SDL #1

1. What are your roles as a Maternal and Child Health Nurse?

-My role as a Maternal and Child Health Nurse is to focus on the growth and development of the
baby, as well as supporting the entire family unit as a whole.

2. How can you ensure a healthy outcome for the mother and child?

- As a nurse, I will ensure that the mother maintains good health, learns the art of child care, and to
promote the child's wellbeing and growth.

3. What are some factors that contribute to fetal/neonatal and maternal deaths?

- infections and birth defects are the leading causes of most neonatal deaths.

4. Why is nursing process important in Maternal and Child Health Nursing?

- It is significant because it involves the care of the mother and her family throughout pregnancy and
childbirth as well as the promotion of health and treatment of illness for children and families.

5. How can you contribute in achieving the primary goal of Maternal and Child Health

Nursing?

- By providing support to maternal health and well-being of the mother and her child, deliver health
promotion and education programs and etc.

6. What are the benefits of Nursing Research and Evidence-Based Practice to nursing

practice?

- It provides opportunities for nursing care to be more individualized, more effective, maximize effects of
clinical judgment as well as improve outcomes for patients.

Define the following:

1. Nursing Process – Is a logical planning approach that directs all nursing actions in providing all-
encompassing, patient-focused care.

2. Nursing Theory - are organized, knowledge-based concepts that essentially define the scope of
nursing practice.

3. Nursing Research - is research that provides evidence used to support nursing practices.

4. Evidence-Based Practice - is a process used to review, analyze, and translate the latest scientific
evidence.

5. Birth Rate _ is usually given as the number of live births divided by the average population.

6. Fertility Rate- average number of children born to women during their reproductive years.
7. Fetal Death - refers to the spontaneous intrauterine death of a fetus at any time during pregnancy.

8. Neonatal Death - when a baby dies during the first 28 days of life.

9. Infant Mortality - is the death of young children under the age of 1.

10. Child Mortality - is the mortality of children under the age of five

11. Maternal Mortality - refers to deaths due to complications from pregnancy or childbirth.

Obtain the leading causes and the latest statistics of the following (data should be from

the Department of Health):

1. Fetal Mortality Rate

 The total numbers of registered fetal deaths were 7,474 which was equivalent to a fetal
death ratio (FDR) of 4.2 per one thousand livebirth. There was a decrease in number of
about 4.9 percent from previous year’s fetal deaths. This was translated to an average
of more than 20 fetal deaths per day for the year 2013. Almost all (99.1%) of fetal
deaths were attended by qualified medical professionals such as physician, nurse and
midwife. The rest or 0.9 percent were attended by hilot or unlicensed midwife. Most
number of fetal deaths occurred to mothers in age-group 25-29 years, with 1,702
reported cases or 22.8 percent of total fetal deaths. High number cases of fetal deaths
were also registered to mothers of ages 20-24 years (1,648; 22.0%) and 30-34 years
(1,638; 21.9%). However, statistics show that older mother (40-49 years old) had higher
risk of having fetal deaths than the younger ones. The ratio of fetal deaths to livebirths
was high on mothers belonging to age groups 40-44 and 45-49 years.
2. Neonatal Mortality Rate

 In 2019, neonatal mortality rate for Philippines was 13.3 deaths per 1,000 live births. Neonatal
mortality rate of Philippines fell gradually from 25.7 deaths per 1,000 live births in 1970 to 13.3 deaths
per 1,000 live births in 2019. The leading causes are:

 31% Preterm birth complications

 24% Intrapartum related events

 14% Sepsis | tetanus

 17% Congenital abnormalities

 1% Diarrhea

 6% Pneumonia

 8% Other conditions
3. Infant Mortality Rate
 In 2019, infant mortality rate for Philippines was 21.6 deaths per 1,000 live births. Infant
mortality rate of Philippines fell gradually from 55.3 deaths per 1,000 live births in 1970
to 21.6 deaths per 1,000 live births in 2019. Pneumonia, congenital problems,
respiratory distress are the leading causes of infant mortality.

4. Child Mortality Rate

 In 2019, child mortality rate for Philippines was 27.3 deaths per 1,000 live births. Child
mortality rate of Philippines fell gradually from 83.8 deaths per 1,000 live births in 1970
to 27.3 deaths per 1,000 live births in 2019. 3

5. Maternal Mortality Rate

 Philippines maternal mortality ratio was at level of 121 deaths per 100,000 live births in
2017, down from 124 deaths per 100,000 live births previous year, this is a change of
2.42%. According to data from the Philippines Department of Health the top 4 causes of
maternal mortality are labor complications, pregnancy-related hypertension,
postpartum hemorrhage, and unsafe abortion.
SDL # 2

Provide a brief answer on the following questions.

1. Describe three physiologic functions that supress ovulation when the “the pill” is used as a

method of contraception?

- The pill's estrogen component inhibits follicle-stimulating hormone and luteinizing hormone
production. The cervical mucus' permeability is reduced by the progesterone component, which restricts
sperm movement and access to the ova. Progesterone prevents endometrial growth and tubal transfer,
which makes implantation unlikely.

2. Describe how the “minipill” differs from the traditional oral contraceptives.

- Minipill is unique from the conventional oral contraceptive in that it exclusively contains progestins.
Ovulation takes place, but implantation doesn't.

3. Discuss the use of IUD, spermicides, and condoms as a method of reproductive life

planning.

- Teenagers frequently employ barrier techniques like condoms and spermicides. They are affordable
and don't need parental permission. Spermicides, on the other hand, have a 20% failure rate. Teenagers
should be carefully warned about using condoms. When used ahead of any penile-vulvar contact, they
work best. Less often do self-lubricating types break. The condom should be lightly fitted so that the
penis tip can gather the ejaculate without being put under excessive strain. The effectiveness of the
condom is further increased by the use of a vaginally implanted spermicide.

4. What are the common treatments for menstrual irregularities?

- To assist prevent irregular periods, doctors frequently recommend birth control pills (oral
contraceptives) that include the hormones estrogen and progesterone.

5. How will you justify the role of nurses in promoting family planning?

- In a family planning center, a nurse's main responsibilities are to care for the client, reassure them, and
provide information. The patient may feel more at ease talking to the nurse during the consultation than
the doctor, and she may be more open to hearing about the patient's medical history or any concerning
symptoms. Following the medical consultation, the nurse thoroughly explains the prescription and
informs the patient whether any extra tests or procedures are necessary.

Define the following:

1. Dyspareunia- difficult or painful sexual intercourse.

2. Vaginismus - is the involuntary tensing or contracting of muscles around the vagina.

3. Premature ejaculation - when ejaculation happens sooner than a man or his partner would
like during sex.

4. Aspermia - inability to produce or ejaculate semen.

5. Andrenarche - the stage of prepubertal development marked by the start of androgen

secretion by the adrenal cortex

6. Menorrhagia - menstrual periods with abnormally heavy or prolonged bleeding.

7. Metrorrhagia - abnormal bleeding between regular menstrual periods.

8. Gynecomastia - an overdevelopment or enlargement of the breast tissue in men or boys.

9. Thelarche - the beginning of breast development at the onset of puberty.

10. Culdoscopy - A procedure in which A lighted magnifying instrument is used to check the
cervix, vagina, and vulva for signs of disease.
SDL # 3

I. Give the meaning of the following abbreviations.

1. NSVD - Normal Spontaneous Vaginal Delivery

2. LTCS - Low Transverse Cesarean Section

3. BTL - Bilateral Tubal Ligation

4. IUFD - Intrauterine fetal demise

5. TAHBSO - total abdominal hysterectomy with bilateral salpingo-oophorectomy

6. PUFT - Productive Use of Free Time.

7. PROM - Premature rupture of membranes

8. BOW - Bag Of Waters.

9. D&C - Dilation and curettage

10. IUGR - Intrauterine growth restriction

11. CPD - cephalopelvic disproportion

12. LGA - Large for gestational age

13. SGA - Small for gestational age

14. RBOW - Rupture Of Bag Of Water

15. EDD - expected date of delivery

16. AOG - Age of Gestation

17. FHR - fetal heart rate

18. FHT - fetal heart tone

19. LMP - Last Menstrual Period

20. LOA - left occiput anterior

II. Supply the meaning of the acronym GPTPALM:

G - GRAVIDA

P - PARA

T - TERM

P - PRETERM

A - ABORTIONS
L - LIVING

M - MULTIPLES

III. Situation: Miss Anne, 25-year-old, G1P1T1P0A0L1M0, delivered a healthy baby girl via NSVD.

Episiotomy was done and with a 3 rd degree laceration. Upon assessment, vital signs:

BP:110/80 mmHg, BT: 36.1 degree celsius, PR: 60 BPM, RR: 17 CPM, Pain score (perineal)

7/10. Breasts are engorged with a pain score of 8/10, uterus well-contracted, has not

moved bowel for 5 days, bladder is not distended, with minimal lochial flow, (-) Homan’s

sign, and with no signs of emotional distress.

Based on the assessment findings, make a nurse’s notes using FDAR format.

Use the back page of this paper.

DATE/TIME FOCUS PROGRESS NOTE

08/14/22 PAIN D: Episiotomy with a 3rd

degree laceration. Vital signs:
8AM Normal BP:110/80 mmHg, BT:
36.1 degree celsius, PR: 60 BPM,
RR: 17 CPM.

Perineal pain of 7/10 and

breasts pain of 8/10. Uterus
well-contracted, has not moved
bowel for 5 days, bladder is not
distended, with minimal lochial
flow, (-) Homan’s sign, and with
no signs of emotional distress.

A: Administer ibuprofen for

pain prescribed by physician.
Suggest comfort techniques
such as the use of ice on sore
stitches or sitting and lying
positions that can help the
mother more comfortable.

R: Patient now rates pain 2/10.

IV. Answer the following:

 1. What are the common/routine health assessments during the first prenatal visit?
- Weight, blood pressure, blood sugar test, and urine dipstick results showing glucose, albumin,
and ketones are the most typical/routine health assessments for prenatal visits. Documenting
the fetal movement and fundal height after 20 weeks, and recording the fetal heart rate using
auscultation after 10 weeks. As well as STD tests, Pap smears, and genetic carrier screening.

2. What are the signs indicating possible complications of pregnancy?

- These are the danger signs indicating pregnancy complications: vaginal bleeding,
convulsions/fits, severe headaches with blurred vision, fever and too weak to get
out of bed, severe abdominal pain, fast or difficult breathing.

SDL # 4
A. Discuss the following:

1. How is oral glucose challenge test administer and describe how will you categorized a

pregnant woman be given such blood serum examination.

- During pregnancy, the glucose challenge test is used to check for gestational diabetes, a type of
diabetes that develops during pregnancy. The test is done in two steps. First you drink a sugary solution.
One hour later, your blood sugar level is measured.

- Pregnancy-associated plasma protein screening (PAPP-A). In the first trimester of pregnancy, the
placenta produces this protein. Abnormal levels are linked to a higher risk for chromosome problems.

-Human chorionic gonadotropin (hCG). Early in pregnancy, the placenta produces this hormone.
Abnormal levels are linked to a higher risk for chromosome problems.

2. For each of the following activities, explain why it is important to discuss this with the

pregnant woman: bathing, breast care, perineal hygiene, dressing, sexual activity, exercise,

sleep and travel.

-It is important to discuss bathing with pregnant woman because bathing during pregnancy can help
relieve stress and is a great way of soothing tired muscles. Next, Lack of milk production and illnesses
including non-protruding nipples, infections, blocked milk ducts, mastitis, and lumps can result from
breastfeeding women neglecting their breasts during pregnancy. It is also important to discuss perineal
hygiene to pregnant woman since practicing proper hygiene keeps you comfortable and helps prevent
infections during pregnancy. Moreover, wearing comfortable clothes during pregnancy is essential to
facilitate easy movement and give space to the baby bump. In regards to sexual activity, we must also
explain that intercourse does not cause miscarriage and that miscarriages, especially those that occur in
the first trimester, are usually the result of a chromosomal abnormality or some other problem related
to fetal development. In addition, it also necessary for pregnant women to engage in some regular
exercise since it can improve posture and decrease some common discomforts such as backaches and
fatigue. Lastly, the amount of sleep a pregnant woman should have has an impact towards the pregnant
woman as well as her baby and also if she plans to travel, she must first consult her doctor.

3. Describe five categories of potential teratogenic drugs.

A - Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal
abnormalities.

B - Animal studies have revealed no evidence of harm to the fetus; however, there are no adequate and
well- controlled studies in pregnant women. Or Animal studies have shown an adverse effect, but
adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus.

C - Animal studies have shown an adverse effect and there are no adequate and wellcontrolled studies
in pregnant women. Or No animal studies have been conducted and there are no adequate and well-
controlled studies in pregnant women.

D - Studies, adequate well-controlled or observational, in pregnant women have demonstrated a risk to

the fetus. However, the benefits of therapy may outweigh the potential risk.
 X - Studies, adequate well-controlled or observational, in animals or pregnant women have
demonstrated positive evidence of fetal abnormalities. The use of the product is contraindicated in
women who are or may become pregnant.

4. Discuss the relationship between maternal dietary intake and fetal growth and development.

- The diet and nutrition of the mother have a significant impact on the growth and development of the
fetus. Due to a lack of certain nutrients or amino acids that are crucial for cell metabolism and function,
inadequate maternal protein consumption during pregnancy can result in embryonic losses, IUGR, and
reduced postnatal growth.

B. Develop a teaching plan for the techniques of perineal exercises. Include a proposed time

schedule for implementing the exercises for a woman who works from 8:00 am to 5:00

pm.

Learning outcome Content Methodology Time Evaluation

Before you sit or 6AM FOR 20 MINS 1. Learner
1. Learner will The pelvic floor lie down, be sure comprehend
comprehend the muscles, which your bladder is the value of
value of exercise. support the empty. Tighten 12NOON FOR 20MINS exercise.
uterus, bladder, your pelvic floor
2. Learner will small intestine, muscles. Hold 2. Learner can
demonstrate the and rectum, are firmly for 3 to 5 6PM FOR 20 MINS demonstrate
perineal exercise. strengthened seconds. Count the perineal
with kegel from 3 to 5 exercise.
exercises. seconds while
letting your
muscles relax.
Repeat 10 times,
3 times a day.

C. Outline the main features of the popular Lamaze method of birthing. What behavioral

characteristics would you look for in the family that would be most appropriate for this

method?

-The Lamaze method of birthing was created by obstetrician Dr. Ferdinand Lamaze in the 1940s and
aims to inspire women to have faith in their abilities to give birth. The Bradley method of natural
childbirth is an alternative to the Lamaze method.

-The core beliefs of Lamaze International are summarized in a list called "Six Healthy Birth Practices",
which are:
Practice 1: Let labor begin on its own

Practice 2: Walk, move around and change positions throughout labor

Practice 3: Bring a loved one, friend or doula for continuous support

Practice 4: Avoid interventions that are not medically necessary

Practice 5: Avoid giving birth on your back and follow your body's urges to push

Practice 6: Keep mother and baby together – It's best for mother, baby and breastfeeding

- The family should behave with patience, bravery, and confidence when using this approach or
the Lamaze method of childbirth. Given that giving birth is not a simple process for both
expectant women and multiple mothers, having supportive family members who exhibit these
traits can at the very least make the patient feel less stressed and give her more confidence to
give birth fearlessly.