BY NURSE HADIZA SHEHU S.NURSE RASHIDA LAWAL O TO DEPT OF NURSING SERVICES CONTINUE EDUCATIONS PRESENTATION FMC BIRNIN KEBBI

2. 
 INTRODUCTION
 AIMS AND OBJECTIVES
 EPIDEMIOLOGY OF ANTENATAL CARE
 RECOMMENDED EIGHT ANTENAL VISIT
 STATISTICS FOR ANTENATAL PATIENT
 TYPES OF ANTENATAL CARE
 INITIAL ASSESSMENT
 INVESTIGATION
 PROPHYLAXIS
 IMMUNIZATION
 HEALTH EDUCATION
 NURSING DIAGNOSIS/ CARE PLAN
 SUMMARY
 REFERENCE
OUTLINE

3. 
OPENING AND CLOSING PRAYER
Oh God of creation,
Direct our noble cause
Guide our leaders right
Help our youths the truth to know
In love and honesty to grow
And living just and true
Great lofty heights attain
To build a nation where peace
And justice shall reign.

4. 
Anetenal care is care given to a pregnant
women from the period pregnancy is
confirm to the onset of labour, which
includes the basic antenatal services
recommended for all pregnant women,
plus the care for their own health and
intervention to prevent mother to child
transmission (MTCT) of HIV to there
babies.
INTRODUCTION

5. 
To monitor the progress of pregnancy to
optimize maternal and fetal health by
facilitating the woman and her family in
preparing to meet the demand of birth and
making a birth plan.
Facilitating the women to make an informed
choice about methods of infant feeding and
giving appropriate and sensitive advice to
support her decision especially in HIV
positive mother.
AIMS AND OBJECTIVES

6. 
 WHO (2016) recommended Eight antenatal
visit for a healthy woman with a normal
pregnancy, scheduled at specific times in the
pregnancy to deliver the essential
intervention during antenatal care. But HIV
positive pregnant woman usually require
more visit than HIV negative pregnant
women.
EPIDEMIOLOGY OF ANTENATAL CARE

7. 
1ST 2ND 3RD 4TH 5TH 6TH 7TH 8TH
12weeks 20weeks 26weeks 30weeks 34weeks 36weeks 38wees 40weeks
RECOMMENDED EIGHT (8)
ANTENATAL VISIT

8. 
Months No of patient New Revisit
January 468 97 371
February 507 132 375
March 552 90 462
April 295 77 218
May 0 0 0
June 385 113 272
STATISTICS FOR ANTENATAL PATIENT
ATTENDING ANTENATAL CLINIC IN THE FIRST
HALF OF (2018) JANUARY – JUNE IN FMC
BIRNIN KEBBI

9. 
 General (Routine) antenatal care
 Focused antenatal care
 Initial assessment (First booking)
 Physical assessment
TYPES OF ANTENATAL CARE
TYPES OF ASSESMENT

10. 
 PERSONAL DATA
 Name
 Age
 Date of birth
 Religion
 Ethnic group
 Occupation
 Family data
 Husband's name
 Husband's occupation
 Date of booking
 Next of kin
INITIAL ASSESSMENT CONSIST OF
THE FOLLOWING:

11. 
Heart disease
Chest disease
Blood transfusion
Kidney disease
Others e.g: surgery
PREVIOUS MEDICAL HISTORY

12. 
Multiple pregnancy
Tuberculosis
Hypertension
Heart disease
Others e.g: Diabetics, Epilepsy
III. FAMILY HISTORY

13. 
 e.g: Previous C/Section, previous reproductive tract
infection, Fibroids and infertility.
 Year
 Duration of pregnancy
 Remark on pregnancy labour & pueperium
 Remark on each child (sex, weight, status and method of
feeding)
 Abortion should be indicated in red (+)
IV. PAST /GYNEA COLOGICAL HISTORY
V. PAST OBSTETRICS HISTORY

14. 
Date of last menstrual period
Expected date of delivery(
EDD)
Estimated weeks of gestation
at booking
VI. PRESENT OBSTETRIC HISTORY

15. 
I. MEASUREMENTS
Height
Weight
Temperature
Pulse
Respiration
Blood Pressure
PHYSICAL EXAMINATION

16. 
Head
Eye
Ear
Face
Nose
Mouth
Neck
GENERAL EXAMINATION (HEAD TO TOE)

17. 
Axilla
Upper extremities
Breast
Abdomen
Vulva
Lower extremities
Back
GENERAL EXAMINATION (HEAD TO TOE) CONTINUAITON

18. 
EXAMINATION OF BREAST & AXILLA
Inspection
Palpation
Advice
ABDOMINAL EXAMINAITON
Inspection
Palpation
Auscultation

19. 
AT BOOKING
Height and previous delivery are
usually considered
At 36weeks
Pelvic assessment will be done in
primigravida and woman with
second delivery with previous
C/section or malpresentation.
PELVIC ASSESMENT AT BOOKING

20. 
 Urinalysis
 Genotype
 Blood group
 Hepatitis
 Venereal diseases research laboratory test (VDRL)
 Haemoglobin/PCV
 Rhesus factor
 Monteux Test
 HIV/AIDS Test
 Pelvic ultrasound
INVESTIGATION

21. 
Intermittent preventive
treatment of malaria (every 4
weeks from 16 – 20 weeks)
Heamatenic
PROPHYLAXIS/DRUGS

22. 
Types of Immunization Dosage Next appointment Coverage
TT1 0.5mils Nil
TT2 0.5mils 4weeks 3years
TT3 0.5mils 6months 5years
T4 0.5mils 1year 10years
T5 0.5mils 1year For life
IMMUNIZATION
Mother’s Immunization

23. 
 The pregnant mother will be advice on the
importance of coming to the clinic on time and they
will have health education on the following:
 Nutrition: Eating of well balanced diet, using locally
available food substance such as beans, rice,
vegetable palm oil, fruit, fish and for the growth and
development of her baby and her nourishment.
 Personal Hygiene: The importance of personal
hygiene will be addressed e.g bathing daily, care of
hair, perineal and underwear’s.
SUMMARY OF MOTHERCRAFT AND
OTHER CLASSES ATTENDED

24. 
 Environmental Hygiene: The important of proper
hygiene will be over emphasis which will help to prevent
breeding of mosquitoes and hence prevent malaria
infection and also prevent breeding of other
microorganism to prevent infection.
 Rest & Sleep: The important of rest and sleep will be
explain to the them so as to conserved energy and good
health.
 Clothing: Health education on wearing free clothing and
low shoes not high for easy movement and to prevent
accident, backache and maintain body posture.
SUMMARY OF MOTHERCRAFT AND OTHER
CLASSES ATTENDED COTN

25. 
 Medication: They will be advice on taken their
routine drugs, avoid self medication and taking of
harmful traditional medicine.
 Care of breast: Important of wearing of firm
brassieres and cleaning of nipples, inform them
about the present of colostrum at 16 – 20weeks of
pregnancy.
 Exclusive Breast feeding/ breastfeeding option:
They will be encourage on exclusive breastfeeding
and the important of exclusive breast feeding and
how to breast feed exclusively but in HIV positive
mother it is optional.
SUMMARY OF MOTHERCRAFT AND OTHER
CLASSES ATTENDED COTN

26. 
 Immunization: Health education on immunization on
both mothers and their babies will be explain both
prenatal and postnatal.
 Birth preparedness: They will be informed the
important of hospital delivery, preparation for delivery
and its importance, which include material and
financial, at 32weeks of pregnancy and items to bring
to the hospital for delivery.
 Labour/Danger sign: Danger Signs of pregnancy and
signs of true labour will be explain in details especially
primigravida and HIV positive mothers.
SUMMARY OF MOTHERCRAFT AND OTHER
CLASSES ATTENDED COTN

27. 
Family planning: Health education on need
for them to rest after delivery will be
emphasize in order for them to breast feed
their babies for at least 1-2years and that
system affected by pregnancy will go back to
pre-pregnant state e.g reproductive system,
cardio vascular & urinary system and to
prevent unintended pregnancy.
SUMMARY OF MOTHERCRAFT AND OTHER
CLASSES ATTENDED COTN

28. 
NURSING DIAGNOSIS
Pain (back and leg) related to progress of
pregnancy evidence by verbalization.
Sleeping disturbance related to frequent
micturition evidence by verbalization.
Anxiety related to the unknown outcome of
pregnancy evidence by changed of mood.
NURSING DIAGNOSIS AND NURSING
CARE PLAN

29. Date/
Time
S/N Nursing
Diagnosis
Nursing
Outcome
Nursing Action Rationale Evaluation
13/9/18 1. Pain (back
and leg)
related to
progress of
pregnancy
evidence by
verbalization
Patient
verbalized
less pain
within the
period of
pregnancy
1) Avoid using high hill
shoes
2) Encourage using of
sitting toilet
3) Encourage sleeping on
flat surface
4) Served prescribed
analgesic
1) Prevent twist of muscles
2) It promote comfort
3) It relax the muscles thus
preventing pain.
4) It blocked the pain
receptors
Patient complain
less of pain with
in the period of
intervention
NURSING CARE PLAN

30. 
PREGNANCY RELATED COMPLICATION
Aneamia
V.V.F
Rupture uterus
Maternal and fetal death
Antepartum haemorrhage
 Pre -eclampsia and eclampsia

31. 
PREVENTION OF PREGNANCY RELATED
COMPLICATION
 Health education
 Early detection
 Identified patient at risk
 Prompt management/intervention
 Changed in life style
 Drugs
 Immunization
 Early referral

32. 
CONCLUSION
 Antenatal care for pregnant woman includes basic
antenatal services recommended for both HIV and
non HIV pregnant woman for their own health and
intervention to prevent pregnancy complication.
 All pregnant woman need to be supported in order
for them to engage in healthy behaviour maintain
their own health and that of their unborn baby.
Doing this will reduce some of the risk of maternal
and perinatal problems.

33. 
REFERENCES
ADESOKAN, F.O.O (2011) Reproductive health of all ages, revised
edition Ijigbo junction printers Ado Ekiti, Ekiti State.
Ajayi, F.T (2004). A guide to primary healthcare practice in developing
countries 4th eduction Government Printers, Ekiti State.
AKINLEYE, F. et al (2009). Perceptions of care and services by the clients
and families.
DIANE, M.F et al (2012), Myles text book for midwives 14th edition
Edinburg London New York.
National PMTCT Training manual April, (2018).