WILKES UNIVERSITY PASSAN SCHOOL OF NURSING 84 West South Street Wilkes-Barre, PA 18766 (570) 408-4071 Course Title: Credits: Course Description: NSG 241: Nursing Care of the Child Bearing Family 4 Credits The nursing process is utilized in childbearing families within their communities to meet their human needs. Nursing theory is correlated with clinical practice in a variety of health care settings. This course is designated for Women s and Gender Studies (WGS). Pre-Requisite Courses: NSG 213, NSG 235, NSG 236, NSG 342 Co-Requisite Courses: NSG 237, NSG 238 Placement: Semester, Junior Year. Faculty: Class: Textbooks/Materials American Psychological Association (2009). Publication manual of the American psychological association (6th ed.). Washington, DC: American Psychological Association. Andrews, M., M. & Boyle, J., S. (2012). Transcultural concepts in nursing care (6th Ed.). Philadelphia, PA: Lippincott, Williams & Wilkins. Durhan, R. & Chapman, L. (2014). Maternal-newborn nursing (2nd Ed.). Philadelphia, PA: F. A. Davis Company. Recommended Textbooks/Materials 1
Course Outcomes: At the conclusion of the course the student will: 1. relate concepts from the humanities, physical and social sciences to the care of the growing family. 2. use the nursing process to assist the growing family to prevent illness and promote, maintain, and restore health. 3. use standards of care to meet the needs of the growing family. 4. discuss research findings in relation to maternal health nursing practice. 5. demonstrate development of the professional role in obstetric clinical practice. Teaching Strategies: Description: The following teaching strategies may be utilized: 1. Lecture 2. Power Point 3. Case Studies University Mission: To continue the Wilkes tradition of liberally educating our students for lifelong learning and success in a constantly evolving and multicultural world through a commitment to individualized attention, exceptional teaching, scholarship and academic excellence, while continuing the University s commitment to community engagement. Passan School of Nursing Mission: The mission of the Passan School of Nursing is to promote interprofessional practitioners of nursing, who provide quality health care in a constantly evolving multicultural world, engage in lifelong learning, and expand nursing science through scholarship, technology, and academic excellence, while engaging in community service Requirements and Evaluation Components: Assessment of the student s progress is an ongoing process involving the student and instructor. The final grade is the composite of the theoretical. The stated course outcomes serve as the basis of evaluation. Course evaluation tools vary and may include unit quizzes, unit exams, a final exam, term project, and written assignments. 2
Tests will be objective and/or subjective. Tests will include materials from lectures, readings, and CNSC assignments (Specific to Physical Assessment). If a discrepancy exists among resources, the required textbook is considered the final authority on the subject. Unannounced quizzes and assignments may be given at any time and additional readings may be assigned. All unit and final exams must be taken on the scheduled dates. Test dates are subject to change with adequate notification by faculty. If a student is unable to be present for an exam, the student must contact the instructor prior to the exam for permission to miss the exam. If this is not done, a makeup examination will not be given and the test score will result in a 0. Equivalence of grades: The theory grade is determined by the following: 4.0 = 92 100 % 3.5 = 88 91% 3.0 = 84 87% 2.5 = 79 83% 2.0 = 75 78% 1.5 = 70 74% 1.0 = 65 69% 0.0 = less than 65% PROGRESSION POLICY In order to progress INTO clinical nursing courses, students must: Complete the ATI/TEAS test exam o Wilkes University s Passan School of Nursing requires that the student score 58.7 or higher, including the Accelerated Baccalaureate students. Earn a 2.5 or better in all prerequisite nursing courses: o BIO 113 (Microbiology); BIO 115, and 116 (Anatomy and Physiology I and II); CHM 111 (Fundamentals of Chemistry); and ENG 101 (Composition). Maintain an overall Grade Point Average (GPA) of 2.5 or greater. In order to progress THROUGH the nursing curriculum, all nursing majors must: 3
Earn a 2.5 or better in all nursing courses. Earn a 2.5 or better in all required science courses. Meet expected outcomes in all nursing courses. o A nursing student who earns less than a 2.5 in a nursing course may repeat that course once. A nursing student who earns less than a 2.5 in a second nursing course is ineligible to continue in the nursing program. Maintain an overall Grade Point Average (GPA) of 2.5 or greater. The theory grade will be determined as follows: Exam I.20% Exam II... 20% Writing Assignment....10% ATI.....10% Other Assignments..15% Final Exam...25% Course Policies: The link for the Passan School of Nursing Handbook is: http://www.wilkes.edu/academics/colleges/school-of-nursing/assets/undergradute-nursing-handbook.pdf All students are required to read and submit an attestation document at the beginning of each academic year. Students must adhere to all policies in the Passan School of Nursing Handbook Professionalism: Attendance: The faculty and staff of the Passan School of Nursing understand that the student is an adult learner. Attendance is required at all classes. Dress Policy: 4
Academic Honesty: At Wilkes the faculty and the entire University community share a deep commitment to academic honesty and integrity. The following are considered to be serious violations and will not be tolerated: 1. Plagiarism: the use of another s ideas, programs, or words without proper acknowledgement. 2. Collusion: improper collaboration with another in preparing assignments, computer programs, or in taking examinations. 3. Cheating: giving improper aid to another, or receiving such aid from another, or from some other source. Any student who violates the Intellectual Responsibility and Plagiarism Policy will fail the course. Communication Policy: Taping: The School of Nursing adheres to all university policies on academics published in the Wilkes University Student Handbook. In addition, the student is advised to read and comply with the policies of the School of Nursing published in the Nursing Student Handbook as noted online. Students are not permitted to tape lectures without specific permission from the instructor. Completion of Required Clinical Nursing Simulation (CNSC) Requirements: Examination Policy & Procedure: Medication Proficiency Policy: Assignment Due Dates: 5
Academic Support: If a student earns a grade of less than 79% on any exam, the student is expected to meet with the course instructor. The student may also be asked to meet with the Retention and Remediation Coordinator. At the time of midterm, the student is strongly advised to discuss their academic concerns, if any, with their nursing advisor, course instructor, and Retention & Remediation Coordinator. The student may be referred to University College, located in Conyngham Hall, for academic support services (i.e. peer tutoring, test taking support, time management, note taking, and study skills). Clinical Requirements and Evaluations of Components: Attendance at all clinical experiences is required. Refer to School of Nursing Student handbook Guidelines Governing Attendance at the Clinical Experience. All written assignments must be satisfactorily completed in order to pass the clinical component of the course. Students who do not satisfactorily complete assignments at the appropriate time will jeopardize their satisfactory completion of the clinical component of the course. Clinical Skill Checklist: Each student will receive his/her clinical skills checklist during the first day of class for all incoming students. The nursing student is responsible for bringing the checklist to each clinical experience throughout the nursing program. The clinical instructor will be responsible for initialing and dating the skills when first accomplished and at the point of proficiency. The clinical instructor and student will review the form for completeness and accuracy at the time of each clinical evaluation. The student is responsible for maintaining the hard copy of the clinical skills checklist throughout the program. A scanned copy will be submitted to an electronic drop box at the completion of the clinical rotation. Student Community Service Requirement: Policy on Integrated Testing Program: All students are required to complete the Integrated Testing Program administered by the School of Nursing. Course Examinations: 6
Advisement: Every nursing major is assigned a faculty advisor within the Passan School of Nursing. Students must check the roster as posted in the Passan School of Nursing. SM/bl 12/10 SM/bl 05/11 SM/bl/8/12 BZ/bl 02/17/16 Revised: LP/bz 5/16 Revised: SM/bl 01/17 7
Module Content Student Learning Outcomes Resources Assessment Activities Welcome Review course syllabus Identify course requirements Women s Health Alterations in Women s Health LIVE: Desire2Learn e-learning System Orientation by clinical faculty in CNSC Health promotion/risk reduction Cultural awareness: Care beliefs Reproductive changes across the life span (puberty to menopause) Osteoporosis Signs and symptoms Risk factors Risk reduction Pharmacotherapy Common diagnostic procedures Hysterectomy Menstrual disorders Chronic pelvic pain Polycystic ovary syndrome Endometriosis Infections STI/STD Discover course resources in D2L/LIVE Identify factors that place women at risk for adverse health conditions Discuss preventive screenings for women across the lifespan Describe lifestyle factors that influence the health of women Discuss changes related to perimenopause and menopause Identify pharmacology prescribed in women s health Describe diagnostic procedures commonly used in women s health Discuss various causes of menstrual disorders Read course syllabus Review course resources in D2L/LIVE Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 18 Course Outcomes 1 1 8
Well Antepartum Pharmacotherapy Identify pharmacology prescribed in alterations in women s health Leiomyomas Ovarian cysts Disorders of pelvic support Breast disorders Breast self-exam Gynecological cancers Cervical Endometrial Ovarian Intimate partner violence Methods of contraception Pharmacotherapy Cultural considerations Genetics and the childbearing family Teratogens Anatomy & physiology review (female and male) Menstrual cycle Ovarian cycle Endometrial cycle Oogenesis Spermatogenesis Conception Embryo and fetal development Placenta, membranes, amniotic fluid & umbilical cord Discuss the relevance of genetics of the childbearing family Identify components of conception, embryotic development, and fetal development Describe the common tests in diagnosing infertility Describe the common methods used in fertility Identify major components of preconception health care Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 19 Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 3, 4, 5 & 6, pgs. 324-326 Quiz I: Alterations in Women s Health Demonstratio n of Postpartum Assessment and Newborn Assessment with Clinical faculty in CNSC 1,2 9
Infertility and reproductive technology Preconception health care Diagnosis of pregnancy Presumptive Probable Positive Sonographic diagnosis Calculation of due date Nutritional needs of pregnancy Pregnancy (physiological changes) Reproductive system Cardiovascular system Respiratory system Renal system Gastrointestinal system Musculoskeletal system Integumentary system Endocrine system Immune system Prenatal assessment First trimester Second trimester Third trimester Psycho-social-cultural aspects Maternal tasks Maternal adaptation Sexuality in pregnancy Identify methods for diagnosis of pregnancy and estimated delivery Identify anatomical and physiological changes in pregnancy Describe interventions to relieve discomforts of pregnancy Identify assessments, education and anticipatory guidance during pregnancy Describe emotional changes of the pregnant woman Identify maternal, paternal and family adaptation Identify cultural factors that influence pregnancy Discuss factors in preparing for childbirth Identify antepartal tests (purpose and indication) Identify patient teaching related to antenatal tests Identify pharmacology prescribed in well antepartum period 10
High-Risk Antepartum Paternal adaptation Sibling adaptation Social support Cultural aspects Planning for birth Provider Birth plan Place of birth Doula Childbirth education Antepartal testing Ultrasonography Chorionic villus sampling Amniocentesis Alpha-Fetoprotein Non-stress/contraction test Amniotic fluid index Biophysical profile Pharmacotherapy Gestational complications Preterm labor and birth Preterm premature rupture of membranes Incompetent cervix Multiple gestation Hyperemesis gravidarum Diabetes in pregnancy Gestational diabetes Pregnancy hypertension Preeclampsia Eclampsia HEELP syndrome Placental abnormalities & hemorrhagic complications Placenta previa Placental abruption Describe primary complications of pregnancy Demonstrate understanding of knowledge related to preexisting medical complications of pregnancy and related management Identify potential antepartal complications of the women, the fetus, and the newborn Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 7 Culture Topic Writing Assignment Due 1,6 11
Placental accrete Abortion Ectopic pregnancy Gestational trophoblastic disease Identify pharmacology prescribed in high risk antepartum period Intrapartal Period Infections HIV/AIDS STI/STD TORCH Trauma during pregnancy Pregestational complications Substance abuse Smoking/tobacco use Alcohol Illicit drugs Pharmacotherapy Labor Triggers Maternal factors Fetal factors The Process of labor Factors affecting labor (5) Power Passage Passenger Position Psyche Culture and birth traditions Onset of labor True vs. false labor Identify premonitory signs of labor. Compare and contrast true versus false labor. Describe the four stages of labor Demonstrate understanding of supportive care of the laboring woman Identify the five P s of labor Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 8 & 9 Exam I: Women s Health & Antepartum 1 12
Assessment of rupture of membranes Effacement Dilatation Mechanisms of labor 7 cardinal movements Stages and phases of labor and childbirth First stage Latent phase Active phase Transition phase Second stage Third stage Fourth stage The newborn at time of birth Apgar score Management of pain and discomfort during labor and delivery Non-pharmacological Pharmacological Fetal assessment during labor and delivery Modes or types of fetal and uterine monitoring Auscultation Palpation of contractions External monitoring Internal monitoring Influences on fetal heart rate Fetal reserves Describe the mechanism of spontaneous vaginal delivery and related nursing care Discuss various comfortpromotion and pain-relief strategies used during labor and birth. Analyze the nurse s role throughout the labor and birth process including fetal assessment. Describe components and patterns of fetal heart rate Identify pharmacology prescribed in intrapartal period 13
High-Risk Intrapartal Period FHR and contraction pattern Baseline Variability Fetal tachycardia Fetal bradycardia Accelerations Decelerations Early Variable Late Prolonged Monitoring multiple gestation Pharmacotherapy Dystocia Shoulder Precipitous labor Fetal Pelvic Labor interventions Labor induction Labor augmentation Cervical ripening Membrane stripping Amniotomy Complementary therapies Operative vaginal delivery Vacuum assisted Forceps-assisted Vaginal birth after cesarean (VBAC) Post-term delivery Describe primary causes of dystocia and related care Understand induction of labor, augmentation of labor and vaginal birth after cesarean (VBAC) Identify obstetrical emergencies and related care Identify factors of women at risk for cesarean birth Discuss preoperative nursing care and anesthesia management for cesarean birth Discuss intraoperative nursing care and Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 10 & 11 Quiz II: Intrapartal Period 1,2 14
Postpartum Period Umbilical cord prolapse Vasa previa Rupture of uterus Amniotic fluid embolism DIC Multiple gestation delivery Delivery of fetal demise Cesarean birth Indications Classifications Risks Perioperative care Intraoperative care Postoperative care Pharmacotherapy Reproductive system Uterus Endometrium Vagina and perineum Breasts Cardiovascular system Respiratory system Immune system Urinary system Endocrine system Diaphoresis Muscular and nervous system Gastrointestinal system Discharge teaching Transition to parenthood anesthesia management for cesarean birth Discuss postoperative nursing care of cesarean birth with women, and their family Identify potential intraoperative and postoperative complications related to cesarean birth and nursing actions to reduce risk Identify pharmacology prescribed in high risk intrapartal period Describe the physiological changes that occur during the postpartum period Identify the critical elements of assessment and nursing care during the postpartum period Describe the critical elements of discharge teaching Describe process of becoming a mother Identify factors that influence women and men Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 12 & 13 Quiz III: High Risk Intrapartal Period 1,2 15
High-Risk Postpartum Period Maternal phases Cultural considerations Fatherhood Adolescent parents Bonding and attachment Family dynamics Sibling adjustment Postpartum blues Pharmacotherapy Hemorrhage Risk factors Uterine atony Lacerations Hematomas Subinvolution Retained placental tissue Coagulation disorders DIC Thrombosis Infections Metritis Cystitis Mastitis Wound infections Psychological complications Postpartum depression Postpartum psychosis Paternal postnatal depression Pharmacotherapy in their role transitions to mother or father Discuss bonding and attachment Identify factors that affect family dynamics Identify pharmacology prescribed in postpartum period Describe primary causes of postpartum hemorrhage and related nursing actions and medical care Describe primary causes of postpartum coagulation disorders and related nursing actions and medical care Describe primary causes of postpartum infections and related nursing actions and medical care Describe primary causes of postpartum psychological complications and related nursing actions and medical care Identify pharmacology prescribed in high risk postpartum period Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 14 1,2 16
Neonatal Period Transition to extrauterine life Respiratory system Circulatory system Thermoregulatory system Cold stress Metabolic system Hepatic system Gastrointestinal system Renal system Immune system Neonatal assessment General survey Gestational age Common newborn characteristics Newborn reflexes Pain assessment Ballard scale Behavioral characteristics Periods of reactivity Brazelton assessment Nursing care of the neonate Bathing and skin care Laboratory and diagnostic tests Newborn hearing screening Immunization Hepatitis B Newborn medications Vitamin K Identify the changes that occur during the transition from intrauterine to extrauterine life and related nursing actions List critical elements of neonatal assessment and gestational age Discuss methods used in neonatal pain management Describe the nursing care of neonates the first week of life Describe common laboratory and diagnostic tests for neonates Describe nursing actions that support parents in the care of their newborn Identify teaching and learning newborn care of patients Discuss nutritional needs of newborns and infants Demonstrate cultural values in care of newborns Describe the stages and process of human milk production Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 15 & 16 Exam II: Intrapartal & Postpartum 1 17
Erythromycin ointment Circumcision procedure Newborn nutrition and feeding Breastfeeding Formula feeding Overview of human milk production/teaching topics Bottle feeding Cultural considerations Newborn care Bathing Bulb syringe Circumcision care Clothing Colic Cord care Diapering Elimination Follow-up care Potential signs of illness Safety Soothing babies Sudden infant death syndrome Swaddling Temperature taking Pharmacotherapy Identify teaching plan for breastfeeding Identify teaching plan for formula feeding Understand information regarding newborn care Identify pharmacology prescribed in neonatal period 18
High-Risk Neonatal Preterm neonates Assessment findings Medical management Nursing actions Kangaroo care Respiratory distress syndrome Bronchopulmonary dysplasia Periventricularintraventricular hemorrhage Necrotizing enterocolitis Retinopathy Postmature neonates Meconium aspiration syndrome Pulmonary hypertension Small for gestational age Large for gestational age Hyperbilirubinemia Jaundice Physiological Pathological Breastfeeding Central nervous system injuries Infants of mothers with T1 diabetes Neonatal infection Group B streptococcus Substance abuse exposure Describe the physiology and pathophysiology associated with selected complications or the neonatal period Identify critical elements of assessment and nursing care of the high-risk neonate Develop a discharge plan for high-risk neonates Describe the loss and grief process experienced by parents whose infant has died Identify pharmacology prescribed in high risk neonatal period Durham & Chapman (2014) Maternal- Newborn Nursing Ch. 17 SBL with Clinical Faculty in CSNS 1, 2 3, 5, 7 19
Common congenital anomalies Discharge planning Loss and grief Pharmacotherapy ATI Testing & Final Exam: Time and Day TBA 1, 2 20