Ateneo de Zamboanga University

College of Nursing
Level 2 - NCM 107j - CARE OF MOTHER, CHILD AND ADOLESCENT (WELL CLIENTS)
Synchronous Learning Topics (SLT Module#2)
Focus: Assessing Fetal and Maternal Health: Prenatal Care
Learning Objectives: After synchronous online session, students will be able to:
1. Recognize the importance of prenatal consultation.
2. Utilize assessment skills during prenatal through health history and physical examination, and
assess woman’s health status and readiness for pregnancy;
3. Formulate nursing care plan related to health status during pregnancy;
4. Identify areas related to prenatal care that could benefit from additional nursing research or
application of evidence-based practice;
5. Use critical thinking to analyse ways to ensure that prenatal care is family-centered;
6. Integrate knowledge of pregnancy health assessment with the nursing process to achieve
quality maternal and child health care.
7. Describe the areas of health assessment commonly included in prenatal visits like: History,
current pregnancy (EDD, AOG, gravid, para), previous pregnancies & outcomes (TPAL score),
gynecologic history, medical history, nutritional status, etc.

Commonly Asked? What’s Your Answer/s?

What is prenatal care?

Are prenatal visits

necessary?

What is the purpose of

prenatal care?
When should prenatal care
begin?

What is the importance of

taking health history for
pregnant patients?

What information is
important at every
prenatal visit?

How often do pregnant

woman see their OB or
care provider during
pregnancy?

Tasks/Activities:

1. Develop a format of an interview sheet following the components of the health history.

2. In a given scenario, complete the maternal health history utilizing the the data on the case
scenario. (Use your interview form)
3. Determine the obstetrical history by answering the following questions:
a. What is the gravidity and parity (GP) of Ms. Newman?
b. What is her obstetrical history of TPAL? Describe what the 4 letter represents on
Ms. Newman OB history.
c. When is the expected date of delivery (Neagels rule)?
d. What is the estimated gestational age in months?

(note: use separate sheet for your answer…)

PATIENT CASE SCENARIO

Andrea Newman, 30 years old, comes to an
obstetrician's office, and verbalized “I think I'm
pregnant" because she has completed a home
pregnancy test so is certain she is pregnant. Mrs.
Newman has been married for 6½ years; she has
3½- and 4½-year-old children at home. She works
as a drugstore clerk. Her husband works as a stock
broker.
Present pregnancy was planned. Couple
had been attending a fertility clinic because they
had not been using a contraceptive for 2½ but could
not seem to conceive. Husband's sperm count was
found to be subnormal. Couple was advised to
space coitus further apart (no closer than 1 x per
week). Pregnancy occurred after fourth month of
new regimen.
Her first Menarche at 13 years; cycle 30 to 32 days, duration of flow 7 days. Has "terrible"
dysmenorrhea she treats with Motrin. Last menstrual period: 6 weeks ago. Used vaginal sponge as method
of contraception up until 2 years ago. Papanicolaou smear negative as of 6 months ago.

Client admits to long hours of standing to meet needs of drugstore customers; drinks six cups of
coffee daily; no alcohol since she thought she might be pregnant; does not smoke. Takes no medication
except for occasional acetaminophen for headache; Motrin for dysmenorrhea. Walks a city block daily from
bus to store. Twenty-four hour recall nutrition history reveals a diet low in protein and possibly iron.
According to Ms. Newman, she had therapeutic abortion at age 18. Male born 4 years ago, vertex
presentation, alive and well. Male, born 3 years ago, vertex presentation; alive and well. Membranes were
ruptured longer than 24 hours and labor was induced. Andrea had a mild endometritis treated with
intravenous antibiotics for 4 days following birth. Feels this was the reason for her infertility. At age 16 she
undergo Appendectomy. "Bad" adolescent acne treated with tetracycline during adolescence; tuberculosis
treated for one year at age 22. No hospitalizations except for previous childbirths. Claimed that husband's
father has hypertension; a mother's cousin has renal failure.

Review of systems and physical examination done:

General appearance: mildly overweight, pleasant appearing Caucasian woman; Height: 5'7", Weight: 238
pounds. HEENT: Normocephalic; slight bleeding at gum lines. Conjunctiva of eyelids appear pale. Marked
cholasma on face. Chest: Normal breast development; areola darkened; occasional veins present. Lungs
clear to auscultation; heart sounds normal and at 76 beats per minute; blood pressure 130/80.
Abdomen: Soft, no masses; uterus not palpable; suggestion of linea nigra present. Extremities: Mild
varicose vein on medial aspect of left leg; full range of motion in all joints; deep tendon reflexes 2+
Pelvic exam: Vagina and cervix deep purple in color; uterus slightly enlarged; Hegar's sign present.
Negative except for urinary tract infection 6 years ago following marriage. Pre-pregnancy weight: 230 (BMI
36.0 or obese). Laboratory results revealed: Hemoglobin : 10 mg/dL; Hematocrit: 39% ; Urinalysis:
negative for protein, glucose, and ketones
Evaluation: 3-2-1 Ticket- Out Activity

3 – Things / concepts you’ve

learned from the
asynchronous learning
topics

2 – Interesting things /
concepts about the
asynchronous learning
topics

1 – Question that you like to

ask about from the
asynchronous learning
topics

Note:

 Do not limit your answers/discussions on the questions asked.

 Answers must be properly cited. Please provide sources/ references that
support your answer.
 All Deliverables for Synchronous learning topic/s will be submitted on or
before September 01, 2020 (12:00 midnight) @ email:
marbdagalea@gmail.com or google drive.
 You may ask questions or clarification through messenger or GC.
Website :

https://www.vectorstock.com/royalty-free-vector/couple-in-love-pregnant-woman-with-her-
husband-vector-4410823

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.slideshare.net%2Fyashika54%2
Fnew-patient-forms-new-patient-medical-
history&psig=AOvVaw0lctdFYm5qMzZGXMkbsGzG&ust=1598458119271000&source=images&c
d=vfe&ved=0CA0QjhxqFwoTCNiB57HutusCFQAAAAAdAAAAABAD

https://www.google.com/url?sa=i&url=https%3A%2F%2Fprintabletemplates.com%2Fmedical
%2Fmedical-history-
form%2F&psig=AOvVaw0lctdFYm5qMzZGXMkbsGzG&ust=1598458119271000&source=images
&cd=vfe&ved=2ahUKEwj1rq_U3rbrAhWdyYsBHUtIBo8Qr4kDegUIARD0AQ

https://www.cdc.gov/genomics/famhistory/famhist_during_pregnancy.htm

https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/prenatal-care

(Psychological and Physiological Changes of Pregnancy - Maternal & Child Health Nursing 7th Edition
Vol. 1, by Adele Pilliteri pp. 217)