Teaching Plan INUR 3314

College of Nursing, Christian University of Thailand
Teaching Plan (Theory)

Semester 1 Academic Year 2557
Course code: INUR 3314 Course Title: Midwifery I
Teaching Topic: Evolution concepts and theories related to midwifery
Name of Instructor: Ms. Gladys U. Desmanos
Day/Month/Year: 13/09/ 2015 Time: 9:00-11:00
Venue: Christian University Room 401
Year of Students: Third Year
Learning Outcome : LO
The Responsible Distribution Map of Student Leaning Outcome from Curriculum to Courses (Curriculum Mapping)
Major Responsibility
Minor Responsibility
-- None
Course Title/
Learning
Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding of
and weaknesses
knowledge and
basic life science,
basic health
science which
cover
consumer rights, sciences,
once potentials
of self in order
to have selfdevelopment
enhancing
capability
Interpersonal Skills
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
to apply
logic,
mathematics
and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
nursing.
Professional skills
patient rights
humanities, social
leading to
democratic
practice,
and professional sciences, laws and

nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
differentiate
right, goodness
and badness.
3. Respect the
value and
dignity of
governance
2.Holding
knowledge and
teaching,
efficient
knowledge
understanding of
searching and
Midwifery and
leadership.
factors
search and
Nursing care for
health system and

influencing social
changes and
humanity
health system
responsible for
knowledge and
4. Be
nursing
3. Holding
strong nursing
2. Be able to
analyze data
from various
sources.
3. Be able to
use data and
work as a team, to transform

leader and
member of
nursing health
team and
community
nursing data
into quality
information
and able to
team in public
analyze
system on all
transfer
health service
levels of public
health system in
different
contexts or
situations.
reading and
nursing
information
to others
with
3.Be able to
comprehens
leadership skill
3. Be able
express
in driving
appropriate
ion.
to
self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
ethics and
holding ability
to manage
ethical problems
in daily living
and
understanding of
evidence-based
and application in
and critically
nursing process
nursing
therapeutics.
4. Holding
solve problems.
4. Be able to
have analytical
nursing
organization in
various
situations and
immediate
searching process,
related
knowledge
management,
7. Be a good
management
nursing practice. research process,
process and
knowledge and
knowledge
including using
experience-
and follower of
the various
roles in
healthcare
services at all
levels and in
different.
based for safety situations.

and quality
language
including
reading,
professional
of knowledge
e in English
a team leader
essential contents
by using
communicat
speaking,
system thinking 4. Can work as
understanding
effectively
situations
knowledge and
professional
role model to
in reference
changes in
listening,
writing
and
presenting,
as well as
being able
to read
journal and
textbook
others in daily
living and
professional
nursing
nursing
with
management .
5.Be able to
ng.
knowledge and
process,
to use
nursing
research and
basic
Minimum Nursing
nursing
programs.
organizational
nursing practice. 5.Holding

8. Advocate for
patients/clients
in obtaining
understanding
own rights in
order to protect
their own rights
which are
violated.
understanding of
informatics and
Data System
(MNDS).
services.
understandi
use scientific
conducting
appropriate
innovation in
solving
health
and nursing
problem.
6. Be able to
develop
problem solving
4. Be able
essential
computer
5. Be able
to choose
and use
various approaches
in presenting
information
communication and
technology
effectively and
appropriately.
techniques
related to
health and
efficient nursing
ad relevant to
changing health
situation and
contents.
INUR 3315
Midwifery II
3 4

5 6

7 8 1 2

3 4

5 6

2 3 1
4 5 6
3 4 1
3 4 5
Behavioral
Objectives of each
teaching topic
1. Define
midwifery.
2. Discuss the
evolution of
midwifery.
3. Explain the
concepts and
theories
related to
midwifery.
4. Identify and
describe the
roles and
responsibilitie
s of a midwife.
Content of Each Teaching Topic (in brief)
Teaching and
Learning
Activities
Lecture
1. Midwifery
Discussion
is defined as the practice of assisting in
childbirth
Midwifery- meant with woman.
France- "wise woman," or "sage femme.
World Health Organization- distinguishes
midwifery for its continual health care of
women and infants worldwide.
1.1Evolution of midwifery
Ancient civilizations of the West- midwives
were women with some medical training.
By the Middle Ages, though, midwives
basically used the knowledge acquired
through their own experience to assist in
deliveries.
In the 16th century, childbirth was placed
squarely in the realm of physicians for the first
time.
Contemporary Midwives
Midwives of today work in hospitals, homes
and birthing centers and have different
programs for training and certification.
1.2 Concepts and theories related to
midwifery
Theory is the acknowledged foundation to
practise methodology, professional identity
Teaching
Aides
PowerPoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
and growth of formalized knowledge. It has

been noted that practice must not only be
evidence-based but also theory-based. Hence,
midwifery must be theory based because
theories serve as a broad framework for
practice and may also articulate the goals of a
profession and core values. In this paper, an
evolving theory on the empowerment of
childbearing women is introduced, where the
midwifes professionalism is central. The
theory is synthesized from nine datasets and
scholarly work, and then more than three
hundred studies were reviewed for
clarication and conrmation. According to
the theory, the midwifes professionalism is
constructed from ve main aspects: The
professional midwife cares for the
childbearing woman and her family. This
caring within the professional domain is seen
as the core of midwifery. The professional
midwife is professionally competent. This
professional competence must always have
primacy for the sake of safety of woman and
child.
1.3 The roles and responsibility of
midwives
1.3.1 Certified Nurse Midwife
Have atleast a bachelors degree or doctoral
degree.
Have completed both nursing and midwifery

training.
Have passed national and state licensing
exams to become certified.
May work in conjunction with doctors.
1.3.2 Certified Midwife- is not a registered
nurse but otherwise meets the same
qualifications as a certified nurse-midwife.
Because this certification has only existed
since 1996, there are few CMs. Currently, only
some states recognize this certification as
sufficient for licensing.
1.3.3 A lay or direct-entry midwife may or
may not have a college degree or a
certification. Direct-entry midwives may have
trained through apprenticeship, workshops,
formal instruction, or a combination of these.
Not all states require them to work in
conjunction with doctors, and they usually
practice in homes or non-hospital birth
centers. But not every state regulates directentry midwives or allows them to practice.
10
Reference:
1. Olds. S.B. al (2008). Maternal Newborn Nursing Womens Health Care. 8th ed. New Jersey : Pearson.
2. Goorrle, T.M. McKinney, E.S. Murray, S.S. (1998) Foundation of Maternal Newborn
Nursing. 2nd ed. Philadelphia : W.B. Saunders Company.
3. Lowdermilk, D.L. and Perry, S.E. (2004) Maternity and Women Health Care.8th ed.
St. Louis : Mosby-Year. Book, Inc.
4. Lawdermilk. D.L. and Perry. S.E. (2004) Maternity and womens Health Care. 8th ed. Missuri.
Mosby.
Overview Assessment
11
College of Nursing, Christian University of Thailand

Teaching Topic: Critical Factors in Labor
12
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
which cover
sciences,
once potentials
self in order to
have self-
development
enhancing
capability leading
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
to apply
logic,
mathematic
s and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
nursing.
Professional skills
13
patient rights and

professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
differentiate right,
goodness and
badness.
3. Respect the
value and dignity
of humanity
humanities,
to nursing
laws and
efficient
social sciences,
democratic
governance
2.Holding
knowledge
searching and
strong nursing
knowledge and
leadership.
of Nursing care
search and
and health
various sources.
understanding
for Midwifery
system and
factors
4. Be responsible
influencing
5.Holding
and health
for self-doing.
practice, teaching,
social changes
2. Be able to
analyze data from
3. Be able to use
data and
evidence-based in
reference and
critically solve
work as a team, to
leader and
member of
nursing health
team and
community
transform
nursing
data into
quality
team in public
information
system on all
analyze
health service
levels of public
health system in
different
contexts or
situations.
and able to
reading and
transfer
nursing
information
3.Be able to
to others
leadership skill
comprehens
express
in driving
appropriate
with
ion.
14
discipline and
honesty.
6.Practice
according to
nursing code of
ethics and holding

ability to manage
ethical problems
in daily living and

professional
nursing practice.
7. Be a good role
system
problems.
knowledge and
have analytical
3. Holding
understanding
of nursing
process and
by using
professional
knowledge and
therapeutics.
including using
knowledge and
for safety and
nursing
4. Holding
essential
professional
contents of
8. Advocate for
searching
nursing practice.
system thinking
application in
model to others in understanding

daily living and
4. Be able to
knowledge
changes in
nursing
organization in
various
situations and
immediate
situations
4. Can work as
related knowledge a team leader

experience-based
quality nursing
services.
5.Be able to use

scientific process,
conducting
and follower of
the various
roles in
healthcare
services at all
3. Be able
to
effectively
communicat
e in
English
language
including
speaking,
listening,
reading,
writing
levels and in
and
situations.
as well as
different.
presenting,
being able
15
patients/clients in
obtaining
process,
research and
to read
nursing innovation
textbook
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential
5.Holding
and efficient
computer
understanding
relevant to
5. Be able
informatics and
situation and
and use
knowledge
understanding own management,

rights in order to research
protect their own
rights which are
violated.
management
nursing
management .
knowledge and
of nursing
Minimum
appropriate
in solving
journal and
health
problem.
develop problem
related to health
nursing ad
changing health
contents.
with
ng.
to use
basic
programs.
to choose
various
16
Nursing Data
approaches
System
in
presenting
(MNDS).
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
17
Behavioral
Objectives of each
teaching topic
1. Define and
explain
critical factors
of labor.
2. Discuss the
four critical
factors of
labor.

1. Critical factors of labor
The successful labor depends on four
integrated concepts, often referred to as the
four Ps
1.1 Birth passageway
The ability of the pelvis and cervix to
accommodate the passage of the fetus.
BIRTH CANAL, FETOPELVIC
DIAMETERS
Consists of the soft tissues of the pelvic floor,
cervix, vagina, introitus, and maternal pelvis.
1.2 Birth passenger
Biological influences
Teaching and
Learning
Activities
Lecture
Discussion
Teaching
Aides
PowerPoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
18
A pregnancy that terminates during the 38-42

week gestation is likely to indicate a healthy
fetus.Mechanical influences, Fetal head,
Fetopelvic relationships, Cardinal movements
1.3 The powers of labor
Uterine labor contraction of the myometrium.
Ctx.phase consists of a descending gradient:
The wave begins in the fundus (greatest #
myometrial cells).
Then moves downward through the corpus of
the uterus.
Intensity of ctx.diminishes from fundus to
cervix.
1.4 Psyche
The progress of labor and birth can be
adversely affected maternal fear and tension.
Norepinephrine and epinephrine may stimulate
both alpha and beta receptors of the
myometrium and interfere with the rhythmic
nature of labor.
Anxiety can also increase pain perception and
lead to an increased need for analgesia &
anesthesia
19
Reference:
1.
Olds. S.B. al (2008). Maternal Newborn Nursing Womens Health Care. 8th ed. New Jersey : Pearson.
2.
Goorrle, T.M. McKinney, E.S. Murray, S.S. (1998) Foundation of Maternal Newborn
3.
Lowdermilk, D.L. and Perry, S.E. (2004) Maternity and Women Health Care.8th ed.
4.
Lawdermilk. D.L. and Perry. S.E. (2004) Maternity and womens Health Care. 8th ed. Missuri.
Mosby.
Overview Assessment
20

Teaching Topic: Physiology of Labor
21
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
which cover
sciences,
once potentials
self in order to
have self-
development
enhancing
capability leading
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
to apply
logic,
mathematic
s and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
work as a team,
nursing.
Professional skills
22
professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
goodness and
badness.
3. Respect the
value and dignity

of humanity
4. Be responsible
humanities,
to nursing
laws and
efficient
social sciences,
democratic
governance
2.Holding
knowledge
searching and
strong nursing
knowledge and
leadership.
of Nursing care
search and
and health
various sources.
understanding
for Midwifery
system and
factors
for self-doing.
influencing
discipline and
and health
5.Holding
practice, teaching,
social changes
2. Be able to
analyze data from
3. Be able to use
data and
evidence-based in
reference and
critically solve
leader and
member of
nursing health
team and
community
team in public
to
transform
nursing
data into
quality
health service
information
levels of public
analyze
system on all
and able to
health system in reading and

different
contexts or
situations.
3.Be able to
transfer
nursing
information
express
to others
in driving
comprehens
leadership skill
appropriate
changes in
with
ion.
23
honesty.
6.Practice
according to
nursing code of
ethics and holding
ability to manage
ethical problems
in daily living and

professional
nursing practice.
7. Be a good role
system
problems.
knowledge and
have analytical
3. Holding
understanding
of nursing
process and
by using
professional
knowledge and
therapeutics.
including using
nursing
4. Holding
essential
nursing practice.
contents of
patients/clients in
searching
8. Advocate for
system thinking
application in
model to others in knowledge and

understanding
daily living and
professional
4. Be able to
knowledge
nursing
organization in
various
situations and
immediate
situations
4. Can work as
a team leader
related knowledge and follower of

experience-based
for safety and
quality nursing
services.
5.Be able to use

scientific process,
conducting
the various
roles in
healthcare
services at all
levels and in
different.
situations.
3. Be able
to
effectively
communicat
e in
English
language
including
speaking,
listening,
reading,
writing
and
presenting,
as well as
being able
24
obtaining
process,
research and
to read
management,
nursing innovation
textbook
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential
5.Holding
and efficient
computer
understanding
relevant to
5. Be able
informatics and
situation and
and use
understanding own knowledge

rights in order to
protect their own

rights which are
violated.
research
management
nursing
management .
knowledge and
of nursing
Minimum
appropriate
in solving
journal and
health
problem.
develop problem
related to health
nursing ad
changing health
contents.
with
ng.
to use
basic
programs.
to choose
various
25
Nursing Data
approaches
System
in
presenting
(MNDS).
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
26
Behavioral
Objectives of each
teaching topic
1. Discuss the
theories of
labor.
2. Explain
myometrial
activity.
3. Describe the
musculature
changes in
the pelvic
floor.
4. Identify the

1. Possible causes of labor onset
1.1 Theories of labor
1.1.1Uterine Stretch theory -a hollow
organ when stretched to capacity contract and empty.
1.1.2 Oxytocin theory- production of oxtytocin
from posterior pituitary gland----contraction of the uterus.
1.1.3Progesterone Deprivation theoryprogesterone inhibit uterine motility. A decrease in
progesterone----uterine contraction.
1.1.4 Prostaglandin Theory- increase
prostaglandin synthesis---uterine contraction.
1.1.5 Theory of aging placenta- decrease in blood
Teaching
and
Learning
Activities
Lecture
Discussion
Teaching
Aides
Evaluation
Methods
PowerPoint
presentation
Quiz
Examination
Midterm and
Final
Evaluation
results
27
premonitory
signs of
labor.
5. Compare
and contrast
between true
and false
labor.
supply to the placenta----uterine contraction.

2. Myometrial Activity
The myometrium stretches (the smooth muscle cells
expand in both size and number during pregnancy to allow
for the harboring of the pregnancy, and contracts in a
coordinated fashion, via a positive feedback effect on the
"Ferguson reflex"), during the process of labor. After
delivery the myometrium contracts to expel the placenta
and reduce blood loss; where the crisscrossing fibres of
middle layer compress the blood vessels. Thus a positive
benefit to early breast feeding is a natural stimulation of
this reflex to reduce blood loss and facilitate a swift return
to prepregnancy uterine and abdominal muscle tone.
3. Musculature changes in the pelvic floor
The structures of the pelvis go through dramatic changes
during pregnancy and at the time of vaginal childbirth.
The term pelvic floor refers to the collection of pelvic
muscles that provide support to the pelvic organs,
including the vagina (sometimes called the birth canal), the
urinary bladder, and the rectum (which leads to the anus,
surrounded by the anal sphincter muscles that control the
passage of stool and gas).
For vaginal childbirth to occur, the baby must be able to fit
past the pelvic muscles and connective tissue. There is
usually some amount of stretching or tearing that allows
this to happen.
4. Premonitory signs of labor
4.1 Lightening
Increased frequency of voiding
28
Increased amount of vaginal discharge

Increased lordosis as the fetus enters the pelvis and falls
further forward
Increased varicosities
Shooting pains down the legs because of pressure on the
sciatic nerve
4.2 Braxton Hicks Contractions-In the last week or
days before labor.These are false labor contractions,
painless, irregular, abdominal and relieved by
walking, and are also known as practice
contractions
4.3 A sudden burst of maternal energy/activity
because of hormone epinephrine. This is meant to
prepare the body for the labor ahead.
4.4 Slight decrease is maternal weight.
Loss of weight is about 2-3 lbs. One to two
days before the onset of labor because of the decrease
in progesterone level and probably loss of appetite.
4.5Softening/ripening of the cervix-Goodells Sign
4.6Ruptured Bow- Ruptured bag of water
4.7Show-Sudden gush of blood (pinkish vaginal
discharge)
5. Differences between true labor and false labor
True labor: Produce progressive dilation and effacement of
the cervix. Occur regularly and increase in frequency,
duration, and intensity. Show is present. Cervix becomes
effaced and dilates progressively. No significant change,
even though fetus continues to move.
False labor: Do not produce progressive dilatation and
29
effacement. Are irregular and do not increase in frequency,

duration, and intensity. Show is not present. May have
brownish discharge that may be from vaginal exam if
within the last 48 hours. Cervix usually uneffaced or
closed. Fetal movement may intensify for a short period or
it may remain the same.
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
30

Teaching Topic: Stages of Labor and Birth
Name of Instructor: Ms. Ruffel Joy C. Manalo
31
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
Knowledge
1.Holding
Cognitive Skills
1.Be aware of
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
Professional skills
32
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and

professional
nursing rights
which are
important to
nursing
therapeutics.
knowledge and
once potentials
of basic life
self in order to
understanding
science, basic
health science
which cover
have self-
development
enhancing
capability leading
social sciences,
practice, teaching,
democratic
knowledge
laws and
governance
2.Holding
2. Be able to
knowledge and
goodness and
of Nursing care
and weaknesses of professionally
sciences,
humanities,
understanding
adjust
to nursing
efficient
searching and
strong nursing
leadership.
2. Be able to
search and
and interact
creatively with
clients,
colleagues and
superiors.
2. Be able to
to apply
logic,
mathematic
s and
statistics in
nursing.
2. Be able
work as a team, to
leader and
member of
nursing health
team and
community
transform
nursing
data into
quality
team in public
information
system on all
analyze
health service
levels of public
health system in
and able to
reading and
33
badness.
3. Respect the
value and dignity
of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
for Midwifery
analyze data from
system and
3. Be able to use
and health
factors
influencing
social changes
data and
evidence-based in
reference and
and health
critically solve
3. Holding
4. Be able to
understanding
system thinking
system
knowledge and
ethics and holding of nursing

ability to manage
various sources.
process and
ethical problems
application in
professional
therapeutics.
in daily living and nursing
problems.
have analytical
by using
professional
knowledge and
different
contexts or
situations.
3.Be able to
express
leadership skill
nursing
information
to others
with
in driving
comprehens
changes in
3. Be able
appropriate
nursing
organization in
various
situations and
immediate
situations
4. Can work as

including using
transfer
and follower of
the various
ion.
to
effectively
communicat
e in
English
language
including
speaking,
34
nursing practice.
7. Be a good role
4. Holding
knowledge and

daily living and
essential
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
understanding own
rights in order to
protect their own

rights which are
violated.
experience-based
for safety and
quality nursing
services.
roles in
healthcare
services at all
levels and in
different.
listening,
reading,
writing
and
contents of
5.Be able to use
searching
conducting
being able
knowledge
appropriate
journal and
research
in solving
management
problem.
ng.
nursing
develop problem
to use
knowledge
process,
management,
process,
process and
organizational
scientific process,
research and
presenting,
as well as
to read
nursing innovation
and nursing
situations.
health
6. Be able to
solving techniques
textbook
with
understandi
4. Be able
essential
35
management .
related to health
basic
knowledge and
nursing ad
programs.
of nursing
changing health
to choose
Minimum
contents.
various
5.Holding
understanding
informatics and
Nursing Data
System
(MNDS).
and efficient
relevant to
situation and
computer
5. Be able
and use
approaches
in
presenting
information
communicat
ion and
technology
effectively
and
36
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
Behavioral
Teaching and
Objectives of each
Learning
teaching topic
Activities
Lecture
1. Describe the
1. First Stage of Labor
characteristics From the beginning of labor to the full opening Discussion
of the four
(dilation)of the cervix(about 4inches or 10cm).
stages of
1.1 Three phases
labor and
1.1.1 Latent Phase
their
-cervix dilates at 0-3cm
accompanyin
-mild contractions
g phases.
-duration of 20-40sec
2. Identify and
-frequency of every 5-10min
4 5 6 1
Teaching
Aides
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
3 4 5
Evaluation
results
37
describe the
three phases
of stage of
first stage
labor.
3. Discuss the
two types of
placental
delivery.
4. Identify the
signs of
placental
separation.
5. Discuss and
describe the
nursing
interventions
on each
stages.
1.1.2 Active Phase

-cervical dilatation reaches 4-7cm
-moderate contractions
-frequency of 3-5min
1.1.3 Transition Phase
-cervix at 8-10cm
-strong contractions
-frequency of 2-3min
1.2 Nursing interventions
Hospital admission: a. personal data
b. obstetrical data, Vital Signs, FHR- normally
120-160/min, Laboratory routine: CBC, Hgb,
Hct, Enema, Perineal Shaving, Provide
emotional and psychological support, Timing
of uterine contractions, Assisting the doctor in
giving meds or analgesia and Giving local
anesthesia (lidocaine) when in DR table.
2. Second Stage of Labor
From the complete dilatation of the cervix to
delivery of the baby.
- CROWNING hallmark of 2nd stage
-PRIMI50 minutes
-MULTIGRAVID-20minutes
Position legs into stirrups at the same time,
when the head crowns, instruct mother not to
push but to pant and assist in episiotomy.
38
3. Third Stage of Labor

From delivery of the baby to delivery of the
placenta.
3.1 Types of placental delivery
3.1.1 SCHULTZ fetal surface, bluish and
shiny.
3.1.2 DUNCAN-uterine surface, reddish
and rough.
3.2 Signs of placental separation
Lengthening of the cord, sudden gush if blood
Change in the shape of the uterus of Calkins
sign and firm contraction of uterus
Just watch for the signs of placental separation
Take note of the time of placental delivery
Inspect for the completeness of the cotyledons
Check for the condition of the fundus
-massage carefully
-apply ice cap over abdomen to help contract
the uterus
-injection of Methergin or Syntocinon (IM) to
maintain uterine contraction
and prevents hemorrhage.
Inspect the perineum for laceration
Make mother comfortable
Position the newly delivered mother flat on her
back without pillows
Give initial nourishment (milk, soup, tea)
Allow patient to sleep
39
4. Fourth Stage of Labor

Critical period for the mother on the 1st 1-2hrs
after delivery
Monitor VS every 15 minutes
Fundus should be checked every 15 minutes x
1 hr then every 30 minutes for the next 4 hours
Check for the amount of bleeding
Check for bladder distention
Encourage rooming-in
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
Overview Assessment
40

Teaching Topic: Maternal Systemic Response to Labor
41
Name of Instructor: Ms. Ruffel Joy C. Manalo

-- None
Course Title/
Learning Outcome
Ethics and Moral
Knowledge
Cognitive Skills
and Responsibility
Numerical
Analysis,
Communication
Professional skills
42
and Information
technology
Skills
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
once potentials
self in order to
have self-
development
which cover
enhancing
humanities,
to nursing
sciences,
social sciences,
laws and
democratic
governance
2.Holding
knowledge and
capability leading
practice, teaching,
efficient
knowledge
searching and
strong nursing
leadership.
1. Be able to
adjust
professionally
and interact
creatively with
clients,
1. Be able
to apply
logic,
mathematic
s and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
nursing.
work as a team, to
leader and
member of
nursing health
team and
transform
nursing
data into
community
quality
health service
and able to
team in public
information
43
goodness and
badness.
3. Respect the
value and dignity
of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
understanding
2. Be able to
for Midwifery
analyze data from
of Nursing care
and health
system and
factors
various sources.
3. Be able to use
data and
influencing
evidence-based in
and health
critically solve
3. Holding
4. Be able to
social changes
system
knowledge and
nursing code of
understanding
ability to manage
process and

ethical problems
search and
application in
reference and
problems.
have analytical
system thinking
by using
professional
knowledge and
system on all
levels of public
health system in
different
contexts or
situations.
analyze
reading and
transfer
nursing
information
3.Be able to
to others
leadership skill
comprehens
express
in driving
appropriate
changes in
nursing
organization in
with
ion.
3. Be able
to
effectively
various
communicat
immediate
English
situations and
situations
4. Can work as
e in
language
44
nursing practice.
experience-based
professional
7. Be a good role
model to others in
daily living and
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
therapeutics.
4. Holding
knowledge and
understanding
essential
quality nursing
services.
the various
roles in
healthcare
services at all
speaking,
listening,
reading,
writing
levels and in
and
situations.
as well as
5.Be able to use
searching
conducting
being able
appropriate
journal and
knowledge
process,
rights in order to
management,
rights which are
process,
violated.
for safety and
and follower of
contents of

protect their own
including using
including
scientific process,
research and
in solving
management
problem.
process and
and nursing
presenting,
to read
nursing innovation
research
different.
health
6. Be able to
textbook
with
understandi
ng.
4. Be able
45
nursing
develop problem
to use
management .
related to health
basic
knowledge and
nursing ad
programs.
of nursing
changing health
to choose
Minimum
contents.
various
organizational
5.Holding
understanding
informatics and
Nursing Data
System
(MNDS).
solving techniques
and efficient
relevant to
situation and
essential
computer
5. Be able
and use
approaches
in
presenting
information
communicat
ion and
technology
46
effectively
and
appropriatel
y.
1
Behavioral
3 4
5 6
7 8 1
3 4
5 1
2 3 1
Teaching and
4 5 6 1
Teaching
Evaluation
3 4 5
Evaluation
47
Objectives of each
teaching topic
1. Describe the
Physiologic
and
Psychosocial
changes that
are indicative
of the
maternal
progress
during each of
the stages of
labor.
Learning
Activities
1. Cardiovascular System
Cardiac outputincreases about 12 - 31% in
the 1st stage. -Increases about 50% in the
second stage. Heart rateincreases slightly
2. Blood Pressure
Systolic increases in 1st stage
Systolic and Diastolic increase in 2nd stage.
Rises with each contraction. May rise further
with pushing.
3. Fluid and Electrolyte Balance
Increase in renin, plasma renin activity, and
angiotensinogen.
Edema may occur at base of bladder due to
pressure of fetal head.
4. Respiratory System
Respiratory rate increases. Increase in oxygen
demand and consumption.
Mild respiratory acidosis usually occurs by
time of birth.
5. Renal System
Nephrology findingsslight proteinuria may
occur; polyuria; GFR increased due to
increased CO.
6. Gastrointestinal System
Gastric Motilitydecreased
Gastric emptying is prolonged.
Gastric volume remains increased.
Lecture
Discussion
Aides
Powerpoint
presentation
Methods
Quiz
Examination
Midterm and
Final
results
48
7. Immune System and other blood values

WBCincrease due to stress
Tempmay slightly increase especially if
mom is dehydrated, Blood glucosedecreases
8. Pain
In the first stage: arises from dilatation of
cervix, stretching of lower uterine segment,
pressure, and hypoxia of uterine muscle cells
during contractions.
In the second stage: arises from hypoxia of
contracting uterine muscle cells, distention of
the vagina and perineum, and pressure.
In the third stage: arises from contractions and
dilatation of cervix as placenta is expelled.
Reference:
1.
2.
3.
49
4.
Mosby.
Overview Assessment

Teaching Topic: Fetal Response to Labor
50

-- None
Course Title/
Learning Outcome
Ethics and Moral
Knowledge
Cognitive Skills
and Responsibility
Numerical
Analysis,
Communication
Professional skills
51
and Information
technology
Skills
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
once potentials
self in order to
have self-
development
which cover
enhancing
humanities,
to nursing
sciences,
social sciences,
laws and
democratic
governance
2.Holding
knowledge and
capability leading
practice, teaching,
efficient
knowledge
searching and
strong nursing
leadership.
1. Be able to
adjust
professionally
and interact
creatively with
clients,
1. Be able
to apply
logic,
mathematic
s and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
nursing.
work as a team, to
leader and
member of
nursing health
team and
transform
nursing
data into
community
quality
health service
and able to
team in public
information
52
goodness and
badness.
3. Respect the
value and dignity
of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
understanding
2. Be able to
for Midwifery
analyze data from
of Nursing care
and health
system and
factors
various sources.
3. Be able to use
data and
influencing
evidence-based in
and health
critically solve
3. Holding
4. Be able to
social changes
system
knowledge and
nursing code of
understanding
ability to manage
process and

ethical problems
search and
application in
reference and
problems.
have analytical
system thinking
by using
professional
knowledge and
system on all
levels of public
health system in
different
contexts or
situations.
analyze
reading and
transfer
nursing
information
3.Be able to
to others
leadership skill
comprehens
express
in driving
appropriate
changes in
nursing
organization in
with
ion.
3. Be able
to
effectively
various
communicat
immediate
English
situations and
situations
4. Can work as
e in
language
53
nursing practice.
experience-based
professional
7. Be a good role
model to others in
daily living and
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
therapeutics.
4. Holding
knowledge and
understanding
essential
quality nursing
services.
the various
roles in
healthcare
services at all
speaking,
listening,
reading,
writing
levels and in
and
situations.
as well as
5.Be able to use
searching
conducting
being able
appropriate
journal and
knowledge
process,
rights in order to
management,
rights which are
process,
violated.
for safety and
and follower of
contents of

protect their own
including using
including
scientific process,
research and
in solving
management
problem.
process and
and nursing
presenting,
to read
nursing innovation
research
different.
health
6. Be able to
textbook
with
understandi
ng.
4. Be able
54
nursing
develop problem
to use
management .
related to health
basic
knowledge and
nursing ad
programs.
of nursing
changing health
to choose
Minimum
contents.
various
organizational
5.Holding
understanding
informatics and
Nursing Data
System
(MNDS).
solving techniques
and efficient
relevant to
situation and
essential
computer
5. Be able
and use
approaches
in
presenting
information
communicat
ion and
technology
55
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
56
Behavioral
Objectives of each
teaching topic
1. Describe Fetal
Heart rate
adaptations to
Labor.
2. Explain acid
base status of
the fetal
during labor
3. Describe
hemodynamic
changes of the
fetal during
labor.
Teaching and
Learning
Activities
Lecture
1. Heart rate changes
The presence of fetal heart rate accelerations is Discussion
one of the most important signs of well-being
during labor. Accelerations are defined as
short-term rises in the heart rate of at least 15
beats per minute, which last at least 15
seconds. In many cases, they last longer.
4. Acid base Status in Laboratory
Care provider sometimes need to employ
additional methods to further assess fetal
oxygenation and acid base status.
5. Hemodynamic Changes
Plasma volume increases 45% at term, RBC
volume increases 20%, thus while pregnant
patients have increased RBC mass, they appear
anemic. Normal hemoglobin is 12 g/dL.
During labor, contractions squeeze blood into
the systemic circulation, and after delivery,
uterine involution autotransfuses 500 cc/blood.
Teaching
Aides
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
57
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
58

Teaching Topic: Maternal Assessment
59
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
professional
nursing rights
which are
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
once potentials
self in order to
have self-
development
which cover
enhancing
humanities,
to nursing
laws and
efficient
sciences,
social sciences,
capability leading
practice, teaching,
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
to apply
logic,
mathematic
s and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
nursing.
work as a team, to
leader and
member of
nursing health
transform
nursing
Professional skills
60
important to
nursing
therapeutics.
2. Be able to
goodness and
badness.
3. Respect the
value and dignity
of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
democratic
knowledge
2.Holding
strong nursing
governance
knowledge and
leadership.
understanding
2. Be able to
for Midwifery
analyze data from
system and
3. Be able to use
influencing
evidence-based in
of Nursing care
and health
factors
social changes
and health
honesty.
system
according to
knowledge and
6.Practice
searching and
3. Holding
search and
various sources.
data and
reference and
critically solve
problems.
4. Be able to
have analytical
team and
community
team in public
health service
system on all
data into
quality
information
and able to
levels of public
analyze
different
transfer

contexts or
situations.
3.Be able to
express
leadership skill
in driving
nursing
information
to others
with
comprehens
appropriate
ion.
nursing
to
changes in
organization in
various
3. Be able
effectively
61
nursing code of
understanding
system thinking
process and
professional

ability to manage
ethical problems
in daily living and

professional
nursing practice.
7. Be a good role
model to others in
daily living and
professional
nursing practice.
application in
nursing
therapeutics.
4. Holding
knowledge and
immediate
situations
4. Can work as
a team leader

including using
the various
communicat
e in
English
language
including
speaking,
experience-based
roles in
understanding
quality nursing
services at all
contents of
5.Be able to use
searching
conducting
being able
appropriate
journal and
knowledge and
essential
8. Advocate for
knowledge
obtaining
process,
rights in order to
management,
patients/clients in
by using
situations and
for safety and

services.
scientific process,
research and
nursing innovation
healthcare
levels and in
different.
situations.
listening,
reading,
writing
and
presenting,
as well as
to read
textbook
62
protect their own

rights which are
violated.
research
in solving
management
problem.
ng.
nursing
develop problem
to use
management .
related to health
basic
knowledge and
nursing ad
programs.
of nursing
changing health
to choose
Minimum
contents.
various
process,
process and
organizational
5.Holding
understanding
informatics and
Nursing Data
System
(MNDS).
and nursing
health
6. Be able to
solving techniques
and efficient
relevant to
situation and
with
understandi
4. Be able
essential
computer
5. Be able
and use
approaches
in
presenting
63
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
64
Behavioral Objectives of
each teaching topic
1. Discuss prenatal
record.
2. Discuss high-risk
screening and
intrapartal
assessment of
maternal physical
and
psychosociocultura
l factors.
3. Discuss methods
used to evaluate the
progress of labor.
Content of Each Teaching Topic (in

brief)
Teaching
and
Learning
Activities
Lecture
1. Prenatal Record
Discussion
Prenatal care is often the primary way
young women access basic health care. The
prenatal record and the initial prenatal
evaluation are so closely linked that they
must be discussed together. During the
initial prenatal visit, the practitioner
collects most of the information that will be
used to evaluate obstetrical risks and
determine what special interventions, if
any, are needed. This visit establishes the
foundation for the physicianpatient
relationship, particularly when the patient is
new to the physician.
2 Intrapartal High-Risk Screening
Screening for intrapartal high-risk factors is
an integral part of assessing the normal
laboring woman. As the history is
Teaching
Aides
Evaluation
Methods
Powerpoint
presentation
Quiz
Examination
Midterm and
Final
Evaluation
results
65
obtained,note the presence of any factors

that may be associated with a high-risk
condition.For example,the woman who
reports a physical symptom such as
intermittent bleeding needs further
assessment to rule out abruptio placentae or
placenta previa before the admission
process continues. It is also important to
recognize the implications ofa highrisk
condition for the laboring woman and her
fetus.For example,if there is an abnormal
fetal presentation,labor may be
prolonged,prolapse of the umbilical cord is
more likely, and the possibility of a
cesarean birth is increased.
3 Intrapartal Physical and
Psyhosociocultural Assessment
The physical assessment portion includes
assessments performed immediately on
admission as well as ongoing
assessments.When labor is progressing
very quickly,there may not be time for a
complete nursing assessment. In that case
the critical physical assessments include
maternal vital signs, labor status, fetal
status, and laboratory findings. The cultural
assessment portion provides a starting point
for this increasingly important aspect of
assessment. Individualized nursing care can
66
best be planned and implemented when the

values and beliefs of the laboring woman
are known and honored. It is sometimes
challenging to achieve a balance between
cultural awareness and the risk of
stereotyping because cultural responses are
influenced by so many factors. Nurses are
most effective when they combine an
awareness of the major cultural values and
beliefs of a specific group with the
recognition that individual differences have
an impact.Developing Cultural
Competenceprovides examples of selected
beliefs of some Native American women.
4 Evaluating Labor Progress
The nurse assesses the womans
contractions and cervical dilatation and
effacement to evaluate labor progress.
Contraction Assessment Uterine
contractions may be assessed by palpation
or continuous electronic monitoring.
Palpation. Assess contractions for
frequency, duration, and intensity by
placing one hand on the uterine fundus. It is
important to keep the hand relatively still
because excessive movement may stimulate
contractions or cause discomfort.
Determine the frequency of the
contractions by noting the time from the
67
beginning of one contraction to the

beginning of the next.
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
Overview Assessment
68

Teaching Topic: Fetal Assessment
Name of Instructor: Mr. Ariel Jul D. Alon
Day/Month/Year: 08/11/2014 Time: 9:00-11:00
69
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
once potentials
self in order to
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
to apply
logic,
mathematic
Professional skills
70
human rights,
children rights,
consumer rights,
patient rights and

professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
science, basic
have self-
which cover
enhancing
health science
sciences,
humanities,
social sciences,
to nursing
practice, teaching,
efficient
governance
searching and
knowledge and
leadership.
democratic
2.Holding
understanding
3. Respect the
for Midwifery
of humanity
system and
value and dignity
capability leading
laws and
goodness and
badness.
development
of Nursing care
and health
knowledge
strong nursing
2. Be able to
search and
analyze data from

various sources.
3. Be able to use
clients,
colleagues and
superiors.
2. Be able to
work as a team,
leader and
s and
statistics in
nursing.
2. Be able
to
member of
transform
team and
data into
nursing health
community
team in public
health service
system on all
nursing
quality
information
and able to
levels of public
analyze
different
transfer

contexts or
situations.
3.Be able to
nursing
information
71
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
ethics and holding
ability to manage
ethical problems
factors
data and
social changes
reference and
influencing
and health
system
3. Holding
critically solve
problems.
4. Be able to
knowledge and
have analytical
of nursing
by using
understanding
process and
in daily living and application in

nursing
professional
nursing practice.
evidence-based in
therapeutics.
7. Be a good role
4. Holding
daily living and
understanding
system thinking
professional
knowledge and
express
leadership skill
in driving
appropriate
changes in
nursing
for safety and
quality nursing
with
comprehens
ion.
3. Be able
organization in
to
situations and
communicat
various
immediate
situations
4. Can work as
a team leader

including using
the various
experience-based
to others
roles in
healthcare
services at all
levels and in
effectively
e in
English
language
including
speaking,
listening,
reading,
writing
72
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
understanding own
rights in order to
protect their own

rights which are
violated.
different.
essential
services.
knowledge
scientific process,
as well as
process,
research and
to read
management,
nursing innovation
textbook
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential
5.Holding
and efficient
computer
contents of
searching
knowledge
research
management
nursing
management .
knowledge and
5.Be able to use

conducting
appropriate
in solving
presenting,
being able
journal and
health
problem.
develop problem
related to health
nursing ad
situations.
and
with
ng.
to use
basic
programs.
73
understanding
relevant to
5. Be able
informatics and
situation and
and use
of nursing
Minimum
changing health
to choose
contents.
various
Nursing Data
approaches
System
in
presenting
(MNDS).
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
74
Behavioral
Objectives of each
teaching topic
1. Discuss
determination
of fetal
position and
presentation.
2. Discuss
auscultation
and
monitoring of
fetal heart
rate.

1 Determination of Fetal Position and
Presentation
FETAL POSITION AND PRESENTATION
Fetal position and presentation are determined
by inspecting the womans abdomen,palpating
it,performing a vaginal examination, and
auscultating FHR. Ultrasound may also be
used.
Inspection Observe the womans abdomen for
size and shape.Assess the lie of the fetus by
noting whether the uterus projects up and
down (longitudinal lie) or left to right
(transverse lie).
Palpation: Leopolds Maneuvers Leopolds
maneuvers are a systematic way to evaluate
Teaching and
Learning
Activities
Teaching
Aides
Lecture
Discussion
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
75
the maternal abdomen. Frequent practice

increases the examiners skill in determining
fetal position by palpation. Leopolds
maneuvers maybe difficult to perform on an
obese woman or on a woman who has
excessive amniotic
fluid (hydramnios). Before performing
Leopolds maneuvers,have the woman (1)
empty her bladder and (2) lie on her back with
her feet on the bed and her knees bent. (See
Figure 185 for technique.Also see Clinical
Vaginal Examination and Ultrasound During a
vaginal examination, the examiner can palpate
the presenting part if the cervix is dilated.The
examination also provides information about
the position of the fetus and the degree of
flexion of its head (in cephalic presentations).
Visualization by ultrasound is used when the
fetal position cannot be determined by
abdominal palpation.
2 Auscultation of Fetal Heart Rate
The handheld Doppler ultrasound or the
fetoscope is used to auscultate the FHR
between,during,and immediately after uterine
contractions.Instead of listening haphazardly
over the womans abdomen for the FHR,it is
useful to perform Leopolds maneuvers first.
Leopolds maneuvers not only indicate the
probable location of the FHR but also help
76
determine the presence of multiple fetuses,

fetal lie, and fetal presentation.The FHR is
heard most clearly at the fetal back
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
77

Teaching Topic: Electronic Fetal Monitoring
Name of Instructor: Mr. Ariel Jul D. Alon
78
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
Knowledge
1.Holding
knowledge and
Cognitive Skills
1.Be aware of
once potentials
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
to apply
Professional skills
79
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
understanding
and weaknesses of and interact
science, basic
have self-
of basic life
health science
development
which cover
enhancing
humanities,
to nursing
laws and
efficient
governance
searching and
sciences,
social sciences,
democratic
2.Holding
knowledge and
understanding
badness.
for Midwifery
goodness and
self in order to
of Nursing care
capability leading
practice, teaching,
knowledge
strong nursing
leadership.
2. Be able to
search and
analyze data from
creatively with
clients,
colleagues and
superiors.
logic,
mathematic
s and
statistics in
2. Be able to
nursing.
leader and
to
work as a team, 2. Be able

member of
nursing health
team and
community
team in public
health service
system on all
levels of public
transform
nursing
data into
quality
information
and able to
analyze

different
contexts or
transfer
80
3. Respect the
value and dignity

of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
and health
various sources.
factors
data and
system and
influencing
social changes
and health
3. Be able to use
evidence-based in
reference and
critically solve
system
problems.
knowledge and
have analytical
3. Holding
understanding

ability to manage process and
4. Be able to
system thinking
by using
professional
ethical problems
application in
knowledge and
professional
therapeutics.
including using

nursing practice.
4. Holding
situations.
3.Be able to
express
leadership skill
in driving
appropriate
information
to others
with
comprehens
changes in
ion.
organization in
to
nursing
various
situations and
immediate
situations
4. Can work as
3. Be able
effectively
communicat
e in
English
a team leader
language
the various
speaking,

experience-based
nursing
roles in
healthcare
including
listening,
81
7. Be a good role
for safety and
essential
services.
knowledge
scientific process,
as well as
process,
research and
to read
management,
nursing innovation
textbook
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential

daily living and
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
understanding own
rights in order to
protect their own

rights which are
violated.
services at all
knowledge and
contents of
searching
knowledge
research
management
nursing
management .
quality nursing
5.Be able to use
conducting
appropriate
in solving
levels and in
different.
situations.
reading,
writing
and
presenting,
being able
journal and
health
problem.
develop problem
related to health
with
ng.
to use
basic
82
5.Holding
and efficient
computer
understanding
relevant to
5. Be able
informatics and
situation and
and use
knowledge and
of nursing
Minimum
Nursing Data
System
(MNDS).
nursing ad
changing health
contents.
programs.
to choose
various
approaches
in
presenting
information
communicat
ion and
technology
effectively
and
appropriatel
83
y.
1
Behavioral
Objectives of each
teaching topic
3 4
5 6
7 8 1

1. External and Internal Monitoring
Electronic fetal monitoring produces a
continuous tracing of the FHR ,which allows
3 4
5 1
2 3 1
4 5 6 1
Teaching and
Learning
Activities
Teaching
Aides
Lecture
Discussion
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
3 4 5
Evaluation
results
84
visual assessment of many characteristics of

the FHR.
1.1. External monitoring
In this method, your health care provider
straps an ultrasound transducer over your
abdomen that will pick up the baby's heartbeat.
The heartbeat will be recorded continuously on
a paper strip. There may be another device
strapped on top of your abdomena pressure
gauge that measures the frequency of your
contractions. The combination of these two
measurements will provide detailed
information as to how your baby is doing
during labor.
1.2 Internal monitoring
This method can only be used if membranes
(fore-waters) and your cervix have ruptured
either spontaneously or artificially.
An electrode is placed on the babys scalp to
directly monitor the fetal heart rate. An
electrode is called a fetal scalp electrode
(FSE).
2. Telemetry
Telemetry is an electronic fetal monitor
without wires. It does not improve the false
readings of an EFM, but it does eliminate
many of the problems associated with mobility
and positioning. Some telemetry units are safe
85
to use in water. Telemetry is not available in all

hospitals.
3. Fetal Heart Rate Patterns
3.1 Baseline Rate
The NICHD nomenclature defines baseline
fetal heart rate as: The baseline FHR is
determined by approximating the mean FHR
rounded to increments of 5 beats per minute
(bpm) during a 10-minute window, excluding
accelerations and decelerations and periods of
marked FHR variability (greater than 25 bpm).
There must be at least 2 minutes of identifiable
baseline segments (not necessarily contiguous)
in any 10-minute window, or the baseline for
that period is indeterminate. In such cases, it
may be necessary to refer to the previous 10minute window for determination of the
baseline. Abnormal baseline is termed
bradycardia when the baseline FHR is less
than 110 bpm; it is termed tachycardia when
the baseline FHR is greater than 160 bpm.
3.2 Baseline Variability
The NICHD nomenclature defines baseline
FHR variability as: Baseline FHR variability is
determined in a 10-minute window, excluding
accelerations and decelerations. Baseline FHR
variability is defined as fluctuations in the
86
baseline FHR that are irregular in amplitude

and frequency. The fluctuations are visually
quantitated as the amplitude of the peak-totrough in bpm.
3.3 Fetal Heart Rate Changes
Accelerations
The NICHD nomenclature defines an
acceleration as a visually apparent abrupt
increase in FHR. An abrupt increase is defined
as an increase from the onset of acceleration to
the peak in less than or equal to 30 seconds. To
be called an acceleration, the peak must be
greater than or equal to 15 bpm, and the
acceleration must last greater than or equal to
15 seconds from the onset to return to baseline
Decelerations
Periodic refers to decelerations that are
associated with contractions; episodic refers to
those not associated with contractions.
3.4 Scalp stimulation
Fetal scalp stimulation test is a diagnostic test
used to detect fetal metabolic acidemia. It can
be used as a non-invasive alternative to fetal
scalp blood testing.
3.5 Cord Blood Analysis at Birth
Cord blood refers to a sample of blood
collected from the umbilical cord when a baby
is born. The umbilical cord is the cord
connecting the baby to the mother's womb.
87
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment

Teaching Topic: Nursing therapeutics for high risk and complicated pregnancies.
Name of Instructor: Asso. Prof. Areena Phanusopone
88
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
Knowledge
1.Holding
knowledge and
Cognitive Skills
1.Be aware of
once potentials
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
to apply
Professional skills
89
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
understanding
and weaknesses of professionally
science, basic
have self-
of basic life
health science
which cover
sciences,
development
enhancing
capability leading
humanities,
to nursing
laws and
efficient
governance
searching and
social sciences,
democratic
2.Holding
knowledge and
understanding
badness.
for Midwifery
goodness and
self in order to
of Nursing care
practice, teaching,
knowledge
strong nursing
leadership.
2. Be able to
search and
analyze data from
and interact
creatively with
clients,
colleagues and
superiors.
logic,
mathematic
s and
statistics in
nursing.
2. Be able to
2. Be able
leader and
transform
work as a team, to
member of
nursing health
team and
community
team in public
nursing
data into
quality
information
health service
and able to
levels of public
reading and
system on all
analyze
health system in transfer

different
90
3. Respect the
value and dignity

of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
and health
various sources.
factors
data and
system and
influencing
social changes
and health
3. Be able to use
evidence-based in
reference and
critically solve
system
problems.
knowledge and
have analytical
3. Holding
understanding

ability to manage process and
4. Be able to
system thinking
by using
professional
ethical problems
application in
knowledge and
professional
therapeutics.
including using

nursing practice.
4. Holding
contexts or
situations.
3.Be able to
express
leadership skill
in driving
information
to others
with
comprehens
appropriate
ion.
nursing
to
changes in
organization in
various
situations and
immediate
situations
3. Be able
effectively
communicat
e in
English
4. Can work as
language
and follower of
speaking,

experience-based
nursing
the various
roles in
including
listening,
91
7. Be a good role
knowledge and
for safety and
essential
services.

daily living and
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
understanding own
rights in order to
protect their own

rights which are
violated.
contents of
quality nursing
5.Be able to use
healthcare
services at all
levels and in
different.
situations.
reading,
writing
and
presenting,
knowledge
scientific process,
process,
research and
to read
management,
nursing innovation
textbook
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential
searching
knowledge
research
management
nursing
management .
conducting
appropriate
in solving
as well as
being able
journal and
health
problem.
develop problem
related to health
with
ng.
to use
basic
92
5.Holding
and efficient
computer
understanding
relevant to
5. Be able
informatics and
situation and
and use
knowledge and
of nursing
Minimum
Nursing Data
System
(MNDS).
nursing ad
changing health
contents.
programs.
to choose
various
approaches
in
presenting
information
communicat
ion and
technology
effectively
and
appropriatel
93
y.
1
Behavioral Objectives
of each teaching topic
1. Define
hyperemesis
gravidarum.
3 4
5 6
7 8 1

1. Hyperemesis Gravidarum
gravidarum (HG) is a complication of
pregnancy characterized by intractable
3 4
5 1
2 3 1
4 5 6 1
Teaching and
Learning
Activities
Teaching
Aides
Lecture
Discussion
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
3 4 5
Evaluation
results
94
2. Discuss the
management for
hyperemesis
gravidarum.
3. Compare and
contrast
polyhydramnios
and
oligohydramnios
.
4. Discuss and
explain about
twins.
nausea, vomiting, and dehydration and is

estimated to affect 0.52.0% of pregnant
women. Malnutrition and other serious
complications, such as fluid or electrolyte
imbalances, may result.
Hyperemesis is considered a rare
complication of pregnancy, but because
nausea and vomiting during pregnancy exist
on a spectrum, it is often difficult to
distinguish this condition from the more
common form of nausea and vomiting
experienced during pregnancy known as
morning sickness.
1.1 Nursing care
Dry bland food and oral rehydration are firstline treatments. Due to the potential for
severe dehydration and other complications,
HG is treated as an emergency. If
conservative dietary measures fail, more
extensive treatment such as the use of
antiemetic medications and intravenous
rehydration may be required. If oral nutrition
is insufficient, intravenous nutritional
support may be needed. For women who
require hospital admission, thromboembolic
stockings or low-molecular-weight heparin
may be used as measures to prevent the
formation of a blood clot.
2. Polyhydramnios and
95
Oligohydramnios
Polyhydramnios (polyhydramnion,
hydramnios, polyhydramnios) is a medical
condition describing an excess of amniotic
fluid in the amniotic sac. It is seen in about
1% of pregnancies. It is typically diagnosed
when the amniotic fluid index (AFI) is
greater than 24 cm.There are two clinical
varieties of polyhydramnios:
Chronic polyhydramnios where excess
amniotic fluid accumulates gradually
Acute polyhydramnios where excess
amniotic fluid collects rapidly.
Oligohydramnios is a condition in pregnancy
characterized by a deficiency of amniotic
fluid. It is the opposite of polyhydramnios.
The common clinical features are smaller
symphysiofundal height, fetal
malpresentation, undue prominence of fetal
parts and reduced amount of amniotic fluid.
3.Twins
Twins are two offspring produced by the
same pregnancy. Twins can either be
monozygotic ("identical"), meaning that they
can develop from just one zygote that will
then split and form two embryos, or
dizygotic ("fraternal"), meaning that they can
develop from two different eggs, each are
fertilized by separate sperm cells.
96
In contrast, a fetus which develops alone in

the womb is called a singleton, and the
general term for one offspring of a multiple
birth is multiple
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
97

Name of Instructor: Asso.Prof. Areena Phanusopone
98
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
patient rights and
professional
nursing rights
which are
important to
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
once potentials
self in order to
have self-
development
which cover
enhancing
humanities,
to nursing
laws and
efficient
sciences,
social sciences,
democratic
capability leading
practice, teaching,
knowledge
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
to apply
logic,
mathematic
s and
colleagues and
statistics in
2. Be able to
2. Be able
superiors.
nursing.
work as a team, to
leader and
member of
nursing health
team and
transform
nursing
data into
Professional skills
99
nursing
therapeutics.
2. Be able to
goodness and
badness.
3. Respect the
value and dignity

of humanity
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
governance
searching and
knowledge and
leadership.
2.Holding
understanding
of Nursing care
for Midwifery
2. Be able to
search and
analyze data from
and health
various sources.
factors
data and
social changes
reference and
system and
influencing
and health
system
6.Practice
3. Holding
nursing code of
understanding
according to
strong nursing
knowledge and
3. Be able to use
evidence-based in
critically solve
problems.
4. Be able to
have analytical
system thinking
community
team in public
health service
system on all
levels of public
health system in
quality
information
and able to
analyze
reading and
different
transfer
situations.
information
contexts or
3.Be able to
express
leadership skill
in driving
appropriate
nursing
to others
with
comprehens
ion.
changes in
3. Be able
organization in
effectively
nursing
various
situations and
to
communicat
100
immediate
by using
ethical problems
knowledge and
ability to manage
process and
application in

professional
nursing practice.
7. Be a good role
therapeutics.
4. Holding
situations
professional
related knowledge
including using
experience-based
4. Can work as
a team leader
and follower of
the various
roles in
e in
English
language
including
speaking,
listening,
knowledge and
for safety and
essential
services.
knowledge
scientific process,
obtaining
process,
research and
to read
rights in order to
management,
nursing innovation
textbook
model to others in
daily living and
professional
nursing practice.
8. Advocate for
patients/clients in
understanding
contents of
searching

protect their own
research
quality nursing
5.Be able to use
conducting
appropriate
in solving
healthcare
services at all
levels and in
different.
situations.
reading,
writing
and
presenting,
as well as
being able
journal and
health
with
101
rights which are

violated.
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential
5.Holding
and efficient
computer
understanding
relevant to
5. Be able
informatics and
situation and
and use
management
nursing
management .
knowledge and
of nursing
Minimum
Nursing Data
System
(MNDS).
problem.
develop problem
related to health
nursing ad
changing health
contents.
ng.
to use
basic
programs.
to choose
various
approaches
in
presenting
information
102
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
103
Behavioral
Objectives of each
teaching topic
1. Discuss
diabetes
mellitus
during
pregnancy.
2. Discuss heart
disease during
pregnancy.
3. Discuss
asthma during
pregnancy
4. Discuss
anemia during
pregnancy
5. Identify the
types of
anemia.
Teaching and
Learning
Activities
Lecture
1.DM
Discussion
Gestational diabetes (or gestational diabetes
mellitus, GDM) is a condition in which
women without previously diagnosed diabetes
exhibit high blood glucose (blood sugar) levels
during pregnancy (especially during their third
trimester). Gestational diabetes is caused when
insulin receptors do not function properly. This
is likely due to pregnancy-related factors such
as the presence of human placental lactogen
that interferes with susceptible insulin
receptors. This in turn causes inappropriately
elevated blood sugar levels.
1.1 Management
The goal of treatment is to reduce the risks of
GDM for mother and child. Scientific evidence
is beginning to show that controlling glucose
levels can result in less serious fetal
complications (such as macrosomia) and
increased maternal quality of life.
Unfortunately, treatment of GDM is also
Teaching
Aides
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
104
accompanied by more infants admitted to

neonatal wards and more inductions of labour,
with no proven decrease in cesarean section
rates or perinatal mortality.
2. Heart Disease
Mechanical artificial heart valves also pose
serious risks during pregnancy due to the need
to adjust use of blood thinners and the
potential for life-threatening clotting
(thrombosis) of heart valves. Congestive heart
failure. As blood volume increases, congestive
heart failure can get worse. Congenital heart
defect. Pregnancy stresses your heart and
circulatory system. During pregnancy, your
blood volume increases by 30 to 50 percent to
nourish your growing baby. The amount of
blood your heart pumps each minute also
increases by 30 to 50 percent. Your heart rate
increases as well. These changes cause your
heart to work harder.
Labor and delivery add to your heart's
workload, too. During labor particularly
when you push you'll experience abrupt
changes in blood flow and pressure. When
your baby is born, decreased blood flow
through the uterus also stresses your heart
3. Asthma
Asthma is a fairly common health problem for
pregnant women, including some women who
105
have never had it before. During pregnancy,

asthma not only affects you, but it can also cut
back on the oxygen your fetus gets from you.
But this does not mean that having asthma will
make your pregnancy more difficult or
dangerous to you or your fetus. Pregnant
women who have asthma that is properly
controlled generally have normal pregnancies
with little or no increased risk to themselves or
their developing babies.
4. Anemia
During pregnancy, your body produces more
blood to support the growth of your baby. If
you're not getting enough iron or certain other
nutrients, your body might not be able to
produce the amount of red blood cells it needs
to make this additional blood.
It's normal to have mild anemia when you are
pregnant. But you may have more severe
anemia from low iron or vitamin levels or
from other reasons.
Anemia can leave you feeling tired and weak.
If it is severe but goes untreated, it can
increase your risk of serious complications like
preterm delivery.
4.1 Types of anemia
4.1.1 Iron-deficiency anemia. This type
of anemia occurs when the body doesn't
have enough iron to produce adequate
106
amounts of hemoglobin. That's a

protein in red blood cells. It carries
oxygen from the lungs to the rest of the
body.
In iron-deficiency anemia, the blood
cannot carry enough oxygen to tissues
throughout the body.
Iron deficiency is the most common
cause of anemia in pregnancy
4.1.2 Folate-deficiency anemia. Folate,
also called folic acid, is a type of
B vitamin. The body needs folate
to produce new cells, including
healthy red blood cells.
4.1.3 Vitamin B12 deficiency. The
body needs vitamin B12 to form
healthy red blood cells
107
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
108

109
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
human rights,
children rights,
consumer rights,
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
health science
which cover
once potentials
self in order to
have self-
development
enhancing
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
colleagues and
superiors.
to apply
logic,
mathematic
s and
statistics in
nursing.
Professional skills
110
patient rights and

professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
goodness and
badness.
3. Respect the
value and dignity
of humanity
sciences,
capability leading
social sciences,
practice, teaching,
humanities,
laws and
democratic
governance
efficient
knowledge
searching and
2.Holding
strong nursing
understanding
2. Be able to
for Midwifery
analyze data from
knowledge and
of Nursing care
and health
system and
4. Be responsible
factors
5.Holding
social changes
for self-doing.
to nursing
influencing
leadership.
search and
various sources.
3. Be able to use
data and
evidence-based in
reference and
2. Be able to
2. Be able
work as a team, to
leader and
member of
nursing health
team and
transform
nursing
data into
community
quality
health service
and able to
team in public
system on all
levels of public
health system in
different
contexts or
information
analyze
reading and
transfer
nursing
situations.
information
express
with
3.Be able to
leadership skill
in driving
to others
comprehens
111
discipline and
honesty.
6.Practice
according to
nursing code of
ethics and holding

ability to manage
ethical problems
in daily living and

professional
nursing practice.
7. Be a good role
and health
critically solve
3. Holding
4. Be able to
system
knowledge and
understanding
of nursing
system thinking
by using
nursing
organization in
various
situations and
experience-based
understanding
essential
8. Advocate for
knowledge
contents of
including using
for safety and
quality nursing
services.
5.Be able to use
scientific process,
effectively
communicat
language
4. Holding
therapeutics.
to
4. Can work as
knowledge and
3. Be able
e in
nursing
application in
ion.
immediate
professional
professional
nursing practice.
have analytical
changes in
process and

daily living and
problems.
appropriate
situations
and follower of
the various
roles in
healthcare
services at all
levels and in
different.
situations.
English
including
speaking,
listening,
reading,
writing
and
presenting,
as well as
112
patients/clients in
obtaining
searching
process,

rights in order to management,
protect their own
rights which are
violated.
conducting
being able
appropriate
journal and
research and
to read
nursing innovation
research
in solving
management
problem.
ng.
nursing
develop problem
to use
management .
related to health
basic
knowledge and
nursing ad
programs.
of nursing
changing health
to choose
process,
process and
organizational
5.Holding
understanding
informatics and
and nursing
health
textbook
6. Be able to
solving techniques
and efficient
relevant to
situation and
with
understandi
4. Be able
essential
computer
5. Be able
and use
113
Minimum
Nursing Data
contents.
various
approaches
System
in
presenting
(MNDS).
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
114
Behavioral
Objectives of each
teaching topic
1. Discuss urinary
tract infection
during
pregnancy.
2. Discuss
appendicitis
during
pregnancy.
3. Define uterine
fibroids/myoma
.
4. Discuss uterine
myoma during
pregnancy.
Teaching and
Learning
Activities
Lecture
5. Urinary Tract Infection
Discussion
A urinary tract infection (UTI), also called
bladder infection, is a bacterial inflammation
in the urinary tract. Pregnant women are at
increased risk for UTIs starting in week 6
through week 24. UTIs are more common
during pregnancy because of changes in the
urinary tract. The uterus sits directly on top of
the bladder. As the uterus grows, its increased
weight can block the drainage of urine from
the bladder, causing an infection.
2. Appendicitis
Appendicitis in pregnancy is a relatively
common phenomenon. Rates of between 1 in
every 1000 to 1 in 2000 pregnancy have been
reported. Pregnant mothers thus do develop
appendicitis too. Not uncommonly, attending
physicians and patients develop a lot of
anxiety about the occurrence of appendicitis
during pregnancy and as to what is the best
way to manage this condition.
Teaching
Aides
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
115
3. Uterine myoma
Uterine fibroids are large masses made up of
tissue cells from your uterus. Actually a type
of non-cancerous tumor, fibroids can grow in
and around your uterus, distorting the shape
and size of this organ. Fibroids typically
range in size, from just a few centimeters in
length to up to 15 centimeters or more.
Fibroid tumors often grow in clusters, so if
you have one uterine fibroid, it is likely that
you may also have more. Fibroids are
actually quite common - between 50% and
80% of all women have at least one. For the
most part, these fibroids cause no symptoms,
though they can be problematic for about
20% of women. Between 10% and 30% of
pregnant women also have fibroids. Uterine
fibroids are usually discovered during your
annual pelvic exam
Reference:
1.
2.
3.
4.
Mosby.
116
Overview Assessment

Teaching Topic: Nursing therapeutics for high risk and complicated pregnancies
Name of Instructor: Asso.Prof. Areena Phanusopone
117
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
science, basic
once potentials
self in order to
have self-
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
clients,
to apply
logic,
mathematic
s and
Professional skills
118
human rights,
children rights,
consumer rights,
patient rights and

professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
goodness and
badness.
health science
development
sciences,
capability leading
which cover
humanities,
social sciences,
laws and
to nursing
practice, teaching,
efficient
democratic
knowledge
2.Holding
strong nursing
understanding
2. Be able to
governance
knowledge and
of Nursing care
for Midwifery
3. Respect the
and health
of humanity
factors
value and dignity
enhancing
system and
searching and
leadership.
search and
analyze data from

various sources.
3. Be able to use
data and
colleagues and
superiors.
2. Be able to
work as a team,
leader and
member of
statistics in
nursing.
2. Be able
to
transform
nursing health
nursing
community
quality
team and
team in public
health service
system on all
levels of public
health system in
data into
information
and able to
analyze
reading and
different
transfer
situations.
information
contexts or
3.Be able to
express
nursing
to others
119
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
ethics and holding
ability to manage
ethical problems
influencing
evidence-based in
and health
critically solve
social changes
system
3. Holding
knowledge and
problems.
4. Be able to
have analytical
understanding
system thinking
process and
professional
of nursing
application in

therapeutics.
professional
nursing practice.
reference and
4. Holding
7. Be a good role
knowledge and
daily living and
essential
by using
knowledge and
related knowledge
including using
experience-based
for safety and
quality nursing
services.
leadership skill
in driving
appropriate
changes in
nursing
organization in
with
comprehens
ion.
3. Be able
to
various
effectively
immediate
e in
situations and
situations
4. Can work as
a team leader
and follower of
the various
roles in
healthcare
services at all
levels and in
different.
communicat
English
language
including
speaking,
listening,
reading,
writing
and
120
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
understanding own
rights in order to
protect their own

rights which are
violated.
situations.
contents of
5.Be able to use
searching
conducting
being able
knowledge
appropriate
journal and
research
in solving
management
problem.
ng.
nursing
develop problem
to use
management .
related to health
basic
knowledge and
nursing ad
programs.
knowledge
process,
management,
process,
process and
organizational
5.Holding
understanding
scientific process,
research and
health
6. Be able to
solving techniques
and efficient
relevant to
as well as
to read
nursing innovation
and nursing
presenting,
textbook
with
understandi
4. Be able
essential
computer
5. Be able
121
of nursing
changing health
to choose
Minimum
contents.
various
informatics and
Nursing Data
situation and
and use
approaches
System
in
presenting
(MNDS).
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
122
Behavioral
Objectives of each
teaching topic
1. Define
abortion.
2. Explain
abortion.
3. Identify the
types of
abortion.
4. Define molar
pregnancy.
5. Discuss molar
pregnancy.
6. Discuss
ectopic
pregnancy.
7. Discuss
abruption
placenta.
Teaching and
Learning
Activities
Lecture
1. Abortion
Discussion
Abortion is the ending of pregnancy by the
removal or forcing out from the womb of a
fetus or embryo before it is able to survive on
its own. An abortion can occur spontaneously,
in which case it is often called a miscarriage.
1.1. Types of abortion
1.1.1. Induced.
Reasons for procuring induced abortions are
typically characterized as either therapeutic or
elective. An abortion is medically referred to
as a therapeutic abortion when it is performed
to save the life of the pregnant woman; prevent
harm to the woman's physical or mental health;
terminate a pregnancy where indications are
that the child will have a significantly
increased chance of premature morbidity or
Teaching
Aides
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
123
8. Discuss
placenta
previa.
mortality or be otherwise disabled; or to

selectively reduce the number of fetuses to
lessen health risks associated with multiple
pregnancy.
1.1.2 Spontaneous
Spontaneous abortion, also known as
miscarriage, is the unintentional expulsion of
an embryo or fetus before the 24th week of
gestation A pregnancy that ends before 37
weeks of gestation resulting in a live-born
infant is known as a "premature birth" or a
"preterm birth". When a fetus dies in utero
after viability, or during delivery, it is usually
termed "stillborn". Premature births and
stillbirths are generally not considered to be
miscarriages although usage of these terms can
sometimes overlap.
2. Molar Pregnancy
Molar pregnancy is an abnormal form of
pregnancy in which a non-viable fertilized egg
implants in the uterus and will fail to come to
term. A molar pregnancy is a gestational
trophoblastic disease which grows into a mass
in the uterus that has swollen chorionic villi.
These villi grow in clusters that resemble
grapes. A molar pregnancy can develop when
fertilized egg had not contained an original
maternal nucleus. The products of conception
may or may not contain fetal tissue. It is
124
characterized by the presence of a

hydatidiform mole (or hydatid mole, mola
hydatidosa). Molar pregnancies are
categorized as partial moles or complete
moles, with the word mole, being used to
denote simply a clump of growing tissue, or a
growth.
3. Ectopic Pregnancy
An ectopic pregnancy, or eccyesis, is a
complication of pregnancy in which the
embryo is implanted outside the uterine
cavity.With rare exceptions, ectopic
pregnancies are not viable. Furthermore, they
are dangerous for the mother, since internal
bleeding is a life-threatening complication.
Most ectopic pregnancies (93-97%) occur in
the distal Fallopian tube (so-called tubal
pregnancies), but implantation can also occur
in the cervix, ovaries, and abdomen. An
ectopic pregnancy is a potential medical
emergency, and, if not treated properly, can
lead to death
4. Abruptio Placenta
Placental abruption (also known as abruptio
placentae) is a complication of pregnancy,
wherein the placental lining has separated
from the uterus of the mother prior to delivery.
It is the most common pathological cause of
125
late pregnancy bleeding. In humans, it refers to

the abnormal separation after 20 weeks of
gestation and prior to birth. It occurs on
average of 0.5% or 1 in 200 deliveries.
Placental abruption is a significant contributor
to maternal mortality worldwide; early and
skilled medical intervention is needed to
ensure a good outcome, and this is not
available in many parts of the world.
Treatment depends on how serious the
abruption is and how far along the woman is in
her pregnancy
5. Placenta Previa
Placenta praevia (placenta previa AE) is an
obstetric complication in which the placenta is
inserted partially or wholly in the lower uterine
segment. It is a leading cause of antepartum
haemorrhage (vaginal bleeding). It affects
approximately 0.4-0.5% of all labours.
In the last trimester of pregnancy the isthmus
of the uterus unfolds and forms the lower
segment. In a normal pregnancy the placenta
does not overlie. If the placenta does overlie
the lower segment, as is the case with placenta
praevia, it may shear off and a small section
may bleed.
126
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
127

Teaching Topic: Pregnancy with infectious diseases
Name of Instructor: Ms. Gladys Desmanos
128
-- None
Course Title/
Learning Outcome
Ethics and Moral
1.
Understanding
of principle of
religions, ethics
and codes of
ethics including
Knowledge
Cognitive Skills
1.Holding
1.Be aware of
understanding
and weaknesses of
knowledge and
of basic life
once potentials
self in order to
and Responsibility
Numerical
Analysis,
Communication
and Information
technology
Skills
1. Be able to
1. Be able
adjust
professionally
and interact
creatively with
to apply
logic,
mathematic
Professional skills
129
human rights,
children rights,
consumer rights,
patient rights and

professional
nursing rights
which are
important to
nursing
therapeutics.
2. Be able to
science, basic
have self-
which cover
enhancing
health science
sciences,
humanities,
social sciences,
to nursing
practice, teaching,
efficient
governance
searching and
knowledge and
leadership.
democratic
2.Holding
understanding
3. Respect the
for Midwifery
of humanity
system and
value and dignity
capability leading
laws and
goodness and
badness.
development
of Nursing care
and health
knowledge
strong nursing
2. Be able to
search and
analyze data from

various sources.
3. Be able to use
clients,
colleagues and
superiors.
2. Be able to
work as a team,
leader and
s and
statistics in
nursing.
2. Be able
to
member of
transform
team and
data into
nursing health
community
team in public
health service
system on all
nursing
quality
information
and able to
levels of public
analyze
different
transfer

contexts or
situations.
3.Be able to
nursing
information
130
4. Be responsible
for self-doing.
5.Holding
discipline and
honesty.
6.Practice
according to
nursing code of
ethics and holding
ability to manage
ethical problems
factors
data and
social changes
reference and
influencing
and health
system
3. Holding
critically solve
problems.
4. Be able to
knowledge and
have analytical
of nursing
by using
understanding
process and
in daily living and application in

nursing
professional
nursing practice.
evidence-based in
therapeutics.
7. Be a good role
4. Holding
daily living and
understanding
system thinking
professional
knowledge and
express
leadership skill
in driving
appropriate
changes in
nursing
for safety and
quality nursing
with
comprehens
ion.
3. Be able
organization in
to
situations and
communicat
various
immediate
situations
4. Can work as
a team leader

including using
the various
experience-based
to others
roles in
healthcare
services at all
levels and in
effectively
e in
English
language
including
speaking,
listening,
reading,
writing
131
professional
nursing practice.
8. Advocate for
patients/clients in
obtaining
understanding own
rights in order to
protect their own

rights which are
violated.
different.
essential
services.
knowledge
scientific process,
as well as
process,
research and
to read
management,
nursing innovation
textbook
process,
and nursing
understandi
process and
6. Be able to
4. Be able
organizational
solving techniques
essential
5.Holding
and efficient
computer
contents of
searching
knowledge
research
management
nursing
management .
knowledge and
5.Be able to use

conducting
appropriate
in solving
presenting,
being able
journal and
health
problem.
develop problem
related to health
nursing ad
situations.
and
with
ng.
to use
basic
programs.
132
understanding
relevant to
5. Be able
informatics and
situation and
and use
of nursing
Minimum
changing health
to choose
contents.
various
Nursing Data
approaches
System
in
presenting
(MNDS).
information
communicat
ion and
technology
effectively
and
appropriatel
y.
1
3 4
5 6
7 8 1
3 4
5 1
2 3 1
4 5 6 1
3 4 5
133
Behavioral
Objectives of each
teaching topic
1. Define
Hepatitis B
virus.
2. Discuss the
etiological
factors of
Hepatitis B
virus.
Teaching and
Learning
Activities
Lecture
1.Hepatitis B Virus
Discussion
Hepatitis B (also referred to as hep B) is a
highly infectious virus that's spread through
blood, semen, and other bodily fluids. If you're
a carrier, you may have contracted the virus:
Through sexual contact with another carrier
At birth, if your mother was a carrier
By sharing needles or getting stuck by a
Teaching
Aides
Powerpoint
presentation
Evaluation
Methods
Quiz
Examination
Midterm and
Final
Evaluation
results
134
3. Identify the
signs and
symptoms of
hepatitis B
virus.
4. Discuss the
possible
complications
of herpes
during
pregnancy.
5. Discuss
syphilis
during
pregnancy.
6. Discuss the
complications
of rubella
during
pregnancy.
needle accidentally
By using a toothbrush or razor that has even a
small trace of a carrier's blood on it (even one
you can't see)
By getting a body piercing or tattoo at a place
where good health practices aren't followed
1.1 Signs and symptoms
you contract hepatitis B, you may feel very
tired. You may also have abdominal pain,
nausea and vomiting, a loss of appetite, joint
pain, or jaundice (your eyes and skin take on a
yellow tinge). But many people have no
symptoms and never even know they've been
infected.
About 10 to 15 percent of people who are 5
years of age or older when they contract HBV
end up as hepatitis B carriers meaning that
their body never gets rid of the virus. About a
quarter of those with a chronic HBV infection
will eventually end up with a life-threatening
liver disease, and about 20 percent of those
with liver disease develop liver cancer. An
estimated 5,000 people in the United States die
every year from illness caused by HBV.
2. Herpes
The biggest concern with genital herpes during
pregnancy is that you might transmit it to your
baby during labor and delivery. Newborn
herpes is relatively rare (about 1,500 newborns
135
are affected each year), but the disease can be

devastating, so it's important to learn how to
reduce your baby's risk of becoming infected.
You can transmit herpes to your baby during
labor and delivery if you're contagious, or
"shedding virus," at that time. The risk of
transmission is high if you get herpes for the
first time (a primary infection) late in your
pregnancy.
3. Syphilis
Syphilis is a sexually transmitted infection
(STI) that's caused by a type of bacterium. If
left untreated, syphilis can have very serious
long-term consequences. Fortunately, if caught
in time, it can be treated with antibiotics.
Syphilis is transmitted by direct contact with a
sore on an infected person. The most common
way to get syphilis is through vaginal, anal, or
oral sex, but it's also possible to get it by
kissing someone with a syphilitic sore on or
around the lips or in the mouth or by exposing
an area of broken skin to a sore.
Syphilis can be transmitted to your baby
through the placenta during pregnancy or by
contact with a sore during birth.
The infection is relatively rare among women
in the United States, with 1 case per 100,000
women in 2011. The rates are significantly
higher in communities with high levels of
136
poverty, low levels of education, and

inadequate access to health care.
4. Rubella
Rubella, also known as German measles, is a
short-lived infectious disease of childhood
caused by a togavirus. German measles and
so-called red measles, or rubeola, are not
directly related to each other, though both are
covered by the common MMR (measles,
mumps, rubella) vaccine. Most women of
childbearing age either have had the disease or
have been immunized against it as a child.
Even if you're not immune, the risk that you
might contract rubella is practically nil since
the disease has been eliminated in this country
and most people are immune and unlikely to
come down with it in the first place. However,
since rubella is contagious and since it hasn't
been eliminated abroad, a nonimmune person
is at risk of getting the illness if she comes into
contact with someone who is infected. The
rubella virus is able to cross the placenta and is
most dangerous early in pregnancy, when
babies exposed to the virus are at risk of a
condition called congenital rubella syndrome,
characterized by eye defects, heart defects, and
mental retardation. The risk of miscarriage or
stillbirth also increases if a pregnant woman
contracts rubella. Exposure after 20 weeks of
137
pregnancy rarely results in such defects
Reference:
1.
2.
3.
4.
Mosby.
Overview Assessment
138

Teaching Plan INUR 3314

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College of Nursing, Christian University of Thailand

Teaching Plan (Theory)

Ethics and Moral

consumer rights, sciences,

and professional sciences, laws and

Nursing care for

health system and

work as a team, to transform

nursing practice. research process,

based for safety situations.

system thinking 4. Can work as

nursing practice. 5.Holding

Content of Each Teaching Topic (in brief)

and growth of formalized knowledge. It has

Have completed both nursing and midwifery

College of Nursing, Christian University of Thailand

patient rights and

ethics and holding

in daily living and

for safety and

model to others in understanding

related knowledge a team leader

5.Be able to use

understanding own management,

Content of Each Teaching Topic (in brief)

A pregnancy that terminates during the 38-42

Teaching Plan (Theory)

value and dignity

health system in reading and

in daily living and

model to others in knowledge and

related knowledge and follower of

5.Be able to use

understanding own knowledge

protect their own

Content of Each Teaching Topic (in brief)

supply to the placenta----uterine contraction.

Increased amount of vaginal discharge

effacement. Are irregular and do not increase in frequency,

Teaching Plan (Theory)

patient rights and

and weaknesses of professionally

analyze data from

ethics and holding of nursing

in daily living and nursing

related knowledge a team leader

model to others in understanding

protect their own

5.Be able to use

1.1.2 Active Phase

3. Third Stage of Labor

4. Fourth Stage of Labor

Teaching Plan (Theory)

Name of Instructor: Ms. Ruffel Joy C. Manalo

Venue: Christian University Room 401

Ethics and Moral

analyze data from

ethics and holding of nursing

in daily living and nursing

related knowledge a team leader

5.Be able to use

rights which are

for safety and

understanding own knowledge