Maternal and Newborn Assessment Quiz
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Questions and Answers

What is a significant change in maternal physiology during pregnancy regarding blood volume?

  • Blood volume increases by 20%
  • Blood volume increases by 50% (correct)
  • Blood volume remains unchanged
  • Blood volume decreases by 10%

    • Which parameter is NOT typically assessed during maternal history taking?

  • Current pregnancy risk factors
  • Current medications
  • Past obstetric history
  • Previous travel history (correct)

    • What complication can arise due to the growing uterus in pregnant women?

  • Compression of the aorta and inferior vena cava (correct)
  • Difficulty accessing electronic notes
  • Increased cardiac output
  • Decreased blood volume

    • How do vessels respond to pregnancy in terms of fluid retention?

    <p>Vessels retain fluid, causing edema</p> Signup and view all the answers

    In cases of non-English speaking maternity patients, what should be utilized for effective communication?

    <p>Language line services</p> Signup and view all the answers

    What condition increases the threshold for conveyance in maternity patients compared to the general population?

    <p>Abnormal observations are considered late signs</p> Signup and view all the answers

    Which of the following conditions is NOT a reason to convey a maternity patient to an obstetric unit?

    <p>Stable woman at 30 weeks gestation</p> Signup and view all the answers

    What action should NOT be taken during maternal cardiac arrest management if the mother is visibly pregnant or the fundus is palpable at umbilicus?

    <p>Delay calling for critical care support</p> Signup and view all the answers

    In the context of acute presentations during maternity, which symptom combination should lead to considering sepsis?

    <p>Hypotension, tachycardia, and tachypnoea</p> Signup and view all the answers

    Which of the following is NOT a cause of maternal cardiac arrest?

    <p>Pregnancy-induced hypertension</p> Signup and view all the answers

    What should be assessed in the first minute of a newborn's life?

    <p>Color, tone, breathing, heart rate</p> Signup and view all the answers

    Which of the following is true regarding the newborn's lungs at birth?

    <p>The lungs are filled with fluid.</p> Signup and view all the answers

    What is the appropriate action regarding the umbilical cord if thermoregulation is not compromised?

    <p>Leave the cord intact until ready to cut.</p> Signup and view all the answers

    How should a newborn be stimulated in the first minute of life?

    <p>Dry and stimulate with gentle taps.</p> Signup and view all the answers

    What should be done if a newborn is not crying spontaneously or has a suboptimal assessment?

    <p>Clamp/cut the cord and take the baby to the resuscitation area.</p> Signup and view all the answers

    What is a notable change in maternal blood pressure during pregnancy?

    <p>It decreases by 10mmHg.</p> Signup and view all the answers

    What specific aspect should NOT be overlooked during history taking in maternity cases?

    <p>Future pregnancy plans.</p> Signup and view all the answers

    Which statement accurately describes the impact of a growing uterus on maternal physiology?

    <p>It may compress the aorta and inferior vena cava.</p> Signup and view all the answers

    What issue can arise from communication difficulties in maternity cases?

    <p>Common themes in adverse outcomes.</p> Signup and view all the answers

    During the first minute of a newborn's life, what should be prioritized?

    <p>Assessing breathing and response.</p> Signup and view all the answers

    What is the primary reason for leaving the umbilical cord intact for a newborn?

    <p>To optimise thermoregulation</p> Signup and view all the answers

    What is the significance of high levels of haemoglobin in newborns?

    <p>It facilitates immediate oxygen transport after birth</p> Signup and view all the answers

    Which assessment method is suitable for determining the overall health of a newborn in the first minute?

    <p>Checking the colour, tone, breathing, and heart rate</p> Signup and view all the answers

    In the immediate care of a newborn, what action should be taken if the baby is not breathing adequately or is floppy?

    <p>Call for assistance and prepare for resuscitation</p> Signup and view all the answers

    What immediate action should be taken to help a newborn maintain body heat after birth?

    <p>Dry and stimulate the newborn while applying a hat</p> Signup and view all the answers

    Which condition is a late sign of deterioration in maternity patients?

    <p>Abnormal observations</p> Signup and view all the answers

    What is the initial management step for maternal cardiac arrest when the patient is visibly pregnant and over 20 weeks gestation?

    <p>Manual displacement</p> Signup and view all the answers

    In which case should a maternity patient be conveyed to the emergency department instead of an obstetric unit?

    <p>The patient is 18 weeks pregnant and unstable</p> Signup and view all the answers

    Which of the following is NOT a cause listed for maternal cardiac arrest?

    <p>Aortic dissection</p> Signup and view all the answers

    Which acute presentation should healthcare professionals suspect when a maternity patient presents with shoulder tip pain and abdominal pain?

    <p>Ectopic pregnancy</p> Signup and view all the answers

    Study Notes

    Maternal and Newborn Assessment

    • Maternal patients include pregnant women at any gestation and women within 4 weeks postpartum.
    • Newborn patients are babies from birth up to 4 weeks of age.
    • The London Ambulance Service NHS Trust provides care for these patients.

    History Taking

    • When gathering a patient's history, consider their PC, HxPC, PMHx, DHx, FHx, SHx, ROS, IMP, and Hx.
    • Inquire about the current pregnancy, including any admissions and risk factors, as well as past obstetric history.
    • For non-English speakers, utilize a language line whenever possible.
    • Review any available hand-held notes, understanding that electronic notes may be challenging to access.

    Maternal Physiology

    • During pregnancy, there is a 50% increase in blood volume and cardiac output.
    • Blood pressure decreases by 10mmHg.
    • The growing uterus may compress the aorta and inferior vena cava.
    • Vessels retain fluid, potentially leading to oedema of the larynx and airway difficulties.
    • NEWS2 is not validated for use in pregnancy.
    • Maternity patients compensate well, making abnormal observations a late sign of deterioration.
    • A lower threshold for conveyance is recommended for maternity patients compared to the general population.

    Critical Maternal Presentations

    • One red flag symptom or two amber flag symptoms require immediate attention.
    • If a woman is 20 weeks or more pregnant and stable, convey her to the nearest maternity (obstetric) unit.
    • If a woman is less than 20 weeks pregnant or unstable, convey her to the nearest ED with onsite obstetrics.
    • If a woman is experiencing a life-threatening hemorrhage, recent seizure, or reduced GCS, she requires immediate conveyance.
    • Do not call a midwife in these critical situations.

    Acute Presentations in Maternity

    • Abdominal pain, shoulder tip pain, or hemorrhage may indicate ectopic pregnancy, miscarriage, placental abruption, or praevia.
    • Hypertension, seizures, or new onset confusion might indicate pre-eclampsia/eclampsia, stroke, or pregnancy-induced hypertension.
    • Hypotension, tachypnoea, or tachycardia could be a sign of sepsis or concealed hemorrhage.
    • Chest pain or shortness of breath could indicate cardiac problems or pulmonary embolism.

    Maternal Cardiac Arrest

    • Potential causes of maternal cardiac arrest include heart failure, hypovolemia, anaphylaxis, embolism, and sepsis.

    Managing Maternal Cardiac Arrest

    • If a woman is over 20 weeks pregnant (or visibly pregnant or fundus palpable at the umbilicus), perform manual displacement, ALS, and early notification of critical care and HEMS.
    • Manual displacement helps reduce aortocaval compression, increasing the likelihood of ROSC.
    • The goal is to save the mother.

    Newborn Physiology

    • At birth, a baby's lungs are filled with fluid.
    • Fetal circulation transitions to newborn circulation.
    • Newborns lack a mechanism to produce and conserve heat.
    • They have low levels of Vitamin K (clotting factors) and high levels of haemoglobin.

    Newborn Care in the First Minute

    • Start a timer or note the time of birth.
    • Dry the baby, stimulate them, apply a hat, and optimize thermoregulation.
    • Assess their color, tone, breathing, and heart rate.
    • Leave the cord intact as long as thermoregulation isn't compromised.
    • Call for help promptly.
    • If the baby isn't crying spontaneously or their assessment is suboptimal, clamp and cut the cord and move them to the resuscitation area.

    Maternity & Newborn Patients

    • Pregnant women at any gestation.
    • Women who have recently given birth, up to 4 weeks postpartum.
    • Babies from birth until 4 weeks of age.

    History Taking

    • Should include: Presenting complaint, history of presenting complaint, past medical, drug, family, social history, review of systems, investigations and medications, and history.
    • Current pregnancy history, including admissions and risk factors should also be included.
    • Use language line if needed for non-English speakers.
    • Review any available written notes.

    Maternal Physiology

    • Increased blood volume and cardiac output by 50%.
    • Decreased blood pressure by 10mmHg.
    • Growing uterus compresses the aorta and inferior vena cava.
    • Vessels retain fluid, leading to possible oedema of the larynx and difficult airway.

    NEWS2 Validation

    • Not validated for use in pregnancy.
    • Maternity patients have good compensatory mechanisms, abnormal observations are late signs of deterioration.

    Conveyance

    • Lower threshold for conveyance in maternity patients than the general population.

    Red Flags

    • 1 red flag or 2 amber flags = TIME
    • 20+ weeks gestation and woman stable = Convey to nearest hospital with obstetrics on site.
    • Less than 20 weeks gestation or woman unstable = Convey to ED with obstetrics on site.
    • Early blue call pre alert via PD09.
    • DO NOT CALL A MIDWIFE.

    Acute Maternity Presentations

    • Abdominal pain, shoulder tip pain, haemorrhage: Think ectopic pregnancy, miscarriage, placental abruption or praevia.
    • Hypertension, seizures, new onset confusion: Think pre-eclampsia/eclampsia, stroke, pregnancy-induced hypertension.
    • Hypotension, tachypnoea, tachycardia: Think sepsis, haemorrhage (concealed?).
    • Chest pain, shortness of breath: Think cardiac, PE.

    Maternal Cardiac Arrest

    • Causes can include: Heart failure, Hypovolaemia, Anaphylaxis, Embolism, Sepsis.

    Maternal Cardiac Arrest Management (Over 20 Weeks)

    • Manual displacement.
    • ALS.
    • Early call to critical care and HEMS.
    • Aim is to increase probability of ROSC by reducing aortocaval compression.

    Newborn Physiology

    • Babies' lungs are filled with fluid at birth.
    • Transition from foetal to newborn circulation.
    • No mechanism for producing and conserving heat.
    • Low levels of Vitamin K (clotting factors).
    • High levels of haemoglobin (Hb).

    Newborn First Minute Management

    • Start timer/note time of birth.
    • Dry, stimulate, apply hat, optimise thermoregulation.
    • Assess COLOUR, TONE, BREATHING, HEART RATE.
    • Leave cord intact as long as thermoregulation is not compromised.
    • Call for help.
    • If baby is not crying spontaneously or has a suboptimal assessment, clamp/cut cord and take baby to resuscitation area.

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    Related Documents

    Maternal and Newborn Assessment PDF

    Description

    This quiz focuses on the assessment of maternal and newborn patients, covering key aspects of history taking and maternal physiology. It is designed for healthcare professionals involved in caring for pregnant women and newborns, offering insights into vital patient information and physiological changes. Test your knowledge on best practices for care in these critical early stages of life.

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