COMPETENCY ITEMS AND VALIDATION TECHNIQUES
COMPETENCY: PRENATAL NURSING CARE
STANDARD: Prenatal nursing care promotes a positive birth experience and healthy birth outcomes, and is an integral component of maternal and child health home visiting nurse care.
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I. The nurse demonstrates ability to assess, plan, intervene, and evaluate (with client & family) their goals and plan of care |
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| Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section A 1. Demonstrates prenatal assessment, compares data with norms and reports abnormal findings to physician or certified nurse midwife: Physical
Psychosocial
Environmental
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2. Develops and modifies the plan of care based upon:
3. Builds a realistic plan of care considering the following:
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Case Review Technical skill item #1 & critical thinking skill #2 & 3 Prenatal assessment includes the following items. The nurse’s ability to compare data with norms and report abnormal findings to physician or certified nurse midwife is evaluated. Physical
Psychosocial
Environmental
Based upon a review of a prenatal client’s chart and discussion with the nurse, the nurse is able to: Technical skill #1 Identify the physical, psychosocial and environmental health risks (abnormal findings.) Critical thinking skill #2 Describe how the health risks (abnormal findings) influenced the client’s plan of care. Critical thinking skill #3 Describe a factor related to family dynamics, family support systems and community resources that influenced the plan of care. |
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Section B 1. Lists physical and/or psychosocial risks associated with adolescent pregnancy 2. Lists benefits of prenatal care for the mother and/or fetus 3. Lists at least one warning sign for each of the following pregnancy complications:
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Written test Technical skill item #1 List 3 physical and/or psychosocial risks associated with adolescent pregnancy Technical skill item #2 List 3 benefits of prenatal care for the mother and/or fetus Technical skill item #3 List at least 1 warning sign for each of the following pregnancy complications
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Section C 1. Identifies the purpose and implications for changes in client’s plan of care related to the following laboratory tests:
2. Describes the purpose of and how to prepare the client for the following procedures:
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Written test Technical skill item #1 Identify the purpose and one implication for changes in client’s plan of care related to the following laboratory tests:
Technical skill item #2 Describe the purpose of and how to prepare the client for the following procedures:
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Section D |
1. Elicits client and partner’s reaction to and expectation of pregnancy 2. Assists the client in devising a plan of action in the event of pre-term labor or other complications 3. Assists the client in devising a plan of action if there are barriers to accessing or using prenatal care |
Case review Based upon a review of a prenatal client’s chart use the following questions to guide a discussion with the nurse. Interpersonal skill item #1, #2 & #3 Questions for discussion 1. Ask the nurse to describe her plan of care. This should include the client’s strengths and needs, what additional information the nurse would seek and interventions the nurse would plan. 2. How would you characterize/describe the client’s feelings about pregnancy? Describe how these feelings affect the client’s plan of care. 3. What seemed to be most helpful to the client in recognizing when to call her primary care provider? 4. What actions did you take to support the client’s follow through of the plan of action in the event of pre-term labor or other complications? 5. Did you identify any barriers the client has in accessing care? What actions did you take to support the client in overcoming these barriers? |
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Section E |
1. Provides support and resources to the client who experiences fetal loss (miscarriage or stillbirth) |
Case study Interpersonal item #1 Case study You call your client to schedule her first Healthy Babies home visit. After hesitating about agreeing to a time, she tells you she had a miscarriage a few days ago. Question for discussion Ask the nurse to describe her plan of care. This would include the client’s strengths and needs, what additional information the nurse would seek and interventions the nurse would plan. The nurse’s plan of care should include:
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II. The nurse demonstrates knowledge of and ability to assess client’s nutritional status, provide nutritional education and refer for nutritional counseling as indicated |
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| Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section A 1. Lists recommended dietary requirements during pregnancy by:
2. Uses a standard weight gain grid (e.g., Health Diary or Vermont Department of Health Weight Gain Chart) to assess weight gain |
Written test Technical skill item #1 Lists the recommended dietary requirements during pregnancy by:
Technical skill item #2 Assesses weight gain, using a standard weight gain grid for a 15 year old G1P0 who is 16 weeks pregnant, pre-pregnant weight of 113 pounds and weighs 118 at 16 weeks
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Section B 1. Lists community resources for supplemental foods
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2. Elicits client and family attitudes about weight gain, eating habits, food preparation, and shopping and involves client and family in developing a nutritional plan |
3. Makes dietary recommendations based on weight gain grid, 24 hour real dietary intake, and other assessment information |
Case review Based upon a review of a prenatal client’s chart use the following questions to guide a discussion with the nurse. Technical skill item #1 , Interpersonal skill item #2 and Critical thinking skill #3 Questions for discussion 1. Ask the nurse to describe her plan of care. This would include the client’s strengths and needs, what additional information the nurse would seek and interventions the nurse would plan. 2. What techniques did you find most helpful in eliciting information from the client? 3. What strategies were most helpful in obtaining a 24 hour recall? 4. What was your rationale for the specific dietary recommendations you made? 5. Name 2 community resources for supplemental foods that might be helpful to the client.
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III. The nurse demonstrates knowledge of and ability to provide prenatal & parenting education to client and family |
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| Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section A 1. Identifies self-care measures for the following common discomforts associated with pregnancy:
2. Describes the impact of the following smoking, drugs, alcohol and environmental hazards on fetal growth and development:
3. List preventive measures related to:
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Written test Technical skill item #1 List 1 self-care measure for each of the following discomforts associated with pregnancy
Technical skill item #2 Describe the impact of 3 of the following on fetal growth and development:
Technical skill item #3 List at least 1 preventive measure for each of the following:
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Section B |
1. Helps client/family identify expectations of labor and childbirth and ways of coping with unexpected developments 2. Assists client in anticipating and planning the impact of baby on parents, and family including:
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Case review Based upon a review of a prenatal client’s chart and discussion with the nurse, the nurse is able to answer the following questions:
1. What are the family’s expectations of labor, childbirth? 2. What are the client’s strengths/resources to deal with unexpected developments? 3. What nursing interventions should be included in the client’s plan of care based upon this knowledge?
What adjustments does the client anticipate and how does the nurse help her plan for those? |
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