Pharmacology
3/17
Describe danger signals or signs in the neonate that indicate actual

or potential problems.
Apply the nursing process to facilitate need fulfillment of the
normal newborn.
Differentiate normal and abnormal physical (incl. VS) and
gestational age assessments of the newborn
Recognize common variations of normal assessment findings in the
newborn.
Provide parent education on behavioral states in the newborn.
Identify neonatal cold stress and provide appropriate nursing
2. Ongoing Care
a. Assessments
i. Risk identification
ii. Physical
iii. Gestational age
assessment
iv. Assessment of
behavioral states
v. Assessment of pain
b. Interventions and
Procedures
i. Circumcisions
ii. Tx of
jaundice/Phototherapy
iii. Newborn screening
Exercise/Quiz 4: HESI case study: Healthy

Newborn
22
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
interventions.
iv. Medication
v. Pain management
vi. Thermoregulation
c. Safe environment
d. Complications
Assess for pain signals in the newborn.

Appropriately manage neonatal pain.
Debate the risks and benefits of circumcision.
Compare and contrast methods of circumcision.
Provide postoperative care of the circumcised patient.
Provide parent teaching for circumcision care.
dosage, route of administration, contraindications and nursing
implications of medications administered during the neonatal
period.
Describe procedures for doing a heel stick, collecting urine
specimens, assisting with venipuncture and restraining the
newborn.
Provide nursing interventions to promote neonatal
thermoregulation.
Maintain a safe environment for the neonatal patient.
Develop appropriate parent teaching discharge plans.
3/24
Describe newborn screening tests and discuss their importance in

preparation for discharge.
Provide anticipatory guidance for the new family at home.
Evaluate neonate for early discharge.
3.
Care of the Newborn at Home/

Parent discharge teaching
Ch 24
Read
o pp. 591-604; Discharge Planning and
23
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Teaching Section
o p. 588, Box 24-7, Care of the
Circumcised Neonate at Home
o pp. 596-597, Box 24-9, Bathing, Cord
Care, Skin Care, and Nail Care
o p. 598, Box 24-10, Newborn Progress
after Early Discharge
o p. 604, Box 24-14, Signs of Illness
3/24
Explain the nutritional requirements of the newborn.

6/2
5 Provide supportive guidance to the family choosing an infant
feeding method.
Provide patient/family teaching on the benefits of breastfeeding.
Recognize newborn feeding-readiness cues.
Describe the anatomy and physiology of breastfeeding.
Provide nursing interventions to facilitate and promote successful
breastfeeding.
Analyze common problems associated with breastfeeding and
nursing interventions to help resolve them.
Evaluate maternal and neonatal indicators of effective
breastfeeding.
Compare and contrast powdered, concentrated and ready-to-use
forms of commercial infant formula.
G. Newborn nutrition and feeding

1. infant development & nutritional
requirements/research findings
2. assessment of responses
3. medical management
4. nursing diagnoses, goals,
5. interventions
6. evaluation of care
Supplemental Reading: Handout on Blackboard

Newborn
Postpartum care and Parent Teaching
Ch. 25
Read
o pp 606-634
o p. 608, Table 25-1, Benefits of
Breastfeeding
o p. 609, Box 25-1, Ten steps to Successful
Breastfeeding for Hospitals
o p. 612, Fig 25-2 Anatomy of the lactating
breast
o p. 612, Fig 25-3, Enhanced view of milk
glands and milk ducts
p. 612, Fig 25-4, Maternal breastfeeding
reflexes
o p. 615, Fig 25-5, Breastfeeding positions
o p. 616, Fig 25-6, Latch
Study
o p. 617, Box 25-2, Signs of Effective
Breastfeeding
o p. 618 Nursing Care Plan: Breastfeeding
and Infant Nutrition
o p. 620, Box 25-5, Warning Signs of
o
24
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Ineffective Breastfeeding
o p. 624, Breast Milk Storage Guidelines
for Home Use for Full Term Infants
o p. 633, Teaching for Self-Care: Formula
Preparation and feeding
Calculate recommended amount of formula per feeding for a

newborn (based on wt).
Provide parent teaching for bottle and breast feeding families.
Supplemental Reading: Handouts on Blackboard:

Infant Feeding and Parent Instructions
AAP Statement 2005
Back to Work TDH
Breastfeeding fact sheets
Breastfeeding twins
Colostrum
Instructional Guide for Breast Feeding Your Baby
3/31
Unit V Special needs

Discuss complications of childbearing and apply the nursing
process to facilitate need fulfillment.
Differentiate among risks factors, etiologies, signs and symptoms,
possible complications, disease transmission and medical and
nursing management for TORCH infections.
Provide patient teaching regarding toxoplasmosis in pregnancy
Discuss the effect of group B streptococcus (GBS) on pregnancy
and management of pregnant women and their fetuses/neonates
with GBS.
Compare and contrast signs, symptoms, and management of
nonpregnant and pregnant women with sexually transmitted
infections (include HIV and Hepatitis)
Provide patient counseling for HIV testing during pregnancy.
V. Special Needs: Care of Women and

Families
A. Infections
1. TORCH
2. Bacterial infections in
pregnancy/neonate (Chlamydia,
Gonorrhea, Syphilis, Group B Strep)
3. Perinatal viral infections - HIV,
Hepatitis
4. Neonatal infections (TORCH, HIV,
sepsis, etc.)
This unit has been introduced through out the

course and now we will cover specific
conditions.
Ch. 7
Scan
o Pp.143-168 focus on effects of infection
during pregnancy & birth as outlined in
objectives, this is not new material
Read
o p. 162, Table 7-6, Pregnancy and Fetal
Effects of Common Sexually Transmitted
Infections
o p. 163; Table 7-7, TORCH Infection:
Maternal and Fetal
Ch 35
Read
o
pp 844-856
25
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o p. 854, Fig. 35-10, Newborn Infection
Management algorithm
o
Study
o p. 844, Table 35-2, Risk Factors for
Neonatal Sepsis
o p. 847, Table 35-3, Signs of Sepsis
o p. 848, Box 35-1, TORCH Infections
Affecting Newborns
Develop a patient teaching care plan for a woman with a sexually

transmitted infection during pregnancy.
Identify the most common bacterial sexually transmitted infection.
Identify risks factors, signs and symptoms, possible complications
and medical and nursing management of neonatal group B
streptococcus (GBS) infection in the neonate.
Explain transmission routes of HIV from mother to fetus/neonate.

Complications
Evaluate risk factors, signs and symptoms, possible

complications and medical and nursing management of HIV
Identify the most important nursing action to prevent neonatal
infection.
3/31
Differentiate the signs and symptoms, medical and nursing
management of incomplete, inevitable, septic and threatened
spontaneous abortions and ectopic pregnancies
Compare and contrast abruptio placenta and placenta previa in
relation to risk factors, signs and symptoms, complications and
management.
Explain nursing management of vaginal bleeding of unknown
origin during pregnancy.
Review the physiology and symptoms of a hydatidiform mole
(gestational trophoblastic disease) and the risk for the womans
immediate health future.
Describe causes, signs and symptoms and medical and nursing
management of postpartum hemorrhage.
B. Hemorrhagic Disorders
1. AntepartumAbortions/Miscarriages,
ectopics, placental abruption/previa;
molar pregnancy
2. Postpartum Hemorrhage
3. Clotting Disorders
Ch 28
Read
o p. 671, Fig 28-1, Types of miscarriages
o p. 672, Table 28-1, Assessing
Miscarriage and the Usual Management
o p. 675, Teaching for Self-Care:
Discharge Teaching for the Woman after
Early Miscarriage
o p. 678, Box 28-1, Nursing
Considerations for Clients Undergoing
Methotrexate Treatment of Ectopic
Pregnancy
o p 680 Nursing alert
o p. 681, Table 28-2, Summary of
Findings: Abruptio Placentae and
Placenta Previa
o p. 682 Nursing Process
26
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date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o p. 684, Fig 28-10 Abruptio placentae
o p. 686, Box 28-2, Clinical Manifestations
and Laboratory Screening Results for
Women with DIC
Describe risk factors, signs and symptoms and medical and nursing
management of postpartum perineal hematomas.
contraindications and nursing implications of medications
administered to treat hemorrhagic conditions during the
perinatal period.
Describe causes, signs and symptoms and medical and nursing

management of thromboembolic disorders during the post partum
period.
Scan
o P. 676 Figs 28-2 & 28-3
o P. 679 Figs 28-5, 28-6 & 28-7
o P. 686, Figs 28-11 & 28-12
Ch 34
Read
o
o
o
o
3/31
Identify risk factors for preterm labor.

Explain the defining characteristics of preterm labor.
Provide patient teaching regarding reportable symptoms of preterm
C. Labor and Birth Complications

1. Preterm labor and birth (PTL)
2. Preterm Premature rupture of
membranes (PPROM)
3. Post term labor and birth
pp 824-833 (PPH ,Coagulopathies,

Thromboembolic disease)
p. 826, Nursing alert
p. 830: Nursing Care Plan, Postpartum
Hemorrhage
p. 828, Fig. 34-1, Nursing
Assessments for postpartum Bleeding
p 829 Nursing alert
o
Study
o p. 825, Box 34-1, Risk Factors and
Causes of Postpartum Hemorrhage
o p. 827, Medication Guide: Drugs Used to
Manage Postpartum Hemorrhage.
Ch 33
Read
o
o
pp. 779-792; 815-821

p. 780, Box 33-1, Risk Factors for
Preterm Labor & Box 33-2,
27
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date
Unit Objective
Lesson Plan
Spring 2014
Content
labor, preterm rupture of the membranes.

Recognize symptoms of preterm labor and provide nursing
interventions.
Analyze the use of tocolytics and antenatal glucocorticoids in
preterm labor and birth.
Recognize the risk factors, signs and symptoms of chorioamnionitis
Provide nursing care for a woman with preterm premature rupture
of the membranes.
Explain the care of a woman with post term pregnancy
Describe immediate nursing care for a patient experiencing:
prolapsed umbilical cord, shoulder dystocia
4. Obstetric emergencies
a. shoulder dystocia
b. prolapsed cord
c. ruptured uterus
d. amniotic fluid embolism
Learning Activity
otherwise stated.
Common Causes of Indicated
Preterm Birth
o p.782, Nursing Care Plan: Preterm
Labor
o p. 784, Box 33-4, Adverse Effects of
Bedrest
o p. 786, Box 33-5, Contraindications
to Tocolysis and Box 33-6, Nursing
Care for Women receiving Tocolytic
Therapy
o Teaching of self-management, p. 791
o Teaching for Self-Management: Postterm Pregnancy p.816
o Emergency: Immediate Management
of Newborn with Meconium-Stained
Fluid p. 817
o Fig 33-15 Application of Suprapubic
pressure & Fig 33-16 McRobers
maneuver p. 818
o Emergency Box: Anaphylactoid
Syndrome of Pregnancy p. 820
Study
o p. 783, Box 33-3, Signs and
Symptoms of Preterm Labor &
Teaching for Self- Management,
What to Do If Symptoms of Preterm
Labor Occur
o p. 786 Safety alert
o pp. 787-790, Medication Guides:
Tocolytic Therapy for Preterm Labor
& Betamethasone
o Fig 33-17& 33-18 Prolapse
Cord/Interventions p. 819
o Emergency Box: Prolapsed Umbilical
28
Holub
date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Cord p. 819
3/31
Differentiate the causes of postpartum infection.

Summarize the assessment and care of the woman with a post
partum infection.
D. Postpartum infections
1. Endometritis
2. Wound infections
3. Urinary Tract Infections
4. Mastitis
Recognize therapeutic effects and side effects of pharmaceuticals

used to treat complications of pregnancy, labor and birth.
Discuss psychosocial adaptation
of a family when the mother has a
high-risk pregnancy.
4/7
4/7
E. Post Partum Depression
Ch 34
Read
o pp 833-835
o p. 834, Box 34-4, Predisposing Factors
for Postpartum Infection
Ch. 32
Read
o
o
Identify postpartum emotional complications, including incidence,

risk factors, signs and symptoms, and management.
Evaluate the role of the nurse in assessing and managing care of

women with emotional complications during pregnancy and
postpartum.
EXAM 2
Differentiate the defining characteristics of gestational
hypertension, preeclampsia/ eclampsia and chronic
hypertension in pregnancy.
Assess an obstetric patient for symptoms of pre eclampsia.
Provide patient teaching regarding reportable symptoms of
preeclampsia.
Develop a plan of care for a woman with pre eclampsia.
F.
1.
2.
3.
4.
5.
6.
Hypertensive disorders
Classifications
Pre eclampsia / Eclampsia / HELLP
Pathophysiology
Medical Management
Nursing Care
Chronic hypertension management
in pregnancy
Study
o
Ch. 27
Read
o
o
o
o
o
o
pp. 767-776
p. 771, Nursing Care Plan:
Postpartum Depression (PPD)
p. 771, Teaching for Self-Care:
Activities to Prevent Postpartum
Depression
p. 772 Nursing alert
p. 768, Box 32-3, Risk Factors for

Postpartum Depression
pp. 654 669

p. 656, Table 27-3, Common
Laboratory Changes in Preeclampsia
pp. 662-663, Teaching for Self Care:
Assessing and Reporting Clinical
Signs of Preeclampsia
Coping with Activity Restriction
Diet for Preeclampsia
29
Holub
date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
o p. 664: Nursing Care Plan: Severe
Preeclampsia
o p. 665, Box 27-3, Care of Women
with Preeclampsia Receiving
Magnesium Sulfate
o p 665 Nursing alerts (2 of them)
o p. 666, Table 27-5, Pharmacologic
Control of Hypertension in Pregnancy
o p. 667, Emergency, Eclampsia

contraindications and nursing implications of medications used to
treat hypertension in pregnancy.
Identify and prioritize nursing care for magnesium toxicity.
Prioritize nursing management of eclamptic seizures.
Interpret laboratory finding related to:
Pre-eclampsia/HELLP/DIC
11/18
Differentiate gestational and pregestational diabetes mellitus.

Discuss the effects of pregnancy on diabetes and of diabetes on
pregnancy outcomes.
Explain medical management of diabetes in pregnancy.
Compare insulin requirements throughout the trimesters of
pregnancy, postpartum and with lactation.
Interpret laboratory finding related to:
Diabetes in pregnancy
G. Endocrine & Metabolic Disorders

1. Diabetes
a. Classifications
i. Gestational / Pre-gestational
ii. Classification of Diabetes in
Pregnancy
b. Pathogenesis
c. Care management
2. Hyperemesis Gravidarum
3. Maternal PKU
Study
o p. 655, Table 27-1, Classification of
Hypertensive States of Pregnancy &
Table 27-2: Differentiation Between Mild
and Severe Preeclampsia
o p. 657, Box 27-1, Risk Factors for
Preeclampsia
o p. 657, Fig 27-1 Etiology of
preeclampsia & Fig 27-2, Consequences
of endothelial cell dysfunction
o p. 664, Box 27-2, Hospital Precautionary
Measures
Ch 29
Read
o pp. 688 708
o p. 690, Table 29-1 Whites Classification
of Diabetes in Pregnancy (Modified)
o p. 690, Fig. 29-1, Changing insulin needs
during pregnancy
o p. 703: Nursing Care Plan, The Pregnant
Woman with Gestational Diabetes
o
30
Holub
date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Study
o p. 695, Table 29-3, Target Blood Glucose
levels during Pregnancy
o p. 695, Teaching for Self Care: Dietary
Management of Diabetic Pregnancy
o p. 703, Fig 29-4, Screening and diagnosis
for gestational diabetes.
Scan/review
o p. 692, Table 29-2, Differentiation of
Hypoglycemia (Insulin Shock) and
Hyperglycemia (Diabetic Ketoacidosis)
o p. 697, Table 29-4, Common Insulin
Preparations
Develop a plan of care for the pregnant woman with pregestational

or gestational diabetes.
Discuss the management of the woman with hyperemesis
gravidarum.
Identify complications associated w/ maternal Phenylketonuria in
pregnancy.
Lecture, Class discussion, PowerPoint, Tegrity and

Case studies
4/14
Apply the nursing process to

facilitate need fulfillment for the
newborn with complications.
Prioritize nursing care for a high risk newborn. Analyze the
differences in the characteristics of preterm, near-term, post term
and post mature neonates.
Identify risk factors for neonatal respiratory distress syndrome.
Discuss respiratory distress syndrome and the approach to
treatment.
Explain the indications for use, therapeutic effects, administration
guidelines and nursing care of the patient receiving neonatal
surfactant.
H. Complications of the newborn

1. High Risk Neonates
a. Preterm
b. Complications RDS, IVH,
NEC, MAS
c. Near-term
d. Post term
e. SGA/LGA/IDM/birth trauma
Ch. 37
Read
o pp 894-928
o pp. 900-901: Nursing Care Plan: The High
Risk Preterm Newborn
o p. 918, Box 37-5, Proposed Risk Factors
for Necrotizing Enterocolitis
o p. 920, Box 37-6, Manifestations of Acute
Pain in the Neonate
o p. 922, Table 37-3, Late Preterm Infant
Assessment and Interventions
Study
o p. 905, Medication Guide: Surfactant
o p. 916, Fig 37-13, Pathogenesis of
respiratory distress syndrome
31
Holub
date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Differentiate among risks factors, etiologies, signs and

symptoms, possible complications and medical and nursing
management for RDS and TTN
Ch 35
Read
o Pp 837- 844
o P 845, Nursing Care Plan:,Infant of the
mother with pregestational or gestational
diabetes.
Analyze the pathophysiology of meconium aspiration syndrome

and its clinical signs.
Differentiate among risks factors, signs and symptoms, possible
complications and medical and nursing management for the LGA
and SGA infants
Differentiate among risks factors, signs and symptoms, possible
complications and medical and nursing management for the
infant of a diabetic mother and a low risk infant.
Analyze complications of Infant of a Diabetic Mother (IDM) and
Large for Gestational Age (LGA) infants.
4/14
1. Acquired Problems of the Neonate

a. Maternal substance abuse
Compare and contrast symptoms of infants born to drug addicted
mothers and infants with fetal alcohol syndrome
Identify the leading cause of preventable mental retardation in the
US.
Compare and contrast physiologic and pathologic jaundice.
Develop nursing plans of care for a neonate with physiologic
jaundice and for a neonate with pathologic jaundice.
Describe neonatal phototherapy. Provide parent teaching for
neonatal phototherapy.
Identify symptoms of hyperbilirubinemia in the neonate.
2.
Hemolytic disorders
a. Physiologic Jaundice
b. Pathologic Jaundice
c. Hemolytic disease of the newborn
Ch. 35
Read
o pp. 856-864
o p. 857, Table 35-4, Summary of Neonatal
Effects of Commonly abused Substances
& Table 35-5, Signs of Neonatal
Abstinence Syndrome
o p. 858, Box 35-2, Diagnostic Criteria for
Fetal Alcohol Syndrome and AlcoholRelated Effects
o p. 860, Box 35-3 Fetal and Neonatal
Effects of Maternal Cocaine Use During
Pregnancy
o p. 863, Nursing Care Plan: The Infant
Experiencing Drug Withdrawal (Neonatal
Abstinence Syndrome)
o p. 863, Box 35-4, Care of the Infant
Experiencing Withdrawal(Neonatal
32
Holub
date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
Abstinence Syndrome)
Ch. 36
Read
o pp 867-873
o p 868, Box 36-1Monitoring for Juandice
after early discharge
o p. 869, Box 36-2 Potential causes of
pathologic hyperbilirubinemia in
neonates
o p. 871, bos 36-3, Indications for amount
of RHo(D) IG to be administered
o p. 872 Nursing care plan
Differentiate physiologic and pathologic hyperbilirubinemia.

Compare RH and ABO incompatibility.
Explain nursing management to prevent the pathologic
consequences of hyperbilirubinemia.
Supplemental reading on Blackboard:

Hyperbilirubinemia
Exercise/Quiz 5 & 6: HESI case studies:
Gestational diagetes; pre eclampsia
4/21
Describe the emotional needs of families with a baby who has

neonatal complications
Promote parent infant interaction in the NICU.
Evaluate the grief process in the family experiencing perinatal
loss.
Identify specific nursing interventions to meet the special needs
of parents and their families related to perinatal loss and grief.
Differentiate among helpful and nonhelpful responses in caring
for parents experiencing loss and grief.
I.
Perinatal grief and loss

a. Grief responses
b. Family aspects
c. Nursing interventions
Ch. 38
Read
o pp. 931-948
o p. 933, Box 38-1, Conceptual Model of
Parental Grief
o p. 942, Box 38-2, What to Say and What
Not to Say to Bereaved Parents
o p. 947, Nursing Care Plan: Fetal Death at
24 weeks
DVD: To Lose a Child to be shown in class
Discuss the personal and societal issues that may complicate

responses to perinatal loss.
33
Holub
date
Unit Objective
Lesson Plan
Spring 2014
Content
Learning Activity
otherwise stated.
4/28
TBA
HESI
FINAL EXAM
34

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Holub

Female reproductive system

Identify the physiologic processes involved in the menstrual cycle .

Induced Abortion pp 189-192. Study Safety alert

Differentiate signs and symptoms of common menstrual disorders.

Describe the prevention of sexually transmitted infections in

Health Promotion and STI prevention

Compare and contrast predictive, presymptomatic and

Identify normal chromosome counts in the human.

Childbirth Practices pp 7-8;

Discuss the impact of pregnancy on family members

D. Psychosocial Aspects in nursing care

Summarize psychosocial and behavioral changes that usually occur

II. Preconception Care, Fertilization/

Figure 35-11p. 856, Critical periods in

Differentiate the major organs or tissues arising from each of the

Develop an individualized teaching plan based on a womans actual

A. Anatomy and physiology of

and the G/P systems.

Explain the expected maternal anatomic and physiologic

Identify dietary recommendations for energy sources, protein, and

Compare the dietary needs of pregnant adolescents and mature

C. Nursing Care during Pregnancy

Review the history of prenatal education.

Watch Evolve Video Series: Jarvis Head to toe

Compare and contrast the different choices of care providers for

Safety During Pregnancy p 349,

of pregnancy and signs and symptoms of potential complications.

Develop a nursing plan of care for an uncomplicated pregnant

Differentiate among diagnostic techniques for assessment of fetal

Assessment of Fetal Wellbeing

Compare and contrast procedures for genetic testing.

Given an electronic fetal monitor tracing, determine:

Distinguish reassuring and nonreassuring electronic fetal heart rate

UNIT II: INTRAPARTUM

Explain the factors that affect the labor process.

Examine the physiologic risks of labor in adolescents.

Explain the maternal and fetal adaptations to labor.

Explain the phases of second stage labor.

Explain the theoretical basis of nonpharmacologic pain relief

DVD on reserve in LRC:

Compare and contrast general anesthesia, local anesthesia and

Assess the intrapartum family to fulfill human needs.

C. Nursing Care of the woman and family

DVDs: View independently in the LRC. Material on videos

High-Touch Nursing Care During Labor

the need for a vaginal exam to assess the progress of labor.

Supplemental Reading: Handout on Blackboard:

Describe symptoms of and nursing interventions for a woman

Develop a safe & comprehensive plan of care for women

High-Touch Nursing Care During Labor

Recognize complications in the third stage of labor and provide

Define labor dystocia; explain 5 causes.

4. Alterations in labor patterns and mode of

Describe nursing responsibilities before and after amniotomy.

Identify risks of cesarean births.

IV. Postpartum Family

Discuss normal postpartum and

Evaluate a patient/family for early postpartum discharge.

Compare and contrast postpartum care for a woman who delivered

Develop nursing care plans for a postpartum woman:

Describe the integration of the newborn into the family.

Examine the effect of the following on the transition to parenthood: