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J.G COLLEGE OF NURSING,
AHMEDABAD.
SUBJECT :Nursing Education
TOPIC :Lesson Plan on Pregnancy and Its Managements
SUBMITTED TO, SUBMITTED BY,
Ms. Rekhamol Sidhanar, Ms.Sonal Patel.
Asst. Professor, F.Y.M.Sc(N).
J.G College of Nursing, J.G College of Nursing,
Ahmedabad. Ahmedabad.
DATE OF SUBMISSION: 23/01/2018
2
LESSON PLAN
 Name : Patel Sonal Parsottambhai.
 Subject :Obstetrics and Gynaecology
 Name Of The College : J.G College Of Nursing
 Batch : 2017-2018 (M.Sc.Nursing)
 Method Of Teaching : Lecture Cum Discussion
 A.V. Aids : Blackboard, LCD Projector, Pamphlet, Chart
 Date : 23/01/2018
 Duration : 45 Min
 Topic :Pregnancy and Its Managements
 Venue : T.Y.GNM
3
OBJECTIVE
 PREVIOUS KNOWLEDGE OF THE GROUP:
• Group has some knowledge about the topic Pregnancy and Its Managements.
 CENTRAL OBJECTIVE
 After completion of the class all the students should have knowledge regarding Pregnancy and Its Managements&
will develop positive skill, Knowledge, Attitude toward the Topic.
 SPECIFIC OBJECTIVE
 At the End of class the students will able to:
 Define Pregnancy.
 List Sign and Symptoms of Pregnancy.
 Discuss Minor disorders during pregnancy.
 Digestive system
 Musculoskeletal system
 Circulatory system
 Nervous system
 Genitourinary system
 Respiratory system
 Integumentary system
 Discuss Antenatal Advice.
 Explain Disorder that require immediate action.
4
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1
2
1 Min
1 Min
Introduction of
self and topic
Define
Pregnancy
Self
Introduction<
Topic-Poliomyelitis
PREGNANCY AND ITS
MANAGMENT
PREGNANCY
 DEFINITION
The period from conception to
birth. After the egg is fertilized by a
sperm& then implanted in thelinin
g of the uterus, it
develops into the placenta &embry
o, and later into a fetus.
Pregnancy usually lasts 40 weeks,
beginning from the firstday of the
Write Title
and subtitle on
Black.
Listens to
explanations
What do you mean
about Pregnancy?
5
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
3 1Min Discuss the
sign and
symptoms of
Pregnancy.
woman's last menstrualperiod,and i
s divided into threetrimesters, each
lasting three months.
 SIGN AND SYMPTOMS:
1. Presumptive signs
These are the symptoms and sensations
that, while possibly indicating
pregnancy, also could be caused by any
number of other conditions. These are
also some of the earliest pregnancy
symptoms.
1. Absent menstrual periods
(amenorrhea)
2. Nausea and/or vomiting (morning
sickness)
3. Unexplained fatigue
4. Frequent urination
5. Breast tenderness and changes
6. Excessive salivation (ptyalism)
7. Skin change.
8. A sensation of movement in
abdomen (quickening)
Explain the
sign and
symptoms of
pregnancy by
using Power
Point
Presentation
Watches
Power Point
Presentation
What are the
Presumptive sign
symptoms of
Pregnancy?
6
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1Min
Explain
Probable sign
of Pregnancy
Discuss the
2. Probable signs
Most of the time, these do indicate
pregnancy but, in certain cases,
they might be false or caused by
another condition.
1. Positive pregnancy test (presence of
hCG detected, by blood or urine
test)
2. Softening of cervix at six to eight
weeks (Goodell's sign)
3. Bluish coloration of cervix, vagina
and vulva at six to eight weeks
(Chadwick's sign)
4. Enlarged abdomen
5. Braxton-Hicks contractions
6. Passive movement of the fetus
during an exam (ballottement)
3. Positive signs
These can't be mistaken for any other
Write signs of
probable
signs.
Interaction.
Showing
Power Point
What are Probable
sign of Pregnancy?
What are Positive
7
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
4
1 Min
1 Min
Positive sign
of Pregnancy.
To enumerate
Trimester
according
weeks.
condition. They're considered absolute
evidence that you are, in fact, pregnant.
They rely on the senses sound, sight
and touch as interpreted by your
caregiver.
1. Fetal heart sounds heard by
Doppler
2. Fetus visible on ultrasound
3. Fetal movements felt by caregiver
4. Fetus visible on X-ray, MRI or
other diagnostic imaging device
(Note: Use of these devices is not
recommended during pregnancy)
 TRIMESTER
Three Trimester
a) The first trimester of
pregnancy is week 1 through
week 12, or about 3 months.
b) The second trimester is week
13 to week 27 or about 3 to
6months.
c) The third trimester of
pregnancy spans from week
Presentation
Note taking
Write the
subtitle on
blackboard.
Note taking.
sign of Pregnancy?
List out Trimester
according weeks?
8
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
5
1 Min
Discuss Minor
disorderof
Pregnancy and
Its
Management
Explain Minor
disorder in that
Digestive
System.
Discuss sign
nausea and
28 to the birth or 6 to birth of
baby.
MINOR DISORDER OF
PREGNANCYAND
MANAGEMENT
 These disorder should be
treated adequately as
they may escalate and
become life-threatening.
 Minor disorder may
occur due to hormonal
changes, accommodation
changes, metabolic
changes and postural
changes.
 Every system of body
may affected by
pregnancy.
 DIGESTIVE SYSTEM
1. Nausea and vomiting
2. Constipation
3. Acidity and heartburn
4. Abdominal discomfort
5. Pica
Write the
subtitle on
blackboard.
Note taking.
Which are point
included in Minor
disorder of
Pregnancy and Its
Management?
9
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
vomiting.
Explain to
Manage
nausea and
vomiting
management
1. NAUSEA AND VOMITING:
 Especially in the morning, soon
after getting out of bed
 Usually common in Primi gravidae.
 50% women have both nausea and
vomiting, 25% have nausea only
and 25% are unaffected
 Most commonly occurs during the
first 10 weeks
 Related to higher levels of HCG
MANAGMENT
 Dietary changes
 Behavior modification
 Hospitalization may be necessary to
correct fluid and electrolyte
imbalance
 Explanation, reassurance, and
symptomatic relief are sufficient.
 Avoid: Disagreeable odors and rich,
spicy, or greasy foods
 Drink water or other fluids between
meals to avoid dehydration and
acidosis
 Medication: well-known over-the-
counter drugs should be
administered only when absolutely
Showing
Power Point
Presentation
Note taking.
Note down
Points.
What is nausea and
vomiting?
How to manage
nausea and
vomiting?
10
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Explain the
sign
constipation
Discuss the
management
of constipation
indicated and prescribed.
2. CONSTIPATION:
 Constipation is quite common
ailment during pregnancy.
 A tonicity of the gut due to the
effect of progesterone, relax the
bowel, it diminished physical
activity and pressure of the gravid
uterus on the pelvic colon is the
possible explanations.
 Iron supplements also can
contribute to constipation.
MANAGAMENT:
 Regular bowel habit may be
restored
 Emphasize ample fluids and
laxative foods and prescribe a stool
softener
 Purgatives should be avoided
because of the possibility of
inducing labor.
 Exercise and good bowel habits are
helpful
Showing
Power Point
Presentation
Watches &
Noting Points.
What is
constipation?
How to manage
constipation?
11
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
Explain the
sign Acidity
and Heartburn
Discuss the
management
 Mineral oil is contraindicated
because it absorbs fat-soluble
vitamins from the bowel and leaks
from the anus.
3. ACIDITY AND
HEARTBURN
(INDIGESTION &
ESOPHAGEAL REFLUX):
 It is s not a “burning or pain in
the heart” but primarily as the
result of the growing uterus
pressing on the stomach, rising
progesterone levels, and
decreased gastric motility.
 These factors cause a burning
sensation in the esophagus and
may a sour taste in the
mother.
MANAGEMENT:
 To avoid over eating and not to
go to bed immediately after the
meal.
 Liquid antacids may be helpful
Explain
Acidity and
Heartburn by
using Power
Point
Presentation
What is Acidity
and Heartburn?
How to manage
Acidity and
12
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
of Acidity and
Heartburn
Explain the
sign
abdominal
discomfort
 Sleeping in semi-reclining
position with high pillows
 Hot tea and change of posture
are helpful.
 Calcium-containing antacids &
the histamine H2-receptor
antagonists are pregnancy
category B (e.g., Tums) to
reduce gastric irritation.
4. ABDOMINAL
DISCOMFORT
 Due to Pressure, pelvic
heaviness, is caused by the
weight of the uterus on the
pelvic supports and the
abdominal wall
 Round ligament tension,
tenderness along the course of
the round ligament (usually the
left) during late pregnancy, is
due to traction on this structure
by the uterus, which is
displaced by the large bowel to
be rotated slightly to the right.
 Flatulence and distention can be
due to large meals, gas-forming
Nothing the
Points
Explain the
abdominal
discomfort by
using Power
Point
Presentation
Interacting the
students
Heartburn?
What is abdominal
discomfort?
13
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Discuss the
management
of abdominal
discomfort
Explain the
sign pica.
foods, and chilled beverages.
 These are poorly tolerated by
pregnant women.
MANAGEMENT
 Rest frequently, preferably in the
lateral recumbent position
 Local heat and change of position
 Dietary modifications
 Regular bowel function should be
maintained, and exercise is
beneficial
 Acetaminophen 0.3–0.6, 2–3 times
daily may be of value
 Intra-abdominal disorders must be
diagnosed and treated
appropriately.
5. PICA
 This is term used when the mother
craves certain food or unnatural
substances such as coal.
 The cause is unknown but
hormones and changes in
metabolism are thought to
contribute to this.
 If the substance craved are harmful
to the unborn baby, the mother
must be helped to seek medical
Discuss the
management
by using
Power Point
Presentation
Note taking
Write the
subtitle on
blackboard
Note taking
How to manage
abdominal
discomfort?
What is Pica?
14
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Explain Minor
disorder in that
Musculoskelet
al System.
Discuss sign
fatigue
Discuss the
management
of fatigue.
Explain the
advice.
 MUSCULO-SKELETOL
SYSTEM
1. Fatigue
2. Backache
3. Leg cramps
1. FATIGUE
 The pregnant patient is more
subject to fatigue during the last
trimester of pregnancy because of
altered posture and extra weight
carried.
MANAGEMENT:
 Anemia and other systemic diseases
must be ruled out.
 Frequent rest periods are
recommended.
2. BACKACHE:
 Common problem (50%) in
pregnancy
 Physiological changes that
contribute to backache are: joint
ligament laxity (estrogen),
weight gain, hyperlordosis and
Explain
Fatigue by
using Power
Point
Presentation
Listens to
explanations
What is Fatigue?
How to manage
fatigue?
What is backache?
15
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
sign backache
Discuss the
management
of backache
Discuss the
anterior tilt of the pelvis.
 May be due to faulty posture
and high heel shoes, muscular
spasm, urinary infection or
constipation.
 Fatigue, muscle spasm, or
postural back strain most often
is responsible
MANAGMENT
 Excessive weight gain should
be avoided.
 Rest with elevation of the legs
to flex the hips may be helpful.
 Improvement of posture, well-
fitted pelvic girdle belt which
corrects the lumbar lordosis
during walking and rest in hard
bed
 Improvement in posture is often
achieved by the wearing of low-
heeled shoes. To achieve proper
posture, the abdomen should be
flattened, the pelvis tilted
forward, and the buttocks
tucked under to straighten the
back.
 Massaging the back muscles,
Showing
Power Point
Presentation
Watches &
Noting Points.
Listens to
explanations
How to manage
backache?
How to manage
backache?
16
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min management
of backache
Explain the
sign Leg
analgesics and rest
 Back exercises under the
supervision of a rehabilitation
physician, an orthopedist, or a
physical therapist.
 Recommend sleep on a firm
mattress.
 Apply local heat and light
massage to relax tense, taut
back muscles.
 Give acetaminophen 0.3–0.6 g
orally or equivalent.
 Obtain orthopedic consultation
if disability results. Note
neurological signs and
symptoms indicative of
prolapsed intervertebral disk
syndrome, radiculitis.
3. LEG CRAMPS:
 Quite common, usually in the leg.
 Worse at night.
 The cause of leg cramps in
pregnancy is not known but it may
be due to deficiency vitamin b1 and
of diffusible serum calcium or
Nothing the
Points
Explain leg
cramps by
using Power
What is Leg
cramps?
17
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
1 Min
cramps.
Discuss the
management
of leg cramps
Explain Minor
disorder in that
Circulatory
System.
Discuss sign
Varicose
elevation of serum phosphoru.
 It may due to ischemia and changes
in ph or electrolyte status
MANAGEMENT:
 Supplementary calcium therapy in
tablet or syrup after the principal
meals may be effective.
 Massaging the leg, application of
local heat and intake of vitamin B1
(30 mg) daily may be effective.
 Sleep with the foot end elevation by
20 to 25 cm. once the cramps is
occur gentle kneading is effective.
CIRCULATORY SYSTEM
1. Varicose veins
2. Hemorrhoids
3. Syncope
4. Ankle edema
1. VARICOSE VEINS
 In the legs and vulva (varicosities)
or rectum (hemorrhoids) may
appear for the first time or
aggravate during pregnancy
 Usually in the later months
 Due to obstruction in the venous
Point
Presentation
Nothing the
Points
Explain the
varicose veins
by using
Power Point
How to manage
Leg cramps?
What is Varicose
Veins?
18
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
1 Min
Veins
Explain the
management
of Varicose
Veins
Explain the
sign
Hemorrhoid
return by the pregnant uterus.
 Due to smooth muscle relaxation,
weakness of the vascular walls, and
incompetent valves.
MANAGEMENT
 For leg varicosities, elastic crepe
bandage during movements and
elevation of the limbs during rest
can give symptomatic relief.
 Elevate legs above the level of her
body and control excessive weight
gain.
 Avoid forceful massage (especially
downward, i.e., against venous
return) and point-pressure over the
legs.
2. HEMORRHOIDS
 It may cause annoying
complications like bleeding or may
get prolapsed.
 May cause considerable discomfort.
 Straining at stool often causes
hemorrhoids, especially in women
prone to varicosities.
MANAGEMENT:
 Regular use of laxative
 Local application of hydrocortisone
Presentation
Interacting the
students
Showing
Power Point
Presentation
Note taking
How to manage
Varicose Veins?
What is
hemorrhoids?
19
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Discuss the
management
of
hemorrhoids
Explain the
sign Faintness
ointment
 Surgical treatment is better to be
withheld as the condition improves
following delivery.
 Treat constipation early.
 Sitz baths, rectal ointments,
suppositories, and mild laxatives
are indicated postoperatively or
post delivery.
 Injection treatments are
contraindicated.
3. SYNCOPE(FAINTING)
 The woman presents with dizziness
or light headedness on standing
upright abruptly or following
standing for a prolonged period.
 Following prolonged standing or
standing upright abruptly
 Due to pooling of blood in the veins
of the lower extremities &
compression of the pelvic veins by
the gravid uterus
 Other causes may be dehydration,
hypoglycemia or overexertion
MANAGEMENT
Write the
subtitle on
blackboard.
Note taking.
How to manage the
hemorrhoids?
What is Faintness?
20
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Discuss the
management
of Faintness
Explain the
sign ankle
edema
 Syncope usually resolves rapidly on
lying in left lateral position.
 Syncope in supine position is also
managed by resting in lateral
recumbent position.
 Recurrent syncope needs
cardiological evaluation.
 Encourage the patient to eat six
small meals a day rather than three
large ones.
 Stimulants (spirits of ammonia,
coffee, tea) are indicated for attacks
due to postural hypotension.
4. ANKLE EDEMA
 Evidenced by marked gain in
weight or evidences of
preeclampsia
 Develops in at least two thirds of
women in late pregnancy
 Due to water retention and
increased venous pressure in the
legs
 Generalized edema, always serious,
must be investigated
MANAGEMENT
 No treatment is required for
physiological edema or orthostatic
Write the
subtitle on
blackboard.
Note taking.
Showing
How to manage
Fainting?
What is ankle
edema?
21
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
Explain the
management
of ankle edema
Explain Minor
disorder in that
Nervous
system.
Explain sign
edema.
 Edema subsides on rest with slight
elevation of the limbs.
 Diuretics should not be prescribed.
 Treatment is largely preventive and
symptomatic.
 The patient should elevate her legs
frequently.
 Restrict excessive salt intake and
provide elastic support for varicose
veins.
 Diuretics may reduce edema
temporarily but may be harmful to
the mother or fetus.
NERVOUS SYSTEM
1. Insomnia
2. Headache
1.INSOMNIA
 This is relatively common in late
pregnancy owning to the
discomfort caused by the fetal
movements, frequency of
mituration, and difficulty in finding
a comfortable position.
 It may also due to some deep-
Power Point
Presentation
Note taking.
Explain
insomnia sign
by using PPT
How to manage
ankle edema?
22
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
1 Min
Insomnia
Discuss the
management
of Insomnia
Explain the
sign headache
seated anxiety or fear.
MANAGEMENT
 Take rest in the afternoon
 Drink a glass of warm milk at bed
time
 Tuck a pillow under the abdomen
when lying in a lateral position
 Talk about her fear and anxiety so
that she can have a sense of
normality and lightness.
2. HEADACHE
 Headache in pregnancy is common
and usually due to tension.
 Refractive errors and ocular
imbalance are not caused by normal
pregnancy.
 Severe, persistent headache in the
third trimester must be regarded as
symptomatic of preeclampsia,
eclampsia until proven otherwise
GENITOURINARY SYSTEM
1. Vaginal discharge
2. Leucorrhea
Note down
Points.
Showing
Power Point
Presentation
Watches &
Noting Points.
Explain
vaginal
What is Insomnia?
How to manage
Insomnia?
What is headache?
23
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Explain Minor
disorder in that
Genitourinary
system.
Explain sign
Vaginal
Discharge and
its
management
Explain
management
of leukorrhea
3. Urinary symptoms
1. VAGINAL DISCHARGE
MANAGEMENT:
 Assurance to the patient and
advice for local cleanliness are
all that are required.
 Presence of any infection
(Trichomonas, Candida,
Bacterial vaginosis) should be
treated with vaginal application
of metronidazole or miconazole
2. LEUCORRHEA
 Gradual increase in the amount
of nonirritating vaginal
discharge due to estrogen
stimulation of cervical mucus is
normal during pregnancy.
 Such vaginal fluid is milky,
thin, and nonirritating unless
infection has occurred.
 Persistent external moisture due
to mucus may cause mild
pruritus, but itching is rarely
severe without infection.
MANAGEMENT
 Reassure the patient, and
suggest protective perineal
discharge by
using Power
Point
Presentation
Write subtitle
on Black.
Listens to
explanations
Discuss the
management
How to manage
vaginal Discharge?
24
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
Explain sign
urinary
symptoms
pads.
 Excessive leukorrhea
accompanied by pruritus or
discoloration of the secretion
may indicate bleeding or
infection, requiring treatment
3. URINARY SYMPTOMPS
 Urinary frequency, urgency,
and stress incontinence in
multiparas are common,
especially in advanced
pregnancy.
 Due to increased intra-
abdominal pressure and reduced
bladder capacity.
 Suspect urinary tract disease if
dysuria or hematuria is present.
MANAGEMENT
 When urgency is particularly
troublesome, limit caffeine,
spices, and popular beverages.
 An 8 oz glass of cranberry juice
assists in both maintaining
urinary acidity as well as
decreasing urinary tract
infections.
of leukorrhea
by using
Power Point
Presentation
Watches
Power Point
Presentation
Discuss the
Urinary
symptoms
management
of by using
Power Point
Presentation
Interaction.
How to manage
leukorrhea?
Which symptoms
included in urinary
symptoms?
25
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Explain sign
breathlessness
Explain the
RESPIRATORY SYSTEM
1. BREATHLESSNESS
 Breathlessness, not actual
dyspnea, is a progesterone
effect.
 In nonsmokers and others free
of cough or allergic problems,
breathlessness occurs as early
as the 12th week of pregnancy,
and most women have this
symptom by the 30th week.
MANAGEMENT
 There is no effective treatment.
INTEGUMENTARY SYSTEM
1. SKIN
 Some mothers complaints of
generalized itching, which often
starts over the abdomen.
 Due to have some connection
with the liver's response to the
hormones in pregnancy and
with raised bilirubin levels.
MANAGEMENT
Showing
Power Point
Presentation
Note taking
Write the
subtitle on
blackboard.
Note taking.
Note taking.
What is
breathlessness?
What are the skin
changes occurs in
26
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
skin changes
Discuss
management
of skin
changes
 It clean soon after the baby is
born and comfort can be gained
from local applications.
 An anti-histamine is often
prescribed.
 If a mother complaint of vulvar
irritation, infection such as
thrush, and glycosuria as a
result of diabetes must be
excluded.
 Washing with mild soap and
cotton underwear might help to
ease the irritation.
Antenatal advice
 • Diet, Rest & sleep, Bowel,
Personal cleanliness, Clothing, shoes &
belt, Dental care, Care of breast, Coitus,
Travelling, Smoking & alcohol,
Immunization, Drug, Mental
preparation, Exercise, Child care, Birth
plan, Warning sign, Family planning
DISORDERS THAT REQUIRE
IMMEDIATEACTION
Write the
disorders that
Pregnancy?
How to manage
skin in pregnancy?
27
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
Explain
thedisorders
that require
immediate
action
Discuss the
component of
the topic to be
taught.
Identify the
reference book
 Vaginal bleeding, Reduced fetal
movement, Frontal or recurring
headache, sudden swelling/edema,
Rupture of the membrane, Premature
onset of contraction, Sudden nausea
and sickness.
SUMMARY OF TOPIC:
REFERENCES
BOOKS
1. Annamma Jacob“A
comprehensive textbook of
midwifery”,2nd edition, jaypee
brothers, New delhi, page no:98-
102.
2. BT Basvanthappa “A Textbook of
Midwifery & Reproductive
Health Nursing”, 1st edition:
require
immediate
action
on
blackboard.
Showing
Power Point
Presentation
Showing
Power Point
Presentation
Which are
disorders that
require immediate
action?
Ask Questions
about Pregnancy
and its
managements.
28
Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids Evaluation
1 Min
1 Min
for the
students about
use write
during
assignment
To give
assignment
related to
Topic.
2006, Jaypee Brothers, New Delhi,
page no: 209-223.
3. D.C.Dutta, “Text Book of
Obstetricts”, New Central Book
Agency (p) LTD;6th
Edition,2004,Page no: 95-104
 Assignment :
Write Nursing care plan on Antenatal
mother.
Submitted Date :26/01/2018
Venue: F.Y.MSc (N) Class
Showing
Power Point
Presentation

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Pregnancy & its management -sign & symptoms in lesson Plan

  • 1. 1 J.G COLLEGE OF NURSING, AHMEDABAD. SUBJECT :Nursing Education TOPIC :Lesson Plan on Pregnancy and Its Managements SUBMITTED TO, SUBMITTED BY, Ms. Rekhamol Sidhanar, Ms.Sonal Patel. Asst. Professor, F.Y.M.Sc(N). J.G College of Nursing, J.G College of Nursing, Ahmedabad. Ahmedabad. DATE OF SUBMISSION: 23/01/2018
  • 2. 2 LESSON PLAN  Name : Patel Sonal Parsottambhai.  Subject :Obstetrics and Gynaecology  Name Of The College : J.G College Of Nursing  Batch : 2017-2018 (M.Sc.Nursing)  Method Of Teaching : Lecture Cum Discussion  A.V. Aids : Blackboard, LCD Projector, Pamphlet, Chart  Date : 23/01/2018  Duration : 45 Min  Topic :Pregnancy and Its Managements  Venue : T.Y.GNM
  • 3. 3 OBJECTIVE  PREVIOUS KNOWLEDGE OF THE GROUP: • Group has some knowledge about the topic Pregnancy and Its Managements.  CENTRAL OBJECTIVE  After completion of the class all the students should have knowledge regarding Pregnancy and Its Managements& will develop positive skill, Knowledge, Attitude toward the Topic.  SPECIFIC OBJECTIVE  At the End of class the students will able to:  Define Pregnancy.  List Sign and Symptoms of Pregnancy.  Discuss Minor disorders during pregnancy.  Digestive system  Musculoskeletal system  Circulatory system  Nervous system  Genitourinary system  Respiratory system  Integumentary system  Discuss Antenatal Advice.  Explain Disorder that require immediate action.
  • 4. 4 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 2 1 Min 1 Min Introduction of self and topic Define Pregnancy Self Introduction< Topic-Poliomyelitis PREGNANCY AND ITS MANAGMENT PREGNANCY  DEFINITION The period from conception to birth. After the egg is fertilized by a sperm& then implanted in thelinin g of the uterus, it develops into the placenta &embry o, and later into a fetus. Pregnancy usually lasts 40 weeks, beginning from the firstday of the Write Title and subtitle on Black. Listens to explanations What do you mean about Pregnancy?
  • 5. 5 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 3 1Min Discuss the sign and symptoms of Pregnancy. woman's last menstrualperiod,and i s divided into threetrimesters, each lasting three months.  SIGN AND SYMPTOMS: 1. Presumptive signs These are the symptoms and sensations that, while possibly indicating pregnancy, also could be caused by any number of other conditions. These are also some of the earliest pregnancy symptoms. 1. Absent menstrual periods (amenorrhea) 2. Nausea and/or vomiting (morning sickness) 3. Unexplained fatigue 4. Frequent urination 5. Breast tenderness and changes 6. Excessive salivation (ptyalism) 7. Skin change. 8. A sensation of movement in abdomen (quickening) Explain the sign and symptoms of pregnancy by using Power Point Presentation Watches Power Point Presentation What are the Presumptive sign symptoms of Pregnancy?
  • 6. 6 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1Min Explain Probable sign of Pregnancy Discuss the 2. Probable signs Most of the time, these do indicate pregnancy but, in certain cases, they might be false or caused by another condition. 1. Positive pregnancy test (presence of hCG detected, by blood or urine test) 2. Softening of cervix at six to eight weeks (Goodell's sign) 3. Bluish coloration of cervix, vagina and vulva at six to eight weeks (Chadwick's sign) 4. Enlarged abdomen 5. Braxton-Hicks contractions 6. Passive movement of the fetus during an exam (ballottement) 3. Positive signs These can't be mistaken for any other Write signs of probable signs. Interaction. Showing Power Point What are Probable sign of Pregnancy? What are Positive
  • 7. 7 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 4 1 Min 1 Min Positive sign of Pregnancy. To enumerate Trimester according weeks. condition. They're considered absolute evidence that you are, in fact, pregnant. They rely on the senses sound, sight and touch as interpreted by your caregiver. 1. Fetal heart sounds heard by Doppler 2. Fetus visible on ultrasound 3. Fetal movements felt by caregiver 4. Fetus visible on X-ray, MRI or other diagnostic imaging device (Note: Use of these devices is not recommended during pregnancy)  TRIMESTER Three Trimester a) The first trimester of pregnancy is week 1 through week 12, or about 3 months. b) The second trimester is week 13 to week 27 or about 3 to 6months. c) The third trimester of pregnancy spans from week Presentation Note taking Write the subtitle on blackboard. Note taking. sign of Pregnancy? List out Trimester according weeks?
  • 8. 8 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 5 1 Min Discuss Minor disorderof Pregnancy and Its Management Explain Minor disorder in that Digestive System. Discuss sign nausea and 28 to the birth or 6 to birth of baby. MINOR DISORDER OF PREGNANCYAND MANAGEMENT  These disorder should be treated adequately as they may escalate and become life-threatening.  Minor disorder may occur due to hormonal changes, accommodation changes, metabolic changes and postural changes.  Every system of body may affected by pregnancy.  DIGESTIVE SYSTEM 1. Nausea and vomiting 2. Constipation 3. Acidity and heartburn 4. Abdominal discomfort 5. Pica Write the subtitle on blackboard. Note taking. Which are point included in Minor disorder of Pregnancy and Its Management?
  • 9. 9 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min vomiting. Explain to Manage nausea and vomiting management 1. NAUSEA AND VOMITING:  Especially in the morning, soon after getting out of bed  Usually common in Primi gravidae.  50% women have both nausea and vomiting, 25% have nausea only and 25% are unaffected  Most commonly occurs during the first 10 weeks  Related to higher levels of HCG MANAGMENT  Dietary changes  Behavior modification  Hospitalization may be necessary to correct fluid and electrolyte imbalance  Explanation, reassurance, and symptomatic relief are sufficient.  Avoid: Disagreeable odors and rich, spicy, or greasy foods  Drink water or other fluids between meals to avoid dehydration and acidosis  Medication: well-known over-the- counter drugs should be administered only when absolutely Showing Power Point Presentation Note taking. Note down Points. What is nausea and vomiting? How to manage nausea and vomiting?
  • 10. 10 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Explain the sign constipation Discuss the management of constipation indicated and prescribed. 2. CONSTIPATION:  Constipation is quite common ailment during pregnancy.  A tonicity of the gut due to the effect of progesterone, relax the bowel, it diminished physical activity and pressure of the gravid uterus on the pelvic colon is the possible explanations.  Iron supplements also can contribute to constipation. MANAGAMENT:  Regular bowel habit may be restored  Emphasize ample fluids and laxative foods and prescribe a stool softener  Purgatives should be avoided because of the possibility of inducing labor.  Exercise and good bowel habits are helpful Showing Power Point Presentation Watches & Noting Points. What is constipation? How to manage constipation?
  • 11. 11 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min Explain the sign Acidity and Heartburn Discuss the management  Mineral oil is contraindicated because it absorbs fat-soluble vitamins from the bowel and leaks from the anus. 3. ACIDITY AND HEARTBURN (INDIGESTION & ESOPHAGEAL REFLUX):  It is s not a “burning or pain in the heart” but primarily as the result of the growing uterus pressing on the stomach, rising progesterone levels, and decreased gastric motility.  These factors cause a burning sensation in the esophagus and may a sour taste in the mother. MANAGEMENT:  To avoid over eating and not to go to bed immediately after the meal.  Liquid antacids may be helpful Explain Acidity and Heartburn by using Power Point Presentation What is Acidity and Heartburn? How to manage Acidity and
  • 12. 12 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min of Acidity and Heartburn Explain the sign abdominal discomfort  Sleeping in semi-reclining position with high pillows  Hot tea and change of posture are helpful.  Calcium-containing antacids & the histamine H2-receptor antagonists are pregnancy category B (e.g., Tums) to reduce gastric irritation. 4. ABDOMINAL DISCOMFORT  Due to Pressure, pelvic heaviness, is caused by the weight of the uterus on the pelvic supports and the abdominal wall  Round ligament tension, tenderness along the course of the round ligament (usually the left) during late pregnancy, is due to traction on this structure by the uterus, which is displaced by the large bowel to be rotated slightly to the right.  Flatulence and distention can be due to large meals, gas-forming Nothing the Points Explain the abdominal discomfort by using Power Point Presentation Interacting the students Heartburn? What is abdominal discomfort?
  • 13. 13 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Discuss the management of abdominal discomfort Explain the sign pica. foods, and chilled beverages.  These are poorly tolerated by pregnant women. MANAGEMENT  Rest frequently, preferably in the lateral recumbent position  Local heat and change of position  Dietary modifications  Regular bowel function should be maintained, and exercise is beneficial  Acetaminophen 0.3–0.6, 2–3 times daily may be of value  Intra-abdominal disorders must be diagnosed and treated appropriately. 5. PICA  This is term used when the mother craves certain food or unnatural substances such as coal.  The cause is unknown but hormones and changes in metabolism are thought to contribute to this.  If the substance craved are harmful to the unborn baby, the mother must be helped to seek medical Discuss the management by using Power Point Presentation Note taking Write the subtitle on blackboard Note taking How to manage abdominal discomfort? What is Pica?
  • 14. 14 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Explain Minor disorder in that Musculoskelet al System. Discuss sign fatigue Discuss the management of fatigue. Explain the advice.  MUSCULO-SKELETOL SYSTEM 1. Fatigue 2. Backache 3. Leg cramps 1. FATIGUE  The pregnant patient is more subject to fatigue during the last trimester of pregnancy because of altered posture and extra weight carried. MANAGEMENT:  Anemia and other systemic diseases must be ruled out.  Frequent rest periods are recommended. 2. BACKACHE:  Common problem (50%) in pregnancy  Physiological changes that contribute to backache are: joint ligament laxity (estrogen), weight gain, hyperlordosis and Explain Fatigue by using Power Point Presentation Listens to explanations What is Fatigue? How to manage fatigue? What is backache?
  • 15. 15 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min sign backache Discuss the management of backache Discuss the anterior tilt of the pelvis.  May be due to faulty posture and high heel shoes, muscular spasm, urinary infection or constipation.  Fatigue, muscle spasm, or postural back strain most often is responsible MANAGMENT  Excessive weight gain should be avoided.  Rest with elevation of the legs to flex the hips may be helpful.  Improvement of posture, well- fitted pelvic girdle belt which corrects the lumbar lordosis during walking and rest in hard bed  Improvement in posture is often achieved by the wearing of low- heeled shoes. To achieve proper posture, the abdomen should be flattened, the pelvis tilted forward, and the buttocks tucked under to straighten the back.  Massaging the back muscles, Showing Power Point Presentation Watches & Noting Points. Listens to explanations How to manage backache? How to manage backache?
  • 16. 16 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min management of backache Explain the sign Leg analgesics and rest  Back exercises under the supervision of a rehabilitation physician, an orthopedist, or a physical therapist.  Recommend sleep on a firm mattress.  Apply local heat and light massage to relax tense, taut back muscles.  Give acetaminophen 0.3–0.6 g orally or equivalent.  Obtain orthopedic consultation if disability results. Note neurological signs and symptoms indicative of prolapsed intervertebral disk syndrome, radiculitis. 3. LEG CRAMPS:  Quite common, usually in the leg.  Worse at night.  The cause of leg cramps in pregnancy is not known but it may be due to deficiency vitamin b1 and of diffusible serum calcium or Nothing the Points Explain leg cramps by using Power What is Leg cramps?
  • 17. 17 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min 1 Min cramps. Discuss the management of leg cramps Explain Minor disorder in that Circulatory System. Discuss sign Varicose elevation of serum phosphoru.  It may due to ischemia and changes in ph or electrolyte status MANAGEMENT:  Supplementary calcium therapy in tablet or syrup after the principal meals may be effective.  Massaging the leg, application of local heat and intake of vitamin B1 (30 mg) daily may be effective.  Sleep with the foot end elevation by 20 to 25 cm. once the cramps is occur gentle kneading is effective. CIRCULATORY SYSTEM 1. Varicose veins 2. Hemorrhoids 3. Syncope 4. Ankle edema 1. VARICOSE VEINS  In the legs and vulva (varicosities) or rectum (hemorrhoids) may appear for the first time or aggravate during pregnancy  Usually in the later months  Due to obstruction in the venous Point Presentation Nothing the Points Explain the varicose veins by using Power Point How to manage Leg cramps? What is Varicose Veins?
  • 18. 18 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min 1 Min Veins Explain the management of Varicose Veins Explain the sign Hemorrhoid return by the pregnant uterus.  Due to smooth muscle relaxation, weakness of the vascular walls, and incompetent valves. MANAGEMENT  For leg varicosities, elastic crepe bandage during movements and elevation of the limbs during rest can give symptomatic relief.  Elevate legs above the level of her body and control excessive weight gain.  Avoid forceful massage (especially downward, i.e., against venous return) and point-pressure over the legs. 2. HEMORRHOIDS  It may cause annoying complications like bleeding or may get prolapsed.  May cause considerable discomfort.  Straining at stool often causes hemorrhoids, especially in women prone to varicosities. MANAGEMENT:  Regular use of laxative  Local application of hydrocortisone Presentation Interacting the students Showing Power Point Presentation Note taking How to manage Varicose Veins? What is hemorrhoids?
  • 19. 19 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Discuss the management of hemorrhoids Explain the sign Faintness ointment  Surgical treatment is better to be withheld as the condition improves following delivery.  Treat constipation early.  Sitz baths, rectal ointments, suppositories, and mild laxatives are indicated postoperatively or post delivery.  Injection treatments are contraindicated. 3. SYNCOPE(FAINTING)  The woman presents with dizziness or light headedness on standing upright abruptly or following standing for a prolonged period.  Following prolonged standing or standing upright abruptly  Due to pooling of blood in the veins of the lower extremities & compression of the pelvic veins by the gravid uterus  Other causes may be dehydration, hypoglycemia or overexertion MANAGEMENT Write the subtitle on blackboard. Note taking. How to manage the hemorrhoids? What is Faintness?
  • 20. 20 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Discuss the management of Faintness Explain the sign ankle edema  Syncope usually resolves rapidly on lying in left lateral position.  Syncope in supine position is also managed by resting in lateral recumbent position.  Recurrent syncope needs cardiological evaluation.  Encourage the patient to eat six small meals a day rather than three large ones.  Stimulants (spirits of ammonia, coffee, tea) are indicated for attacks due to postural hypotension. 4. ANKLE EDEMA  Evidenced by marked gain in weight or evidences of preeclampsia  Develops in at least two thirds of women in late pregnancy  Due to water retention and increased venous pressure in the legs  Generalized edema, always serious, must be investigated MANAGEMENT  No treatment is required for physiological edema or orthostatic Write the subtitle on blackboard. Note taking. Showing How to manage Fainting? What is ankle edema?
  • 21. 21 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min Explain the management of ankle edema Explain Minor disorder in that Nervous system. Explain sign edema.  Edema subsides on rest with slight elevation of the limbs.  Diuretics should not be prescribed.  Treatment is largely preventive and symptomatic.  The patient should elevate her legs frequently.  Restrict excessive salt intake and provide elastic support for varicose veins.  Diuretics may reduce edema temporarily but may be harmful to the mother or fetus. NERVOUS SYSTEM 1. Insomnia 2. Headache 1.INSOMNIA  This is relatively common in late pregnancy owning to the discomfort caused by the fetal movements, frequency of mituration, and difficulty in finding a comfortable position.  It may also due to some deep- Power Point Presentation Note taking. Explain insomnia sign by using PPT How to manage ankle edema?
  • 22. 22 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min 1 Min Insomnia Discuss the management of Insomnia Explain the sign headache seated anxiety or fear. MANAGEMENT  Take rest in the afternoon  Drink a glass of warm milk at bed time  Tuck a pillow under the abdomen when lying in a lateral position  Talk about her fear and anxiety so that she can have a sense of normality and lightness. 2. HEADACHE  Headache in pregnancy is common and usually due to tension.  Refractive errors and ocular imbalance are not caused by normal pregnancy.  Severe, persistent headache in the third trimester must be regarded as symptomatic of preeclampsia, eclampsia until proven otherwise GENITOURINARY SYSTEM 1. Vaginal discharge 2. Leucorrhea Note down Points. Showing Power Point Presentation Watches & Noting Points. Explain vaginal What is Insomnia? How to manage Insomnia? What is headache?
  • 23. 23 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Explain Minor disorder in that Genitourinary system. Explain sign Vaginal Discharge and its management Explain management of leukorrhea 3. Urinary symptoms 1. VAGINAL DISCHARGE MANAGEMENT:  Assurance to the patient and advice for local cleanliness are all that are required.  Presence of any infection (Trichomonas, Candida, Bacterial vaginosis) should be treated with vaginal application of metronidazole or miconazole 2. LEUCORRHEA  Gradual increase in the amount of nonirritating vaginal discharge due to estrogen stimulation of cervical mucus is normal during pregnancy.  Such vaginal fluid is milky, thin, and nonirritating unless infection has occurred.  Persistent external moisture due to mucus may cause mild pruritus, but itching is rarely severe without infection. MANAGEMENT  Reassure the patient, and suggest protective perineal discharge by using Power Point Presentation Write subtitle on Black. Listens to explanations Discuss the management How to manage vaginal Discharge?
  • 24. 24 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min Explain sign urinary symptoms pads.  Excessive leukorrhea accompanied by pruritus or discoloration of the secretion may indicate bleeding or infection, requiring treatment 3. URINARY SYMPTOMPS  Urinary frequency, urgency, and stress incontinence in multiparas are common, especially in advanced pregnancy.  Due to increased intra- abdominal pressure and reduced bladder capacity.  Suspect urinary tract disease if dysuria or hematuria is present. MANAGEMENT  When urgency is particularly troublesome, limit caffeine, spices, and popular beverages.  An 8 oz glass of cranberry juice assists in both maintaining urinary acidity as well as decreasing urinary tract infections. of leukorrhea by using Power Point Presentation Watches Power Point Presentation Discuss the Urinary symptoms management of by using Power Point Presentation Interaction. How to manage leukorrhea? Which symptoms included in urinary symptoms?
  • 25. 25 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Explain sign breathlessness Explain the RESPIRATORY SYSTEM 1. BREATHLESSNESS  Breathlessness, not actual dyspnea, is a progesterone effect.  In nonsmokers and others free of cough or allergic problems, breathlessness occurs as early as the 12th week of pregnancy, and most women have this symptom by the 30th week. MANAGEMENT  There is no effective treatment. INTEGUMENTARY SYSTEM 1. SKIN  Some mothers complaints of generalized itching, which often starts over the abdomen.  Due to have some connection with the liver's response to the hormones in pregnancy and with raised bilirubin levels. MANAGEMENT Showing Power Point Presentation Note taking Write the subtitle on blackboard. Note taking. Note taking. What is breathlessness? What are the skin changes occurs in
  • 26. 26 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min skin changes Discuss management of skin changes  It clean soon after the baby is born and comfort can be gained from local applications.  An anti-histamine is often prescribed.  If a mother complaint of vulvar irritation, infection such as thrush, and glycosuria as a result of diabetes must be excluded.  Washing with mild soap and cotton underwear might help to ease the irritation. Antenatal advice  • Diet, Rest & sleep, Bowel, Personal cleanliness, Clothing, shoes & belt, Dental care, Care of breast, Coitus, Travelling, Smoking & alcohol, Immunization, Drug, Mental preparation, Exercise, Child care, Birth plan, Warning sign, Family planning DISORDERS THAT REQUIRE IMMEDIATEACTION Write the disorders that Pregnancy? How to manage skin in pregnancy?
  • 27. 27 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min Explain thedisorders that require immediate action Discuss the component of the topic to be taught. Identify the reference book  Vaginal bleeding, Reduced fetal movement, Frontal or recurring headache, sudden swelling/edema, Rupture of the membrane, Premature onset of contraction, Sudden nausea and sickness. SUMMARY OF TOPIC: REFERENCES BOOKS 1. Annamma Jacob“A comprehensive textbook of midwifery”,2nd edition, jaypee brothers, New delhi, page no:98- 102. 2. BT Basvanthappa “A Textbook of Midwifery & Reproductive Health Nursing”, 1st edition: require immediate action on blackboard. Showing Power Point Presentation Showing Power Point Presentation Which are disorders that require immediate action? Ask Questions about Pregnancy and its managements.
  • 28. 28 Sr. no Time Specific Objectives Content Teaching & Learning Activity A.V Aids Evaluation 1 Min 1 Min for the students about use write during assignment To give assignment related to Topic. 2006, Jaypee Brothers, New Delhi, page no: 209-223. 3. D.C.Dutta, “Text Book of Obstetricts”, New Central Book Agency (p) LTD;6th Edition,2004,Page no: 95-104  Assignment : Write Nursing care plan on Antenatal mother. Submitted Date :26/01/2018 Venue: F.Y.MSc (N) Class Showing Power Point Presentation