LINCOLN MEMORIAL UNIVERSITYCAYLOR SCHOOL OF NURSINGNURS 246SPRING 2008LESSON PLAN: CARE OF WOMEN DURING THE PRENATAL PERIODDATES & TIMES: See SyllabusOBJECTIVES: Upon completion of this unit, the student will demonstrate in the clinical/community setting, inindividual and group conferences, and on writtenmaterial an understanding of the following:1. Define key terms found in each assigned chapter.2. Describe the components of fertilization.3. Explain milestones in human development from conception to term pregnancy.4. Identify the etiology of risk factors that can affect conception, gestation, and embryonic/fetal growth and development adversely.5. Describe fetal circulation and the development, structure, and functions of the placenta, amniotic fluid, and umbilical cord.6. Describe methods of prenatal screening and diagnostic procedures. 7. Compose a nursing plan of care for a client facing prenatal diagnosis options.8. Describe the presumptive, probable, and positive signs of pregnancy and relate them to physiologic changes in a woman’s body.9. Identify approaches that will enable the nurse to provide culturally sensitive and relevant care to the expectant woman and family.10. Explain the impact of age on pregnancy.11. Describe physiological and emotional changes during pregnancy and identify nursing interventions for each change.12. Compose a nursing plan of care for the physiological changes that occurs with pregnancy13. Describe the presumptive, probable, and positive signs of pregnancy and relate them to physiologic changes in a woman’s body14. Summarize the components of an assessment for pregnant women, focused on appropriate history taking, physical examination, and laboratory evaluation.15. Utilize Naegele’s Rule to determine estimated date of delivery (EDD).16. Describe methods of diagnostic assessment of the fetus.17. Describe common discomforts of pregnancy and measures to relieve them.18. Describe Rubin’s themes of maternal tasks of pregnancy.19. Identify nutritional requirements during each trimester of pregnancy.20. Develop a plan of care that maintains and promotes well-being in each trimester of pregnancy.21. Perform nursing assessments and plan interventions for the family unit throughout1the prenatal period.22. Identify the role of risk assessment in pregnancy as well as areas of focus in performing such evaluation23. Describe the psychosocial considerations along with communication techniques the nurse utilizes when working with a pregnant client with risk factors.24. Outline the nursing process in the management of common disorders for the pregnancy at risk: respiratory disorders, anemia, autoimmune diseases, infections, psychosocial disorders, obesity, substance abuse, diabetes mellitus, cardiovascular disease, hyperemesis gravidarum, Preterm premature rupture of membranes, hypertensive disorders, DIC, and HELLP 25. Discuss the effects and treatment of infectious processes and environmental agents on pregnancy and the fetus.26. Identify uses, side effects, and nursing implications of medications used during normal and high-risk pregnancies27. Summarize reasons for early as well as perinatal loss and describe nursing interventions in each situation.28. Describe the various prenatal care providers29. Describe the relationship between childbirth preparation and health promotion for women, infants, children, and families.30. Identify specific types of childbirth preparation classes and their areas of focus and emphasis.31. Describe influences fear, pain, and control can have over a client’s preferences for labor and birth.REQUIRED READINGS:Orshan, S. A. (2008). Maternity, newborn, & women’s health nursing:Comprehensive care across the life span. Philadelphia: Lippincott,Williams & Wilkins. Chapters 11, 12, 13, 14.TOPICAL OUTLINE:I. Conception/Fetal Development (362 - >)A. Membranes, Placenta, and Amniotic FluidB. Fetal CirculationC. TeratologyD. Multiple GestationsE. Fetal Development (to page 379)II. Assessment of the Woman Who is PregnantA. Signs of Pregnancy1. Presumptive22. Probable3. PositiveB. Physiologic Changes in PregnancyC. Physiologic Changes Related to Age/Race1. Assessment2. Nursing Care Related to Age/Race Variationsa. age related variationsb. sociocultural variationsc. religious variations D. Psychological and Emotional Changes in PregnancyIII. Antepartal Health AssessmentA. Initial Prenatal Health Assessment1. Health Historya. menstrual historyb. sexual historyc. past pregnancy historyd. current pregnancy historye. past medical/surgical historyf. family historyg. sociocultural historyh. history of abuse2. Physical Examinationa. Nagele’s Rule3. General Survey and Pelvic Adequacy4. Laboratory Evaluation and Disease Screening5. Subsequent Follow-up AssessmentsB. Prenatal Screening and Diagnostic Procedures1. MSAFP2. Ultrasound Evaluation3. Invasive Testsa. amniocentesisb. CVSc. PUBSC. Assessment of Fetal Well-Being1. Fetal Activity2. Biophysical Profile3. CST/OCT4. Umbilical Artery Doppler VelocimetryIV. Care of Women Experiencing Common Discomforts/Concerns of Pregnancy3V. Nutrition During PregnancyA. Weight GainB. Nutritional RequirementsC. SupplementsD. Role of Nutrients in Pregnancy (Down to Lactation, pg 102)E. Nutritional Concerns for Pregnant Adolescents (to adulthood, pg 109)VI. Care of the Couple Experiencing a Genetic DisorderA. Teratology (pg 375 to Multiple Gestation, pg 377)B. Preconception Health AssessmentC. Genetic CounselingD. Basic Genetic Principles 1. Mendelian Patterns of Inheritance2. Prenatal Health Assessment for Genetic Disorders3. Anticipatory Care/Counseling4. Pre-implantation Genetic Disorder Diagnosis5. Postnatal Screening and Diagnostic ProceduresVII. Caring for Women Experiencing A High Risk PregnancyA. Pregnancy Risk Assessment1. Psychosocial Risk Factors2. Economic Risk Factors3. Nutrition Risk Factors4. Family Risk FactorsB. Psychosocial Disorders & Problems C. Common Interventions in High Risk Pregnancies1. Fetal Health Surveillance2. BedrestD. Pre-Gestational/Gestational Health Complications Found in Pregnant Women1. Asthma2. Cystic Fibrosis3. Cardiovascular Disease4. Anemia5. Autoimmune Diseases6. Infectionsa. TORCHb. Others7. Renal/Urinary Problems8. DM9. Psychosocial Disorders10. Obesity4E. Caring for Women Experiencing High Risk