ARELLANO UNIVERSITY

Jose Abad Santos Campus

COLLEGE OF NURSING

DYNAMIC LEARNING PROGRAM (DLP)

ACTIVITY #1

I. HOSPITAL/ HEALTH CENTER/AREA: ARELLANO UNIVERSITY

II. CLINICAL INSTRUCTOR:
III. ACTIVITY TITLE: “CARE OF THE MOTHER DURING PEE-NATAL PERIOD”
IV. LEARNING TARGETS:
-Prenatal History
-Discuss the signs of pregnancy
-Procedures and laboratory exams
V. REFERENCE/SOURCE:
VI. AUTHOR:
VII. PAGE #:
VIII. AREA ACTIVITY & GUIDE QUESTIONS:

1. Identify and enumerate the risk factors in the prenatal period?

- Prenatal risks factors include chronic maternal illness, certain maternal
infections, toxin exposures and nutritional deficiencies. It also includes
pregnancy-related complications, premature and low birth weight, and infection
exposure during pregnancy or at time of birth.
2. Discuss the following components of a prenatal history
a. History
- Less than 100 years ago, most American women gave birth at home with no
painkillers. Prenatal care history was first inspired by the desire to prevent
pre-eclampsia. Today, doctors focus on many different aspects of pregnancy
to provide the safest experience for both baby and mother.
b. Obstetrical History (GPTPAL)
- GTPAL is crucial during the initial assessment to ensure that healthcare
professionals gather all essential information about an individual’s
reproductive history. It also provides insights into potential complications,
such as lost pregnancies or preterm births, and helps create a better
healthcare plan.
-“G” stands for gravida, which represents the total number of times an
individual has conceived, including any current pregnancy. It
includes all pregnancies, regardless of gestational age or outcome.

- “T” term represents the number of times an individual has carried a

pregnancy to at least 37 weeks of gestation and delivered a live
baby.
 - “P” refers to the number of times an individual has delivered a baby
between 20 and 36 weeks and 6/7 days of gestation.

- “A” represents the total number of times the individual has lost a pregnancy,
whether elective (medical or surgical) or spontaneous (miscarriage, ectopic
pregnancies), before 20 weeks of gestation.

-“L” indicates the number of living children the individual currently has.

c. Social, Psychological, Physical Examination

-Social support plays a crucial role in alleviating emotional and physical pressures for
expectant mothers and improving the well-being of both mother and child.
- Assessing maternal psychological well-being during pregnancy is crucial. Considerations
include mood stability, emotional changes, and mental health challenges. Effective
depression screening and psycho social assessment are essential components of prenatal
care
- Regular physical examinations are vital to monitor the health of both the mother and the
developing fetus. These examinations include assessing blood pressure, weight gain, fetal
growth, and overall maternal health. Monitoring physical changes during pregnancy helps
identify any potential risks or complications

d. Signs of Pregnancy (PLEASE DISCUSS EACH SIGNS)

PRESUMPTIVE PROBABLE POSITIVE

 Breast tenderness (3-4 weeks)  Positive pregnancy test (4-  Ultrasound verification
 Amenorrhoea (4 weeks) 12 weeks) of embryo or fetus(4-6
 Nausea and vomiting (4-14  Goodells’s sign (5 weeks) weeks)
weeks)  Chadwick’s sign (6-8  Auscultation of fetal
 Breast enlargement (6 weeks) weeks) heart tones via
 Urinary frequency ( 6-12  Hegar’s sign (6-12 weeks) Doppler (10-12 weeks)
weeks)  Abd enlargement (14  Fetal movement felt by
 Uterine enlargement ( 7-12 weeks) experienced clinician
weeks)  Ballottement (16-28 weeks) (20 weeks)
 Fatigue (12 weeks)  Braxton hick’s contractions
 Hyper pigmentation of the skin (16-18 weeks)
( 16 weeks)
 Fetal movements ( 16-20
weeks)

3. Illustrate the manner and formula of the following assessment approach:

a. Naegel's Rule
- Purpose: To estimate the due date of pregnancy.
- Assumption: Assumes a 28-day menstrual cycle with ovulation occurring
on day 14.
-Formula: Start with the first day of the last menstrual period (LMP). Add 280
days (approximately 9 months) to the LMP. This gives an estimated due date.
 b. Bartholomew’s Rule
- Purpose: To determine the age of gestation based on the height of the
fundus (the top of the uterus).
- Method: Uses landmarks rather than numerical height values.
- Application: Clinicians assess the fundic location to estimate gestational
age.
c. Haase’s Rule
- Purpose: To estimate the fetal weight during pregnancy.
-Formula: 28 weeks: Fetal weight (in grams) = 28 x abdominal circumference
(in cm).
32 weeks: Fetal weight (in grams) = 32 x abdominal circumference (in cm).
d. McDonald’s Rule
- Purpose: To assess fundal height during pregnancy.
- Measurement: Clinicians measure the distance from the symphysis pubis to
the top of the uterus (fundus).
- Clinical Significance: Fundal height helps monitor fetal growth and assess
gestational age.

e. FHT (Fetal Heart Tone)

- Purpose: To assess the fetal heart rate.
- Method: Clinicians use a Doppler ultrasound or fetoscope to listen to the
fetal heart sounds.
- Normal Range: Typically between 120 and 160 beats per minute.
f. FH (Fundal Height)
- Purpose: To assess the growth and position of the uterus during pregnancy.
- Measurement: Clinicians measure the distance from the symphysis pubis to
the top of the uterus (fundus).
- Clinical Significance: Abnormal fundal height may indicate issues such
as growth restriction or polyhydramnios.

4. Discuss the following procedures and laboratory exams:

a. Pregnancy test
b. Ultrasound
c. Complete Blood Count
d. Blood Typing
e. Amniocentesis
f. Chorionic Villi Sampling
g. Fetal Movement Count
h. Non-stress Test
i. Stress Test
j. X-ray
k. Alpha fetoprotein testing
l. Rh Incompatibility Test
 TEST WHEN PURPOSE PREPARATION EXPECTED
CONDUCTED NEEDED, RESULTS
POSITIONING
OF THE
CLIENT
a.Pregnancy test Typically, a To determine if a you may have A positive result
pregnancy test is woman is pregnant to need a full indicates
done after a missed by detecting the bladder for the pregnancy, while
period or when presence of human technician to a negative result
there are early chorionic get a clear suggests
signs of pregnancy. gonadotropin image of the otherwise
(HCG) in urine or fetus and your
blood. reproduction
organs.

b.Ultrasound Ultrasounds are To visualize the The pregnant Visualization of

performed at fetus, assess woman lies on the fetus,
various stages growth, check for her back, and a determination of
during pregnancy. abnormalities, and gel is applied to gestational age,
monitor overall the abdomen. and assessment
health. The ultrasound of fetal well-
technician uses being.
a transducer to
capture images.

c.Complete Blood Routinely during To evaluate blood No specific Expected

Count (CBC) pregnancy. components, preparation and Results: Normal
including red blood no specific CBC values vary,
cells, white blood position of the but any
cells, and platelets. client significant
deviations may
indicate anemia,
infection, or other
conditions.

d.Blood Typing Early in pregnancy. To determine the No specific Knowledge of

pregnant woman’s preparation in blood type and
blood type (e.g., A, blood typing Rh factor for
B, AB, or O) and Rh potential
factor (positive or compatibility with
negative). the baby.
e.Amniocentesis Usually between 15 To diagnose Counseling and Accurate
and 20 weeks of genetic disorders, informed information about
pregnancy. chromosomal consent. The fetal health and
abnormalities, and pregnant potential risks
neural tube defects. woman sits or
lies down while
a needle is
inserted into the
amniotic sac to
collect fluid.

f,Chorionic Villus Usually between 10 To detect genetic Counseling and Early diagnosis
Sampling (CVS) and 13 weeks of conditions and informed of specific
pregnancy. chromosomal consent. Similar genetic
abnormalities to conditions.
amniocentesis,
a needle is
inserted either
through the
abdomen or
cervix to obtain
tissue from the
placenta.

g.Fetal Movement Throughout To monitor fetal N/A (observed Regular fetal

Count pregnancy. activity and well- by the pregnant movements
being. woman). indicate a
healthy baby.

h.Non-stress Test Usually in the third To assess fetal The pregnant A reactive test
trimester. heart rate in woman reclines indicates a
response to while fetal heart healthy baby.
movement. rate and
movement are
monitored.

I.Stress Test When there are To evaluate fetal The pregnant Assessment of
concerns about heart rate during woman reclines fetal response to
fetal well-being. contractions while fetal heart stress.
(usually induced). rate and
movement are
 monitored.

J.X-ray Rarely during To diagnose Consultation Accurate

pregnancy due to specific conditions with a diagnosis while
radiation exposure. (only if benefits healthcare minimizing fetal
outweigh risks). provider. N/A exposure.
(depends on the
area being
imaged).

K.Alpha- AFP tests are AFP tests measure The client can Normal AFP
Fetoprotein (AFP) typically performed levels of alpha- be in a levels are
Testing between 16 and 22 fetoprotein, a comfortable essential, but if
weeks of protein produced by sitting or lying there’s an
pregnancy the fetus’s liver. position. No atypical result,
These tests help specific follow-up testing
assess the fetus’s preparation is is necessary
risk of birth required for the
defects or genetic AFP test.
conditions.

L.Rh The Rh factor blood It checks for Rh The client can The test helps
Incompatibility test is done during incompatibility when be in any identify the Rh
Test the first prenatal the pregnant comfortable factor and guides
visit person is Rh position. No appropriate care
negative, and the specific during
baby is Rh positive. preparation is pregnancy
Rh incompatibility needed for the
can affect the Rh factor test.
baby’s health and
requires special
care.
 5. LEOPOLD’S MANEUVER

a. Definition
- Leopold maneuvers are a common, non-invasive assessment for pregnant
clients. It involves palpating the abdomen using specific hand movements in four
steps to gather valuable information about the fetal position, which is essential for
safe and effective labor and delivery management.
b. Position of the Client
- Place woman in dorsal recumbent position, supine with knees flexed to relax
abdominal muscles. Place a small pillow under the head for comfort.
c. Special Nursing Considerations
-Empty the patient’s bladder before performing Leopold’s Maneuvers.
-Ensure patient privacy by draping properly.
-Explain the procedure to the patient.
-Use palms for palpation instead of fingers.
d. Procedure & results

MANEUVER PROCEDURE/RESULTS
FIRST (Fundal Grip)  Procedure: The examiner palpates the
maternal abdomen to identify the location of
the fetal head or buttocks.

 Results: This helps determine the fetal

presentation.

SECOND(Lateral Grip)  Procedure: The examiner identifies the location

of the fetal back.

 Results: This provides information about

the fetal lie.

THIRD (Pelvic Grip or Pawlik’s Grip)  Procedure: The examiner palpates to identify
the fetal part occupying the pelvic inlet.

 Results: This assists in assessing

the engagement of the fetal head.

FOURTH(Leopold’s First Pelvic Grip)  Procedure: The examiner identifies the fetal
part in the pelvic cavity.

 Results: This further helps determine the fetal

position within the uterus.