Podcast
Questions and Answers
Which factor is NOT classified under biophysical factors when assessing pregnant clients at risk?
Which factor is NOT classified under biophysical factors when assessing pregnant clients at risk?
Which screening procedure is primarily used to detect chromosomal or genetic abnormalities?
Which screening procedure is primarily used to detect chromosomal or genetic abnormalities?
What is NOT a characteristic of a high-risk pregnancy?
What is NOT a characteristic of a high-risk pregnancy?
In the context of nursing care planning for pregnant clients, which principle is essential for achieving the best clinical outcomes?
In the context of nursing care planning for pregnant clients, which principle is essential for achieving the best clinical outcomes?
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Which of the following factors would be classified as a sociodemographic factor?
Which of the following factors would be classified as a sociodemographic factor?
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What is one of the primary purposes of prenatal screening tests?
What is one of the primary purposes of prenatal screening tests?
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What is the role of percutaneous umbilical blood sampling (PUBS) during pregnancy?
What is the role of percutaneous umbilical blood sampling (PUBS) during pregnancy?
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Which of the following conditions indicates the need for individualized nursing care in pregnant clients?
Which of the following conditions indicates the need for individualized nursing care in pregnant clients?
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What is the primary purpose of the indirect Coombs’ test?
What is the primary purpose of the indirect Coombs’ test?
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What is NOT a reason for performing a first trimester Fetal Ultrasound (UTZ)?
What is NOT a reason for performing a first trimester Fetal Ultrasound (UTZ)?
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Which statement accurately describes the use of Cardiotocography (CTG)?
Which statement accurately describes the use of Cardiotocography (CTG)?
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At what stage of pregnancy is Chorionic Villi Sampling (CVS) typically performed?
At what stage of pregnancy is Chorionic Villi Sampling (CVS) typically performed?
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What is the primary goal of the Contraction Stress Test (CST)?
What is the primary goal of the Contraction Stress Test (CST)?
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Which of the following is NOT typically monitored during a second trimester Fetal UTZ?
Which of the following is NOT typically monitored during a second trimester Fetal UTZ?
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A Nonstress Test (NST) is generally performed after how many weeks of age gestation (AOG)?
A Nonstress Test (NST) is generally performed after how many weeks of age gestation (AOG)?
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What type of information does a Fetal Ultrasound (UTZ) primarily provide in the third trimester?
What type of information does a Fetal Ultrasound (UTZ) primarily provide in the third trimester?
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Study Notes
NUR C202: Care of Mother and Child at Risk or with Problems (Acute and Chronic)
- Course offered by José Rizal University
- Instructor: Gina M. Dumawal, RN, MAN
- Additional instructors: JoAnne Silbert-Flagg, Adelle Pillitteri
Objectives
- Students will be able to apply knowledge of normal pregnancy, anatomy, physiology, and assessment techniques for clients at risk.
- Students will be able to assess pregnant clients' health status.
- Students will be able to prioritize nursing diagnoses using assessed data.
- Students will be able to plan client care using evidence-based research, ethical/moral principles, and legal principles to achieve best clinical outcomes and implement effective care plans.
- Students will be able to implement individualized nursing care plans.
- Students will be able to evaluate the effectiveness of nursing care, revise plans as needed, and promote/maintain/restore functional health status for clients with reproductive/sexual disorders.
- Students will be able to accurately report and document clinical findings.
Identifying Clients at Risk
- Women with pre-existing disorders before pregnancy are at risk.
- Factors that categorize a pregnancy as high-risk need to be identified.
- Risk identification begins with the first prenatal visit and continues throughout the pregnancy.
Assessment of Risk Factors
Biophysical Factors
- Genetic considerations
- Nutritional status
- Medical & obstetrical disorders
Psychosocial Factors
- Substance abuse
- Psychological status
Sociodemographic Factors
- Low income
- Lack of prenatal care
- Age
- Parity
- Marital status
- Residence
Environmental Factors
- Air pollutants
Review of Screening Procedures
- Prenatal screening tests identify pregnancies at increased risk for birth defects or problems.
Review of Screening Procedures (Details)
- Ultrasound (Doppler UTZ, transvaginal, transabdominal) – used in high-risk pregnancies to assess fetal compromise.
- Chorionic villus sampling (CVS) – used to detect chromosomal or genetic abnormalities.
- Amniocentesis – used to detect chromosomal/genetic issues.
- Percutaneous umbilical blood sampling (PUBS) – used to detect fetal abnormalities.
- Maternal serum-alpha fetoprotein (MSAFP) – used to detect neural tube defects and open abdominal wall defects.
- Magnetic resonance imaging (MRI) – used to evaluate fetal structure and overall growth, and maternal structures.
- Coombs' test (indirect) – screens for Rh incompatibility.
Review of Diagnostic & Laboratory Exam
What is a Diagnostic Test?
- A diagnostic test confirms the presence or absence of a disease, guiding treatment decisions for symptomatic or screened-positive individuals.
Review of Diagnostic & Laboratory Exam (Fetal UTZ)
- First trimester fetal UTZ evaluates pregnancy progression, determines the number of fetuses, estimates gestational age (AOG), and assesses risk of chromosomal defects.
- Check for birth defects affecting the brain and spinal cord.
Review of Diagnostic & Laboratory Exam (Additional Tests)
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Second trimester fetal UTZ:
- Estimates AOG.
- Evaluates fetal size, position, placenta, and amniotic fluid.
- Detects major birth defects (neural tube defects or heart problems)
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Third trimester fetal UTZ:
- Confirms fetal viability.
- Assesses fetal size, position, placenta, and amniotic fluid
- Evaluates for major birth defects
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Cardiotocography (CTG): a method of recording fetal heart rate (FHR) and uterine contractions.
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Nonstress Test (NST): a method of monitoring FHR in response to fetal movements- useful for women at risk of fetal death.
Review of Diagnostic & Laboratory Exam (Further Tests)
- Contraction Stress Test (CST) - performed towards end of pregnancy to measure fetal response to contractions.
- Chorionic villus sampling (CVS) - analysis of chorionic villi for chromosomal/genetic disorders. Detects abnormalities from early pregnancy (weeks 10-13)
- Amniocentesis - used to detect genetic/chromosomal issues in the fetus. Common during pregnancies with elevated risk (e.g., advanced maternal age, family history, prior abnormal screening).
Review of Diagnostic & Laboratory Exam (Additional Tests)
- Embryoscopy - examines the embryo up to 10 weeks for genetic/fetal abnormalities
- Fetoscopy - visually inspects the fetus for abnormalities, confirming findings from other tests.
- Percutaneous Umbilical Cord Blood Sampling (PUBS/Cordocentesis) - examines fetal blood to detect abnormalities.
- Biophysical Profile (BPP) - evaluates fetal well-being.
- Nonstress Test (NST) - monitors fetal heart rate (FHR) in response to fetal movements.
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Description
This quiz assesses your understanding of the care of mothers and children at risk, covering both acute and chronic issues. It focuses on normal pregnancy, assessment techniques, and the implementation of effective nursing care plans. Prepare for clinical application by reviewing evidenced-based research and best practices in nursing.
