RELATED LEARNING EXPERIENCE

(NCM 109)
WEEK 2 : DAY 1
Prepared by:
Galarpe, Lovelie Grace
Monterey, Brian
Vitales, Jasmin Mae
ENRIQUEZ, GABRIEL EDWARD R.
 Plan of Activities
• To utilize the nursing process comprehensively as a tool in the care of the patient with
obstetrical problems, pre-existing conditions and newly acquired illness.
• To demonstrate the proper procedure in taking and recording of vital signs.
• Correct and accurate making of medication cards, Rights in Giving Medication,
Patient’s Bill of Rights.
• To understand the importance of correct and accurate documentation using the
different hospital forms
 Plan of Activities
TIME ACTIVITY
8:00 – 8:15 AM Arrival in the area
Morning prayer led by the assigned group member
8:15 – 8:30 AM
Checking of attendance, uniform, materials/duty paraphernalia, and grooming
8:30 – 8:45 AM Pre – conference: Recap of Previous discussion
8:45 – 9:15 AM Live Quiz (Abbreviations/Terminologies, IV Computation and EDD Computation)
• Discussion and Answering of the Previous Activity (Hospital Forms)
• Continuation of discussion (Bill of Rights & Consent Form)
9:15 – 12:00 NN
• Discussion of Case Presentation Format
• Discussion of the Nursing Care Plan Updates
12:00 – 1:00 PM Lunch break
1:00 – 3:45 PM Asynchronous (Short Film Planning)
3:45 – 4:00 PM Post – conference/Housekeeping/Closing Prayer
4:00 PM Departure
 01

Quiz
 IDENTIFY THE TERMINOLOGY OF THE FOLLOWING:

1. What is the term used in number of pregnancy?

2. What is the term used in number of deliveries?
3. PUFT means
4. GTPPAL means
5. FHT means
 IDENTIFY THE ABBREVIATION OF THE FOLLOWING:

6. Discontinue
7. Every 4 hours
8. Bag of water
9. Urinalysis
10. Abnormal uterine bleeding
ENUMERATE ME! (5PTS)

GIVE ATLEAST 5 (FIVE)

PARAPHERNALIA
NEEDED OR SHOULD BE
KEPT ON YOUR
POCKET WHILE ON
DUTY
 COMPUTATIONS

1. The doctor orders an IV infusion of PNSS 1000 mL to

infuse over the next 4 hours. The IV tubing that you are
using delivers 20 gtt/mL. What is the correct rate of
flow?
a. 42 gtts/min
b. 60 gtts/min
c. 72 gtts/min
d. 83 gtts/min
 COMPUTATIONS

2. An infant is ordered 150 mL of Hartmann's solution to

run over 6 hours. The microdrip delivers 60 drops per
millilitre. What is the required drip rate in drops per
minute?.
a. 25 mgtts/min
b. 3 mgtts/min
c. 35 mgtts/min
d. 20 mgtts/min
 COMPUTATIONS

3. The doctor orders an IV infusion of D5 LRS 1000 mL to

infuse over the next 10 hours and you received it in
550ml on your morning shift. The IV tubing that you are
using delivers 20 gtt/mL.

• What is the correct flow rate?

• Will you able to change your IV Fluid bottle within
your shift? If yes, what time will you change the fluid?
 COMPUTATIONS

4. The volume of the fluid is 1.5 L and the IV pump set at

100 mL/hour. How long will it take for the fluid to run?

a. 24 hours
b. 20 hours
c. 15 hours
d. 10 hours
 COMPUTATIONS

NAEGEL’S RULE

1. Last menstrual period: May 21, 2020

2. Last menstrual period: November 25, 2020
3. Last menstrual period: January 20, 2020
4. Last menstrual period: March 14, 2020
5. Last menstrual period: August 28, 2020
 02

Answer Key
 ANSWER KEY

OB TERMINOLOGIES
1. GRAVIDA
2. PARA
3. PREGNANCY UTERINE FULL TERM
4. GRAVIDA, TERM BIRTHS, PRE TERM BIRTHS, POST
TERM BIRTHS, LIVING
5. FETAL HEART TONE
 ANSWER KEY

ABBREVIATIONS
6. D/C
7. Q4
8. BOW
9. UA
10. AUB
 ANSWER KEY

IV COMPUTATION

1. D – 83 gtts/min
2. A – 25 gtts/min
3. 33-34 gtts/min : Yes, 1pm
4. C – 15 hours
 ANSWER KEY

NAEGEL’S RULE
1. February 28, 2021
2. September 1, 2021
3. October 27, 2020
4. December 21, 2020
5. June 4, 2021
 03
Review and Discussion
of Hospital Forms
1. Make an IV tag for patient
Cadis, Kate from Bed No.
3. D5 LRS 1L hooked at
10:00 am (February 7,
2022) as first bottle to be
run for 10 hours. No
medicine incorporated. Fill
out the needed information
and answer the indicated
below.
a. Indicate the flow rate
b. Indicate the time when the
fluid will be consumed.
1. Make an IV tag for patient
Cadis, Kate from Bed No.
3. D5 LRS 1L hooked at
10:00 am (February 7,
2022) as first bottle to be
run for 10 hours. No
medicine incorporated. Fill
out the needed information
and answer the indicated
below.
a. Indicate the flow rate
b. Indicate the time when the
fluid will be consumed.
2. Transcribe the medications ordered for
patient Cadis, Kate into the medication
record form. Orders were made at 8am
02/07/2022. ANST were done at 8:15am.
a. Ampicillin 2g IV every 4 hours (ANST)

3. Transcribe the following order at 10am

02/08/2022 for the same patient as above:
a. Ferrous sulfate 500 mg cap 1x a day
PO
b. Cefuroxime 500mg IV once a
c. Dexamethasone 6mg every 12 hours x 3
doses
2. Transcribe the medications ordered for
patient Cadis, Kate into the medication record
form. Orders were made at 8am
02/07/2022. ANST were done at 8:15am.
a. Ampicillin 2g IV every 4 hours (ANST)

3. Transcribe the following order at 10am

02/08/2022 for the same patient as above:
a. Ferrous sulfate 500 mg cap 1x a day PO
b. Cefuroxime 500mg IV once a
c. Dexamethasone 6mg every 12 hours x 3
doses
VITAL SIGN FOR 24 HOURS
RESPIRATORY PULSE BLOOD
TEMPERATURE STOOL URINE
RATE RATE PRESSURE

2/7/22

8am 37.0 20 84 120/70 0 1

9am 36.6 19 85 110/80 0 0

12pm 36.6 19 85 120/80 0 1

4pm 36.2 17 91 110/70 1 1

8pm 37.4 21 83 120/80 0 1

2/8/2022

12am 36.6 18 84 120/80 0 1

4am 36.4 20 86 110/70 0 0

8am 36.6 19 82 120/70 1 1

5. Write the intake and output of the patient
using the information stated in this file.
Transcribe this in your Intake and Output
Monitoring Sheet for 8am to 4pm shift only.
INTAKE
● 7 am = 1 cup of soup
● 8 am = 250 ml of water
● 10 am = orange juice 8 oz + D5 LRS
1000 x 10 hrs
● 12 pm = 400 ml water
● 3 pm = 350 ml of water
6. Instruction:

▪ Fill out the consent form accordingly

▪ Informed consent shall be obtained from
the patient concerned if he is of legal age
and of sound mind. In case the patient is
incapable of giving consent and a third
party consent is required, who else may
give consent?
 Consent Form

• Fill out the consent form accordingly

• Informed consent shall be obtained from the

patient concerned if he is of legal age and of
sound mind. In case the patient is incapable of
giving consent and a third party consent is
required, who else may give consent?
 Patient Bill of Rights

1. THE RIGHT TO EMERGENCY TREATMENT – Healthcare

professionals have a responsibility to provide medical
treatment to any person with an emergency medical condition.
Patients have the right to emergency medical treatment
regardless of their ability to pay.
 Patient Bill of Rights

2. THE RIGHT TO RESPECT

• The patient's right to respect, otherwise known as nondiscrimination, is the

right to be treated with dignity and respect and is not to be discriminated
against for any reason regardless of sex, race, age, national origin,
ethnicity, religion, sexual orientation, gender identity or expression, veteran
or military status, religion or any other basis prohibited by federal, state, or
local law.
• This also means that patients have the right to be treated humanely and
never be subjected to degrading treatment by any healthcare professional.
 Patient Bill of Rights

3. THE RIGHT OF INFORMED CONSENT

• The most important right that a patient has is the right of informed consent.
A patient should only consent to medical treatment if they have sufficient
information about their diagnosis and all treatment options available in
terms he/she can understand.
• Before a physician can begin any course of treatment, the physician must
make the patient aware of what he plans to do. For any course of
treatment that is above routine medical procedures, the physician must
disclose as much information as possible so the patient may make an
informed decision about his/her care.
 Patient Bill of Rights

4. THE RIGHT TO REFUSE TREATMENT

• The patient has the final decision regarding the medical treatment
they receive even when it means to choose to decline such treatment

5. THE RIGHT TO CHOOSE PROVIDER – All patients have the right to

choose the providers who render health care services to them.
 Patient Bill of Rights

6. THE RIGHT TO PRIVACY

• One of the most basic rights that a patient has is the right to privacy. Patients have
the right to decide to whom, when, and to what extent their private individually
identifiable health information is disclosed. This information includes but is not limited
to medical diagnosis, treatment plans, prescriptions, health insurance information,
genetic information, clinical research records, and mental health records. For patient
lack of privacy could lead to personal embarrassment, public humiliation, and
discrimination.
 Patient Bill of Rights

7. The right to appeal

Patient have the right to review or appeal of any complaint

against physician, hospital or any health care provider regarding

adequacy of treatment, actions of health care provider, wait

times, operating hours, billing and payment issues.

 Patient Bill of Rights

8. PATIENT RESPONSIBILITIES
• Patients have a number of responsibilities to the medical office
including active participation in their treatment plan, timely
resolution of their financial obligation and respectful
interaction with all staff.
 04
Discussion of Case
Presentation Format
I. OVERVIEW OF THE EXISTING HEALTH PROBLEM (can be based on the book and other related study
or literature)
II. PROFILE OF THE PATIENT (include the socio – economic condition, health history)
III. ANATOMY AND PHYSIOLOGY (normal condition of the system or body system/part involved,
mention the normal functions and support with illustration or image)
IV. PATHOPHYSIOLOGY (discuss disease condition itself and support with an illustration/image)
V. SIGNS AND SYMPTOMS
VI. DRUG STUDY (what are the medications given to the patient)
VII. LABORATORY STUDY
A. Laboratory Exam:
• Blood Test (Example: CBC, hct, hgb, Na, K, Creatinine test)
• Liver Test (Cholesterol, Triglyceride, HDL)
• FBS
• RBS
• Pregnancy Test
• Thyroid Function Test
• ESR
• Urinalysis
• Fecalysis / Stool Exam
B. Diagnostic Exam
• X – ray (of what body part)
• ECG
• Endoscopy
• Colonoscopy
• CT Scan (of what body part)
• MRI (of what body part)

VIII. MEDICAL MANAGEMENT (based on the doctor’s order)

IX. SURGICAL MANAGEMENT (based on the doctor’s order)
X. NURSING CARE PLAN
 WESLEYAN UNIVERSITY – PHILIPPINES
College of Nursing and Allied Medical Sciences

DRUG STUDY

NUIRSING
NAME OF ACTION/ SHAPE & COLOR OF
IMPLICATIONS/NUR
MEDICATION GENERIC NAME DOSAGE CONTRAINDICATI THE MEDICATION
CARD TO BE USED SING
(BRAND NAME) ON/SIDE EFFECTS
RESPONSIBILITIES
 WESLEYAN UNIVERSITY – PHILIPPINES
College of Nursing and Allied Medical Sciences

NURSING CARE PLAN

ASSESSMENT DIAGNOSIS ANALYSIS PLANNING IMPLEMENTATION RATIONALE EVALUATION

 05
Discussion of Nursing
Care Plan Updates
Nursing process
• Step by step
• Dynamic
• Cyclical
 → Collection
ASSESSMENT → Recording

HOW?
A. Observation SOURCES OF
TYPES
B. Interviewing DATA
• Direct 1. SUBJECTIVE
• Indirect 1. Primary
2. OBJECTIVE
2. Secondary
C. Examine
DIAGNOSIS
• Condition or statement regarding
the nature of phenomenon PARTS:

• Nursing Diagnosis: clinical P – Problem

judgement about individual, E – Etiology
S – Sign and
family, community, response to Symptoms
actual/potential problem.
EXAMPLE:
• Ineffective breathing pattern related to tracheobronchial
secretions as evidenced by difficulty of breathing and
fatigue
DIAGNOSIS
TYPES:
1. Actual
CLASSIFICATION:
2. Risk
3. Possible
1. High
4. Wellness
2. Medium
5. Collaborative
3. Low
Problem
6. Syndrome
 → Decision making
PLANNING → Problem Solving

• GOAL – Broad statement (general)

TYPES:
• OBJECTIVE – More specific
- Data 1. Initial
- Time Frame 2. On – going
• OUTCOME CRITERIA – Data with time frame
3. Discharge
IMPLEMENTATION → Prioritization

TYPES:
A. INDEPENDENT
B. DEPENDENT
C. INTER – DEPENDENT
D. COLLABORATIVE
RATIONALE → A rationale is a stated purpose for
carrying out a nursing intervention

EXAMPLE:
NURSING DIAGNOSIS: Activity Intolerance related to bed rest as
manifested by general weakness

GOAL: Improved level of energy

MANAGEMENT: 1. Ability to perform activities

EVALUATION
WE HAVE TO CHECK:

1. Goal met
2. Goal partially met
3. Goal unmet
ESCOMBIEN, GRACIELLE
RELATED LEARNING EXPERIENCE
(NCM 109)
WEEK 2 : DAY 2
Prepared by:
Galarpe, Lovelie Grace
Monterey, Brian
Vitales, Jasmin Mae
FREGILLIANA, TOM EDISON
 Plan of Activities
• To utilize the nursing process comprehensively as a tool in the care of the patient with
obstetrical problems, pre-existing conditions and newly acquired illness.
• To demonstrate the proper procedure in taking and recording of vital signs.
• Correct and accurate making of medication cards, Rights in Giving Medication,
Patient’s Bill of Rights.
• To understand the importance of correct and accurate documentation using the
different hospital forms
 Plan of Activities
TIME ACTIVITY
8:00 – 8:15 AM Arrival in the area
Morning prayer led by the assigned group member
8:15 – 8:45 AM
Checking of attendance, uniform, materials/duty paraphernalia, and grooming
8:45 – 9:00 AM Pre – conference: Live Practice and Recitation about filling out of Hospital Forms
Review and discussion of:
• Introduction of OB – Gyn (Labor and Delivery Room)
• Stages of Labor
• Instruments and Equipment Used in Delivery Room
9:00 – 11:50 NN
• Pediatric ward
• Age of Gestation & GTPAL (Gravida, Term Births, Pre – Term, Abortion, Living)
• Recitation about Age of Gestation and GTPAL
• Case Scenario in Labor/Delivery Room
11:50 – 12:00 NN Giving of Case Problems for Reporting (By pair)
12:00 – 1:00 PM Lunch break
Asynchronous
1:00 – 3:45 PM • Formulate a Nursing Care Plan (According to the case scenario that has been discussed)
• Making of short film
3:45 – 4:00 PM Post – conference/Housekeeping/Closing Prayer
4:00 PM Departure
 01
Practice
 PRACTICE

1. Make an IV tag for patient Grey, Meredith from Bed No. 1. D5 LRS 1L
hooked at 10:30 am (February 14, 2022) as second bottle to be infuse for
10 hours with the drop factor of 20. No medicine incorporated. Fill out the
needed information and answer the indicated below.

A. Indicate the flow rate

B. Indicate the time when will the 2nd bottle be consumed
 PRACTICE

2. A patient is receiving D5 LRS 1L IV to be infused for 480 minutes.

Find the rate of infusion in drops per minute. The drop factor is 15.

3. A patient is to receive 300 ml of D5 NM over 2 hours. What is the

flow rate per hour and the rate of infusion in micro drops per minute.

A. Find the cc/hr flow rate

B. Find the mgtts/min flow rate
 PRACTICE

4. Nurse Roxanne’s patient is having PNSS 1L IV to be infused for 6 hours and

you received it 650 ml. The infusion set is calibrated for a drop factor of 20
gtts/mL.
A. Find the cc/hr flow rate
B. Find the gtts/min flow rate
C. Will you be able to change your IV Fluid bottle within your shift? Compute
how many ml will you consumed within your duty hours
 PRACTICE

5. Patient Carl is to receive 500ml of PLRS over the next 480 minutes.
What is the flow rate per hour and the rate of infusion in micro drops
per minute.

A. Find the cc/hr flow rate

B. Find the mgtts/min flow rate
C. Will you be able to change your IV Fluid bottle within your shift?
Compute how many ml will you consumed within your duty hours
 02
Video
(RETURN DEMONSTRATION SKILLS)
 03
Introduction of
Ob-Gyn (DR/LR)
OB - GYN
• An obstetrician – gynecologist, or OB – GYN, has
expertise in female reproductive health, pregnancy and
childbirth.
• Obstetrics involves working with pregnant women,
including delivering babies
• Gynecology involves the female reproductive system,
treating a wide range of conditions
Labor room/delivery room
• A special room in a hospital where women give birth to
babies
• The labor and delivery room is where you’ll spend most
of your time while in labor at the hospital.
• A nurse will monitor your labor and your baby’s heart
rate, either once per hour or continuously.
• If you get an epidural, an anesthesiologist will go
through the process with you and administer the epidural
in the room
 FIRST STAGE OF LABOR
ACTIVITY STUDENT NURSES’ TASKS
Receive the patient from the OB/ER check contraptions such as IV fluid (type and level), foley catheter, oxygen
inhalation and others

Patient identification Fill out the identification tag correctly and place on the patients’ wrist
Obtain obstetrical history Include parity, gravid, LMP, EDC, AOG and onset of true labor (this can be
obtained thru the admission and discharge record endorsed by the OB/ER nurse
Check initial vital signs
Conduct physical examination Check for patient’s status
Check for dentures, jewelries, unclipped nail, nail polish and others
Obtain information regarding allergies to food and drugs
Perform Leopold’s maneuver and obtain fundic height
Bedside care • Assist the patient by offering bedpan
• Provide or assist with oral care
• Provide bed bath and shampooing if necessary
• Change lines and gown if soiled
• Provide perineal care as necessary
Fetal monitoring
Monitor fetal heart rate and uterine contraction. Monitor labor progression and
fetal condition using CTG machine, refer result promptly to the resident on duty
(CTG monitoring last up to 20 minutes per cycle)
Monitor progress of labor • frequency
• Duration
• Intensity
• Interval
Check vital signs hourly until transfer to Delivery Room
Coach and guide mother on process of labor
Prepare delivery room, instruments and equipment needed BASIC PRIMI SET:

Maintains adequacy of supplies to be used during delivery a. Kidney basin

b. 7 cotton rollS with 7.5% povidone iodine plus 7 cotton roll with 10%
*Use supplies diligently povidone iodine
c. 1 Metz scissor
d. 1 Mayo scissor
e. 1 kelly clamp
f. 1 thumb forcep
g. 1 tissue forcep
h. 1 needle holder
OTHER MATERIALS to include in the mayo table/tray
a. Cord clamp
b. Leggings
c. Sterile towel
d. Simple drape
e. Straight catheter
f. Sterile OS (operating sponge)
MAYO TABLE
a. Mayo table cover
b. 2. Mayo table cover drape
 SECOND STAGE OF LABOR
Transfer client safely from the LR per stretcher to the DR 1. Allay patient’s fear and apprehension
table
2. Transfer patient from stretcher to DR table (with rubber sheet and Kelly pad)
(Fully dilated cervix)
3. Place the patient in lithotomy position

4. Guide where the patient should place her hand

5. Obtain BP, vital signs

6. Ensure patients’ safety

Prepare the patient for delivery 1. Wear clean gloves
(this procedure is done by the assisting student nurse) 2. Perineal flushing with water
Perineal disinfection using the 7-stroke method
• Use 7 cotton balls with 7.5% povidone iodine
• Followed by another set of 7 cotton rolls with
10% povidone iodine

1. Do surgical handwashing
(this procedure is done by the assigned “actual”
student nurse)
1. Wear surgical gloves
2. Sterile draping:
a. Place the leggings using the aseptic technique
b. Place a drape over the patients’ abdomen
(due to shortage of supplies and attempt to
deliver cost effective hospitalization for our
patients, most hospitals in Cabanatuan City
uses just leggings and simple drapes for this
procedure)
Take note of the arrangement of the instruments placed in
the mayo table, re-orient yourself to the equipment and
ensure completeness.
Anticipate induction of anesthesia
Coach mother on breathing and pushing technique
Keenly observe actions done by the OB to assist mother • Perineal support
during delivery
• Epiosiotomy

➢ Median

➢ Right medio lateral

➢ Left mediolateral
1. Identify presentation
• Cephalic
• Breech (footling or frank)

2. Delivered neonate carefully

3. Call out correct time of delivery and gender of the
newborn (baby boy, 11:21 am)
4. Checks and manages cord recoil correctly

5. EINC four time-bound interventions:

✓ immediate and thorough drying,
✓ early skin-to-skin contact followed by,
✓ properly-timed clamping and cutting of the cord
after 1 to 3 minutes, and.
✓ non-separation of the newborn from the mother
for early breastfeeding initiation and rooming-in.

6. Identify newborn outcome

✓ Delivered live
✓ Newborn is full term
✓ Still birth
✓ APGAR scoring
✓ Meconium staining
 THIRD STAGE OF LABOR
Delivers the placenta carefully, takes note of 1. Performs Brandt-Andrews maneuver correctly
the time
2. Identify signs of placental separation
4 signs of placental separation:
✓ Lengthening of the cord
✓ Sudden gush of blood
✓ Uterus rises in the abdomen
✓ Uterus becomes firm and globular
1. Obtain blood pressure as soon as the placenta is delivered
then announce to the doctor.
2. Checks the characteristics and completeness of the placenta
Assists with uterine exploration

Assess the amount of blood loss (normal <500

cc)
Employs interventions to achieve and maintain a • Uterine massage
well contracted uterus to prevent/control • Correct administration of oxytocin.
hemorrhage
➢ During labor the doctor may order incorporation of 10 units oxytocin on
1 liter of d5 LRS regulated at 10-15 gtts per min.
➢ after delivery the same IVF will be regulated at 30 gtts per min. To
prevent post-partum hemorrhage doctors’ may order another 10 units
oxytocin IM
Assess for the presence and degree of
laceration

Assist in repair (if indicated)

Check size, consistency and location of uterus
Provide emotional support to the mother • demonstrate proper uterine massage
throughout labor and delivery
FOURTH STAGE OF LABOR
Patient care post NSD 1. Wash and wipe both blood and povidone iodine around the perineum
and legs of the patient using water
2. Place an adult diaper accordingly
3. Assist in transferring patient to stretcher then to the breastfeeding area
4. Obtain vital signs every 15 minutes for the first hour post-delivery, then
hourly until transfer to ward
5. Ensure well contracted uterus
6. Monitor vaginal bleeding
✓ Minimal
✓ Moderate
✓ Large
1. provide health teaching regarding perineal care
2. Ensure client comfort
After care 1. Performs aftercare of the materials and equipment used
2. Observe proper disposal of hazardous and non-hazardous
wastes
3. Segregate soiled linen accordingly (wet, dry)
4. Ensure proper disposal of hospital waste including blood and
other fluids
5. Perform proper disinfection and sterilization protocols
6. Conduct inventory of DR resources

Health Education 1. Demonstrate proper “latch on” breastfeeding technique

2. Provide instructions regarding infant care (feeding and
bathing of newborn)
3. Provide information regarding advantages and
disadvantages of breastfeeding

Record management/ documentation 1. Document all pertinent data correctly, timely and completely
2. Maintain a legible, accurate and updated documentation of
client care in the chart and DR forms
3. Secure informed consent for all procedures related to labor
and delivery
4. Maintain an organized system of filing and keeping records
of the client subject to Privacy Law.
PEDIATRIC WARD
• Acutely ill children, pediatric
neurology research patients,
rehabilitation patients, and surgical
and research patients needing
round-the-clock care are treated at
the Pediatric Ward
 03
Age of Gestation
&
GTPAL
 AGE OF GESTATION

LMP – November 29, 2021

DATE TODAY: February 15, 2022
November 1
December 31
January 31
February 15 -date today
= 78/7 = 11 weeks and 1 day
 AGE OF GESTATION

LMP – June 28, 2021

DATE TODAY: February 15, 2022
June 2
July 31
August 31
September 30
October 31
November 30
December 31
January 31
February 15 -date today
= 232/7 = 33 weeks and 1 day
 AGE OF GESTATION

LMP – July 19, 2021

DATE TODAY: February 15, 2022

July 12
August 31
September 30
October 31
November 30
December 31
January 31
February 15 -date today
= 211/7 = 30 weeks and 1 day
 Identify the Age of Gestation of the given Last
Menstrual Period (LMP):

Date Today: February 15, 2022

1. May 13, 2021
2. June 24, 2021
3. August 28, 2021
4. September 5, 2021
5. December 10, 2021
 GTPAL

1. A 27 year old female is currently 16 weeks pregnant. She has 2

year-old twins that were born at 37 weeks gestation and a 5
year-old who was born at 40 weeks gestation. She had no
history of miscarriage or abortion. What is her GTPAL?

Gravida –
Term births –
Preterm births –
Abortions –
Living –
 GTPAL

2. A 20 year old female is currently 8 weeks pregnant. She had a

miscarriage at 15 weeks gestation two years ago. She has no living
children. What is her GTPAL?

Gravida -
Term births -
Preterm births -
Abortions -
Living -
 GTPAL

3. A 26 year old female is currently 26 weeks pregnant. She had a

miscarriage at 10 weeks gestation five years ago. She has a three
year old who was born at 39 weeks. What is her GTPAL?

Gravida -
Term births -
Preterm births -
Abortions -
Living -
 GTPAL

4. A 30 year old female is 20 weeks pregnant with twins. She has a

6 year-old who was born at 40 weeks gestation. She has no history
of miscarriage or abortion. What is her GTPAL?

Gravida -
Term births -
Preterm births -
Abortions -
Living -
 GTPAL

5. A 39 year old female is currently 18 weeks pregnant. She has two sets of
twin daughters that were born at 38 and 39 weeks gestation and an 11
year-old son who was born at 32 weeks gestation. She has no history of
miscarriage or abortion. What is her GTPAL?

Gravida -
Term births -
Preterm births -
Abortions -
Living -
 04
Case Scenario
(DIFFERENT COMPLICATIONS OF PREGNANCY)
SCENARIO #1
Patient name Janet de Leon 20 y/o G2P0A1 14 weeks pregnant by AOG came to ER
ambulatory, pale looking and with moderate vaginal bleeding. She was complaining of mild
abdominal cramps. Her vital signs are BP 100/70 mmHg, pulse 80 bpm, Temp/37.5. She was
seen by Dr. Pagtalunan vaginal examination was done. The cervix is close. The physician
ordered IV fluid D5LRS 1L for 8 hours, antibiotic Cefoxime 1 gram IV ANST .Bed rest without
bathroom privileges .Janet will be under observation if bleeding is severe she will under go
special procedure dilatation and curettage

Dx: G2POA1 14Weeks AOG Incomplete Abortion Non – Induced Non septic
Dilatation and curettage is an operation performed on women to scrape the uterine lining.
Different types of abortion
Dilatation and curettage
SCENARIO #2
Patient name Anna Concepcion 38 y/o G6P5 30 weeks AOG pregnant with chief complaint of
painless vaginal bleeding, pale looking .Vitals signs BP 120/80 mmHg, pulse 90, afebrile. Seen
by physician with orders. Bed rest without bathroom privileges, IVF D5LRS , Cephalexin 1gram
IV stat ANST given, NPO, CBC, blood typing, to secure 1unit of blood as stand by. Ultrasound
done. Monitoring of FHT to check for contractions and cervical manipulation was not done to
allow time for fetal maturation. Observation and saving perineal pads to check for amount of
bleeding, If bleeding continue or labor starts patient will undergo Caesarean section.

Dx G6P5 30 WEEKS AOG PLACENTA PREAVIA

PLACENTA PREVIA
 PLACENTA PREVIA

PARTIAL
COMPLETE MARGINAL
KEY POINTS:
• PLACENTA PREVIA is a cause of bleeding late in pregnancy. This is after about
20 weeks.
• It causes bleeding because the placenta is close to or covers the cervix
• Bleeding with placenta previa is painless
• You may need bed rest or early delivery of your baby

PLACENTA PREVIA
SCENARIO #3
Patient name Susan Enriquez 25 years old G1P0 smoker admitted to DR with chief compliant of missed
menses, sudden lower quadrant stabbing pain on one side of abdomen, with slight vaginal bleeding
nauseated, shoulder pain scale 7/10, V/S taken BP 90/60mmhg, pulse 100, pale, laboratory results shows
hgb, hct low, hCG confirming pregnancy, ultrasound revealed empty. Patient was seen by the doctor ordered
for admission. oxygen administered via face mask 3lit /min, NPO, CBC, blood typing done. To secure 1 unit
of blood Culdocentesis was done and revealed positive, IVFLUID, Cefuroxime 500mg IV stat given ANST.
Methotrexate was given. Patient for Emergency salpingostomy. Consent taken, pre – op checklist done and
OR and anesthesiologist notified. Patient send to OR immediately.

Dx: GIP0 ECTOPIC PREGNANCY

SALPINGOSTOMY – surgical excision of part of a portion or entire fallopian tube
culdocentesis
Ectopic pregnancy
WHAT IS AN ECTOPIC PREGNANCY?
Normal pregnancies develop inside your uterus,
after a fertilized egg travels through your fallopian
tube and attaches to your uterine lining. Ectopic
pregnancy is when a fertilized egg attaches
somewhere else in your body, usually in your
fallopian tube — that’s why it’s sometimes called
“TUBAL PREGNANCY.”
ECTOPIC PREGNANCY
Ectopic pregnancy
• Ectopic pregnancies can also happen on your ovary, or
somewhere else in your belly.

• Ectopic pregnancies are rare — it happens in about 2

out of every 100 pregnancies. But they’re very
dangerous if not treated. Fallopian tubes can break if
stretched too much by the growing pregnancy — this is
sometimes called a RUPTURED ECTOPIC
PREGNANCY. This can cause internal bleeding,
infection, and in some cases lead to death.
ECTOPIC PREGNANCY
Ectopic pregnancy
Risk for an ectopic pregnancy
We don’t always know the cause of ectopic
ECTOPIC PREGNANCY
pregnancy. But you may be more likely to have an
ectopic pregnancy if you:

• Have an STD, Pelvic Inflammatory Disease or

Endometriosis
• have already had an ectopic pregnancy
• have had Pelvic or Abdominal Surgery
• are 35 or older
• Smoke cigarettes
SCENARIO #4
Patient name May Lopez 18 years old primi 36 weeks pregnant came to ER with
chief complaint of headache and edema on face and both feet noted, in labor. Vitals
checked BP 160/90 mmHg, afebrile, pulse 80bpm, urine dipstick test done +1
protein. Seen by Dr. Pagtalunan Internal Examination was done revealed 4cm dilated
with mild uterine contraction. IV Fluid D5LRS 1L started with 10 units oxytocin
regulated at 10 gtts/min. Hyocine 1amp IV q4hrs for 3 doses. Aldomet 1tab given
bid. Apresoline 10mg IV stat and PRN for BP 140/90 mmHg. Dexamethasone
1/2amp IV given q12hr. Magnesium SO4 10mg injected IM on each buttocks then q
6hrs for 4 doses after checking patellar reflex or deep tendon reflex, urine output
not less than 30cc/hour, respiration not less than 12bpm. Bed rest without bathroom
privileges. For insertion of Foley catheter to monitor urine output hourly. Vital signs
q15min and FHT monitoring to monitor fetal status. To give Calcium gluconate if there
is MgSo4 toxicity.
GARCIA, JOUREIN