METHODICAL INSTRUCTION FOR STUDENTS OF INTERNATIONAL NURSING SCHOOL ADN-2 PROGRAM OF FOREIGN STUDENT FACULTY
LESSON 7 (practical 5 hours)
Themes: Labour and Birth Complications (Distocia, Obstetric operations, Obstetric emergencies). Nursing management during labour with birth complications
Aim: to know peculiarities of nursing care during labour and delivery, using the nonpharmacological and pharmacologicl interventions to relive the discomfort during the different stages of labour; peculiarities of nursing care during complicated labour
Professional orientation of students: Pregnant woman commonly worry about the pain they will experience during labour and birth and how they will react to deal with that pain. A variety of childbirth preparation methods help the woman or couple cope with discomfort of labour. The interventions selected depend on the situation and preference of both the woman and her health care provider. The discomfort experienced during labour are the nonpharmacological and pharmacologicl interventions to relive the discomfort possible during the different stages of labour. The information provides the basis for understanding the nurse’s role in the management of mathernal discomfort during labour.
When complications arise during labour and birth, risk of perinatal morbidity and mortality increase. Some complications are anticipated, especially if the mother is identified as risk during the antepartum period; others are unexpected or unforeseen. The woman, her family, and the obstetric team can feel devastated when things go provide effective support. It is crucial for nurses to understand the normal birth process to prevent and detect deviations from normal labour and birth and to implement nursing measures when complications arise. Optimal care of the laboring woman, fetus and family experiencing complications is possible only when the nurse and other members of the obstetric team use their knowledge ans skills in a concerted effort to provide care
1. Algorithm of students’ communication with patients with pathology in subject (communication skills) (for clinical department):
Work 1. Students work with case study
Work 2. Students analyze the partogram and check the type of labour complication.
Work 3. Students develop nursing care plan in case of dysfunctional labour
Work 4. Students try to apply and assist during forceps and vacuum assisted delivery (on phantom).
Work 5. Students participate in preparing pregnant woman to CS.
2. Individual Students Program.
1. Dysfunctional labour: predisposing factors, type
2. Hypotonic uterine dysfunction: symptoms, partogram, management, related maternal and fetal risk
3. Hypertonic uterine dysfunction: symptoms, partogram, management, related maternal and fetal risk
4. Cephalo-pelvic disproportion: cause, management, symptoms
5. Operations: version, forceps- and vacuum assisted birth, CS. Indication, preparation, anesthesia, postoperative care,
6. Trial of labour, induction of labour: indication, management/
7. Bishop scale
8. Cervical ripening method
9. Vaginal birth after delivery
10. Postterm pregnancy: definition, maternal and fetal risk, management
11. Shoulder dystocia: definition management
12. Prolaps of umbilicalcord: risk factors, sign, interventions
13. Rupture of uterus: etiologic factors, clinical manifestation, care management
14. Amniotic fluid embolism: sign, intervention.
3. Seminar discussion of theoretical issues.
4. Test evaluation and situational tasks.
1. The priority nursing care associated with an oxytocin infusion is:
A. measuring urinary output.
B. increasing infusion rate every 30 minutes.
C. monitoring uterine response.
D. evaluating cervical dilation.
2. While assisting with a vacuum extraction birth, which of the following should the nurse immediately report to the physician?
A. Persistent fetal bradycardia below 100
B. Maternal pulse rate of 100
C. Maternal blood pressure of 120/70
D. Decreased intensity of uterine contractions
3. The nurse reviews for the childbirth preparation class the rationales for labor induction, which are:
A. Placenta previa
B. Prolapse of cord
C. High station of fetus
D. Placental insufficiency
5. Initial level of knowledge and skills are checked by solving situational tasks for each topic, by answers in “Krok” test evaluations and constructive questions etc. .
6. Student should know:
– symptoms, partogram, management, related maternal and fetal risk of hypotonic & hypertonic uterine dysfunction, CPD
– type, indication, preparation, anesthesia, postoperative care of obstetric operations
– evaluation of uterine cervix by Bishop scale
– method of cervical ripening
– definition, maternal and fetal risk, management of shoulder dystocia, prolaps of umbilical cord, rupture of uterus, amniotic fluid embolism
7. Student should be able to:
– develop nursing care plan in case of hypotonic & hypertonic uterine dysfunction, CPD, shoulder dystocia, prolaps of umbilical cord, rupture of uterus, amniotic fluid embolism
– prepare pregnant woman to obstetric operations
8. Correct answers of test evaluations and situational tasks:
1. C
2. A
3. D
9. References:
Basic
1. Lowdermilk, D.L.; Perry, S.E.; & Bobak, I.M. (2004). Maternity And Women’s Health Care (8 th Ed.) St. Louis: Mosby, Ch 9
2. Piotrowski, K. (2004). Study Guide: Maternity And Women’s Health Care (8 th Ed.) St. Louis: Mosby
3. A lecturer notes
4.http://intranet.tdmu.edu.ua/index_en.php?dir_name=kafedra&file_name=education.php
Additional
1. Miller Alistair W.F. et al (1998): Obstetric illustrated, 5th ed, Britain, Harcourt Brace and company limited
2. Hacker & Moore, (1998): Essential of Obstetric and Gynecology, 3rd ed, W.B. Saunders Company, USA.
3. Fraser Dian M, et al, (2003): Myles textbook for midwives, 14th ed, Elsevier science limited, china.
4. Ladwing Patrica W, et al, (2003): Maternal and newborursing. 1st ed, Addison wesley longman, Canada
5. Nichols, F. N., and Zwelling, E. (1997) Maternal-Newborn Nursing—Theory and Practice. Saunders: Piladelphia.
6. Maternal & Child Health Nursing. Care of the Childbearing and Childrearing Family. Adele Pillitteri – J.B. Lippincott. – 1895p. 1995
7. Maternal Newborn Nursing. A Family-Centered Approach. Fifth edition. Olds, London, Ladewig. 1219p. 1995
8. Maternity&Pediatric Nursing. Gloria Leifer. 4th ed., 2003.- Saunders.- 884 p
9. Women’s Helth Care Nurse Practitioner Certification Review Guide. 1995 Susan B. Moskosky 493p
10. Women’s Helth Care. Clinical Vignettes.2000 Laure Veet, MD 410p
11. Maternity Nursing. Review& Study Guide to Accompany.1999 Elaine R. Zimber Appleton & Lange 309p
12. Maternal Newborn Nursing Care Plans. Carol, Green, Wilkinson 2004.- Mosby.- 703 p.
13. Journal articles.
Methodical instruction has been worked out by Assistant professor N. Petrenko, MD, PhD
Methodical instruction was discussed and adapted at the Department sitting
27.05.2011. Minute № 13
Methodical instruction was reviewed and adapted at the Department sitting
24.05.2012. Minute № 13
Methodical instruction was reviewed and adapted at the Department sitting
23.05.2013. Minute № 10
Methodical instruction was reviewed and adapted at the Department sitting
__________201 . Minute № ___
Methodical instruction was reviewed and adapted at the Department sitting
__________201 . Minute № ___
Methodical instruction was reviewed and adapted at the Department sitting
__________201 . Minute № ___
Methodical instruction was reviewed and adapted at the Department sitting
__________201 . Minute № ___
Methodical instruction was reviewed and adapted at the Department sitting
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