LP 1 I NCM 107 RLE I CARE OF PREGNANT WOMAN Students

NCM 107 LEARNING PACKET ON RELATED LEARNING EXPERIENCE
RLE FOCUS UNIT: CARE OF PREGNANT CLIENT
COURSE CODE: NCM 107

COURSE TITLE: Care of Mother, Child, and Adolescent (Well Clients)
YEAR LEVEL, ACADEMIC YEAR: LEVEL 2, 1ST SEMESTER SY 2022-2023
CLINICAL AREA OF ASSIGNMENT: OPD -ITRMC
DATE OF CLINICAL EXPOSURE:
NO. OF HOURS: 72
MODULE OVERVIEW
Nursing is a profession that requires intensive training on both theoretical and clinical perspective. This
course deals with concepts, principles, theories, and techniques in the nursing care of individuals and
families during childbearing and childbearing years toward health promotion, disease prevention,
restoration and maintenance, and rehabilitation. The learners are expected to provide safe,
appropriate, and holistic nursing care to pregnant clients utilizing the nursing process.
Having gone through the theoretical inputs in the NCM 107 lecture, the next step that you need to learn
is on the application of these principles and techniques in the nursing care of these clients.
For this 72- hour related learning experience, you will be catered to flexible clinical learning experiences
through this self-instructional module.
Remember, this might not be a substitute for the actual clinical experience, but this can help you
navigate through your patient care experiences in this alternative learning platform. This module has the
following parts:
Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Rose Marie B. Lagasca, MAN / Editha C. Sabalboro , MAN
CLINICAL INSTRUCTORS
LEARNING MAP
At the end of this 72-hour related learning exposure, you are expected to:
1. reflect on the current Maternal and Child Health situation
2. apply knowledge of normal anatomy and physiology and assessment techniques in
caring for clients.
3. describe the growth and development of a fetus by gestation week.
4. assess fetal growth and development through maternal and pregnancy landmarks.
5. provide appropriate client education and health maintenance and family-based care
efficiently utilize available resources in the care of pregnant clients to achieve
outcomes.

FIRST STEP TO ACHIEVE YOUR OBJECTIVE
You had your discussion on the concepts and principles in the nursing care of individuals and families
during pregnancy in Maternal and Child Nursing NCM 107 lecture (well client) A nurse’s responsibility
includes the identification of concerns of patients upon admission to any medical facility or during
bedside rounds. Choose from among the following patients who have presented symptoms of pregnancy
by placing a (/) check mark and an (X) if otherwise. And then you can distinguish the different physiologic
changes of pregnancy.
_____ Patient C. M. is complaining of abdominal discomfort on upper right quadrant.
_____ Patient S. G. was admitted to the ER experiencing vomiting 4x for two days.
_____Patient A. M. has difficulty breathing with wheezing noted.
_____ Patient A. W. complains about lower limb weakness with tingling sensation.
_____ Patient B. C. is pale upon arrival in the ER and complains of dizziness.
_____ Patient B. T. has bipedal edema with and difficulty walking.
_____ Patient C. L. experience morning sickness smells sensitivity.
_____ Patient R. M. complaint of mild cramping and spotting.
_____ Patient R. P. felt fetal movement in her abdomen.
_____ Patient M. G. experience frequent urination.
_____ Patient M.G. experience weight gains monthly.
_____ Patient M.G. is having globular abdomen with fetal heart tone

You are now on duty in the OPD of Ilocos Training Regional Medical Center. In this 72- hour
duty, you are expected to handle and manage the care of patients in the OPD. You are assigned
to take care of at least 1 patient. You will be performing the following nursing responsibilities:
• Vital Signs Monitoring and checking FHT
• Patient History takin
• Computation of AOG/EDC
• Continuous Patient Assessment and monitoring
• Preparation and Administration of Medications
• Planning of Nursing Care Plans
• Patient Care Documentation/FDAR
In your provision of the nursing care, you are reminded of the following behaviors:
•Professional behaviors – engage appropriate legal and ethical behaviors.
•Communication – communicate effectively with your patient, SO and the health team
•Clinical Decision-Making – develop critical thinking skills to make responsible decisions related
to assessing the patient.
•Caring Interventions – maintaining a safe environment for the patient, including assessing
social, cultural and spiritual influences
•Teaching and Learning – provide health education to patient and SO
•Collaboration – collaborate with patient and SO

THE BIG LEAP
A 20-year-old female client had her consultation June 28, 2020, at 10:00 am, in Outpatient
Department of Ilocos Training and Regional Training Center complaining of vomiting four times
per day, feeling dizzy and weak. She states she is nauseated, especially in the morning, smells
sensitivity, have frequent urination and sometimes feel burning sensation while urinating. She had
her urine examine for urinalysis and pregnancy test. Her LMP is April 20,2020. She is a
multigravida. Based on her interview, she had 4 prior pregnancies. One child born at 37 th weeks
via NSD, 2nd baby born at 32 weeks via Cesarean Section. She had twins for her third pregnancy
born at 36th week. After one week, one of the twins died. After 5 years, she was pregnant again
for the 4th time. She never received any Tetanus toxoid during her pregnancy. When she has her
prenatal visit in the clinic she was discussing with the nurse where she will give birth. She has
options where to deliver in a tertiary hospital or City Health & Wellness Hospital. She arrives for
her visit with her mother and notices that she seems to be bothered with something. The clinic
nurse asks them what is wrong? When there is little response, she asks if she is starting to
experience some fears about labor and delivery, and quickly goes on to reassure her that they will
discuss all the options for coping. She does not make eye contact. After an uncomfortable
silence the clinic nurse begins to enquire about fetal movement, changes in vaginal discharge,
whether she is taking her prenatal supplement, feel headaches. She answers with yes or no.
The clinic nurse explains she will delivery in a hospital. After a moment, her mother (Mila) replies
that she will deliver in a tertiary hospital, and she will be there to accompany her. Her mother
informs the clinic nurse that she is upset because she does not want to leave her husband and
kids when she delivers. She is attending to the needs of her family. Preparing food for breakfast,
lunch, and dinner. As a routine work of a mother. She sees also that she eats a balance diet. The
clinic nurse proceeds to explain the next steps in setting appointment with her physician, Dr.
Camille Angara.
Although the clinic nurse suspects that there may be something bothering her. The clinic nurse
casually asks whether there are any plans to attend to her and if other person who can
accompany her. There are vague responses. When the clinic nurse asks questions,
she speaks directly to her mother until she initiates eye contact.
The clinic nurse goes to ask about fetal movements and jokes about how active the baby is. She
smiles a little and makes brief eye contact with the clinic nurse, which the clinic nurse sees an
indication that she is ready to speak about her concerns. When she feels that she is relaxed, she
asks about her husband and how they are doing as a couple. She answers that she is worried
about having to choose between bringing her mother or husband (Dominic), with her when she
will deliver.
Her mother (Mila) then asks when she will be “sent out”. The clinic nurse asks her where she will
deliver and asks them if they have discussed their plans and considerations. Her mother replies
that her daughter will deliver in a tertiary hospital, and she will accompany her. The clinic nurse
glances her to see how she reacts. She reassures them that she will request if her husband can
accompany her.
When the clinic nurse starts to assess the client, the client looks weak in appearance. She has
vital signs of BP 110/70, PR=78/min, Temp=36.8’C. RR= 20/min, FHT=108bpm; Weight=58kgs.
LMP was April 20, 2020. She had her blood works done for CBC. Ultrasound was done. The
baby is in cephalic presentation, amount of amniotic fluid is adequate, gender cannot be identified.
The height of the fundus is aligned on the umbilicus. Her abdomen is globular in shape. No striae
noted. Her breast is engorged. No swelling on the lower extremities. Oral Ferrous Sulfate 30 mg
was ordered to be taken once a day. Folic acid 400 mcg/day. Tetanus Toxoid was also given via
IM. She does not have any allergies.
The referral appointment is booked for one week from the current visit.
She fills up a birth plan where she wants to be admitted in the hospital ITRMC under the service
of Dra. Camille Angara. She prefers to be in a Medicare room. She will be accompanied by her
husband’s name is Dominic Argueza. His contact number 0916 -284- 3207. They have savings of
35,000 for her delivery. In case she will have emergency caesarian section delivery, she will be
under the team of Dra. Angara. Her blood type is AB if blood transfusion is needed.
The day following her scheduled appointment in the clinic, she calls the clinic nurse to tell her that
she has noticed blood in the toilet and that she is at home. The clinic nurse advises her for
consultation. She was accompanied by her husband to the clinic. She was examined by her
Obstetrician and she advised her for admission already.

ARRIVAL CHECK
You immerse yourself in the care management of your patient, let us take note of the detailed
description of your patient care tasks. Using the Case Scenario assigned to you are expected to
perform the following:
• Conduct a patient history taking and physical assessment of your patient following the format by
the Lorma College of Nursing Patient History
• Compute the AOG/EDC.
• Fill up the birth plan.
• Formulate a Nursing Care Plan for you patient based on 3 prioritized problems using the Lorma
College of Nursing NCP Form. Integrate your nursing care interventions significant to bioethical
and legal standards in patient care.
• Prior to administering the patient’s medications, you are required to make a drug study of all
medications required by your patient in oral or parenteral form and document it. Use the Lorma
Colleges Drug Study Format for your documentation.
• Formulate a teaching plan for the discomforts during pregnancy(brochure)
• Submit an article report/case journal using APA format with references. Use Lorma College of
Nursing Journal format.
• In your 5-day duty, you are required to document your care for 3 days (Day 2-5) using Focus
Charting (FDAR). Be sure to indicate your patient’s vital signs using your own clinical judgment.
You can watch the videos in Leopold’s Maneuver:

1. https://www.youtube.com/watch?v=wYcxmiJRa8M
2. https://www.youtube.com/watch?v=VBE1I4W8x-0
3. https://www.youtube.com/watch?v=G-6x6Po5orc
4. https://www.youtube.com/watch?v=jITAO8AcLz0

You will be graded based on your output:
EVALUATION PARAMETERS:
OB history / Physical Assessment 15 pts 10%
Computation of AOG/EDC 20pts 20%
Nursing Care Plan /FDAR 30pts 30%
Drug Study 30pts 15%
Health Teachings Brochure 15pts 10%
Journal 15pts 15%
REFLECTION TIME
Jillian Michaels wrote: “Sometimes people will hear you and be able to change their behavior, but
often their behavior has more to do with their own need for approval than with your need for
support. No matter what their response, you need to be firm and hold your ground. At the end of the
day, your health is your responsibility.”
MODULE EVALUATION
Before we move on to the next topic, I would want to listen to your feedback for this RLE learning
packet. Kindly rate each area with a scale of 1-5 with 1 as the lowest and 5 as the highest.
EVALUATION RATING

1. Comprehensive Content
2. Relevance of Content
3. Clarity of the text and the message
4. Alignment of the assessment activities to learning outcomes
REFERENCES:
Palompon, Daisy (2020) Developing Self-Learning Modules for flexible Learning in the Related Learning
Experience, ADPCN Webinar August 3, 2020.
Pilliterri, Adele (2010), Maternal and Child Health Nursing: Care of the Childbearing and the Childbearing
Family 6th edition.
https://www.healthline.com/health/pregnancy/early-symptoms-timeline#next-steps
https://www.hellomotherhood.com/presumptive-probable-positive-signs-pregnancy
6502448.html
ANSWERS TO THE ACTIVITIES INT ARRIVAL CHECK
FIRST STEP TO ACHIEVE OBJECTIVES

You had your discussion on the concepts and principles in the
nursing care of individuals and families during pregnancy in Maternal
and Child Nursing NCM 107 lecture (well client)
A nurse’s responsibility includes the identification of concerns of
patients upon admission to any medical facility or during bedside
rounds. Choose from among the following patients who have
presented symptoms of pregnancy by placing a (/) check mark and an
(X) if otherwise. And then you can distinguish the different
physiologic changes of pregnancy.
/ Patient C. M. is complaining of abdominal discomfort on upper
right quadrant.
/ Patient S. G. was admitted to the ER experiencing vomiting 4x for
two days.
X Patient A. M. has difficulty breathing with wheezing noted.
X Patient A. W. complains about lower limb weakness with tingling
sensation.
/ Patient B. C. is pale upon arrival in the ER and complains of
dizziness.
/ Patient B. T. has bipedal edema with and difficulty walking.
/ Patient C. L. experience morning sickness, smells sensitivity.
/ Patient R. M. complaint of mild cramping and spotting.
/ Patient R. P. felt fetal movement in her abdomen.
/ Patient M. G. experience frequent urination.
/ Patient M.G. experience weight gains monthly.
/ Patient M.G. is having globular abdomen with fetal heart tone

COMPUTATION OF EDC AND AOG

OBSTETRICS HISTORY SHEET
A. PATIENT’S PROFILE
1. Name:____Mrs. A_________________ ___________
2. Marital Status: ____ Single __/___ Married _____Separated ______ Widow
3. Age: _____________20________________
4. Religion: _________Roman Catholic_______________
5. Reason for this visit: ___vomiting four times per day, feeling dizzy
and weak, smells sensitivity, have frequent urination and sometimes feel burning sensation while
urinating._______________________________________________
6. Occupation:_________housewife______________________________________
7. Contact Number:___ 0916 -284- 3207______________________
8. Name of Husband/Partner: Dominic Arqueza______________
9. Occupation of Husband: ______________Businessman______________
10. Referring Physician: ____________________________________________________
B. MENSTRUAL HISTORY
11. Age at first period: _____14__________________________
12. If your menstrual periods are regular, period starts every ______23________ days
13. If your menstrual periods are irregular periods starts every _____ to ______ days
14. Duration of bleeding: ____4______ days
15. Does bleeding occur between periods? ______/____ Yes ________No
16. Does bleeding or spotting occur after intercourse? ________Yes ____/____No
17. First day of Last menstrual period __April__________20__________2020_______
(Month) Day Year
18. Is pain associated with periods? ________Yes ______No __/__Occasionally
19. If yes to 18 is it: ________before menses ______during menses ______both
C. HISTORY OF PREGNANCY (All pregnancies) _____ Have never been pregnant
20. Obstetrical History including abortion & Ectopic (Tubal Pregnancy)
Year Place of
Delivery Duration of
Pregnancy Hours of
Labor Type of
Delivery Complications of Mother
And/or Infant Sex Birth
Weight Present
Health
37 weeks NSD
32 weeks Cesarean Section
36 weeks Not indicated
D. BIRTH CONTROL HISTORY

21.What birth control method/s do you currently use? ____________
E. SEXUAL HISTORY
22.Do you have a sexual partner? _____Yes ______No
23.Are there concerns about your sexual activity which you want to discuss with your doctor?
_________Yes __________No
F. PAST OBSTETRICAL SURGERY/GYNECOLOGICAL SURGERY /SURGICAL HISTORY
24.Check any that apply or ________None
SURGERIES YEAR
Cesarian Section Not indicated
G.OTHER PAST GYNECOLOGICAL HISTORY

25. Check ant that apply
________Venereal warts ________ Endometriosis ____Others
________ Herpes-genital ________ Chlamydia _____________
________ Syphilis ________ Gonorrhea
________ Pelvic Inflammatory Disease ________ Vaginal Infections
H. PAST MEDICAL HISTORY: Check Any That Apply ___/____None
_____Arthritis _____Kidney Disease ______Asthma

_____ Diabetes _____ Gallstone ______ Emphysema
___Diet Controlled _____ Liver disease (Including Hepatitis)
___ Pill Controlled _____ Epilepsy ______ HIV
___ Insulin Controlled _____ Blood Transfusion ______ Eating Disorder
____ Hypertension _____ Thyroid Disease
______Other:______________
____ Heart Disease
I. CURRENT MEDICATIONS (Include dose/amount/ per day)

Medication Dose Frequency
Ferrous Sulfate 30mg once a day
Folic acid 400mg daily
Injected via IM
J. DO YOU CURRENTLY
1. Smoke _______No ___Yes ____ Sticks/day _____Packs per day
2. Use alcohol _______No ___Yes ___wine(glass/day) __
Beer(bottles/day)
____Hard Liquor (Oz/day)
3. Use illicit drugs: _____No ____Yes If Yes: Type__________ Amount:_______
4. Exercises _____No ____Yes If Yes: Type:___________ How
Often_________
K. ALLERGIES
1. Drugs: ____No ____Yes If Yes: Name of Drug/s:______________
2. Foods: ____No ____Yes If Yes: Name of Food/s: _____________
L. FAMILY HISTORY
_____ Diabetes _____Heart Disease ____Cancer Pls. Specify:___________
Others: _____________________
If “yes” to any, please list affected relatives:
Name_________________________ Relationship: ______________
Name: ________________________ Relationship: ______________
M.OTHER SYMPTOMS
____ weight loss ___hair growth ____ none of the above
____ weight gain ___hair loss _____other:_______________
____ Change In energy ____Change in urinary function
____ Breast discharge
N. OTHER INFORMATION
Have you or the baby’s father or anyone in your families ever had of the following.
Down Syndrome (Mongolism)? ____No ____Yes If yes:

Who:____________________
Other Chromosomal abnormality? ___No ____ Yes If Yes: Specify:____________________
Neural Tube Defect (spina bifida, anencephaly) ____No ____Yes If yes:
Who:__________
Hemophilia or other coagulation abnormality? ____No ____Yes If yes:
Who:__________
Muscular Dystrophy? ____No ____Yes If yes: Who:____________________
Cystic Fibrosis? ____No ____Yes If yes: Who:____________________
_________________________ __10/8/2020__ _____________

Patient’s Name w/Signature Date Time
_________________________ __10/8/2020__ ____________

Physician’s Name w/Signature Date Time
Findings:
- does not make eye contact because something is bothering her
- client is multigravida
- Vital signs:
BP: 110/70
RR: 20/min
PR: 78/min
FHT: 108/min
TEMP: 36.8C
- baby is in a cephalic presentation

- Amniotic fluid is adequate
- Gender not yet identified
- Ultrasound and CBC is done

BIRTH PLAN
I know that I might be having complications during my delivery No Complication

I know that I will deliver in a health care facility Yes
My doctor will be Dr. Camille Angara.
My plan to give birth at Ilocos Training and Regional Medical Center (ITRMC)
I have Philhealth / yes _____________no
The possible amount to be prepared during delivery including the baby is 10,000 – 20,000
Mode of payment is Cash
The transportation to be used when going to the hospital will be Private Vehicle
The person who will bring me to the hospital is Mother and Husband
My companion will be Husband
The person who will be looking after my children when I’m here in the hospital will be Mother
I will breastfeed my baby until 6 months / yes ________No
Just in case I will be needing blood, the following persons will be responsible in donating blood
Name: JUSHUA ALBON
Address: Sili, Naguilian, La Union
Tel No.: 09285732781
Name: JULLY MAY ALBON

Tel No. 09051267543
Name: JOSHUA MARTYN ALBON

Tel No. 09176578934
Just in case I will be having complications, please bring/refer me immediately to

DR JEZZEL BRINE ABUAN
Hospital: Lorma Medical Center
Tel no : 09163455643
I have saved my money to be used for the check-up of my baby pertaining to his Newborn
Screening / Yes _________No
Person to contact during emergency: Dominic Arqueza

Tel No: 09169825863
Relationship: Husband

For NCP/ FDAR; PROBLEMS ARE.
1. Vomiting four times per day
2. Frequent urination
3. Burning sensation while urination
4. Knowledge deficit

LORMA COLLEGES CON TEMPLATE
NURSING CARE PLAN with FDAR
RELATED LEARNING EXPERIENCE
STUDENT NAME: ROTATION: 3rd Rotation AREA:

YR LEVEL AND SEC: DATES: CLINICAL INSTRUCTOR:
PROBLEM: VOMITING DIAGNOSIS:

PRIORITIZATION: DATE:
NURSING IMPLEMENTATIO
ASSESSMENT DIAGNOSIS PLANNING N RATIONALE EVALUATION
Subjective: Risk for Goal met.
The patient verbalized deficient fluid After 1-2
“vomiting four times a volume hours of
day” related to Independent: nursing
LMP: April 20, 2020 vomiting as The patient will report a Monitor the Vital signs intervention,
evidence by reduction in the severity Observe and record the frequency, the risk of
patient of vomiting after 1-2 amount of vomitus expelled after fluid volume
Objective: vomiting four hours of nursing each bout To act as a basis for deficiency is
times. intervention. Encourage consumption of fluids assessing the patient's prevented
condition. and the
Looks weak and pale  Increased hydration patient
Vital signs: aids in the flushing reported
 BP- 110/70 of toxins and decreased
 PR- 78/min bacteria. severity of
 Temp- 36.8 °C vomiting.
 RR- 20/min
 FHT- 108bpm Dependent:  To increase the
If there are medication ordered like patient's amount of
plasil (antiemetic) iron.
Collaborative:

NURSES' NOTES
PATIENT NAME:
Ms. Mrs. A. AGE: 20 yrs old HOSPITAL NO.:
PHYSICIAN: SEX: F WARD/ROOM:
DATE/TIME FOCUS D - ATA A - ACTION R - RESPONSE NURSE SIGNATURE

D – received patient in bed conscious and coherent. Weak in
January 7, 2020 VOMITING
appearance and looks weak.
6:00am
A - Advise increase of fluid intake. Advise also to eat small amount of
food and eat slowly.
R- The patient feels more relaxed, and she reported decrease of severity
of vomiting.
Signature
Problem #2
STUDENT NAME: ROTATION: AREA:
YR LEVEL AND SEC: DATES: CLINICAL
INSTRUCTOR:
PROBLEM: Prepared by:

Burning sensation while urinating. RELATED LEARNING EXPERIENCE ROTATION
DIAGNOSIS:
CLINICAL INSTRUCTORS DATE: 6/28/2020
PRIORITIZATION:
NURSING
ASSESSMENT PLANNING IMPLEMENTATION RATIONALE
DIAGNOSIS
SUBJECTIVE:  Risk for SHORT-TERM GOAL: INDEPENDENT: S
 The client says she is infection  After 2 hours of  Assess the client’s  Serve as a basis for 
having frequent related to nursing pattern of determining appropriate
urination and pregnancy as interventions, the elimination. interventions.
evidenced by client will achieve
sometimes feel
burning normal urinary
burning sensation  The goal of client teaching
sensation elimination  Teach the client
while urinating. while pattern. about the is to resolve the current
urinating. importance of infection and prevent
OBJECTIVE: recurrence.
. preventing urinary
 Pale skin and
 Impaired infections.
physically weak.
Urinary
Elimination  Assess for signs  Common symptoms
 V/S taken as follows: related to and symptoms of include fever, chills,
Temp: 36.8 0C pregnancy as urinary tract cloudy urine, reports of
PR: 78 bpm evidenced by infection frequency, urgency, or
RR: 20 bpm frequent burning on urination.
FHT: 108 bpm urination.  Encourage the
client to void every
BP: 110/70 2-3 hours.
mmHg  To prevent the
accumulation of urine
Encourage increase
thus limiting the number
fluid intake
of bacteria.
EVALUATION
SHORT-TERM GOAL:
 Goal not met, after 2 hours of nursing interventions, the client still has a feeling of burning sensation while urinating.

NURSES' NOTES
PATIENT NAME: E.L.A AGE: 18 HOSPITAL NO.: 00123
PHYSICIAN: Dr. SEX: Female WARD/ROOM: 05
DATE/TIME FOCUS D - ATA A - ACTION R - RESPONSE NURSE SIGNATURE
6/28/2020
FREQUENT URINATION D - received patient conscious, coherent. Noted with frequent urination and
WITH BURNING sometimes feel burning sensation while urinating.
SENSATION
A advice to have increase fluid intake

- maintained balanced I&O with clear, odor-free urine, free of bladder
distension/urinary leakage. Rest promoted.
R - Relieved from frequent urination with burning sensation. Patient not in

distress. Referred to Dr. Verceles for reassessment.
signature
Ducusin, Mildred
LMC ,BSN II- Hall
Problem # 3

STUDENT NAME ROTATION: AREA: OPD-ITRMC

YR LEVEL AND SEC: DATES: CLINICAL INSTRUCTOR:
PROBLEM:Physiologic Alterations in Normal Pregnancy DIAGNOSIS

Health Teaching on the Normal Phyiologic :
PRIORITIZATION DATE: June 28, 2020
:
NURSING IMPLEMENTATIO
ASSESSMENT DIAGNOSIS PLANNING N RATIONALE
Subjective: Knowledge Short term Health Teaching on the Normal Health Teaching and

She states she is physiologic alterations of normal
nauseated, pregnancy for every trimester
especially in the Discuss the common discomforts
morning, smells during pregnancy and its
sensitivity, have management.
frequent urination 1. Describe, discuss and
and sometimes explain the normal
feel burning physiologic alterations providing knowledge is very
sensation while during pregnancy. important to the patient so
urinating. 2. Dietary changes can be a that the patient will
Dizzy big help to manage her understand the information,
Vomiting 4x a day nausea and vomiting be comfortable with their
a. To avoid fatty foods care and confidently use
Objective: b. Eat dry crackers in the this knowledge as they
plan: morning tackle their condition
The patient c. Eat small frequent 2. Morning Sickness,
will be able meals nausea and vomiting are
to d. Avoid odors that normal discomforts during
understand predispose to her 1st trimester of pregnancy
Deficit related the Normal nausea and it may come anytime of
to physiologic Physiologic e. Avoid acidic foods and the day this is due to
alterations in Alterations to avoid liquids during hormonal and psychological
normal and her meals. changes.
pregnancy discomfort 3. Explain that frequent 3. Frequent urination is a
during urination is normal during normal physiologic change
pregnancy first trimester and third during 1st trimester of
and the trimester of pregnancy due pregnancy due to the
proper to the increasing size of the enlarging uterus that
management uterus that compresses the compresses the bladder-
Weak in and coping urinary bladder. anatomically.
appearance mechanisms Teach the patient on how to Kegels exercises known to
after 1 hour perform Kegels exercise and to strengthen the muscles that
of health limit fluid intake especially at night support the bladder, uterus
teaching and to check urine for urinalysis to and bowels.
check for urinary tract infection
EVALUATION
Goal Met- the patient
verbalizes her feelings
towards her pregnancy.
Goal Met- the patient was

able to understand the health
teachings when she called a

day prior to her appointment
due to the presence of blood
in the toilet.
DRUG STUDY
1. Ferrous Sulfate 30mg 1 capsule a day
2. Folic Acid 400mg 1 capsule daily
3. Tetanus toxoid IM

DRUG STUDY
STUDENT
NAME: AREA:
YR LEVEL
AND SEC: CLINICAL INSTRUCTOR:
DATES:
DRUG MECHANISM
NAME CLASSIFICATION OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
- Excess iron
due to
Iron repeated
combines blood - Constipation
with transfusions - Contact irritation Take ferrous sulfate on an empty
This
porphyrin and - an overload - Diarrhea stomach, at least 1 hour before or 2
medication is
globin chains of iron in the - Dark stools hours after a meal. Avoid taking
Oral an iron
to form blood - Nausea antacids or antibiotics within 2 hours
Ferrous supplement
Iron supplement hemoglobin, - an ulcer - Stomach pain before or after taking ferrous sulfate .
Sulfate used to treat
which is from too - Superficial tooth Take ferrous sulfate with a full glass of
30mg or prevent low
critical for much discoloration (oral water. Do not crush, chew, break, or
blood levels of
oxygen stomach acid solutions) open an extended-release tablet or
iron
delivery from - a type of - Urine discoloration capsule.
the lungs to stomach - Vomiting
other tissues. irritation
called
gastritis

DRUG MECHANISM
NAME CLASSIFICATION OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
Folic acid,
whether given - flushing;
by mouth or - nausea, loss of
parenterally, appetite;
stimulates the - bloating, gas;
- Administer orally if
Folic acid production of - bitter or
Treatment of - contraindicated for possible.
400ug red blood cells, unpleasant
megaloblastic use in patients with - Monitor patient for
Vitamins white blood taste in your
anemias of folic acid hypersensitivity reactions,
1 Tablet cells, and mouth;
pregnancy hypersensitivity especially if drug
daily platelets in - sleep
previously taken.
persons problems;
suffering from - depression; or.
certain - feeling excited
megaloblastic or irritable.
anemias.
Tetanus toxoid Prevention Hypersensitivity, febrile Local reactions (e.g., - Observe the 12 rights in
adsorbed against tetanus illness and other acute redness, swelling & giving the medication.
induces active in children and infections, patient with pain with local - Monitor vital signs.
Tetanus Vaccine immunity to adults low immune response lymphadenopathy), - Allow the patient to lie
Toxoid tetanus antigen tachycardia, down to prevent
Via IM by stimulating hypotension, flushing, vomiting.
- Educate the patient to
the immune muscle pain,
increase fluid intake to
system to thrombocytopenia.
prevent dehydration.
produce - Educate patient that pain
specific and tenderness in the
antitoxin injection site may occur

HEALTH TEACHING- BROCHUR

JOURNAL ANALYSIS

JOURNAL ANALYSIS
STUDENT NAME: ROTATION: 3rd AREA: Outpatient D
YR LEVEL AND SEC: DATES: Nov. 5, 2020 CLINICAL INSTRUCTOR:
ARTICLE
COVID-19 Treatment guidelines: Special Considerations in Pregnancy
SUMMARY
There are reported cases of COVID-19 in pregnant women and to counter the rates from increasing, the Center
for Disease Control and Prevention (CDC) formulated the present guidelines to handle COVID-19 in pregnancy. This
involves warning the pregnant women concerning the possible severe outcome of the disease and discussing suggested
measures to protect themselves and their families from being infected. It suggests that affected pregnant patients should
be monitored in a facility with complete equipment to ensure their safety with their unborn children. In accordance to
the guidelines, when it comes to the approved medications, it should be discussed between the patient and the clinical
team.
There should be an effective management of pregnant mothers who are suspected or who contracted the
disease and for this matter, it is advised that possible treatments should not be refused because of beliefs related to the
safety therapeutic agents during pregnancy. Currently, the rates of hospitalized pregnant and non-pregnant women are
low but extra precautions must be taken especially for the pregnant women. They should have a detailed guidance from
the time they have been suspected until their delivery. There should also be post-delivery management of their infants
and of course, preventive measures should be done including physical distancing, hand hygiene and proper protective
equipment to avoid worse case scenarios or to prevent contracting or spreading the disease.
DISCUSSIONS
The update talks about the status of the pandemic with regards to the condition of pregnant women who
are at more risk because they have children in their wombs, needing support; knowing this is an advantage.
The update explained that pregnant women are more likely to be hospitalized among the reported cases and

such information is helpful because it serves as an admonition to pregnant women so they can be much careful
about their health and safety since they are not just the only one affected, they also have their babies that they
must be concerned with. It is good to know from the update about the guidelines that must be followed to
manage the predicament and avoid the increase in rates of suspected and affected mothers. It is wise that the
update included the warnings, possible interventions, and ways on how to secure safety through simple
procedures such as hand hygiene.
However, the only concern in the update is that there is no many details regarding the management of
COVID-19 during pregnancy. There are no thorough explanations about the therapeutic agents used for the
management. It can be better if the medications and their components are included which can prove that they
are safe to be used for pregnant women because it given that due to mothers’ love for their precious children,
they never want to do any harm and thus, they need to have a detailed information about the treatment so they
will know as to why they should not refuse it. The detailed information can also be useful for the health care
professionals who reads the article, so that they can be assured that the potential treatment will not cause any
harm and thus, these should not be withheld from the pregnant women. In addition, the article could have been
finer if it also includes the uses of each from the preventative measures and the techniques on how to do them
appropriately.
If we are to look at the recent update for the management of the disease in pregnancy, it is feasible in
local setting as long as there is the availability of equipment, medications and facilities. I think it is not the matter
of feasibility but is about the matter of capability to adapt to the crisis. Hospital institutions should adapt based
on the situation and do necessary adjustments to implement the management of the disease to treat or help the
involved individuals. Being able to perform the appropriate management can ensure the safety of the mothers,
their babies and their families who wanted the best for them. Health is a top priority and so in any setting the
interventions should be adapted, and practitioners should be flexible to carry them out.
Today we can see that everyone is adapting to the current circumstance. Same with the update, all
including the pregnant women are very cautious about following physical distancing, hand hygiene and wearing
protective equipment. Pregnant women are also not allowed to enter crowded places like the market because
they are part of the vulnerable population. There is a strict monitoring of everyone including the pregnant
mothers. The hospital institutions are also doing the best they can to fulfill their duty to contain the affected and
suspected individuals including pregnant women to prevent infection.
To manage the issue at hand, the main key to resolve it is to follow the guidelines for safety. We should
all know that knowledge is power and so it is necessary for everyone to acquire beneficial information that can
help maintain our health. Health care professionals must also conduct health teaching for the individuals who
have no or are lacking ideas. Authorities should do continuous monitoring and the government should allocate
budget to provide needed equipment, tool and even medications that can treat the infected. Cooperation is also
an important matter and to do so, everyone should keep in mind the goal of fighting against the disease and
with this, we should all abide to the regulations made to minimize or prevent infection.
Lastly, the update also has an implication on the nursing profession. The update encourages nurses to
take in great considerations the pregnant clients because they are susceptible to grave complications that can
affect them and their babies. As stewards and advocates of health, the update is a reminder of the importance
of health teaching and health promotion. There should be a discussion between them and the pregnant mothers
on how to do the precautionary measures properly. The pregnant mothers should also be reminded about the
importance of adequate intake to maintain the stability of their immune system that can be their weapon to not
easily be infected or have faster recovery.
NURSING THEORY

“Health Promotion Model” by Nola Pender defines health as a positive dynamic state and not merely the
absence of disease. It is also directed to increasing a client’s level of well-being through promotion of health. I
think that it is the best theory related to the article because the main point of the article is to inform the pregnant
mothers that they are susceptible to the disease so they must be very attentive to their health. They should
increase their level of well-being knowing that they are more likely to be hospitalized based on the findings. The
article is also directed to the management of the disease in the suspected or infected mothers and like how
health is defined in Health Promotion Model, it is not the absence of disease, but it can be obtained by
enhancing level of well-being through treatment and relevant interventions. The article can be compared to a
strategy in order to promote health and it is like a health teaching for pregnant mothers and their families to
avoid infection by following the guidelines and preventive measures to control the spread of the disease.
REFERENCES:
Pregnancy. (n.d.). COVID-19 Treatment Guidelines. https://www.covid19treatmentguidelines.nih.gov/special-
populations/pregnancy/


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NCM 107 LEARNING PACKET ON RELATED LEARNING EXPERIENCE

RLE FOCUS UNIT: CARE OF PREGNANT CLIENT

COURSE CODE: NCM 107

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

• Vital Signs Monitoring and checking FHT

• Patient History takin

• Continuous Patient Assessment and monitoring

• Preparation and Administration of Medications

• Planning of Nursing Care Plans

• Patient Care Documentation/FDAR

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

• Fill up the birth plan.

You can watch the videos in Leopold’s Maneuver:

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

3. Clarity of the text and the message

4. Alignment of the assessment activities to learning outcomes

ANSWERS TO THE ACTIVITIES INT ARRIVAL CHECK

FIRST STEP TO ACHIEVE OBJECTIVES

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

D. BIRTH CONTROL HISTORY

G.OTHER PAST GYNECOLOGICAL HISTORY

H. PAST MEDICAL HISTORY: Check Any That Apply ___/____None

_____Arthritis _____Kidney Disease ______Asthma

I. CURRENT MEDICATIONS (Include dose/amount/ per day)

Down Syndrome (Mongolism)? ____No ____Yes If yes:

_________________________ __10/8/2020__ _____________

_________________________ __10/8/2020__ ____________

- baby is in a cephalic presentation

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

I know that I might be having complications during my delivery No Complication

Name: JULLY MAY ALBON

Name: JOSHUA MARTYN ALBON

Just in case I will be having complications, please bring/refer me immediately to

Person to contact during emergency: Dominic Arqueza

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

STUDENT NAME: ROTATION: 3rd Rotation AREA:

PROBLEM: VOMITING DIAGNOSIS:

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

DATE/TIME FOCUS D - ATA A - ACTION R - RESPONSE NURSE SIGNATURE

PROBLEM: Prepared by:

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

DATE/TIME FOCUS D - ATA A - ACTION R - RESPONSE NURSE SIGNATURE

A advice to have increase fluid intake

R - Relieved from frequent urination with burning sensation. Patient not in

LORMA COLLEGES CON TEMPLATE

STUDENT NAME ROTATION: AREA: OPD-ITRMC

PROBLEM:Physiologic Alterations in Normal Pregnancy DIAGNOSIS

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Goal Met- the patient was

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

LORMA COLLEGES CON TEMPLATE

YR LEVEL AND SEC: DATES: Nov. 5, 2020 CLINICAL INSTRUCTOR:

H. PAST MEDICAL HISTORY: Check Any That Apply _/__None

___Arthritis _Kidney Disease ____Asthma

Down Syndrome (Mongolism)? No Yes If yes:

_____________ 10/8/2020 _

_____________ 10/8/2020