RNC-NIC Question and answers rated A+ 2023

What risks are present in infants born to mothers who receive no or little prenatal care? LBW premature birth Maternal iron-deficiency anemia Increased neonatal mortality Describe the fetal response to mothers with diabetes Because glucose crosses the placenta, the baby's BG increases as the mom's does. Insulin does not cross the placenta and the fetal pancreas does not produce it until 20 weeks. So, before insulin production, the increased BG leads to restricted growth. Once the insulin is produced, it produces rapidly to respond to the high BG, and these high levels trigger rapid fetal growth— hepatosplenomegaly, cardiomegaly, increased head size What is commonly seen in IDM immediately after birth? Why? Hypoglycemia The sudden withdrawal from maternal glucose + continued production of insulin What conditions does an IDM present with? Birth trauma r/t cephalopelvic disproportion Hypoglycemia RDS because inc insulin inhibits surfactant production Polycythemia & hyperviscosity bc inc insulin & BG inc metabolic rate and oxygen consumption Iron deficiency bc polycythemia leaches iron Hyperbilirubinemia from inc rbc destruction CV & congenital malformations Electrolyte disturbances (low Ca and Mg) What is pre-eclampsia? Inc BP, proteinuria, edema that occurs around 20 week's gestation What's the initial tx for pre-eclampsia? Mag sulfate to prevent maternal sz If severe—premature delivery What complications occur to fetus with a mother suffering from pre-eclampsia? Why? IUGR— longstanding HTN causes uteroplacental vascular insufficiency which impairs transfer of nutrients and oxygen which causes IUGR and inc mortality What is the purpose of amniotic fluid and how is it produced? When? To cushion fetus and allow normal development of lungs Produced mainly by fetus' excretion of urine and fluids excreted by respiratory tract & oral/nasal cavity Around 20 week's What is oligohydramnios? What conditions are associated with it? Decreased AF UT anomalies like obstructive uropathy, renal agenesis, polycystic kidneys Pulmonary hypoplasia Pressure deformities Compression of umbilical cord & hypoxia Mecon staining (remember hypoxia causes release of mecon in utero) Post-term gestation Leaking AF, prolonged or premature ROM What is polyhydramnios & what is it associated with? Increased AF TEF, EA, duodenal atresia Anencephaly CNS abnormalities that impair swallow Twin-twin transfusion Macrosomia Fetal/neonatal hydrops & assoc CV rhythms Trisomy 21, 18, 13 Skeletal malformations Inc risk for prolapsed cord/placental abruption What is the biochemical marker useful in predicting preterm birth? Fibronectins What is the best indicator of fetal oxygenation status during labor as seen on electric fetal monitoring? Variability What are the five parts of the biophysical profile? Fetal tone, breathing, movement; no stress test, amniotic fluid volume When should one have a glucose screening during pregnancy if they're at low risk for developing GD? 24-28 weeks When women give birth sitting upright, what shows lower values in cord blood? PCO2 An intrauterine pressure catheter, placed for monitoring of uterine pressure, amino infusion, and fluid sampling, is useful in the treatment of what? Variable decelerations by correcting cord compression What is the normal blood volume for a neonate? 85-100 mL/kg What are some risks for fetal maternal hemorrhage? Maternal trauma Placental abruption Placental tumors Third semester amnios Fetal hydrops Twins What test is used to determine if FMH has taken place? Kleihauer-Betke test examines maternal blood for fetal hemoglobin; determines the amount of hemorrhage that has taken place What increases the chances of having multiple births? Delayed childbearing What are risks of multiple gestations? Premature birth LBW Morbiditie