University of Northeastern Philippines

College of Nursing
MODULE 14
Assessing Childbearing

NCM - 101
Women, Newborns and
Infants

A Student Module for NCM 101

(Health Assessment)

Robert A. Cabañes, RN, PhD

Professor

This module belongs to

_____________________________________
__________
 PRE-LECTURE QUIZ

True/False. For each true statement, insert T before the number. if any of the statements are
false, underline the incorrect term(s) then write the correction after each statement. NO
ERASURES!

1. During pregnancy, the client’s respiratory pattern changes from costal to abdominal.

2. Ptyalism or excessive salivation may occur in the first trimester.

3. Prominence of superficial veins is one of the breast changes that a woman notes during
pregnancy.

4. During pregnancy, at 16 weeks’ gestation, the top of the uterus, known as the fundus,
should be at the level of the umbilicus.

5. During pregnancy cardiac output and maternal blood volume increases by approximately
40% to 50%.

6. In newborn boys, the prostate gland is developed and palpable.

7. Epstein pearls, small yellow-white retention cysts on the hard palate and gums, are normal
in newborns.

8. After birth, the newborn's sebaceous glands are active because of high levels of maternal
androgen.

9. Long, broad extremities, hyperextensible joints, and a palmar simian crease may indicate
Down syndrome.

10. At birth, the newborn’s head circumference is greater (by 2 cm) than that of the chest.

Fill-in-the-Blank. Complete the statement by writing the missing term in the answer blank. NO
ERASURES!

1. ___________ is primarily responsible for the changes that occur to the pituitary, thyroid,
parathyroid, and adrenal glands.

2. As the pregnancy progresses, ___________ influences the relaxation of the ligaments

and joints.

3. ___________ anemia results primarily from the disproportionate increase in blood volume
compared to the increased red blood cell (RBC) production.

4. ___________ also known as the facial “mask of pregnancy” is a darkening of the skin on
the face.
5. Women who are placed on bed rest during pregnancy are at very high risk for development
of ___________.

6. When the newborn’s hands and feet appear blue due to a body temperature drop, the
condition is known as _________.

7. Newborns react with the ___________ reflex when they hear loud sounds at 90 decibels.

8. During the _________ stage of psychosexual development the erogenous zone is the
mouth.

9. To elicit the _________ reflex, hold the newborn’s foot and stroke up the lateral edge and
across the ball.

10. The _____ ________closes within the first hour because of the newly created low
pressure in the right side of the heart.
ACTIVITY 1 – ANSWER THE FOLLOWING.

1. A client in her last trimester of pregnancy is being assessed by a registered nurse. The client
complains of shortness of breath, constipation, and blood in her stool. Additionally, her skin
assessment shows stretch marks over the breasts and abdomen and varicose veins in the lower
legs. The client wants to know if these marks will fade after delivery and if these are normal
symptoms of pregnancy.
a. What is one possible risk that the nurse should note for this client?

b. What information should the nurse provide to the client in response to her queries?

c. What should the nurse consider when preparing a teaching plan for this client?
2. A 23-year-old client in the second week of pregnancy visits a health care facility for a prenatal
assessment. At 5 ft 9 in, the client weighs 102 lb (46.3 kg) and looks pale. She also complains of
fatigue since becoming pregnant. Further, she says, “I don’t want to give up the weight-loss
program that I’m on. I have been on and off of a couple of crash diets, but this program has worked
well for me. I don’t know what this pregnancy will do to my body, and I’m so scared I will never
look like this again.”
a. What questions should the nurse ask the client to obtain a complete health history?

b. What risks should the nurse note and explain to the client?
 c. What are the subjective and objective data that the nurse should collect?

3. A 40-year-old primigravida client who is 12 weeks pregnant presents to the health care
facility for her prenatal examination. The client is a divorcee, has been smoking one pack
a day for the past 10 years. She works as a librarian in a community college and has been
under a lot of stress since the new semester started. The father of the baby is not involved.
The client states that she has a very supportive family, and they will help her once the
baby is born. She states that she is concerned about her age and pregnancy-related
complications. She has heard and read on the Internet that women who have first
pregnancies after the age of 35 have many risks. She tells the nurse she smokes
cigarettes and that she has tried really hard to quit smoking but just cannot do it. “I’m
eagerly looking forward to having this baby, but I’m worried about the risks involved. I
smoke at least 1 pack a day. I know I may have delayed my first pregnancy by too many
years. What should I do?”

a. What are the subjective and objective findings?

b. What nursing diagnoses can you propose based on the patient’s data?

c. What education can the nurse provide to alleviate the client’s concerns regarding her
age and pregnancy-related complications?
 d. Based on the information provided by the client, what plan of care would be most
appropriate for her?

ACTIVITY 2 – ANSWER THE FOLLOWING.

1. A 1-day-old infant in the health care facility has been crying continuously. On
assessment, the nurse notes a yellowish discoloration on the baby’s skin, which
suggests jaundice. Later, during a blood pressure assessment, the infant starts to cry,
and the blood pressure reading is higher than expected for a 1-day-old infant. The nurse
quickly picks the baby up and tries to calm him. After 3 minutes, the infant stops crying,
and the nurse continues the assessment. The infant’s mother came into the nursery
and requested to take the infant back to her room. She was breastfeeding and knew it
was almost time for the next feed. The nurse gave the mother the infant and told her to
let her know when she was done with the feeding because she had to complete her
nursing assessment. Ten minutes later, the mother called the nursery and informed the
nurse that she was done with the feeding. When questioned about the short amount of
time, the mother stated that the infant was not sucking and that he was crying. The
nurse brought the baby back to the nursery.

a. Once the infant is back in the nursery, what additional assessment should the nurse
make?
b. The nurse knows that the neurologic system is not fully developed at birth. However,
based on the assessment, what factors should be cause for concern?

2. A nurse is caring for a newborn infant who has been diagnosed with a CNS injury
sustained during delivery.
a. What reflexes should the nurse expect to be absent in the infant?
3. On assessment of a newborn baby, the nurse notes that the baby has abnormal
placement of the legs. The nurse suspects hip dysplasia in the baby.
a. How should the nurse determine if the baby has hip dysplasia?