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1.     Describe the pathophysiology, clinical manifestations and nursing care of gestational problems.

Pre-eclampsia/Eclampsia ♦ HELLP syndrome ♦ Gestational Diabetes ♦ Hyperemesis Gravidarum ♦ Hemorrhagic conditions

2. Describe the care of the pregnant woman with a pre-existing condition.

Obesity ♦ Diabetes ♦ Thyroid disorder ♦Cardiovascular/Pulmonary

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 4. Describe diagnostic tests used to assess maternal and fetal well-being.

Antepartum/Prenatal testing: • 1st trimester • 2nd trimester • 3rd trimester

5. Describe the care of the pregnant woman with a pre-existing condition.

RH/ABO Incompatibility - RhoGAM/WinRho

 Group B streptococcal (GBS) - Penicillin

6. Discuss the role of the nurse in a pregnancy at risk.

Antenatal risk assessment ♦ Educator ♦ Support

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 2. Discuss determinants of health as risk factors and their implications for pregnancy.

• Biology & Genetic Factors • Demographic Characteristics • Personal Health Practices & Coping Skills

3. Explore Canadian maternal health problems.

• Causes of maternal death • Mental health issue •Intimate partner violence

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9. Identify danger signs during pregnancy

Table 11-2 Signs of Potential Complications during the 1st, 2nd & 3rd Trimesters

• vaginal bleeding /vaginal discharge • rupture of membranes (ROM and PROM) • uterine contractions • swelling of fingers or face •continuous headache • visual disturbances • persistent or severe abdominal pain• chills/fever • painful urination • diarrhea • persistent vomiting • change infrequency or strength of fetal movement • glycosuria

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 7. Describe health teaching to promote adaptation during pregnancy

Teaching Health Behaviors: • recognizing potential complications • breast care • exercise, Kegel exercises • rest and sleep • employment • exposure to teratogens • travel• over-the-counter drugs, herbal preparations • tobacco, alcohol, caffeine • immunizations• transition to the parenting role – prenatal classes

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Identify factors that will influence the process of maternal role transition.

Psychosocial and Cultural Assessment:

·      psychological response to pregnancy

·      availability of resources

·      communication style

·       health beliefs

·       language

·      culture

6. Describe common discomforts of pregnancy, causes and measures that prevent or give relief.

Table 11-4Discomforts Related to Pregnancy

·       nausea and vomiting

·       heartburn

·       backache

·       urinary frequency

·       constipation

·       varicosities

·       hemorrhoids

·       leg cramps

·       ankle edema

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Describe the psychological responses to pregnancy.

- maternal responses during pregnancy:

• 1st trimester

• 2nd trimester

• 3rd trimester

- maternal adaptation

- accepting the pregnancy

- identifying with the mother role

- reordering personal relationships

- establishing a relationship with the fetus

- preparing for childbirth

- paternal adaptation

- sibling adaptation

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Common Lab Tests

·      Blood grouping

·      CBC, Hemoglobin (Hgb)

·      RH factor and antibody screen

·       Rubella

·      Hepatitis B screen

·      STD’s

·       Urinalysis

·       Maternal blood glucose

·       GBS (Group B Strep)

- Ongoing Assessment

·      vital signs

·      weight

·       urinalysis – protein, glucose, ketones

·       fundal height

·      Leopold’s maneuvers

·       fetal heart rate

·       fetal activity

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1.     Describe maternal physiological and psychosocial changes that occurduring pregnancy.

2.     Identify signs of pregnancy

a.     Presumptive

b.     Probable

c.     Positive

3. Describe antepartum assessment.

Initial Assessment

- History:

·       calculate (GPAL = gravida, para, abortions, living children) and length of gestation

·       any maternal or infant complications/multiple gestation

·       calculate Estimated Date of Birth (EDB)

8. Describe perinatal care choices.

• Physician care • Midwives • Doulas • Birth plan

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1.    Relate the pathology to therapy; describe pharmacological and nursing interventions associated with an acute respiratory illness in the pediatric population.

a.     Epinephrine, dexamethasone, bronchodilators, corticosteroids, nebulized normal or hypertonic saline, etc.

b. Oxygen therapy, cold humidity, corticosteroid therapy, inhalation therapy, positioning, maintaining a calm environment, Croup score, hydration, prevention and health teaching