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Participants: BSN II 1
Date: August 18, 2016
Method of
Instruction
Opening Prayer
Pre-Test
II.
III.
Instructional
Resources
Method of
Evaluation
10
minute
s
I.
Time
Frame
Lecture
and
Discussion
10
minute
s
3 hours
Visual Aids
Recitation
10
minute
s
Intrapartum Care
A. Extends from the beginning of contractions that cause cervical dilatation to the first 1
to 4 hours after delivery of the newborn and placenta.
B. Refers to the medical and nursing care given to the pregnant woman during labor
and delivery.
C. Admitting the laboring mother.
1. Personal Data
2. Baseline Data
3. Obstetrical Data
4. Physical Exams
5. Pelvic Exam
II.
B. 4 Ps of Labor
1. Passenger (fetus)
Sphenoid
Ethmoid
Temporal
Frontal Sinciput
Occipital or Occiput
Parietal
c. Suture Lines
Sagittal connect 2 parietal bones
Coronal connects parietal and frontal bones
Lambdoidal connects parietal and occipital bones
Android
Platypelloid
3. Power the forces acting to expel the fetus and placenta
a. Involuntary contractions
b. Voluntary bearing down efforts.
c. Characteristics: wave like.
d. Timing: frequency, duration, intensity.
4. Psyche and Person psychological stress exists when mother is fighting the
labor experience.
a. Cultural interpretation
b. Preparation
c. Past experience
d. Support System
III.
I.
Stage 1
Latent Preparatory Phase
The latent stage starts at the onset of regularly perceived uterine contractions and ends when
rapid cervical dilation begins. This is also called the preparatory phase.
Contractions
Duration of
Cervical Dilation
Duration
0-3 cm
Nullipara: 6
Contractions
Mild and short
20 to 40 seconds
hoursMultipara: 4.5
5-30 mins
hours
Nursing Considerations
Woman with a non-ripe cervix will have a longer than usual latent phase
Analgesia given too early during this period may prolong this phase
Woman who is psychologically prepared for labor only have minimal discomfort
Active Phase
During the active phase, cervical dilatation occurs more rapidly and contractions grow stronger.
Contractions
Duration of
Cervical Dilation
Duration
4 to 7 cm
Nullipara: 3
Contractions
Stronger, longer and
40 to 60 seconds
causes true
every 3 to 5 minutes
discomfort
hoursMultipara: 2
hours
Nursing Considerations:
Administration of analgesic at this point has little effect on the progress of labor
Transition Phase
During this phase, the contractions reach their peak intensity, cervix to maximum dilatation and
to full effacement.
Contractions
Duration of
Cervical Dilation
Duration
8 to 10 cm
Contractions
At peak intensity
60 to 90 seconds
every 2-3 minutes
dilation
Nursing Considerations:
If membranes have not previously ruptured or been ruptured by amniotomy, they will
rupture as a rule at full dilation.
Both full dilation and cervical effacement have occurred at this stage
Woman may have intense discomfort and may be accompanied by nausea and
vomiting.
This stage ends at 10 cm of dilatation and feels a new sensation (i.e., irresistible urge
to push).
II.
Second Stage
The second stage starts from full dilatation and cervical effacement to birth of the infant;
with uncomplicated birth, this stage takes about 1 hour. Contractions change to an
overwhelming, uncontrollable urge to push or bear down with each contraction as if to move her
bowels.
Effacement is shortening and thinning of the cervical canal. Normally, the canal is
approximately 1 to 2 cm long.
Dilatation refers to the enlargement or widening of the cervical canal from an opening a
few millimeters wide to one large enough (approximately 10 cm) to permit passage of a
fetus
The circle enlarges from the size of a dime, then a quarter, then a half-dollar. This is
called crowning.
The fetal head touches the internal side of the perineum; the perineum begins to bulge and
appears tense. The anus may become everted and stool may be expelled.
As the fetal head pushes against the perineum, the vaginal introitus opens and the fetal scalp
appears at the opening to the vagina. At first, it appears slit-like then becomes oval and then
circular. This is called crowning.
All of her energy and her thoughts are being directed towards giving birth. As she pushes, using
her abdominal muscles to aid the involuntary uterine contractions, the fetus is pushed out of the
birth canal.
III.
Stage 3
A. Care of the Baby
Clear airway of mucus
Observe frequently and use APGAR scoring to determine respiratory effort and
physical status
Keep thermoregulated
Assess for visible abnormalities
Administer antibiotic ophthalmic medication into each eyes to prevent ophthalmia
neonatorum
B. Assist with the delivery of placenta
Placenta is delivered about 3-10 minutes after the delivery of the baby
Duncan: from edges to center and presents the maternal surface which is red
beefy and dirty
Nursing Interventions
Do not hurry the expulsion of the placenta by forcefully pulling out the
cord or doing vigorous fundal push as this can cause Uterine Inversion.
Just watch for the signs of placental separation
Tract the cord slowly, winding it around the clamp until placenta
spontaneously comes out, rotating it slowly so that no membranes are left
inside the uterus, a method called Brandt Andrews maneuver.
(mechanical manipulation of the placenta)
Inspect for completeness of cotyledons (15-28)
C. Palpate the uterus to determine degree of contraction. If relaxed, boggy, or noncontacted, first action is to massage, gently and properly. An ice cap over the abdomen
will also help contract the uterus.
D. Check the vital signs especially BP
E. Administer medications as ordered:
Methylergonovine Maleate (Methergine) ergotrate derivatives
- Prevents or controls excessive bleeding after delivery
- If BP is high, never give Methergine because it may lead to hypertension
- Administer IM or IV
Oxytocin
- Maintains uterine contraction post-delivery to prevent hemorrhage
- Administer via piggy-back
Oxytocins are not given before placental delivery because placental
entrapment may occur unless it is used to induce labor
F. Inspect the perineum for lacerations
G. Assist the physician in doing episiorrhapy (repair of episiotomy or lacerations)
In vaginal episiorrhapy, packing is done to maintain suture line, thus preventing
futher bleeding
Vaginal packs have to be removed 24-48 hours because it becomes medium for
bacterial growth which may lead to puerperal sepsis.
IV.
Stage 4:
A. Monitor vital signs. Blood pressure and pulse rate maybe slightly increased from
excitement and effort of delivery but normalizes within one hour
B. Immediately after delivery, it is palpable between umbilicus and symphysis pubis; two
hours after delivery, the fundus is at the same height with umbilicus
C. Palpate fundus every 15 minutes for firmness and height in relation to umbilicus; if
relaxed and dextroverted
Check for bladder distention; determine voiding pattern; a full bladder can lead to
uterine atony leading hemorrhage
D. Monitor mother as body gradually regains homeostasis
Lochia post-partum vaginal discharge, containing blood, mucus, and placental
tissue.
Should be moderate in amount
Types:
1. Rubra (reddish): 1-3 days postpartum
2. Serosa (brownish): 4-10 days
3. Alba (whitish): 10-14 days can be up to weeks to 2 months
Lochial discharge typically continues for 4 to 6 weeks after childbirth
The strength and character of this attachment will influence the quality of all
future bonds to other individuals
There is a sensitive period in the first hours of life during which it is necessary
that the mother and father have close contact with their neonate for later
development to be optimal.
G. Adhere to Rooming-in concept as stated per hospital protocols
Strict baby stays with mom the whole time
Partial baby stays with the mother in the morning and stays in the nursery at
night
NURSING CARE OF POSTPARTAL FAMILY
Clients lochial ow is no more than one saturated perineal pad (50 mL) every 3
hours. Client states she is tired but feels able to manage her newborn and
family care.
Psychological Changes of the Postpartal Period
I. Phases of the pueperium
A. Taking in-phase
It is a time of reflection
Woman is passive during 2-3 day period
She prefer the nurse to minister her because of physical discomfort of after pains,
hemorrhoids and partly from her uncertainty in caring for her newborn and from
exhaustion that follows childbirth
Usually a woman wants to talk about her pregnancy.
B. Taking-Hold Phase
C. Letting-Go Phase
Claiming or Bonding - Mother begins to express more warmth and touch to her child
She begins to play with her child and become more comfortable
En Face position - Mother is directly looking at her newborns face with direct eye contact
-
Engrossment it is term how actively the parents are bonding with the newborn
Rooming-In
Infants stays in the room with her mother to become more acquianted and to feel more
confident about her ability to care for the newborn
2 Types of Rooming-IN
Complete infant stays with mother for 24 hours
Partial infant stats with the mother for such time and return to a central nursery
Sibling Visitation
Siblings get the feeling of separation if a mother is gives birth to a new child they feel
their mother cares for the new child and not them.
Taking the sibling to the hospital is helpful for the sibling to see her mother and the
newborn reduces the feeling that their mother cares more about the newborn than them.
Maternal Concerns and Feelings in the Postpartal Period
Abandonment
Women can get jealous about her own baby and feel abandonment because people only
talk about the newborn and as if she was less important
Examination of competitive feelings for both mother and father involve some
compromise in favor of babys interest and should start during the start of pregnancy or
early in postpartal period.
Disappointment
Common feelings of the parents when they experience that their expectation from the
was not achieved
They may felt unattractive and the feeling of inadequacy all over again
Nurse can help by comment on childs good points during the period of crisis and also
support them to accept the situation to cope with new circumstances
Postpartal Blues
Course Outline
Method of
Instruction
Introduction to class
Opening Prayer
Orientation to the class
of activities and topics
I.
Singing a song
(insert song)
II.
Community
Helpers
Proper hand
washing
10 minutes
(10:10 10:20)
Lecture,
Discussion
Methods of
Evaluation
20 minutes
(10:20 10:40)
Performing the
song
Visual aids
Recitation
Visual aids
Recitation
Visual aids
Recitation
15 minutes
(10:40 10:55)
Demonstration,
Lecture
Games/Activity
IV.
Instructional
Resources
10 minutes
(10:00 -10:10)
BREAK
III.
Time Frame
20 minutes
(10:55 11:15)
10 minutes
(11:15 11:25)
Demonstration,
Lecture
20 minutes
(11:25 11:45)
Summary of topics,
closure, closing prayer
10 minutes
(11:45 11:55)
General Objectives:
At the end of the discussion, the Kinder I students will be able to understand the basic concepts
of different community helpers; along with acquiring knowledge with regards to importance and
performance of proper hand washing and caring for teeth.
Specific Objectives:
At the end of the discussion, the participants will be able to:
State different community helpers and their functions and importance in the
community
State and understand the importance of hand washing
Discuss the possible effects of not doing proper hand washing technique
Demonstrate proper hand washing techniques
State and understand the importance of caring of our teeth
Demonstrate proper brushing of teeth
Importance of teeth
A Why do we need teeth
1 Ask students what we do with our teeth. (smiling, talking, chewing)
2 Have the students chew and smile at each other.
3 Teeth also helps us make our food into little pieces that prevents us from
choking
4 Our teeth are important because they help us talk properly, chew our food and
give us beautiful smiles!
B Teeth Characteristics
1 What are your teeth? Are they soft or hard? Are they strong? Our teeth are
hard and are strong.
C Baby teeth and Permanent teeth
1 When did you get your teeth? (When you were a baby) Why do babies need
teeth? (To learn how to talk and so that they can eat solid food) How many
baby teeth do children get? (20 strong teeth)
2 When you get older, your 20 baby teeth will be replaced by 32 permanent
teeth. Your permanent teeth are bigger and stronger than your baby teeth.
They are made to last the rest of your life.
II
III
What plaque is. When you brush your teeth at night, they feel clean and
your mouth tastes good, right? Well, if you dont brush your teeth before
going to bed, how does your mouth feel when you wake up in the
morning? (Tastes bad, smells bad, teeth feel sticky). That is because there
is something else that gets on your teeth besides the food you eat. Its
called plaque. Can you say plaque? Although you cant see it, plaque is a
sticky film that is forming on your teeth all the time. Plaque is a sticky, clear
film that forms on your teeth all the time.
Healthy food. Eating healthy and nutritious food will keep our teeth clean
and strong. Eat vegetables and fruits. Dont eat t much sweets as this will
weaken you teeth.
Dentist
A Role of dentist
1 Doctor who keeps our teeth clean and healthy
B Importance of visiting dentist
2 Who visits their dentist? (To make our teeth clean and healthy)
3 The dentist is our partner in caring for our teeth.
Reference: https://www.manitobadentist.com
COMMUNITY HELPERS
Community helpers are important people whose job is to help others. Everyone who
lives in a community can be a community helper. Some examples of community helpers
are grocery store clerks, teachers, firefighters, paramedics, police officers, and bakers.
There are a lot more community helpers than this, but these are just a few examples.
But, the important thing about community helpers is they work together to create a
community.
House Painter
They are painters who know how to paint a house. They
have tools to paint a house. Building a school, maybe
drawing designs
Astronaut
They go into space. They have 4 jobs that are commander,
pilot, mission specialists and payload specialists. They wear
a spacesuit and have a helmet.
Baker
Bakers make
baked goods and
they send the food
to the market
where people buy
the goods that the
bakers made.
Most bakers work
at bakeries,
grocery stores,
and restaurants.
Most bakers go to work before sunrise. Another job of
a baker is to keep their bakeries clean. Bakers wear
white uniforms and tall white hats. Some bakers wear
aprons to keep food off their clothes. Most bakers
wear white gloves so when they make pastries the
food does not stick to their hands. Also, when the
bakers wear their gloves the dirt on their hands does
not get on the food or pastries.
Carpenter
Carpenters use wood to build things. They
use hand tools such as hammers and screw
drivers. They also use electronic tools such
as power drills. They also use levels to make
sure their work is straight. They work with
architects. Also, they work with contractors.
Chef
Some chefs place their
orders. Most buy their
food at the store.
Chefs cook food for other
people and sometimes
present their food. They
experiment
with
new
ingredients or a new
recipe.
Chefs
wear a white hat and apron and shirts and
pants.
Grocer
workers
to
Construction Worker
A Construction Worker helps our community by building
houses, apartments, and buildings. A Construction
worker usually wears boots, a vest, a tool belt, gloves, a
hard plastic hat, and their plans. Their equipment is a
saw, a water jug, a cord, a wheelbarrow, cones, a tool box, and a ladder.
Dentist
They use tools like a toothbrush and a special
light. Dentist wear gloves, a white coat, a mask
and magnifying glasses. Makes sure that your
teeth are healthy and clean and shows how to
properly brush our teeth.
Doctor
A doctor takes care of peoples health by
giving checkups and helping sick or injured
patients. Before students can be doctors they
have to go to college and four years of
medical school. Some doctors work at
hospitals and do operations on people.
Doctors wear a long white coat so that they
dont get germs. When doctors do operations
they wear gloves so that no germs get into other peoples bodies.
EMT
An E.M.T.s job is to help people that are
hurt. When they are not helping patients
they rest and eat at the station. Today
E.M.T.s teach children how to ride bikes
and play safely. E.M.T.s wear uniforms
to show that they are emergency
workers. Their pants have many pockets
to hold supplies. They wear gloves to
treat a cut. The gloves help stop the
spread of germs.
Fire fighter
Fire fighters are very brave. They fight fires. They are
like heroes. They are total protectors. They wear
protective clothing. They help our community by
saving people from dangerous fires. They have
walkie-talkies to communicate with other fire fighters.
They have a big hose to put out giant fires. They
usually wear red and yellow hats and red boots.
Lastly they wear red jackets.
Teacher
Teachers jobs are to teach kids new
stuff like reading, writing, and spelling.
She also teaches us math and other
subjects. Teachers wear shoes, pants
and shirts. Teachers tools are pens,
chalk board, and books. The book helps
the teacher by telling the her what to do
with the kids today. The pens help
teachers by writing with them and
grading stuff. The chalk board helps the
teacher by writing math problems to the
kids.
Mailman
A mailman's job is to deliver important letters
and bills to people. They wear a short sleeved
shirt and short pants in summer.
In winter
they wear a long jacket and long pants and
boots. They can be women too.
Mayor
Nurse
My community worker job is helping
people when they are sick or hurt.
Nurses give papers that tell you what
kind of medicine to take. Nurses give
special food for women that are having
babies.
Nurses wear uniforms called scrubs. Nurses also wears clean
comfortable shoes.
Pharmacist
They read about new medicines. They also
count pills, weigh medicines, and measure
liquid medicines. They label medicine bottles.
A pharmacist fills your prescription. They wear
a white shirt and white pants.
Plumber
Plumbers put pipes in buildings.
Plumbers put sinks, toilets, and bathtubs.
Plumbers fix pipes that leak.
Police officer
They work to keep the townspeople safe. They stop fights. They
catch criminals. They wear uniforms, nametags, and a bulletproof
vest. They carry guns, handcuffs, pagers, notebooks, pens, and
telephones. They investigate crimes. They take reports. They give
speeding tickets. They put bad people in jail. Those are some things
police officers do.
Sanitation Worker
They pick up trash that is stinky and they
sometimes pick up leaves. Sanitation
workers work in all different places and
weather. They wear gloves to keep their
hands safe from sharp trash. They wear a
hard shirt to protect their stomachs.
Veterinarian
There are many different jobs of a
veterinarian and one job of a
veterinarian is to help animals when
animals are sick. Another thing a
veterinarian does is bury animals when
they
are
dead.
Sometimes
veterinarians have kennels so when
the owners have to go away they take
care of them in the kennel. Here are
some of the tools a veterinarian
uses\wears. They use lights, x-rays,
That is what a
Zoo keeper
Move your right palm over left dorsum with interlaced fingers and vice versa
make sure to really rub in between your fingers.
Then interlock your fingers and rub the back of them by turning your wrist in a
half circle motion.
Clasp your left thumb in your right palm and rub in in a rotational motion from the
tip of your fingers to the end of the thumb, then switch hands.
And finally scrub the inside of your right hand with your left fingers closed and the
other hand.
Hand hygiene is regarded as the most important intervention to reduce healthcareassociated infections, but there is limited evidence on which technique is most effective.
Course Outline
Introduction to class
Opening Prayer
Orientation to the class
of activities and topics
Method of
Instruction
Time Frame
10 minutes
Instructional
Resources
Methods of
Evaluation
I.
Singing a song
II.
Masustansiya at
Dimasustansiyang
Pagkain
10 minutes
Lecture,
Discussion
BREAK
III.
Pagkain ng
Almusal
Kahalagahan ng
pag-inom ng
tubig
Summary of topics,
closure, closing prayer
Visual aids
Recitation
Visual aids
Recitation
Visual aids
Recitation
15 minutes
Lecture,
Discussion
Games/Activity
IV.
20 minutes
Performing the
song
20 minutes
10 minutes
Demonstration,
Lecture
20 minutes
10 minutes
Pagkain ng Almusal
nag-almusal! Bakit po? Ang mga taong hindi nag-almusal ay mas gutom sa
tanghalian, kaya siguradong mapaparami ang kanilang makakain.
PERSONAL INFORMATION:
Date of Birth: December 7, 1994
Place of Birth: Philippine General Hospital, Manila
Citizenship: Filipino
Religion: Roman Catholic
Gender: Male
Mothers Name: Carina A. Santos
Occupation: Nurse Attendant
Fathers Name: Wilfredo R. Santos
Occupation: Utility Worker
EDUCATIONAL BACKGROUND:
Tertiary
2012-Present
Primary
2001-2007
Surgery Ward
ICU
Nursery
OB Gyne Ward
Pedia Ward
Operating Room
Personal Interest:
Microsoft Word
Music
Microsoft PowerPoint
Movie
Basic Troubleshoot
Cooking
Driving
Esports
Sports