Maternal and Child Health Nursing I

Labor and Delivery

• True labor features regular contractions, abdominal discomfort, fetal descent, bloody show, and cervical dilation/effacement.
• Fetal station indicates fetal position relative to ischial spine; measured in centimeters as negative (above) or positive (below), with station 0 at the spine.
• Engagement occurs when the largest diameter of the presenting part passes through the pelvic inlet.
• Floating indicates the fetal presenting part is not engaged and is freely movable above the pelvic inlet.
• Uterine contractions have three phases: increment, acme, and decrement.

Maternal Health

• Pregnancy weight gain averages between 25 to 30 lb (11 to 13.5 kg).
• Pregnancy-induced hypertension (preeclampsia) can be identified by a blood pressure increase of 30/15 mm Hg over baseline or 140/95 mm Hg on two occasions post 20 weeks, combined with edema and albuminuria.
• Women should avoid alcohol during pregnancy, as no safe level of intake exists.
• Goodell’s sign indicates cervix softening, occurring in early pregnancy.
• Chloasma, or the mask of pregnancy, presents as facial pigmentation over the cheeks and nose.

Neonate Considerations

• Excessive oxygen in premature neonates can lead to retrolental fibroplasia, a cause for blindness.
• If the umbilical cord is tight around a neonate's neck during delivery, it should be clamped and cut if it cannot be loosened.
• Apgar scores range from 0 to 10, with scores of 7-10 indicating no distress and scores of 0-3 indicating severe distress.
• To assess jaundice in neonates, examine under natural light; if unavailable, use white light.
• Cow’s milk is not recommended for infants under one year due to its protein content and low linoleic acid levels.

Breastfeeding and Infant Reflexes

• To break suction while breastfeeding, insert a finger at the corner of the infant's mouth.
• Eliciting the Moro reflex involves gently dropping the neonate’s head backward, triggering an abduction and extension response of the extremities.

Pregnancy Monitoring

• Measure rubella immunity using a hemagglutination inhibition test; a titer above 1:8 indicates immunity.
• Vaginal bleeding during pregnancy should be treated as a potential complication until proven otherwise.
• Fundal height at 12 weeks’ gestation should reach the symphysis pubis.

Ovulation and Signs of Pregnancy

• Ovulation ceases during pregnancy; positive pregnancy signs include ultrasound, fetal heart tones, and examiner-felt fetal movement (normally after 4 months).
• Quickening, or the first fetal movements felt by the mother, typically occurs between 16 and 19 weeks’ gestation.

Delivery Date Calculation

• Estimate the delivery date using Nägele’s rule by counting backward 3 months from the last menstrual period and adding 7 days.

Maternal Positions During Labor

• The side-lying position often provides comfort during the first stage of labor, though any comfortable position is acceptable for the patient.

Pelvic Types

• Gynecoid pelvis is the most favorable for delivery; other types include platypelloid (flat), anthropoid (apelike), and android (male-like).

Test your knowledge on key concepts from Maternal and Child Health Nursing I. This quiz covers topics such as true labor characteristics, breastfeeding techniques, and care for premature neonates. Enhance your understanding of critical nursing practices related to maternal and child health.