ADN 407 - Clinical Practicum 3

Course Objectives
Obstetrics
1. Demonstrate the application of the nursing process as it relates to the maternity setting.
2. Complete discharge teaching for each patient.
3. Demonstrate appropriate scrubbing and hand washing in caring for the newborn.
4. Admit the newborn to the nursery, including physical assessment, medication, identification, and chemistix.
5. Provide daily nursing care of the newborn, including physical assessments of the newborn and appropriate charting of each assessment, and an explanation of usual medications and tests for the newborn and their significance.
6. Identify normal and abnormal assessments of the newborn and report to the instructor or appropriate person immediately.
7. Demonstrate bath/newborn care and/or evaluate a return bath/care demonstration including stools, voiding, temperature, circumcision care, jaundice, safety, car seat use, and metabolic screening for each mother and/or father.
8. Perform an evaluation of one newborn for approximate gestational age using the Dubowitz Scale.
9. Determine the calorie and fluid requirements of the newborn based on weight and compare to the actual calorie and fluid intake of that newborn. Demonstrate appropriate assessment, interventions, teaching and evaluation in assistingmother and/or father with bottle feeding.
10.Demonstrate appropriate assessment, interventions, teaching and evaluation in assisting mother and/or father with breast feeding.
11.Care for the newborn in the isolette, under the warmer, under the Bililite, or using other equipment as available.
12.Provide appropriate care for the preterm, small for gestational age, large for gestational age, congenital anomaly or other high risk neonates as available.
13.Suggest possible resources to the family of a neonate with a congenital anomaly and/or compromised family situations.
14.Assess the antepartal patient appropriately, including the necessary assessments for the risk factor or factors involved during hospitalization as available. Admit the labor patient, including the necessary assessments of emotional state, vitals, timing contractions, FHT’s performing Leopold’s maneuver and performing the perineal prep and enema if required, and identifying changes in the labor patient’s condition as they relate to the stages of labor.
15.Demonstrate an understanding of sterile techniques as he/she sets up the  delivery room/LDRP (Labor, Delivery, Recovery, Postpartum).
16.Demonstrate appropriate techniques in scrubbing for a delivery and assisting the physician under the direct guidance of an instructor.
17.Follows directions and relates appropriately in circulating for a delivery under direct guidance of the instructor or hospital staff, including the identification and initial care of the neonate.
18.Observe a Cesarean delivery as available, and discuss the reasons for the Cesarean delivery and the two usual types of Cesarean.
19.Identify the basic components of the FHM strip including rate, accelerations, decelerations, variability by noting the different patterns with the assistance of RN or instructor.
20.Admit the postpartum patient to the postpartum unit, including the appropriate assessment and reporting while providing in depth care.
21.Demonstrate in depth planning of daily assessment and care for the postpartum patient, by appropriate charting and reporting of normal and abnormal findings.
22.Communicate effectively with all post-partum patients and families, including the adolescent parent, parents of high risk infants, parents of stillbirths, and other high risk groups.
23.Identify effective means of communication that may be used in caring for families of various cultures.
24.Demonstrate the five rights in giving medications and relate in-depth information about medications, IV fluids and IV medications by demonstrating appropriate techniques in their administration.
25.Demonstrate competency in performing procedures as available, such as
catheterization, enema, Harris flush, dressing change, pre-op teaching, post-op teaching, surgical prep, etc.
26.Keep abreast of all new physician’s orders, lab values, information on Kardex, and make additions to the Kardex.
27.Discharge the patient and newborn demonstrating safety, and completing
charting.
28.Perform and educate patients about self-breast examinations.

Pediatrics
1. Plot weights and heights on growth charts.
2. Utilize nursing interventions to reduce stress in the hospitalized child based on the child’s developmental stage.
3. Take accurate vitals on various aged children. Report abnormal vital signs
promptly.
4. Use appropriate safety measures for hospitalized children.Support for the child during treatments.
5. Complete the pre-op teaching and post-op for a child having surgery.
6. Use appropriate play materials in caring for various aged children.
7. Assess fluid and electrolyte balance in the pediatric patient.
8. Calculate fluid needs for 24 hours for a hospitalized child.
9. Calculate correct dosages and give injections to children with the correct needle and in the correct sites.
10.Calculate correct dosages and give oral medications to the pediatric patient.
11.Administer IV fluids and medications to the child including saline loc, central lines, IV pumps
12.Care for children of various ages including infants, toddlers, preschoolers, school age children and adolescents.
13.Provide anticipatory guidance to parents about common concerns related to the age of their children.
14.Assess children appropriately and report abnormalities and changes in condition promptly.
15.Interact therapeutically with children and family members.
16.Adapt procedures to the pediatric patient.
17.Record a nursing history accurately and promptly.
18.Integrate collected data with knowledge of etiology, development, and prognosis of common and more complex health problems in caring for children or various ages.
19.Determine nursing diagnoses, formulate appropriate goals and establish priorities of care for a child with more complex health problems.
20.Provide individualized care for children of various ages.
21.Analyze strengths and limitations of families while completing care of a child and in planning for discharge.
22.Evaluate effectiveness of care given to the child.
23.Assist with diagnostic procedures and treatments.
24. Analyze learning needs and complete discharge teaching for the family of the child who is going home.
25.Identifies appropriate resources to meet learning needs and post hospital care.
26.Provides ongoing teaching and records family learning.
27.Work with the care manager or other health care providers or agencies in meeting family needs.