. A few of them have tested positive for group B streptococcus (GBS) and will need antibiotics in labor (as recommended by the CDC) to prevent transmission of GBS to the fetus and possible neonatal sepsis. - ANS
When you leave the room, Dr. Barnett asks you: What do you think are the a...
. A few of them have tested positive for group B streptococcus (GBS) and will need antibiotics in
labor (as recommended by the CDC) to prevent transmission of GBS to the fetus and possible
neonatal sepsis. - ANS
When you leave the room, Dr. Barnett asks you: What do you think are the advantages of group
prenatal care?
Select all that apply.
The best options are indicated below. Your selections are indicated by the shaded boxes.
A. Group prenatal visits offer an opportunity for group support and peer education.
B. Group visits allow more time for education and anticipatory guidance with each patient.
C. Particularly among African American females, preterm delivery is less likely if they participate
in group prenatal care.
D. Prenatal knowledge, labor preparedness, adequacy of prenatal care, and patient satisfaction
of females in group prenatal care appear to be better than those in routine care.
E. Females enrolled in group prenatal visits who experience preterm deliveries have infants with
greater birth weights than those enrolled in routine prenatal care. - ANS
Advantages of Group Prenatal Care - ANS Group prenatal care is an excellent opportunity
for group support, and the women help educate each other as well, which can be very effective.
In addition, it can be more efficient for the clinician because, in many cases, most of the time in
individual visits is taken up by education and anticipatory guidance.
Ultimately, women enrolled in group prenatal care receive more time for prenatal education and
anticipatory guidance than those in routine care.
Preterm delivery is less likely in women participating in group prenatal care. This effect is more
significant for African American females, as shown in one study and in a subsequent systematic
review.
Furthermore, if an infant is preterm, the birth weight (a significant survival determinant) is
greater when the mother has participated in group prenatal visits.
The incidence of preterm birth is higher in African American women than European American
women, and preterm birth is the leading cause of neonatal death in African American infants (as
opposed to congenital anomalies in European American infants). Although direct causal links
are often difficult to elucidate, studies have shown that there are significant relationships
between these racial health disparities and maternal stress, experiences of racism, and harmful
environmental exposures. The advantages of group visits may be an important tool to help
combat the racial disparities seen in maternal health in the United States.
, Overall, the prenatal knowledge, labor preparedness, adequacy of prenatal care, and patient
satisfaction of women in group prenatal care also appears to be better than those in routine
care.
Group visits can be used for a variety of medical conditions, including diabetes and chronic
pain.
Interpreting a Non-Stress Test Strip - ANS A non-stress test is an assessment of fetal
well-being in the antepartum period before labor. Remember, the red line is fetal heart rate
(FHR), the pink line is the maternal heart rate (measured by a pulse oximeter), and the black
line is uterine contractions. Each thin vertical line on the graph represents ten seconds, and
each thick vertical line represents one minute.
First check the FHR. A normal FHR has a baseline between 110 and 160 beats per minute with
variability of 6 to 25 beats per minute.
Next, determine whether the strip is 'reactive' or not - ANS A neurologically intact and
healthy fetus in the late third trimester should have two heart rate accelerations of at least 15
beats per minute over at least 15 seconds in a 20-minute period, which is called a 'reactive'
strip.
For someone in labor, admitted to the birthing unit, they are not required to have a reactive NST
in order to be considered reassuring. For an antepartum patient with medical issues indicating
fetal well-being testing and one whom you may consider sending home if she is not in labor,
performing a non-stress test is appropriate.
Which of the following would be non-reassuring with respect to fetal status?
Choose the single best answer.
The best option is indicated below. Your selections are indicated by the shaded boxes.
A. A baseline fetal heart rate of 170 beats per minute.
B. Moderate variability with an amplitude of about 12 beats per minute.
C. The patient reports active fetal movement throughout the day.
D. Two fetal heart rate accelerations in a 20 minute period. - ANS The correct answer is A.
Non-reassuring Fetal Status - ANS A baseline fetal heart rate of 170 beats per minute is
defined as tachycardia, and would be cause for concern. Many problems could cause fetal
tachycardia, including maternal fever or infection and fetal anemia or hypoxia.
Minimal (5 or less beats per minute), absent, or marked (greater than 20 beats per minute)
variability of the fetal heart rate.
Reassuring Fetal Status - ANS Moderate variability (6 to 20 beats per minute).
A subjective report of active fetal movement.
A "reactive" strip showing two heart rate accelerations (of at least 15 seconds with a peak of at
least 15 beats per minute above the baseline) in a 20-minute period.
Which of the following provides evidence that a woman may be in active labor?
Select all that apply.
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