AnkyloglossiaCleft Lip & PalateThrushOmphaloceleGastroschisisDiaphragmatic HerniaImperforate AnusNeural Tube DisordersPolydactyly/SyndactylyReferencesLINCOLN MEMORIAL UNIVERSITYCAYLOR SCHOOL OF NURSINGNURS 246LESSON PLAN: CARE OF THE NEONATE AND POSTPARTAL FAMILYDATES & TIMES: SEE SYLLABUSOBJECTIVES:Upon completion of this unit, the student will demonstrate inthe clinical/community setting, in individual and groupconferences, and on written material an understanding of thefollowing:1. Define the key terms found in each assigned chapter.2. Describe the normal anatomical and physical changes occurring in the postpartal period.3. Compare normal and abnormal signs of mother-child adaptation or bonding4. Explain the nurse’s role during the taking-in and taking-hold phases of the postpartal period.5. Differentiate postpartum blues, depression, and postpartum psychosis and the etiology of each6. Prepare teaching plans for self-care for the postpartum patient.7. Explain the etiology, signs, and symptoms, medical management, and nursing responsibilitieswhen caring for a patient with potential or actual problems during the postpartum period, including the various bleeding disorders and puerperal infections.8. Discuss pharmacologic agents used during the postpartum period, including action, use, usualdosage, route of administration, side effects, and dosage calculation9. Distinguish the physiologic and anatomic changes occurring in the major body systems of thenewborn at birth.10. Identify nursing responsibilities immediately after birth and during the transitional period.11. Recognize normal physical and behavioral assessment findings in the newborn.12. Identify nursing responsibilities during the first 24 hours of the newborn’s life.13. Distinguish factors of anatomical maturity, which may be utilized as indicators of gestational age.14. Describe newborn reflexes and their significance.15. Describe the daily care of the newborn16. Identify the nutritional requirements of the newborn.17. Outline Hepatitis B immunization requirements, contraindications, precautions, and administration for the newborn. 18. Identify uses, side effects, action and nursing implications of drugs used for the newborn following birth.19. Identify alterations in the newborn related to birth trauma.20. Identify prepregnant, prenatal, and intrapartal factors that lead to early identification of high-risk fetuses/neonates.121. Identify high-risk newborns with commonly occurring health problems and the physiologic process of each.22. Identify commonly occurring problems and the nursing care for the preterm and post term infant 23. Identify the clinical assessment and basic nursing care associated with respiratory distress in newborns.24. Describe the cause, diagnosis, and treatment of hyperbilirubinemia.25. Discuss signs, symptoms, prevention, and management of commonly occurring metabolic alterations in newborns.26. Describe common congenital abnormalities of the newborn, including etiology, clinical manifestations, and medical, surgical, and nursing management.27. List signs and symptoms of congenital heart defects and neural tube defects.28. Differentiate hypospadias, ambiguous genitalia, epispadias, extrophy of the bladder, and imperforate anus and describe the surgical correction for each.29. Develop a nursing care plan with the etiology, mode of transmission, signs, symptoms, and treatment of the infant with (1) thrush, (2) opthalmia neonatorum, (3) necrotizing enterocolitis, and (4) sepsis.30. Analyze the clinical manifestations and explain the management of: drug addiction in the newborn, fetal alcohol syndrome, sexually transmitted diseases, hypoglycemia, and AIDS. REQUIRED READINGS:Orshan, S. A. (2008). Maternity, newborn, & women’s health nursing: Comprehensive health care across the life span. Philadelphia: Lippincott,Williams & Willkins. Chapters 18, 19, 20, 21, 22.TOPICAL OUTLINE:I. Nursing Assessment of Women Experiencing Postpartal AdaptationA. Maternal Postpartal Physiologic AdaptationB. Postpartal Psychological Adaptation1. Development of maternal role2. Postpartum blues 3. Postpartum depression4. Postpartum Panic/Postpartum PsychosisC. Postpartal Nursing Management of the New Mother1. Vital signs2. BUBBLES3. Follow-up Assessments to complete Recovery2D. Promotion of Maternal Comfort and Well-being1. Comfort2. Elimination3. Activity/Rest4. Self Care5. Safety6. Sexuality/Contraception7. Nutrition8. Discharge HomeE. Nursing Care of Postpartal Women Experiencing Complications1. Bleeding disordersa. postpartum hemorrhage (early & late)b. lacerationsc. hematomas2. Puerperal infectionsa. uterineb. genital tractc. wound/incisionald. UTIe. mastitis3. Thromboembolic complicationsII. Newborn: Transition to Extrauterine LifeA. Physiologic/Anatomic Changes at Birth1. Resolving fetal circulation2. Respiratory/Circulatory AdaptationB. Nursing Assessment of the Neonate1. Immediate Assessmenta. Vaginal birth versus Cesarean birthb. APGAR scoringc. Identificationd. Weight & Measurementse. Medications1. Aqua Mephyton (Vitamin K)2. Ilotycin (Eye Prophylaxis) 3. Hepatitis B Vaccine C. Major Newborn Assessments1. Gestational age2. Full physical assessment3. Neurological/Reflex assessmentD. Physiologic Adaptation of the Newborn1. Thermoregulation32. Glucose metabolism3. Hematopoietic system4. Hepatic system5. Gastrointestinal system6. Immunologic system7. Integumentary system8. Renal systemE. Strategies for Gentle Transitioning1. Gentle handling2. Use of containment3. Avoidance of gastric suctioning4. Use of low lighting5. Use of axillary temperature assessmentF. Basic Care of the Healthy NewbornG. Newborn NutritionIII. Nursing Care of the High-Risk NewbornA. Problems of Size/Age1. SGA/IUGR2. LGA/macrosomia3. Preterm newborn4. Postterm newbornB. Nursing Care of the Newborn with Acquired/Congenital Conditions1. Hyperbililrubinemia2. FAS/drug-addicted newborn3. Congenital anomaliesa. congenital heart diseaseb. diaphragmatic herniac. neural tube defectsd. gastroschisise. cleft lip and palatef. esophageal atresia/TE fistulag. imperforate anush. skeletal anomalies1. hip dysplasia2. clubfooti. genitourinary anomalies4SKILLS: The following skills would be appropriate for N246 students in the clinical or community setting.1. Perform a postpartal assessment on the new mother, assessing vital signs, uterus, lochia, and perineum after delivery.2. Assess homan’s sign.3. Assess/observe mother-baby