Intro to Maternal Newborn Nursing

Question 1

What is FCMNC national guidelines?

Answer 1

Family centred maternity and newborn care. Developed to improve and create consistency in maternal/newborn health and to inform evidence based practice across Canada.

Question 2

Why is perinatal health important?

Answer 2

Because perinatal mortality (for moms and infants) is an indicator of healthy communities/countries. Healthy women-healthy pregnancy-healthy infant-healthy families-healthy communities (investment in the future)

Question 3

What is indigenous birth support worker program?

Answer 3

Arose out of an external review in 2017 regarding experience of Indg women who had her tube permanently tied w/out consent. Says there needs to be 1 indigenous brith support worker on every shift (their priority is Indg women in labour but they can support anyone)

Question 4

When does obstetrical care start?

Answer 4

Before conception

Question 5

What is preconception?

Answer 5

Means before conception. Need to have 3 months of being optimally healthy before women conceive. Anyone who’s sexually active/menstruating is pre conceptual at any given time

Question 6

What is preconception care/different parts of it?

Answer 6

Opportunity to impact on health of women/men and decrease risk factors that impact pregnancy.

Optimize weight/nutrtion/exercise, modifiable risk factors (drug, smoking, alcohol), folic acid to help with spinal cord development (take 0.4 mg/day) and iron b/c of increased blood volume (16-20 mg/day). Immunizations, screen for STIs, genetic counselling, spacing of childbearing, screen for social risk factors and optimize mental health

Question 7

What is parental preconception?

Answer 7

Has to do with the man. Things associated with it- age, race, education, alcohol/drug use, and BMI

Question 8

Normal BMI?

Answer 8

18.5 to 24.9

Question 9

How much weight do pregnant people gain with a normal BMI?

Answer 9

25-35 pounds

Question 10

Recommended nutrition for pregnant people?

Answer 10

have 2-3 additional serving from Canada food guide (aka don’t eat twice as much). Limit pop, avoid dietetics, and have reasonable activity

Question 11

How much weight can you gain for each trimester?

Answer 11

1st- 6 pounds
2nd- 12 pounds
3rd- 12 pounds

Question 12

Health teaching in pregnancy?

Answer 12

Take 0.4 mg/day of folic acid, no alcohol recommended, don’t smoke (leads to small brith weight/underdevelopment), keep active, don’t travel after 32 weeks, oral health good (helps against small birth weight babies), birth prep classes

Question 13

What are some signs of concern in pregnancy?

Answer 13

Bleeding, trauma/abdominal trauma, extreme itching in hands/feet, dehydration, HTN (headache, edema, epigastric pain), UTI signs, leaking amniotic fluid, monitor pitting edema (rings or shoes don’t fit suddenly), decreased fetal movement, dizziness, and severe cramps (could indicate labour)

Question 14

What to screen for the fetus?

Answer 14

Fetal movement, fetal HR, ultrasound (2 recommended). Non routine screening test in high risk pregnancies (biophysical profile, amniocentesis, doppler)

Question 15

Screening in pregnancy for the pregnant client?

Answer 15

Gestational diabetes (glucose tolerance test) at 24-28 weeks, group B streptococcus 35-37 weeks (treat during labour w/ antibiotics if present to avoid transmission to newborn), perinatal serum screening 15-20 weeks (identifies genetic risk), infectious disease (STI, HIV, rubella, hepatitis), blood group/Rh type

Question 16

When should pregnant women get an ultrasound?

Answer 16

Dating ultrasound between 8-12 weeks (due date) and anatomy ultrasound between 18/22 weeks

Question 17

What are ultrasounds used for?

Answer 17

Confirms pregnancy and EDC (estimated date of confinement aka due date). Let’s you know # of fetuses, size for gestational age, how the babies internal organs are growing, placental position/size (determines if you can have the baby vaginally), and the woman’s uterus/fallopian tubes/ovaries.

Question 18

What is a simple easy way to assess fetal wellbeing?

Answer 18

Fetal movement. A reduction in FM can cause potential for distress/fetus is already in trouble

Question 19

Group B streptococcus (GBS) screening?

Answer 19

Screening done in 3rd trimester. This is common bacteria found in vagina/rectum/bladder. Screening doesn’t around 35-37 weeks. It’s treated with antibiotics in labour.

Question 20

Risk factors for GBS infections?

Answer 20

• preterm labour before 37 weeks
• previous baby with GBS infection
• previous/present GBS bacteruria caused by GBS bacteria
• unexplained mild fever during labour
• term rupture of membranes >18 hrs

Question 21

What are some additional non routine test/screening?

Answer 21

Doppler flow studies (measure velocity of blood flow), marker screening tests, amnoicentesis, non stress test, biophysical profile, measurement of amniotic fluid, and michal translucency

Question 22

Why should you get ultrasound for non routine screening test?

Answer 22

Previous hx of early fetal loss, bleeding/complications, measure amniotic fluid, confirm position of fetus, and measure fetal growth

Question 23

What is biophysical profile?

Answer 23

this is a non routine test that score the fetus based off of normal or abnormal results in these categories (fetal movement/tone/breathing/amniotic fluid volume). Gets score of 2 or 0 (0 is abnormal)

Question 24

T or F- risk for genetic disorder go up as you age?

Answer 24

True

Question 25

What is oligohydraminos and polyhydramnios (hydramnios)?

Answer 25

O= decreased amniotic fluid P= increased amniotic fluid

Question 26

Does amniotic fluid increase in volume and why is it needed?

Answer 26

Yes it increase as the pregnancy progresses (1 L at birth). Needed for proper growth/development. It also protects fetus (cushion), temp control, infection control, umbical cord support (prevents compression of it), muscle/bone development, and lung/Gi development (swallowing of amniotic fluid and breathing allows practice use of these muscles)

Question 27

What is marker screening test (prenatal serum screening)? and the 2 types

Answer 27

Blood test offered to women to determine risk of aneuploidy (genetic or chromosome abnormalities). First trimester serum screening (11-14 week) determine risk of chromosome disorders. Second trimester serum screening (15-20 wks) gives info about neural tube defects

Question 28

What is nuchal scan for translucency?

Answer 28

Nuchal translucency is a collection of fluid under skin at back of fetuses neck. This is a nuchal scan (ultrasound) between 11-14 wks that looks at the collection of fluid/combined with maternal age and this identifies there is a risk of chromosomal abnormality (doesn’t confirm it)

Question 29

What is non invasive prenatal testing (NIPT)?

Answer 29

Take blood sample from pregnant client/analyze it for abnormalities of specific chromosomes like down syndrome or turner syndrome. This has no risk of miscarriage and can be performed 9-10 wks. Not publicly funded in some provinces and its very expensive

Question 30

Amniocentesis in 2nd vs 3rd trimester?

Answer 30

2nd- done 15-16 wks and tests for genetics 3rd- tests for fetal maturity, test L/S ratio (makes sure the lungs are mature) Amniocentesis is very invasive/actually confirms the diagnosis of abnormalities. You have to pierce the amniotic sac which can carry risk of miscarriage/early labour

Question 31

Prenatal classes?

Answer 31

It’s important for pregnant women to be prepared in advance/recognize red flags and what’s normal.

Question 32

What is prenatal care?

Answer 32

Values pregnancy as a state of health. Need to recognize the diversity in needs (there’s personal and cultural meanings). Accessing care in pregnancy provides opportunities for health teaching/positive contributions to overall health status of women/her fam