1. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
2:
MATERNAL
AND
CHILD
HEALTH
NURSING
A.
Signs
of
Pregnancy
AMNIOCENTESIS
ü Possible
after
the
14th
week.
Ø Presumptive
Signs
Aspiration
of
amniotic
ü The
client
should
be
• Amenorrhea
–
absence
of
menses
fluid
for
examination.
supine
during
the
• Nausea
and
Vomiting
procedure
• Increased
breast
sensitivity
and
breast
changes
ü Afterward,
she
should
be
• Increased
pigmentation
placed
on
her
left
side.
• Constipation
ü The
patient
MUST
• Frequent
urination
EMPTY
THE
BLADDER.
• Quickening
ü Vital
signs
are
assessed
• Abdominal
enlargement
every
15
minutes.
ü CALL
THE
PHYSICIAN
Ø Probable
Signs
FOR
THE
FF:
Chills,
fever,
• Uterine
enlargement
leakage
of
fluid,
decrease
fetal
movement
or
• Hegar’s
Sign
uterine
contractions.
• Goodell’s
Sign
• Chadwick’s
Sign
X-­‐RAY
ü Done
only
2
weeks
• Ballottement
before
EDC
• Braxton
Hick’s
contraction
• Positive
Pregnancy
Test
ALPHA-­‐FETOPROTEIN
ü Test
done
between
16
SCREENING
and
18
weeks
Ø Positive
Signs
gestation.
• Fetal
Heart
Tone
Maternal
serum
ü Normal
Value:
10
• X-­‐ray
or
Ultrasound
of
fetus
screens
for
open
mg/dl
• Palpable
fetal
movements
neural
tube
defects.
ü LOW:
Chromosomal
defects
ü HIGH:
Neural
tube
B.
Maternal
and
Fetal
Diagnostic
Test
defects.
CHORIONIC
VILLI
ü Performed
between
the
LECITHIN
-­‐
ü Done
through
SAMPLING
8th
–
11th
weeks
of
SPHINGOMYELIN
– AMNIOCENTESIS
gestation.
(L/S
RATIO)
ü Perform
at
35-­‐36
weeks
Removal
of
a
small
ü Laboratory
results
are
ü Position:
Supine.
piece
of
Chorionic
villi
obtained
in
1
-­‐
7
days
Uses
amniotic
fluid
to
ü Place
folded
towel
on
the
ascertain
fetal
lung
right
buttocks.
Disadvantages:
maturity
ü Needle
insertion
in
a
20-­‐
• Risk
of
Abortion
22
gauge
spinal
needle,
• Infection
withdrawing
amniotic
• Embryo-­‐fetal/placental
fluid.
damage
ü NORMAL
L/S
RATIO
• Spontaneous
abortion
(lecithin/sphingomyelin)
• Premature
rupture
of
the
:
2:1
=
normal
fetal
lung
membranes
maturity
ratio
ü SHOULD
REFRAIN
FROM
LEOPOLDS
ü Palpate with warm hands.
SEXUAL
INTERCOURSE
MANEUVER
ü Use palms, not fingertips.
AND
PHYSICAL
ACTIVITY
ü Woman should lie in
FOR
48
hours.
supine position with knees
ü A
small
amount
of
flexed slightly.
spotting
is
normal
for
the
ü Done with empty bladder.
1st
24-­‐48
hours.
1st:
Presenting
Part
2nd:
Fetal
Back
ULTRASOUND
ü Done
18-­‐40
weeks
for
3rd:
Engagement
fetal
abnormalities.
4th:
Descent
Use
of
sound
and
ü Best
Test
for
ECTOPIC
returning
echo
PREGNANCY
patterns
to
identify
ü Full
Bladder
intrabody
structures.
ü Use
to
locate
the
precise
location
of
the
fetus
and
its
membrane
during
CVS
and
amniocentesis
POSSIBLE
TOPICS
ON
MATERNAL
AND
CHILD
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

2. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
2:
MATERNAL
AND
CHILD
HEALTH
NURSING
C.
Discomfort
of
Pregnancy
D.
Electronic
Monitoring
Changes
Reason
Health
Teachings
Non-­‐Stress
Test
Nausea
and
Increased
HCG
• Dry
crackers
30
min.
Ø Accelerations in heart rate accompany normal fetal
Vomiting
before
arising
movement.
• Small,
frequent,
low
fat
Ø Observation
of
fetal
heart
rate
related
to
fetal
meals
movement.
• Avoid
anti-­‐emetics.
FHT:
Doppler:
8
weeks
Heartburn
Increased
• Pats
of
butter
before
Fetoscope:
16
weeks
/
4
months
progesterone
meals
Stethoscope:
20
weeks
/
5months
which
decrease
Ø Teach mother to count 2-3 times daily, 30-60 minutes
• Avoid
fried,
fatty
foods
gastric
motility
each time, should feel 5-6 movements per counting
• Sips
of
milk
at
frequent
causing
time
intervals.
esophageal
PREPARATION:
• Small,
frequent
meals
v Patient should eat snacks.
reflux.
taken
slowly.
v Position:
Semi-­‐Fowlers
or
left
lateral
positions
• Bends
at
the
knees,
not
RESULTS:
at
the
waist
1.
Reactive
(Normal):
indicates
a
fetal
fetus
Constipation
Due
to
• Increased
fluids
and
§ Greater than 15 beats per minute- occur with
displacement
roughage
in
the
diet.
fetal movement in a 10 or 20 minute period.
of
the
stomach
• Regular
elimination
2. Non-­‐Reactive
(Abnormal):
and
intestines;
time.
§ No
fetal
movement
occurs
iron
• Increase
exercise
§ The
doctor
will
order
an
Oxytocin
Test
supplements
• Avoid
enemas,
harsh
AFTER
the
patient
has
non-­‐reactive
test.
laxatives
and
mineral
oil.
Contraction
Stress
Test
(CST)
Hemorrhoids
Pressure
of
• Warm
sitz
bathing
Ø Response of the fetus to induced uterine contractions.
growing
fetus,
• High
fiber
diet
and
PREPARATION:
Increase
increase
fluid.
v Woman in semi-Fowler’s or side-lying position.
venous
• Sit
on
soft
pillow
v Monitor for post-test labor onset.
pressure
v Indication: 28 weeks pregnancy high risk mother
Urinary
Increase
blood
• Sleep
on
the
side
at
v Contraindicated: Pre Term Labor
Frequency
supply
to
the
night.
kidney/
• Limit
fluid
intake
INTERPRETATION:
Pressure
of
during
evening
Early
Deceleration:
Head
Compression
enlarged
• Bladder
training
Late
Deceleration:
Utero-­‐placental
Insufficiency
uterus
in
the
Variable
Deceleration:
Cord
Compression
3rd
Tri
Backache
From
• Back
exercise
(pelvic
E.
Signs
of
Labor
exaggerated
rock)
1. Lightening
–
setting
of
fetal
head
into
pelvic
brim
lumbo-­‐sacral
• Wear
low-­‐heeled
shoes.
± occurs
approximately
10-­‐14
days
before
labor
.
curving
during
• Avoid
heavy
lifting
± mother
may
experience:
shooting
leg
pains
from
pregnancy.
the
increased
pressure
on
the
sciatic
nerve,
Leg
Cramps
Increase
• Frequent
rest
with
feet
increased
amounts
of
vaginal
discharge
and
pressure
of
elevated
urinary
frequency
from
pressure
on
the
bladder
gravid
fetus,
• Regular
exercise
like
2. Increased
in
Level
of
Activity
low
calcium
walking
3. Braxton
Hicks
Contractions
• Increase
milk
intake
4. Ripening
of
the
cervix
Ankle
Edema
From
venous
5. Weight
Loss
• Elevate
legs
at
least
stasis
6. Rupture
BOW
twice
a
day.
7. Effacement
and
Dilation
• Sleep
on
left
side
Fatigue
Due
to
• Get
regular
exercise
F.
Length
of
Labor
hormonal
• Sleep
as
much
as
changes
needed.
Stages
of
Labor
Primigravida
Multigravida
• Avoid
stimulants.
Breast
Increase
First
Stage
12
and
½
hour
7hours
and
20
• Wear
well
fitted
bra
Tenderness
estrogen
and
minutes
• Warm
compress
progesterone
Second
Stage
80
minutes
30
minutes
level
Third
Stage
10
minute
10
minutes
TOTAL
14
hours
8
hours
POSSIBLE
TOPICS
ON
MATERNAL
AND
CHILD
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

3. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
2:
MATERNAL
AND
CHILD
HEALTH
NURSING
G.
Nursing
Care
During
Labor
4th
Stage
• Promote
parent-­‐infant
bonding
• Assess
maternal
vital
signs,
fundal
1st
Stage
Latent
The
period
of
height,
lochia
and
bladder
• Monitor
frequency,
intensity,
and
immediate
distention
Onset
of
true
labor
patterns
of
uterine
contractions
recovery
and
pain
until
• Monitor
fetal
status
during
labor
by
observation
after
complete
cervical
monitoring
fetal
heart
rate
delivery
of
the
dilation
and
• Assess
bloody
show
(pink
or
blood
placenta
effacement
streaked
mucus),
perineal
bulging,
membrane
status
• Monitor
vital
signs
H.
Micronutrient
Supplementation
• Assess
client’s
ability
to
cope
with
contractions
Vitamin
A
Supplementation
• Provide
emotional
support
Target
Prep.
Dose
Duration
Active
Pregnant
100,000
1
cap
Start
from
the
4th
month
• Finds
assessment
techniques
Women
IU
2x
a
of
pregnancy
until
between
contractions
week
delivery
• Assists
with
frequent
position
Post
200,000
1
cap
One
dose
only
within
4
change
Partum
IU
weeks
after
delivery
• Applies
counter
pressure
to
Women
sacrococcygeal
area
• Encourages
and
praises
Iron
Supplementation
• Keeps
woman
aware
of
progress
• Check
bladder
and
encourages
Target
Prep.
Dose
/
Duration
Remarks
voiding
Pregnant
Coated
1
tab/day
for
6
Women
Tab.
months
or
180
days
Transitional
contains
during
pregnancy
• Woman
experiences
intense
60
mg
period
A
dose
of
discomfort
accompanied
by
nausea
elemental
OR
800
mcg
and
vomiting
iron
with
2
tab/day
if
prenatal
folic
acid
is
• Woman
may
also
experience
a
400
mg
consultation
are
still
safe
to
feeling
of
loss
of
control,
anxiety,
folic
acid
done
during
the
pregnant
panic
or
irritability
2nd/3rd
trimester
woman
Lactating
Coated
1
tab
/
day
for
3
2nd
Stage
• Prep
client
for
delivery
Women
Tab.
months
or
90
days
contains
• Immediate
assessment
of
the
From
complete
newborn
60
mg
dilation
and
elemental
effacement
to
iron
with
delivery
of
the
400
mg
fetus
folic
acid
3rd
Stage
• Assess
umbilical
cord
for
3
vessels
(2
arteries,
1
vein)
I.
Pregnancy
Complications
From
delivery
of
• Assess
placenta
for
intactness
the
fetus
to
ABORTION
• The
fundus
should
be
midline
at
or
delivery
of
the
Ø Threatened, the continuation of the pregnancy is in
2
cm.
below
the
umbilicus
placenta
doubt
• Don’t
hurry
the
expulsion
of
the
Ø Inevitable, loss
that
can
be
prevented
placenta,
just
watch
for
the
signs
of
Ø Complete, products of conception are totally expelled
placental
separation:
Ø Incomplete, some fragments are retained inside the
Lengthening of the cord uterine cavity
Sudden gush of blood Ø Missed, retention of the products of conception after
Change of shape of the uterus fetal death
• Palpate
the
uterus
to
determine
Ø Habitual, 3 spontaneous abortions occurring
degree
of
contraction.
If
relaxed,
successively
massage
gently
and
apply
ice
cap
• Inspect
for
lacerations
• The
fundus
should
descend
approximately
1-­‐2
cm
every
24
hours
POSSIBLE
TOPICS
ON
MATERNAL
AND
CHILD
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

4. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
2:
MATERNAL
AND
CHILD
HEALTH
NURSING
GESTATIONAL
DIABETES
Ø Painful
vaginal
bleeding
Ø Diabetes
during
pregnancy.
Ø Board-­‐like
rigidity
of
abdomen
Ø 3-­‐P’s:
Polyuria,
Polydipsia
and
Polyphagia
Ø The
goal
of
management
in
abruption
placentae
is
to
Ø Because
insulin
does
not
pass
into
the
breast
control
the
hemorrhage
and
deliver
the
fetus
as
soon
milk,
breastfeeding
is
not
contraindicated
for
the
as
possible
mother
with
diabetes
Ø Maternal
Complications:
PIH,
Placental
disorders,
stillbirth,
macrosomia,
neural
tube
defects.
J.
Care
of
the
Newborn
Ø Screen
clients
between
the
24th
and
28th
weeks
of
pregnancy
Ø Suction
the
mouth
first
before
the
nose
Ø If
a
pregnant
diabetic
is
in
labor,
her
blood
glucose
Ø Delay
initial
bath
until
temp.
has
stabilized
for
at
least
6
hours.
should
be
monitored
hourly.
Ø APGAR
scoring
is
taken
twice:
initially
@
1
minute,
Ø Treatment:
Insulin
therapy
(don’t
use
Oral
and
then
@
5
minutes
after
birth
hypoglycemics,
they
are
Teratogenic)
Ø Give
prophylactic
eye
treatment
(credes
ointment)
against
gonorrheal
conjunctivitis
or
ophthalmia
neonatorum
within
the
first
hour
after
delivery.
PREGNANCY
INDUCED
HYPERTENTION
(PIH)
Ø Prevent
hemorrhage
,
give
0.5mg
(preterm)
to
1
Ø Blood
pressure
over
140/90,
or
increase
of
30
mm
mg
(full
term)
Vit.
K
or
Aquamephyton
is
injected
systolic,
15
mm
diastolic
over
pre-­‐pregnancy
level
IM
in
the
NB’s
vastus
lateralis
(lateral
anterior
Ø Pre
Eclampsia:
HPN,
Protenuria
,
Edema
thigh)muscle
(face&hand)
Ø The
cord
is
clamped
and
cut
approximately
within
Ø Eclampsia:
HPN,
Protenuria,
Edema
plus
Fever
and
30
seconds
after
birth
when
cord
pulsation
stop
Epigastric
pain.
Ø The
cord
stump
usually
dries
and
fall
within
7
to
Ø During
pregnancy,
blurred
vision
may
be
a
danger
10
days
sign
of
preeclampsia
or
eclampsia.
Ø Monitor
VS,
I&O
and
breath
sound
Ø ECLAMPSIA:
to
prevent
aspiration,
turn
the
K.
Newborn
Assessment
woman
on
her
side
to
allow
secretions
to
drain
from
her
mouth.
CIRCULATORY
DUCTUS
ARTERIOSUS
constrict
Ø SEVERE
PRECLAMPSIA:
Lateral
recumbent
STATUS
with
establishment
of
respiratory
position
function,
remains
open
cause
PDA
Ø DOC:
Magnesium
Sulfate
(patent
ductus
arteriosus)
Ø Magnesium
Sulfate
Toxicity:
FORAMEN
OVALE
closes
• Decrease
urine
output
functionally
as
respirations
• Decrease
RR
established,
remains
open
cause
• Absence
of
reflexes
ASD
(atrial
septal
defect)
Ø Antidote:
CALCIUM
GLUCONATE
RESPIRATORY
RR
=
30-­‐80
breaths
/minutes
with
STATUS
short
periods
of
apnea
(<
15
seconds)
PLACENTA
PREVIA
RENAL
SYSTEM
Later
pattern
is
6-­‐10
voidings/
Ø Improperly
implanted
placenta
in
the
lower
uterine
day
–
indicative
of
sufficient
fluid
segment
near
or
over
the
internal
cervical
os
intake
Ø Total:
the
internal
os
is
entirely
covered
by
the
DIGESTIVE
IMMATURE
CARDIAC
SPHINCTER
–
placenta
when
cervix
is
fully
dilated
SYSTEM
may
allow
reflux
of
food,
burped,
Ø Marginal:
only
an
edge
of
the
placenta
extends
to
REGURGITATE-­‐placed
NB
right
side
the
internal
os
after
feeding
Ø Low-­‐lying
placenta:
implanted
in
the
lower
uterine
FIRST
STOOL
is
MECONIUM
segment
but
does
not
reach
the
os
- Black,
tarry
residue
from
Ø Painless
Bleeding
lower
intestine
Ø #1
Assessment
-­‐
Monitor
maternal
vital
signs,
- Usually
passed
within
12-­‐24
FHR,
and
fetal
activity
hours
after
birth
Ø Best
Position:
Left
Lateral
TRANSITIONAL
STOOLS
thin,
brownish
green
in
color
After
3
days
MILK
STOOLS:
ABRUPTIO
PLACENTA
a. MILK
STOOLS
for
BF
infant
–
Ø Premature
separation
of
the
placenta
from
the
loose
and
golden
yellow
uterine
wall
after
the
20th
week
of
gestation
and
b. MILK
STOOLS
for
before
the
fetus
is
delivered.
FORMULATED
FED-­‐
formed
Ø Abruptio
placentae
is
associated
with
conditions
and
pale
yellow
characterized
by
poor
uteroplacental
circulation,
HEPATIC
Pathologic
Jaundice,
yellowish
such
as
hypertension,
smoking
and
alcohol
or
cocaine
discoloration
immediately
after
abuse.
POSSIBLE
TOPICS
ON
MATERNAL
AND
CHILD
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

5. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
2:
MATERNAL
AND
CHILD
HEALTH
NURSING
birth
Ä Play:
Parallel
Physiologic
Jaundice,
yellowish
Ä Child
learns
to
be
independent
and
discoloration
2-­‐3
days
after
birth
make
decisions
for
self
(normal)
Ä Favorite
word:
“I”,
“no”
TEMPERATURE
Axillary
temperature:
96.8
to
99F
Preschooler
Initiative
vs.
Guilt
Newborn
can’t
shiver
as
an
adult
(3-­‐6y/o)
Ä Ability
to
try
new
things
does
to
release
heat
Ä Bogus
playmates/imaginary
Cold
stress
increases
o2
Ä Fears:
dark,
being
left
alone,
large
consumption
–
may
lead
to
animals,
ghosts,
body
mutilation,
metabolic
acidosis
and
respiratory
pain
&
objects
distress
School-­‐Age
Industry
vs.
Inferiority
(6-­‐12
y/o)
Ä Makes
things
w/
others
IMMUNOLOGIC
NB
develops
own
antibodies
during
Ä Strives
to
achieve
success
1st
3
months
but
at
risk
for
Ä Child
learns
how
to
do
things
well
infection
during
the
first
6
weeks
Adolescent
Identity
vs.
Role
Confusion
(13-­‐20
y/o)
Ä Determines
own
sense
of
self
Ä Development
of
who,
what
&
where
L.
Freud’s
Theory
they
are
going
Ä Adjusting
to
a
new
body
and
seeking
Freud’s
Psychoanalytic
Theory
emancipation
from
parents,
choosing
Psychosexual
Development
a
vocation
&
determining
a
value
Infants
Oral
Stage
system
(birth
to
1
Ä Child
explores
the
world
by
using
Young
Intimacy
vs.
Isolation
year)
mouth,
especially
the
tongue
Adult
Ä Person
makes
commitments
to
one
Ä Baby
finds
pleasure
in
the
mouth
another
Toddler
Anal
Stage
Ä Isolation
and
self
absorption
if
(1-­‐3
y/o)
Ä Child
learns
to
control
urination
and
unsuccessful
defecation
(18
months)
Ä Independent
from
parents,
possible
Ä Toilet
training
marriage
/
partnership
Preschooler
Phallic
Stage
Ä Major
goals
to
accomplish
in
career
(3-­‐6y/o)
Ä The
genitals
are
the
pleasure
of
the
and
family
child
Middle
Generativity
vs.
Stagnation
Ä Oedipus
and
Electra
Complex
Adult
Ä Physical
Changes:
graying
hair,
Ä Masturbation
is
common
during
this
wrinkling
skin,
pain
&
muscle
aches,
phase
and
may
also
show
menopausal
period
exhibitionism
Ä Mature
adult
is
concerned
w/
School-­‐Age
Latent
Stage
/
Latency
Period
establishing
&
guiding
the
new
(6-­‐12
y/o)
Ä Child’s
personality
development
generation
or
else
feels
personal
appears
to
be
nonactive
or
dormant
impoverishment
Adolescent
Genital
Stage
Ä Become
“Pillars
of
the
Community”
(13-­‐20
y/o)
Ä Adolescent
develops
sexual
maturity
Older
Adult
Integrity
vs.
Despair
and
learns
to
establish
satisfactory
Ä Achieves
sense
of
acceptance
of
own
relationships
w/
the
opposite
sex
life
Ä Adapts
to
triumphs
&
disappointment
w/
a
certain
ego
integrity
M.
Erikson’s
Theory
N.
Physical
Growth
and
Development
Erikson’s
Theory
of
Psychosocial
Development
Mo. Gross Fine Motor Development
Infants
Trust
vs.
Mistrust
Yr. Motor Development
(birth
to
1
Ä Fear:
strangers,
anxiety,
loud
noises,
Ä Largely reflex Ä The eyes is fixated on
year)
falls,
sudden
movements
in
the
0-1 the person
environment
Ä Keeps hands fisted
Ä Play:
Solitary
Ä Holds head up when Ä Development of social
Ä Learning
confidence
or
learning
to
prone smile
2 Ä Responds to familiar
love
voice
Ä Holds head & chest Ä The baby knows how
Toddler
Autonmy
vs.
Shame
up when prone to cry
(1-­‐3
y/o)
Ä Psychosocial
Theme:
“hold
on
or
let
3 Ä Laughs aloud
go”
Ä Babbles and “coos”
POSSIBLE
TOPICS
ON
MATERNAL
AND
CHILD
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE

6. WHAT YOU SHOULD KNOW BEFORE THE PNLE
JULY
2012
PNLE
PEARLS
OF
SUCCESS
PART
2:
MATERNAL
AND
CHILD
HEALTH
NURSING
Ä Grasp Ä Can raise head and
Ä Stepping chest
Ä Tonic neck Ä Reach out to object
4 Ä Reflexes are fading
Ä Turns front to back Ä Roll over
5 Ä Has head lag when Ä Hold blocks at each
pulled upright hand
Ä Turns both ways Ä Doubles birth weight
st
Ä Moro reflex fading Ä Eruption of 1 tooth
Ä Sits w/ minimal support
6 Ä Uses palmar grasp
Ä Reaches out in Ä “dada”, “mama”
anticipation of being Ä Sleeps on prone
picked up position
7 Ä Sits unsteadily Ä Uses fingers to hold
objects
Ä Transfers objects hand
to hand
Ä Sits securely w/o Ä Sits alone steadily for
support an indefinite period
8 Ä Recognizes strangers
Ä Peek-a-boo (to test
memory)
Ä Creeps or crawls Ä Can hold own bottle
Ä Starts to crawl
9 Ä Understands simple
gestures
Ä Pulls self to standing Ä From crawling to
standing
10 Ä Responds when called
by his/her name
Ä From crawling to Ä Walks with assistance
11 standing
Ä Stands alone Ä Triples birth weight
st
12 Ä Some infants take 1 Ä Can say 2 syllable
step words
Ä Can walk w/ help
POSSIBLE
TOPICS
ON
MATERNAL
AND
CHILD
HEALTH
NURSING
FOR
THE
UPCOMING
JULY
2012
PNLE
*Patterned
on
the
previous
board
exams
from
December
2006
–
December
2011…
the
purpose
of
this
note
is
to
GUIDE
students
on
the
possible
topics
that
might
be
part
of
the
upcoming
July
2012
PNLE