Antenatal Care and Assessment Quiz

Third Year Maternity & Gynecology Nursing Skills

• Course covers antenatal, intrapartum and postnatal assessments, care of the mother and newborn, and family planning.
• Students will be able to perform assessments and provide care for expectant and new mothers
• Antenatal assessment includes taking patient history, physical examination, and relevant investigations.
• Understanding abdominal examination techniques during pregnancy and labour
• Monitoring fetal heart rate (FHR)
• Performing vaginal examinations during pregnancy and labour
• Assessing pitting edema
• Providing care for eclamptic patients
• Administering magnesium sulfate
• Providing care during oxytocin infusions
• Monitoring the progress of labour and maternal and fetal condition using partographs
• Providing perineal care and episiotomy care
• Providing immediate care to the newborn
• Assessing the fundus and lochia
• Recording and interpreting labor information on partographs
• Identifying and interpreting intra-partum electronic fetal monitoring (EFM)
• Demonstrating Neonatal assessment and resuscitation
• Counseling patients and explaining family planning methods
• Determining patient suitability for various family planning methods
• Counselling patients making informed choices regarding family planning
• Providing follow-up management for family planning methods, including side effects and health problems

Antenatal Assessment

• Routine health evaluation of pregnant women.
• Aims for early detection, prevention, and treatment of complications (preeclampsia, eclampsia, haemorrhage).
• Comprehensive assessment for malpresentations, malpositions, and disproportion influencing labor.
• Education on hygiene, diet, and warning symptoms.
• Tests for blood group, Rh typing, toxoplasmosis, and syphilis.
• Frequency varies by stage of pregnancy (monthly, bi-weekly, weekly).

Role of the Nurse During Antenatal Assessment

• Arranging the ante-natal room for efficient and comfortable patient care
• Preparing necessary equipment and instruments.
• Greeting the patient with respect and kindness.
• Taking a complete patient history.
• Performing physical and abdominal examinations during visits.
• Recording findings in detail.
• Detecting abnormalities and referring to relevant specialists where needed.

Components of Antenatal Assessment

• Taking complete history from pregnant women
• Performing physical examination (general, abdominal, vaginal)
• Performing laboratory investigations

Daily Habits and Life Style

• Work, transportation, physical activity, rest, diet.
• Substances like dirt, clay, smoking, alcohol use
• Important for identifying risk factors tied to pregnancy.

Menstrual and Contraceptive History

• Age of menarche
• Duration, interval, amount of menstruation.
• Past contraceptive methods, usage time, and reasons for discontinuation.
• LMP (last menstrual period): crucial to calculating estimated date of delivery (EDD).

Antenatal Assessment Return Visits

• Assessing for any medical or other concerns that have developed since the last visit.
• Assessing for changes in daily habits or lifestyle for identification of underlying situations.

General Examination

• Observing general well-being, gait, movement, facial expression, and general cleanliness.
• Measuring weight and height.
• Measuring blood pressure and pulse
• Examining the head's conjunctiva for any relevant conditions.
• Examining the eyes
• Examining hair and nails
• Assessing the mouth and teeth
• Checking the neck (including the thyroid gland)
• Examining the chest
• Examining the breasts, nipples, and areolae
• Examination of the genitalia and relevant structures.
• Checking the extremities.

Abdominal Examination

• Assessing fetal position, presentation, and engagement.
• Determining the gestational age through fundal assessment
• Determining fetal heart rate tone

Leopold's Maneuver

• Series of four maneuvers examining the abdomen to assess fetal position.
• It helps understand the position of the fetus in the uterus
• Determining the fetal lie, presentation, position, and engagement
• Determining fetal heart rate

Various Types of Vaginal Examination

• Assessing cervical dilation and effacement to track the progress of labor.
• Establishing fetal position, presentation, and station.
• Visualizing and examining for presence and type of membranes. Detecting the presence of possible complications.
• Assessing the condition of the membranes and cervix.
• Determining fetal presentation and station within the pelvis.
• Identifying any abnormality in the vagina and cervix.

Administration of Magnesium Sulfate

• Indications: Preventing and managing severe preeclampsia. Eclamptic seizures. Hypertension during pregnancy. Constipation.
• Contraindications: Hypocalcemia, Myasthenia gravis, kidney diseases, cardiac diseases, and severe respiratory diseases.
• Mechanism: Blocks neuromuscular junction activity to prevent excessive uterine muscle contractions and decrease blood pressure.

Management of the First Stage of Labor

• Stages of labor: Cervical dilatation and effacement
• Duration: 12-16 hours for primiparas, 6-8 hours for multiparas.
• Equipments: Vital signs monitoring equipment, fetal heart monitoring devices, speculums, various sized catheters, various fluids, and other supportive supplies.

Management of the Second Stage of Labor

• This is the fetal expulsion stage.
• Purposes: Fetal delivery, preventing perineal lacerations, and ensuring an uncomplicated delivery.
• Equipment: Episiotomy pack, scissors, cord clamp, cotton balls, suction bulb syringe (to prevent inhalation of amniotic fluid).

Management of the Third Stage of Labor

• Stages of labor: Placental delivery
• Purposes: to ensure the placenta is expelled, maintain uterine contractions to limit blood loss, perform assessment to detect any abnormalities or retained fragments
• Equipment: Weighing machine, gloves, trays, dressing.

Management of the Fourth Stage of Labor

• Purpose: To ensure the ongoing well-being of mother and child during the post-delivery period.
• Aims: placenta and membranes inspection, prevention and control of bleeding, maintaining uterine contractions, assessing maternal comfort, initiating breastfeeding to ensure the continuous well-being of both.
• Equipment: IV fluids apparatus, equipment to monitor vital signs (stethoscope, thermometer, sphygmomanometer), cannula, antiseptic solution, cotton swabs, clean pads, and any other necessary materiel.

Cesarean Section

• Surgical delivery of a baby through an incision in the mother's abdomen and uterus
• Classification: based on the site of incision (classical vs. lower segment).
• Indications: Fetal distress, cephalopelvic disproportion, previous C-sections, and other maternal or fetal complications.
• Equipment: steril gowns, forceps, scissors, scalpel, other suture materials and dressings, and the required fluids and medications.

Intrapartum Electronic Fetal Monitoring (EFM)

• The method of continuously monitoring the fetus during labour to ensure adequate fetal oxygenation.
• Types: external and internal
• Indications: abnormal fetal heart rate (FHR), increased risk of perinatal morbidity, or specific maternal or fetal conditions.

Perineal Care

• Cleaning and care of the perineal area.
• Importance during pregnancy and childbirth; prevents skin breakdown, itching, burning, odors.
• Equipment: gloves, sponges, basin with warm water, towels, mackintosh, soap with soap dish, toilet paper.

Test your knowledge on antenatal assessment and care practices critical for monitoring pregnancy. This quiz covers key components such as visit frequency, assessments, and techniques like Leopold's maneuver. Ensure you understand both the purpose and the protocols associated with antenatal visits.