Ateneo de Zamboanga University

College of Nursing
School Year 2020-2021

Learning Packet in Level 2 RLE - GREEN

Name:SANAANI,NUR-FATIMA.M. Date:
Level and Section: BSN-2H Learning Packet No: #2

Topic: Peripartal- week 2 Semester: First

Learning Materials:
 Laptop, computer desktop or android phone
 Ballpen
 Paper
 Video clips
I. INTRODUCTION

What is this about ?

This packet is about Care of family and client during Labor and Delivery/Childbirth

What will you learn?

Assisting with Delivery, Delivering the Placenta, Administration of Oxytocin and

Massaging the Uterus/or fundal massage.

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 Learning Competencies and Objectives

At the end of the 24 hour RLE student will be able to:

a. Analyze how the physiologic and psychological changes of pregnancy ,
labour and childbirth which affects the patient and family.
b. Assess a woman for the degree and type of discomfort a woman is experiencing
or will be experiencing during labor and birth, including her ability to cope with
it effectively
c. Formulate Nursing Care Plan for different situations to promote comfort during
labour, delivery and after birth.

II.LEARNING EXPERIENCE
A. Can you do this?
Activity: experience wise
Directions: Interview a mother you know thru social media/ in your household
with experienced being administered a drug like oxytocin or anesthesia in
natural birth and make a drug study on one:
Guide Questions: 1. How do you assist the mother through care and alleviating
discomfort during child birth and Delivering the Placenta?
2. When do you Administer Oxytocin?
3. Can you make a Nursing Diagnosis?
DRUG ACTION INDICATION/ NURSING
CONTRAINDICATION RESPONSIBILITIES
Generic 0.5-1 mUnit/min  to induce or stimulate labor  Continuously
Name: IV, titrate 1-2  hypersensitive to drug when vaginal monitor
oxytocin mUnit/min q15- delivery is advised contractions, feta
Brand 60min until  when delivery requires conversion land maternal
Name:N/A contraction pattern as in transverse lie heart rate, and
Classification reached that is maternal blood
: N/A similiar to normal pressure and ECG.
Frequency: labor (usually 6 Discontinue
q15-60min mUnits/min infusion if uterine
Route: 0.5-1 hyperactivity
mUnit/min occurs.
IV  Assess fluid intake
Dose: 1-2 and output. Watch
mUnit/min for signs and
symptoms of
water intoxication.

CUES Nursing Diagnosis

Subjective:  Acute pain related to Pressure on
“sumasakit tiyan ko, at likod ko, at ang paa ko ” as adjacent structures.
patients interpretation tof verbalization.
Objective:
Currently patient at the stage of 2nd laboring
with a dilatation of 7cm
 Don’t Forget Putting it All Together
It is important to give supportive care throughout labor.
 Communication
 Cleanliness
 Mobility
 Urination
 Eating, drinking
 Breathing technique
 Pain and discomfort relief
 Birth companion.

B. Let’s start!

Based on the case scenario #1 (your interview)

Guide Questions: 1. What are the degrees of discomfort experienced during
labor and birth including her ability to cope with it effectively?
2. When do you start Massaging the Uterus/or fundal massage
3. What additional Health teaching does the woman need?
4. Can you formulate a health teaching plan?
CUES OBJECTIVES CONTENT STRATEGY TIME EVALUATION
Allotment
Subjective: Patient would To teach patient 15mins Family or the
“sumasakit tiyan be able to breathing pattern Demonstrate, in significant of the
ko, at likod ko, determine, to reduce pain front of the family was able
at ang paa ko ” nonpharmacolog family of the to know the
as patients ical method to To teach patient, about therauptic touch
interpretation to alleviate pain significant other Formulate on the maternal
verbalization. related to of patient , of methods of mother to
the significant of massage, of alleviate pain of
Objective: therapeutic therapeutic patients during
Currently touch to touch,
patient at the alleviate pain in repositioning
lumbar section clients, and
stage of 2nd
breathing Patient was
laboring with a The purposed of patterns, to verbalized that
dilatation of side lying alleviate pain of her pain was
7cm position to maternal mother alleviated
alleviated pain
and hastening of
fetal descent.
Activity: Video Clip Viewing
1. Stages of Delivery: https://www.youtube.com/watch?v=9jjtIuKZsRQ
2. Assisting Delivery: https://www.youtube.com/watch?v=VGRdy1cMXoo
3. Massaging uterus/ fundus: https://www.youtube.com/watch?v=kRav3hBejrw
4. Managing Post partum bleeding https://www.youtube.com/watch?v=2d84AtDz2HY

3-2-1 Reflect
I was able to determine the stages of different delivery, as
would be menstion(first stages/mild contraction, second
stages/painful contraction, third stages/placent being
delivered, and four stages/rejoice of family. )
3- things you have learned from
the video clips
The characteristic of stages of dilation of
cervix(1ststage/4cm,2nd stages/8-10, 3rd stages baby is out, 4th
stages placenta is delivered)

How to apply fundal and uterus massage

The mechanism of the labor stages

2- interesting things about the

video clips The massage fundus and how does it reduce risk of
hemorrhage

N/A

1-Question that you like to ask

about the video N/A
 Think about these
Activity: Think, Pair and Share
Scenario: A patient age 22 G1 T1 P0 L1 During the first 3o minutes of the delivery
of the placenta the nurse noted persistent vaginal bleeding, soft abdomen.
Directions: Make a Nursing Care Plan based on the scenario given.
Then, you may share and discuss your answer with your partner.
( a predetermined classmate assigned to you)
Evaluation Plan
Health Objective of Plan of
Outcome Method/ Tool
Condition/s or Nursing Care Intervention
Criteria/
problem/s
Indicators,
standards
Deficient fluid Prevent excessive .to prevent blood Patient will be able to
volume related to blood loss in loss of patients, alleviated of bleeding
and hemorrhaged
excessive blood postpartum through the
loss of after birth following
intervention;

 Monitor
vital signs
15mins

 Fungal
massage
with
therapeuti
c method.
 By manual
compressio
n
 Administra
tion of
oxytocin

Feedback
Now , let’s check how you are doing so far in the Think, Pair and Share activity
4- Outstanding
3- Very Satisfactory
2- Satisfactory
1- Unsatisfactory
 C. Do you know?

mes for a woman in labour and her partner, be certain they are realistic. Because labour usually takes place over a relatively sh

III. Learning Values

When handling our clients , we need to take care of them focusing in

alleviating the pain they feel. In our daily lives we sometimes become
insensitive to others we tend to even hurt them because of our behaviour. It is
our responsibility as nursing students to be sensitive with our behaviour and
especially with the way we deal with our clients.
Guide Questions: What are the important things that we need put in mind
when we are with our clients?

REMEMBER:

Mothers who are in Labor are sensitive to

sounds, movements and pain

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Activity: Thought shapes
Directions: Write down inside each shape: what you learned, what you enjoyed,
what you felt and what were your thoughts .

The most important thing I have learned… What I enjoyed most……….

How I feel about using the skills and The thoughts still going around
ideas I have learned… in my head are …

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 IV.EVALUATION
I.Multiple choice: Write the letter of your choice on the space provided before the
number.
d1.It is important to document fetal presentation and position,
these help predict if the presentation of a body part other than the
vertex, in doing so it will prevent following EXCEPT:
a. Putting a fetus at risk.
b. Labor is invariably longer because of ineffective descent of the fetus.
c. Ineffective dilatation of the cervix.
d. Regular and strong uterine contractions.
c 2. Which among the following include the Three separate divisions mark
the first stage of labor EXCEPT:
a. Active
b. Latent
c. Placental separation
d. Transition
A3. The second stage of labor is which among the following:
a. the period from full dilatation and cervical effacement to birth of the
infant
b. the placental stage, begins with the birth of the infant and ends with
the delivery of the placenta
c. begins at the onset of regularly perceived uterine contractions and
ends when rapid cervical dilatation begins
d. Active bleeding on the maternal surface of the placenta begins
with separation
b 4. Oxytocin is a synthetic form of the hormone produced by
the hypothalamus and stored in the posterior pituitary. An oxytocic, it
stimulates the uterus to contract to control postpartum
haemorrhage. Which among the following is true regarding Oxytocin
EXCEPT:
a. Adverse Effects are Hypertension, excessive uterine contractility
b. Do not administer after delivery of the placenta until the physician or
nurse-midwife approves the drug’s use.
 c. Do not add to an existing intravenous line
d.Monitor the woman for blood pressure,because hypertension can occur.

a 5. If the placenta does not deliver spontaneously. Which among

the following is a correct intervention EXCEPT:
a. The nurse will ask the new mother to bear down gently
b. The nurse will apply gentle pressure on the contracted
uterine fundus .
c. The nurse will apply gentle traction on the umbilical cord.
b 6. The first hour after birth is potentially the most dangerous time for a
woman because of the following are the reasons EXCEPT:
a. The nurse massages the uterus
b. If her uterus should become relaxed during this time (uterine atony)
c. She will lose blood very rapidly.
d. No permanent thrombi have yet formed at the placental site.

Congratulations for actively participating and answering all the activities in the learning packet, see you on y
g!

Do you have questions? Concerns? Do you need help about the topic?
I am available at our e-class chat room or I am just a text away.
Sources:

Lecture Medical. March 16, 2017 Stages of Delivery: https://www.youtube.com/watch?

v=9jjtIuKZsRQ

Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice. 3rd
edition.https://www.ncbi.nlm.nih.gov/books/NBK326674/?fbclid=IwAR2MwCDNHoe
YR-bYieEqbSsvDxa6-lo7DeskxhXJUcX1UiWi3noysK_7wrU

Pillitteri, Adele, Maternal and Child Nursing: Care of Child bearing and Child rearing,
Edition 6, 2010

S D2020, Massaging Uterus, https://www.youtube.com/watch?v=kRav3hBejrw

Prepared By:

Maria Rosario M. Romero Karen V. Abulencia GlenRose Lao Fernando Cathleen Marie G. Carpio
College of Nursing, College of Nursing College of Nursing College of Nursing
Clinical Instructor, Clinical Instructor Clinical Instructor Clinical Instructor
Level 2- RLE-Green Level 2-RLE- Green Level 2-RLE- Green Level 2-RLE- Green
Level 1- Anatomy Level 1-NCM 100j Level 2- NCM105jD Level 2-NCM 106j
Level1- NTF
Ateneo de Zamboanga University, 2020