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Clinical Syllabus Los Angeles Harbor CollegeName of Course: Nursing 333- Nursing Process and Practice in the Health Care of Women and FamiliesFaculty Information: Alexandra Roberts-Ellis, RN, MSN and Elizabeth Stieglitz, RN, MSNCourse Description: Students’ clinical experiences in meeting the health care needs of women, and of their families, during childbearing, in the hospital setting. Credit/Contact Hours: 81 hours of clinical laboratory.Days&Time: Tuesdays: 0630-1930Required Textbooks:Murray,S.S. & McKinny, E.S.et al (2019). Foundations of maternal-newborn and women’s health nursing(7thed.). St. Louis, MO: Saunders Elsevier.Lewis, S., Bucher, L., Heitkemper, M. et al (2014). Medical-surgical nursing: Assessment and management of clinical problems (9thed.). St. Louis, MO: Mosby Elsevier.Seo-Cho, J. (2000) Nursing process manual: Assessment tool for the Roy Adaptation Model. Glendale, CA: Polaris Publishing Company.Potter, P.A. & Perry, A.G. (2014). Clinical nursing skills and techniques(8thed.). St.Louis, MO: Mosby Elsevier.Green, C.J. (2016). Maternal Newborn Nursing Careplans (3rded). Burlington, MA: Jones & Bartlett.Davis’s drug guide for nurses (current edition).F.A. Davis: Philadelphia (or current drug text of choice).Los Angeles Harbor College Associate Degree Nursing Program (current edition). Student Handbook.Wilmington, CA: AuthorNational Patient Safety Goals- Center for Disease Control- Safety Education in Nursing (QSEN)- Textbooks:Pickar, G.D. (2016). Dosage calculations: A ratio proportion approach (4thEd.). NewYork:Delmar.OrPickar, G.D. (2013). Dosage calculations (9thEd.). NewYork: Delmar.Roy,Sr. C.(2009). The Roy Adaptation Model (3rded.). Upper Saddle River, NJ: Pearson.Taber’s cyclopedic medical dictionary or Mosby’s dictionary for medical,nursing and allied health(current edition)Diagnostic/Laboratory text of choiceUniforms:See Nursing Program Student HandbookClinical Eligibility: To be eligible for clinical attendance all students are required to meet the clinical health requirements as outlined in the Nursing Student Handbook. See Nursing Student Handbook. Evidence of ALL of the clinical health requirements must be turned in to your clinic instructor before starting clinic.In addition to the clinical health requirements, all agency required forms/tests must be completed and submitted to your clinical instructor upon their request. Any behavior by a student that puts the patient in jeopardy or is life threatening will be terminated from the program with a failing grade.Attendance Policy: Clinical hours cannot be missed. Nursing students are urged NOT to be absent and are reminded that the student is responsible for ALL information, announcements, learning materials given and completion of all work assigned in class during class time. An absence from clinic may result in exclusion from the course or receiving an “F” grade.Outcomes: See N333 course syllabusCourse Grading:Nursing 333 is a combined course. Failure of either the theory or clinical portion results in a failure of the entire course. To successfully pass the clinical portion of this course, the student must pass all critical clinical criteria with a satisfactory rating according to clinical criteria. Weekly clinical evaluation performance will be rated as Satisfactory, Needs Improvement or Unsatisfactory. See “Clinic Papers Grading Criteria” and “Weekly Clinical Evaluation Tool” for evaluation criteria. If the final clinical grade is below passing, the highest course grade that can be earned is a “D”. Note: A“D” is not a passing grade in the nursing program.Critical Outcomes: A student must receive a “Satisfactory” rating on all critical outcomes identified for the course in order to pass the clinical component by the end of the term. Students are responsible for all procedures learned and practiced in all previous nursing courses at a satisfactory level.Learning Resources:College Library/College Library Databases Computer Lab Nursing Learning Lab Learning Resource Center (Main Library)Hospital LibrariesMethod of Instruction:Discussions Demonstrations Critical thinking exercises Hospital setting patient care experiencesEvaluation Method:Written assignments- required clinical papers assigned must meet specified criteria- see Clinical Grading pliance with College, Nursing Program, and Course PoliciesWeekly Clinical Evaluation ToolClinical AssignmentsPatient care must not be initiated before the shift starts at 0700 or before receiving safe patient “Hand Off “communication.Pre conference: starts at 0630 till 0700. By that time students must have an outline as to when medications will be administered and procedures will occur.Post conference: Your instructor will determine the start and length of post conference. Students must report to post conference on time. If a patient care activity will conflict with post conference timely attendance, be sure to communicate this with your instructor.Assignments: Students will assume the care of two mother/baby couplets when assigned to mother/baby, census permitting. When assigned to Labor and Delivery or Antepartum, students will be assigned to one patient. Students should expect to give the instructor SBAR on each of their patients and have a working careplan by 12noon.Post Partum: Clinical Requirements: Mother/Baby Biophysical Prep Forms, History and Assessment Forms, Patho physiological Form, Nursing Care Plans, Medication Form, and WorksheetClinical Experiences: Hospital patient care assignment and Case studiesResponsibilities: Complete the Postpartum/Newborn normal Bio-Physiology Prep Sheet prior to arriving on the unit. Use this information as a reference for normal behaviors as you care for the mother/baby dyad. You must bring the normal Bio-Physiology Prep Sheet with you every time you are in clinic. If your patient manifest abnormal behaviors, notify your nurse/instructor in a timely manner.Record patient care findings on the worksheet as you complete patient care.Prepare a Pathophysiology form on a condition affecting the post partum plete the Medication administration work sheet on drugs that be possibly be administered to the postpartum patient and the newborn. You will be expected to readily discuss the information during medication administration,Skills:Fundal assessmentLochia assessmentBladder assessmentAssist with postpartum admissionAssist with postpartum discharge and teachingSkill Activity:Postpartum Assessment return demonstration and teaching: Students are required to perform an instructor proctored post partum assessment and teaching to one of their assigned patients. The assessment and teaching may be on different patients at different times. A score of > 75% on both asessment and teaching is required to pass clinic and to pass the course. The student will have 2 opportunities to pass the return demonstration and teaching.Newborn Care: Clinical Requirements: Mother/Baby Prep Forms, History and Assessment Forms, Nursing Care Plans, Pathophysiological Form, Medication Form, and WorksheetClinical Experiences: Hospital patient care assignment and Case StudiesResponsibilities: Complete the Postpartum/Newborn normal Bio-Physiology Prep Sheet prior to arriving on the unit. Use this information as a reference for normal behaviors as you care for the mother/baby dyad. You must bring the normal Bio-Physiology Prep Sheet with you every time you are in clinic. If your patient manifest abnormal behaviors, notify your nurse/instructor in a timely manner.Record patient care findings on the worksheet as you complete patient care.Prepare a Pathophysiology form on a condition affecting the plete the Medication administration work sheet on drugs that be possibly be administered to the postpartum patient and the newborn. You will be expected to readily discuss the information during medication administration to the plete the Newborn Screening Information Sheet. Skills:Assist with admission procedures of newbornInterventions for maintaining neutral thermal environmentBulb suctionAdministration of Vitamin K injectionAdministration of Hepatitis B vaccine injectionAdministration of Erythromycin ophthalmic OintmentCircumcision careAssist with Newborn ScreeningHeel stickPhototherapyAssessment of parental learning needs regarding infant characteristics and careParental teaching of infant feeding and care(Infant teaching tool)Promote sensory stimulation Assist with Newborn dischargeSkill Activity:Newborn AssessmentMedicating the newbornLabor and Delivery:Clinical Requirements: Labor and Delivery Prep Forms, History & Assessment Forms, Nursing Care Plans, Pathophysiological Form, Nursing Care Plans, Medication Form, and WorksheetsClinical Experiences: Hospital Patient care assignments and case studiesResponsibilities: When assigned to labor and delivery you will change from your school uniforms into scrubs, as this unit is a procedural plete the Labor& Delivery normal Bio-Physiology Prep Sheet prior to arriving on the unit. Use this information as a reference for normal behaviors as you care for the laboring patient. You must bring the normal Bio-Physiology Prep Sheet with you every time you are in clinic. If your patient manifest abnormal behaviors, notify your nurse/instructor in a timely manner.Record patient care findings on the worksheet as you complete patient care.Prepare a Pathophysiology form on a condition affecting the laboring plete the Medication administration work sheet on drugs that be possibly be administered to the laboring patient, the antepartum patient, the newborn and Antibiotics used in obstetrics. You will be expected to readily discuss the information during medication administration to the newborn.When evaluating lab values for the laboring patient refer to Normal Laboratory values for non pregnant and pregnant women.Skills:Auscultation of fetal heart tonesPalpation of uterine contractionsAssist with application of external fetal monitorAssists with application of internal fetal monitorInterpretation fetal monitor stripsDeep tendon reflexesAssessment of clonus Bulb syringeAntepartum CareClinical Requirements: Medication Form, and Worksheets Clinical Experiences: Hospital Patient care assignments and case studiesResponsibilities: When assigned to antepartum patients, complete worksheets as directed by your instructor. Record patient care findings as you complete care. Skills:Auscultation of fetal heart tonesAssist with application of external fetal monitorPathophysiology WorksheetsYou are required to?prepare?three sets of Pathophysiology work sheets: The format can be downloaded from the course website. You will prepare pathos on conditions affecting the obstetric patient and her newborn. Med/Surg pathos will not be accept. You will present your pathos to your instructor the first time you are in each clinical area, until you have completed 3. Examples of diagnosis for which you can research and complete pathophysiology work sheets:??One on Mother/Baby?(For example this can be done on?Gestational?Diabetes or postpartum hemorrhage)One on the?New Born (This can be done on Hyperbilirubinea)One on?Labor and Delivery (It can be done on Pre-eclampsia, Chorioamnionitis, GBS).Biophysical Prep Sheet: Biophysical Prep- sheets are done only once. You will prepare 2 sets: One for?Mother/Baby and One of Labor and Delivery. They are to be handwritten. They are due on the first day you rotate to Mother/Baby or to Labor and Delivery. You present them to your instructor for check off that you have completed that clinical requirement. You also bring these to clinic each week to use as your reference. The forms for the prep sheet can be downloaded from the course website. Biophysical Prep Sheets that are deemed incomplete will result in an unsat for clinical preparation on the WCET. Please see WCET grading criteria for the course.History and Assessment: You have to complete 2 for your entire rotation.? You will prepare 2 sets: One H&A for Mother/Baby?and one H&A for Labor and Delivery. They are real time and are done when you are assigned to?care for a specific patient for the day. The H&A should be submitted by or before the end of your second clinical week on Mother/Baby or your first week on L&D. You will submit them to your instructor’s box by Thursday at 11 am.?? Please note if they are incomplete or inadequate they will be returned as incomplete or inadequate for check off and you have to repeat them. The H&A forms can be downloaded from the course website. History and Assessments that are deemed incomplete will result in an unsat for that clinical requirement on the WCET. Please see WCET grading criteria for the course.Care Plans: You have to complete 2 sets for your entire rotation. A set is a physiological and psychosocial.?One set for Mother/Baby and one set for Labor and Delivery. When developing your Mother/Baby care plan, the physiological care plan must be completed on the newborn and the psychosocial on the mother. Care plans are real time and done when you are assigned to a specific patient. Submit to your clinical instructor box by Thursday at 11am. The careplans are due together with your H&A. The format can be downloaded at the course website. Careplans that are deemed incomplete will result in an unsat for clinical requirement on the WCET. Please see WCET grading criteria for the course.Medication The medication worksheet can be downloaded from the course website. On the first day of your rotation to a clinical area, you will prepare medication work sheets pertinent for that area. You may use your medication work sheet during medication administration to verbalize your knowledge and understanding of the use of the drug, possible side effects and appropriate nursing precaution. When you rotate through Mother/Baby: Prepare medication work sheet on drugs used for the post partum patient and the newborn.Labor and Delivery: Prepare medication work sheet on drugs for the L&D patient, the ante-partum patient, the newborn and the Antibiotic list of medication.Medication sheets that are plagarized or that are deemed incomplete will result in an unsat for that clinical requirement on the WCET. Please see WCET grading criteria for the course.WorksheetYou will submit your daily worksheet documenting the care you provided to your patients. The worksheet will be collected at the end of each clinical day. The Work sheets will be available at the course website for download. WCETYou will be submitting your WCET online or to your instructor’s mail box by Thursday 11 am of each clinical week. Postpartum Assessment Part A: The AssessmentStudent: ______________________________ Instructor: _________________________ Date: ________Instructions: Perform a physical assessment on a Postpartum client demonstrating the proper technique. Verbalize your findings to your instructor as you complete the assessment. Instruct your client to void prior to calling your instructor. You have 20 minutes to complete the assessment. You must obtain a score of 75% or more to pass the assessment.ScorePossible PointsChest4Auscultate lung sounds and states findings5Palpate both breasts with the flat surface of the fingers, using a circular motion and with the hand on the side of the breast being examined placed at the back of the patient’s head and the bed flat.3State the consistency of the breasts (soft, filling, engorged, lumps, nodules or tender spots)2Inspect nipples and describe (erect, inverted, any cracks, lesions, fissures)Abdomen3Assess abdomen: Auscultate bowel sounds if C/Section. Palpate abdomen and describe findings (Soft, distended etc); Describe any incision.2Point out linea nigra and striae gravidarum2Palpate bladder and state findingsUterus5Palpate the uterus by placing one hand above the symphysis pubis and locating the uterine fundus with the opposite hand5State findings (uterine fundus consistency, location, size and height of the fundus in relation to the umbilicus)5Inspect lochia. State color, amount, odor and presence of clotsPerineum5Inspect perineum with patient in the Sim’s position. Describe findings (use REEDA. Assess for presence of hemorrhoids.Lower Extremities5Inspect and palpate legs for edema, redness, varicosities, tenderness, and increased skin temperature2Maintains the patient’s privacy2Practices hand hygiene before and after assessmentPercentageTotal Points /50CommentsPostpartum Assessment Part B: The TeachingStudent: ______________________________ Instructor: _________________________ Date: ________Instructions: You have 20 minutes to complete the Teaching. You must obtain a score of 75% or more to pass the teaching. You may use prepared notes. Instruct the patient on the following: ScorePossible Points 5 5 5 5 Breasts:Breast Engorgement: Explain what it is, how it is caused, S&S, how it can be prevented and how interventions to treat.Mastitis: Explain what it is; how it is caused, S&S, interventions and treatment; breast feeding with mastitis.Self-breast Examination and breast self-awareness: Importance of performing, when it should be done, Techniques for performing; when mammogram screening should be done.Nipple Care: What patient should do to care for her nipples; what the patient should do to prevent cracked nipples. 10Uterusa). Involution of the uterus: Explain what it is, how long does the process takes and how the patient can know the process is happening normally.b). Describe 3 steps the patient can take to promote involution; c). Explain complications of subinvolution; how the patient can recognize subinvolution and actions the patient should take if she suspects subinvolution. 10Lochia Explain what lochia is; explain lochia regression; describe complications of abnormal regression (Hemorrhage) and how the patient can recognize the complication; Explain when patient must call her MD for abnormal lochia progression. 7Perineum and Elimination: Explain how the patient may care for her perineum and or any hemorrhoids or lacerationsDescribe Kegel’s exercises and the importance of performingExplain when the patient should expect her first bowel movement and 3 steps to prevent constipation. 3 Extremities: Explain what DVT is; S&S of DVT and when the patient should call MD PercentageTotal Points /50Comments:Postpartum/Newborn Normal Bio-physiology Prep SheetInstructions: Fill in all normal postpartum/newborn behaviors as requested before the first day of clinic using class notes, clinic modules and Foundations of Maternal -newborn and Women’s Health Nursing (14th ed.) course text (Chapters 17, 18 & 20). The purpose of this exercise is to familiarize you with the normal behaviors of the postpartum and newborn couplet so that you will know when to seek assistance from RN or instructor. In that regard each area must be complete for clinic credit and must be handwritten.Vital Signs: (normal ranges and expected findings)Temperature: _____________Heart Rate: ____________Respirations: __________Blood Pressure: ____________Breasts: (expected findings)Consistency: __________________________________________________________________________________Nipples: __________________________________________ Areolas: ___________________________________Onset of Lactation: _____________________________________________________________________________AbdomenMusculature: __________________________________________________________________________________Pigmentation: _________________________________________________________________________________FundusHeight: _______________________________________________________________________________________Consistency: __________________________________________________________________________________Location: ____________________________________________________________________________________Lochia (Color, Duration, Amount, Contents, Days seen)Rubra: ____________________________________________________________________________________________________________________________________________________________________________________Serosa: ____________________________________________________________________________________________________________________________________________________________________________________Alba: _____________________________________________________________________________________________________________________________________________________________________________________Perineum (Types of lacerations and episiotomy and interventions for each)Episiotomy: ___________________________________________________________________________________Lacerations: ___________________________________________________________________________________Hemorrhoids: _________________________________________________________________________________Lower ExtremitiesAppearance (upon inspection): ____________________________________________________________________Reflexes: _____________________________________________________________________________________EliminationBladder: ______________________________________________________________________________________Urinary Output: ________________________________________________________________________________Bowel: _______________________________________________________________________________________Psychosocial Adaptations (Expectations and Postpartum Phases)First 24 hours: _________________________________________________________________________________24-48 Hours: __________________________________________________________________________________Interactions with Baby: __________________________________________________________________________Student’s Name: ___________________________Newborn Bio-physical Prep SheetVital Signs (Normal ranges)Temperature: _________________________________________________________________________________Pulse: _______________________________________________________________________________________Respirations: _________________________________________________________________________________ Cry: ___________________________________________________________________________________Blood Pressure: _______________________________________________________________________________PostureResting Position: _______________________________________________________________________________Muscle Tone: __________________________________________________________________________________SkinColor: _______________________________________________________________________________________Turgor: ______________________________________________________________________________________Variations: ____________________________________________________________________________________HeadShape: _______________________________________________________________________________________Anterior Fontanelle: (Shape & Time of closure) ______________________________________________________Posterior Fontanelle: (Shape & Time of closure) ______________________________________________________ChestSize: _____________________________________________Shape: ______________________________________Nipples: (placement) ____________________________________________________________________________Breasts: ________________________________________Witches Milk: __________________________________AbdomenAppearance: __________________________________________________________________________________Umbilical Cord: ________________________________________________________________________________GenitaliaFemale: ______________________________________________________________________________________ ______________________________________________________________________________________Male: ________________________________________________________________________________________ ________________________________________________________________________________________NutritionCalorie Requirements 1st 24 hours: ________________________________________________________________Fluid Requirements 1st 24 hours: _________________________________________________________________EliminationFirst void seen within ____________________hours of life. Number of voids in first 24 hrs. of life_____________.First Stool seen within ___________________ hours of life. Number of stools in first 24 hrs of life_____________.Color of Stool (Color, Type, Consistency and days seen): ______________________________________________ExtremitiesMuscle Tone/Position: __________________________________________________________________________Movement/Range of Motion: _____________________________________________________________________Student’s Name__________________________Labor and Delivery Normal Bio-physiology Prep SheetInstructions: Fill in all normal labor & delivery behaviors as requested before the first day clinic using class notes, clinic modules and Foundations of Maternal -newborn and Women’s Health Nursing (14th ed.) course text (Chapters 12, 13, 14, & 27). The purpose of this exercise is to familiarize you with the normal behaviors of the postpartum and newborn couplet so that you will know when to seek assistance from RN or instructor. In that regard each area must be complete for clinic credit and must be handwritten.Vital Signs (Normal ranges; Chapter 13)Temperature: _____________________________ Pulse: _______________________ Respirations: ____________ Blood Pressure: _______________________________________________________________________________Heart Sounds: _________________________________________________________________________________Lungs Sounds: _________________________________________________________________________________Fetal Heart Rate Patterns (class notes; Chapter 14) Baseline Fetal Heart: Definition: ______________________________________________________________ Normal Range: ___________________Bradycardia: ______________________Tachycardia: _____________ Baseline Fetal Heart Rate Variability: Definition: ________________________________________________ __________________________________________________________________________________ Classification: Absent: _______________________________bpm; Minimal _______________________bpm Moderate _____________________________ bpm; Marked: _______________________bpmAccelerations Definition: _______________________________________________________________________ _________________________________________________________________________________________ Cause: ___________________________________________________________________________________ _________________________________________________________________________________________ Clinical Significance: _______________________________________________________________________ _________________________________________________________________________________________Decelerations Early: Definition: _________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Cause: ___________________________________________________________________________________ Interventions: _____________________________________________________________________________ Late: Definition: __________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Cause: ___________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Interventions: _____________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Decelerations Cont’d Variable: Definition: __________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________ Cause: _________________________________________________________________________ _______________________________________________________________________________ Interventions: _____________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Prolonged: Definition: _____________________________________________________________________ _________________________________________________________________________________________ Cause: ___________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Interventions: _____________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Recurrent Decelerations: Definition _________________________________________________________ Intermittent Decelerations: Definition _________________________________________________________Specific Fetal Heart Rate Pattern Sinusoid also: Definition: __________________________________________________________________ ________________________________________________________________________________________ Cause: ___________________________________________________________________________________ ________________________________________________________________________________________ Interventions: _____________________________________________________________________________ _________________________________________________________________________________________ Pseudo-Sinusoidal: Definition: ______________________________________________________________ _________________________________________________________________________________________ Cause: ___________________________________________________________________________________ ________________________________________________________________________________________Uterine Activity (Chapter 14) Contraction duration (Definition): _____________________________________________________________ ________________________________________________________________________________________ Contraction Frequency (Definition): ____________________________________________________________ _________________________________________________________________________________________ Contraction Intensity Measurement: External Method: ___________________________________________________________ Internal Method: ____________________________________________________________ Uterine Resting Tone: Definition ______________________________________________________________ Measurement: External Method: ____________________________________________________________ Internal Method: ____________________________________________________________Montevideo Units: _____________________________________________________________________________ _____________________________________________________________________________Three Tier Fetal Heart Rate Interpretation Systems (Class notes; Chapter 14)Category IDefinition: (What makes the tracing a category I) ______________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Clinical Significance: ___________________________________________________________________________________________________________________________________________________Management: __________________________________________________________________________Category IIDefinition: (What makes the tracing a category II): _____________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Clinical Significance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Management: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Category IIIDefinition: (What makes the tracing a category III): ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Clinical Significance: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Management: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Components of the Birth Process (Describe each component)Powers: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Passage: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Passenger: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Psyche: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Student’s Name_________________________________Characteristics of Normal Labor and Interventions (Chapter 12,13,14,15 and 27)First StageSecond StageThird StageFourth StageWork AccomplishedForcesDuration NulliparaDuration MutliparaCervical Dilation1st Phase2nd Phase3rd phase------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Effacement Nullipara------------------------------------------------------------------------------------------------Effacement Multipara------------------------------------------------------------------------------------------------Rate of Descent Nullipara------------------------------------------------------------------------------------------------Rate of Descent Multipara------------------------------------------------------------------------------------------------------------------------------------------------Strength & rate ofUterine ContractionTypes ofDiscomfortMaternal BehaviorsNursing InterventionsStudent’s Name______________________________________Apgar Score (Chapter 13)AssessmentScore012Heart RateMuscle ToneRespiratory EffortReflex IrritabilityColor----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Purpose of Apgar ScoreRanges of First Minute Apgar ScoreIndications for Resuscitation ................
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