LESSON PLAN

Name of supervisor: Respected Mrs. Harpreet kaur

Name of student teacher: Gurjeet kaur
Class: M.Sc. 2ND year
Subject: community health nursing
Topic: postnatal care
Date: 13-11-2018
Time: 45 min.
Place: G.N.M. 3rd Year class room
A.V.Aids: flash cards , chart, black board
Method of teaching: Lecture cum discussion method
General Objective: At the end group will be able to answer the question related to postnatal
care.
Specific Objective: At the end of the topic the group will be able to :
-Explain the definition
-describe the objective
-explain the components of postnatal care
-explain the immediate care of new born
-explain the immediate care of mother
-explain the postnatal visits
-explain the complication
explain the care of mother
explain the care of new born
-enlist the common health problems in neonates
serial time specifi content teaching a.v evaluati
numbe c learning aids on
r objecti activities
ve
1 1 To INTRODUCTION: My self Gurjeet lecture black
min kaur.I am student of msc first year in cum boar
maint
national institute of nursing. discussio d
ain IPR n
method
with
group.

2 1 To Ask the question like what you know lecture black

min cum boar
review about postnatal care
discussio d
the n
method
previo
us
knowl
edge
of
group

3 1 min To Today I am going to present my topic lecture black

cum board
annou on postnatal care
discussio
nce n
method
the
topic

4 2 min to A postnatal period begins lecture black define

immediately after the birth of a cum board postnatal
define discussion care
child and extends for about six
the weeks as the mother's body, method
including hormone levels
topic
and uterus size, returns to a non-
pregnant state. Less frequently used
are the terms puerperium period.
5 2 min To The aims of care in the postpartum lecture black explain
enlist period are: cum board the
the discussion objective
objecti method
support of the mother and her
ve of family in the transition to a new
postna family constellation, and response to
tal
their needs
care
prevention, early diagnosis and
treatment of complications of
mother and infant, including the
prevention of vertical transmission of
diseases from mother to infant

referral of mother and infant for

specialist care when necessary

counselling on baby care

support of breastfeeding

counselling on maternal nutrition,

and supplementation if necessary

counselling and service provision

for contraception and the
resumption of sexual activity

immunization of the infant

6 8 min explain POSTNATAL ASSESSMENT FORMAT lecture black explain

post cum board the
natal discussion format of
I. History
assess method assessme
ment 1. Identification Data: nt
criteria Name :
Age :
Hospital No :
IP No :
Marital Status :
Address :
Father’s / Husband’s Name :
 Educational Status :
Husband’s Educational Status :
Occupation :
Family Income :
Date and time of Admission :
Date and Time of Delivery :
2. Present Obstetric History
i) Parity
ii) Mode of Delivery
·Normal Vaginal
o With episiotomy
o Without
episiotomy
o With tear – First Degree
/ Second Degree / Third Degree

·Spontaneous / Medical / Caesarean any

other

iii) Full term / Premature

iv) Presentation
Vertex / Breech / Shoulder / Face

3. Part Obstetric History:

4. Family history:
Illness - TB / Hypertension / Diabetes /
Asthma / Jaundice
5. Medical / Surgical History:
Any hospitalization
Surgeries
Medical condition
6. Personal History:
o Dietary
o Habits
o Use of contraceptives
7. Menstrual History:
8. Contraception:
9. Psychological:

II. General Physical Examination

Nourishment : Well nourished /
undernourished
Body built : Thin / Obese
Activity : Active / Dull
Weight : _____________
kgs
Vital
signs : Temperature :
______________ oC
Pulse
: ______________ / min
Respiration
: ______________ / min
Blood
pressure : ______________ mmHg

Mental Status:
Consciousness : Conscious /
unconscious / delirious
Mood : Anxious /
worried / depressed.
Skin Conditions
Colour : Pallor /
Jaundice / Cyanosis / Flushing
Texture : Smooth / rough
Moisture : moist / dry
Skin turgor : Hydrated /
dehydrated
Temperature : warmth / cold /
clammy
Lesions : macules /
papules / vesicles / wounds
Presence of : spider nevi
Palmar erythema
Superficial
varicosities
Hyperpigmentation of : areola nevi
Linea nigra
Chloasma
Head
Scalp : Cleanliness
Condition of the
hair
Dandruff
Pediculi
Face : Pale / flushed /
puffiness / fatigue

Eyes
Eyebrows : normal or absent
Eyelashes : infection, sty
Eyelids : oedema,
lesions
Eyeballs : sunken /
protruded
Conjunctiva : pale / red /
purulent discharge
Sclera : jaundiced
Vision : normal /
shortsighted / longsighted
Ear
Hearing : Hearing acuity
: Any discharges /
cerumen obstructing the ear passage
Nose
External hares : crust ear
discharge
Nostrils : inflammation of
the mucus membrane / septal deviations

Mouth & Pharynx

Lips : redness / swelling
/ crusts / cyanosis / stomatitis
Odour : foul smelling
Teeth : discoloration /
dental care
Mucus membrane : ulceration /
bleeding / swelling / pus formation & gums…

Throat & Pharynx : enlarged

tonsils / redness / pus

Neck
Lymph nodes : enlarged /
palpable
Thyroid gland : enlarged

Chest:

Thorax : Shape
: Symmetry of
expansion
: posture
Breath sounds : Vesicular
 sounds
: Wheezing /

Heart : heart rate

: Location of apex
beat
: Cardiac murmurs

Axilla : any lymph node

enlargement

Breast : secreation of
colostrums /milk

Engorgement : any
tenderness / painful
: tense / dilated
veins / warmth / presence of crust

Nipples : retracted /
inverted / cracked

Abdomen
Inspection : Presence of
scar / wound
If caesarean :
discharge / tenderness
: presence of striae
Palpation : Height of the
Uterus :___
________ cms
Consistency : hard / firm /
boggy
Auscultation : Bowel sounds
____________ present / absent

Perineum : clean
Perineum : Intact / tear /
wound
Episiotomy : mediolateral /
lateral / medial
REEDA: redness / edematous / ecchymosis /
discharge / approximation

Lochia
i) Amount of bleeding : scanty /
moderate / heavy

: No. of beds
changed ___________________
ii) Colour : Red / Yellow /
White
rubra / serosa /
alba.
iii) Odour : Fishy odour / foul
smelling
iv) Clots : Present / absent

Cervix : Oedematous /
thin / fragile

OS : Open / closed
: any tear

Vaginal Mucosa : smooth /

distended / thin / atrophic
Vaginal introitus : erythomatous /
oedematous
Bladder function : amount of urine
output _________________ ml
Bowel Function :
Haemarroids / anal varicosities: present /
absent
Ankel oedema / varicose veins

Extremities : Generalized
muscular fatigue

Nails : Colour
: Capillary refill
: Shape

Newborn Assessment
NEW BORN ASSESSMENT FORMAT

I Identification date:
a. Name:
b. Age:
c. Date of
Birth: Time:
d. Sex:
e. Hospital Number:
f. Date of Admission:
g. Birth Weight:
h. Father name:
i. Mother’s Name:

II History:
a. Antenatal History:
b. Intranatal History:
c. Postnatal History:
d. Family History (if significant):

III Physical Assessment :

a. Biological Assessment :
Length: ………………… Weight: …
……………….
Head
circumference: ………………………
Chest circumference: ………
Mid arm circumference: …………………
Abdominal circumference: …………….
Skin co lour
Vital Signs
- Temp
- Heart rate
- Respiration

Activity
Spontaneous Activity:
Working State (Active, alert, crying):
Sleep State:
Cry:
Brest feeding

b. Head to foot examination:

Area
Head
Appearance:
Over riding of suture
Moulding:
Fontanelles:
Hair texture:
Presence of caput:

Face
Appearance:

Eyes:
Any hemorrhage:
Presence of Tears
Size & reaction of
pupils:
Cornea & Sclera:
Visual response:

Ears:
Size and shape:
Hearing:
Nose:
Nares
Presence of Milia

Mouth & Throat:

Any congenital
deformity:

Chest
Symmetry of Chest:
Chest abdominal
Movements:
Apical pulse
Normur
Location
Pulse (peripheral)

Abdomin
Appearance
(soft, distended)
Liver
Umbilical cord

Extremeties
Length (Equal/
Unequal)
Number of fingers
Number of toes
Palmar creases
Sole creases
Muscle tone

Spine
Normal curvature
 Any deformity

Genitatia
Male
Testis descended/not
Any congenital
deformity
Time of first voiding
Female
Labia minora
Labia majora
Any discharge

Reflexes
Moro reflex
Palmar grasp
Plantar reflex
Stepping reflex
Sucking &
Swallowing
Reflex
Traction reflex
Blinking reflex

III Investigations

IV Treatment

V Remarks

7 10 explai lecture black explain

min n the cum board the
post -Brisk walking discussio exercise
natal n s
exercis method
es -Swimming

-Aqua-aerobics

-Yoga
 -Pilates
-Low-impact aerobic workouts
-Light weight training
-Cycling.

8 5 min explai care of the baby soon after the birth lecture black explain
n the cum board the care
is very important the aim of
care of discussio of child
child immediate care is to help new born n
method
baby to adjust to new environment
which is quite harsh for baby
OBJECTIVE:
-to establish and maintain breathing
of baby
-to maintain body temperature
-to prevent infection
-to detect any congenital
abnormality
Essential routine PNC for all
newborns
• Assess for danger signs, measure
and record weight, and check
temperature and feeding
• Support optimal feeding practices,
particularly exclusive breastfeeding
• Promote hygiene and good skin,
eye, and cord care
• If prophylactic eye care is local
policy and has not been given, it is
still effective until 12 hours after
birth

DANGER SIGNS FOR THE NEWBORN

Advise the mother and family to seek
care immediately, day or night. They
should not wait if the baby has any
of these signs:
 difficulty in breathing or
indrawing
 fits
 fever
 feels cold
 bleeding
 not feeding
 yellow palms and soles of
feet
 diarrhoea
The mother and family should go to
the health centre as soon as possible
if a baby has any of the following
signs:
 difficulty feeding (poor
attachment, not suckling
well)
 is taking less than 8 feeds in
24 hours
 pus coming from the eyes or
skin pustules
 irritated cord with pus or
blood
 yellow eyes or skin.
 ulcers or thrush (white
patches) in the mouth -
explain that this is different
 from normal breast milk in
the mouth

9 5 min explai after the baby is born placenta is lecture black explain
n care cum board the care
delivered it is very important that
of discussio of
mothe the mother is made comfortable and n mother
r method
watched for any complication
-the fundus is palpated , clots are
expressed and fundal height is
measured
-the perineum is inspected for any
laceration or tear , perineal care is
given , napkin fixed
-mother is made comfortable by
removing the soiled linen , through
cleaning and by keeping warm
-hot drink is given
-the vital signs are recorded
Essential routine PNC for all mothers
• Assess and check for bleeding,
check temperature
• Support breastfeeding, checking
the breasts to prevent mastitis
• Manage anaemia, promote
nutrition and insecticide treated
bednets, give vitamin A
supplementation
• Complete tetanus toxoid
immunisation, if required
• Provide counselling and a range of
 options for family planning
• Refer for complications such as
bleeding, infections, or postnatal
depression

• Counsel on danger signs and home

car

POSTPARTUM DANGER SIGNS IN

THE WOMAN
She should go to the hospital or
health centre immediately, day or
night.
SHE SHOULD NOT WAIT if she has
any of the following danger signs:
 vaginal bleeding has
increased
 fits
 fast or difficult breathing
 fever and too weak to get out
of bed
 severe headaches with
blurred vision
 calf pain, redness or swelling;
shortness of breath or chest
pain.

10 2 min explai complication of post partum period: lecture black enlist

cum board the
n the -puerperal sepsis
discussio complica
compli -secondary hemorrhage n tion of
method postpart
cation -thrombophlebitis
um
of post period
 partu -mastitis
m -UTI
period
common health problems are
following:
-hyperbilirubinaemia
-hypothermia
-neonatal hypoglycemia
-opthalmia neonatorum
-neonatal tetnus
-birth asphyxia
-the infected new born
-oral thrush
-sepsis

11 5 min explai 1. Caregiver lecture black explain

n the 2. Communicator cum board the
role of 3. Teacher discussio function
nurse 4. Client advocate n s of
5. Counselor method nurse
6. Change agent
7. Leader
8. Manager
9. Case manager
10. Researcher
Expanded role of the nurse
1. Clinical Specialists
2. Nurse Practitioner
3. Nurse-midwife
4. Nurse anesthetist
5. Nurse Educator
6. Nurse Entrepreneur
7. Nurse administrator
12 2 min To student teacher summarize the topic lecture black
summ today we learn about post natal cum board
arize care , objective,post natal visit, post discussio
 the natal care n
topic components ,complication, common method
health problems.
13 1 min lecture black
cum board
bibliography:
discussio
R.P. sexana a book of community n
method
health nursing ; edition 1st; lotus
publishing house
sTHRESSIAMMA PM ”procedure and
theories of community health
nursing”;edition firs t , Jalandher ,
jaypee brothers medical publisher,
Park K “essential community health
nursing” edition fourth ,Jabalpur
banarsi dass bhanot publishing
house
kk gulani; a book of community
health nursing; edition
nd
2 ;published by kumar publishing
house
www.google.com
www.linkdin.com
NATIONAL INSTITUTE OF NURSING,SANGRUR

HEALTH TEACHING
ON
POSTNATAL CARE

SUBJECT: COMMUNITY HEALTH NURSING

SUBMITTED TO : RESPECTED Mrs .HARPREET KAUR( H.O.D.OF CHN)
SUBMITTED ON : 13-11-18

SUBMITTED BY:
GURJEET KAUR

MSc. NURSING

2nd year