Calling all maternal child nursing professionals and students! Ready to sharpen your prenatal assessment skills? In our free maternal and child health nursing quiz, you'll tackle the 5 client findins that require further evaluation, spotting early warning signs in prenatal care and common complications. This interactive maternal child nursing quiz challenges you with community health nursing questions, guiding you through pregnancy complications assessment and realistic labor management nursing test scenarios. Whether you're gearing up for the NCLEX or reinforcing best practices, this focused tool provides immediate feedback with detailed rationales and lets you benchmark against peers. Curious to see how you stack up? Dive in now, then explore our obstetrics nursing quiz for extra practice and elevate your expertise today!
At how many weeks gestation is the uterine fundus typically at the level of the umbilicus?
18 weeks
16 weeks
20 weeks
22 weeks
By approximately 20 weeks' gestation, the fundus reaches the level of the umbilicus and fundal height in centimeters closely approximates weeks of gestation. This measure helps assess fetal growth. Discrepancies may warrant further evaluation for growth restriction or polyhydramnios. For more details, see ACOG Prenatal Development FAQ.
What is the normal baseline fetal heart rate range during the second and third trimesters?
90 - 110 beats per minute
60 - 100 beats per minute
160 - 180 beats per minute
110 - 160 beats per minute
A normal fetal heart rate ranges from 110 to 160 bpm. Rates below 110 or above 160 may indicate bradycardia or tachycardia, respectively, and require further assessment. Continuous monitoring is crucial during labor and high?risk pregnancies. See more at UpToDate: Fetal Heart Rate Monitoring.
Which of the following is considered the earliest presumptive sign of pregnancy?
Hegar's sign (softening of isthmus)
Fetal heart sounds
Amenorrhea
Chadwick's sign (bluish discoloration)
Amenorrhea, or absence of menstruation, is often the first noticeable change in early pregnancy. Probable signs (like Hegar's and Chadwick's) follow, and positive signs (like fetal heart sounds) confirm pregnancy. Always correlate with laboratory and imaging studies. More info at NCBI: Signs of Pregnancy.
What is quickening in obstetric assessment?
First fetal movement felt by the mother
Elevated maternal blood pressure
Softening of the cervical isthmus
Onset of Braxton Hicks contractions
Quickening refers to the first time a pregnant woman perceives fetal movements, usually between 16 and 20 weeks of gestation. It is a presumptive sign of pregnancy and helps estimate gestational age. Absence of quickening by 22 weeks may prompt further evaluation. See ACOG Prenatal Development FAQ.
Which test is considered a positive sign of pregnancy?
Visualization of the fetus by ultrasound
Positive urine hCG test
Bluish discoloration of cervix (Chadwick's sign)
Softening of the cervix (Goodell's sign)
Positive signs of pregnancy include direct evidence of the fetus, such as ultrasound visualization or auscultation of fetal heart tones. Goodell's and Chadwick's signs are probable signs, and urine hCG is a presumptive test. Confirming fetal presence is definitive. More at NCBI: Positive Signs of Pregnancy.
Which vaccine is contraindicated during pregnancy?
Influenza (inactivated)
Tdap (tetanus, diphtheria, pertussis)
MMR (measles, mumps, rubella)
Hepatitis B
Live attenuated vaccines, such as MMR, are contraindicated in pregnancy due to the risk of fetal infection. Inactivated influenza and Tdap are recommended during appropriate trimesters to protect mother and baby. Hepatitis B is also safe if indicated. See CDC guidelines at CDC Pregnancy Vaccine Guidelines.
What is the recommended total weight gain for a woman with a normal pre-pregnancy BMI?
25 - 35 pounds
15 - 25 pounds
10 - 15 pounds
5 - 10 pounds
For women with a normal pre-pregnancy BMI (18.5 - 24.9), the Institute of Medicine recommends a total weight gain of 25 - 35 pounds to support fetal growth and maternal health. Less or more can increase risks like low birth weight or cesarean delivery. More at NIH: Weight Gain Guidelines.
At what gestational age is group B streptococcus (GBS) screening routinely performed?
35 - 37 weeks
24 - 26 weeks
30 - 32 weeks
38 - 40 weeks
GBS colonization screening is recommended between 35 and 37 weeks' gestation to guide intrapartum antibiotic prophylaxis and prevent neonatal sepsis. Earlier or later screening may not accurately reflect colonization at delivery. Key CDC recommendation: CDC GBS Guidelines.
Which hemoglobin level defines anemia in pregnancy in the first or third trimester?
<11.0 g/dL
<12.0 g/dL
<10.0 g/dL
<10.5 g/dL
Anemia in pregnancy is defined as hemoglobin below 11.0 g/dL in the first and third trimesters (and below 10.5 g/dL in the second trimester). Early detection allows dietary and supplement interventions to prevent maternal and fetal complications. For details, refer to ACOG Anemia in Pregnancy FAQ.
What daily dose of folic acid is recommended for women of childbearing age to prevent neural tube defects?
800 mcg
200 mcg
400 mcg
1000 mcg
The CDC recommends 400 mcg of folic acid daily for all women of reproductive age to reduce the risk of neural tube defects. Women with a prior affected pregnancy may need higher doses as advised by a provider. More at CDC Folic Acid Recommendations.
During which trimester is organogenesis essentially complete?
Second trimester
Perinatal period
Third trimester
First trimester
Organogenesis - the formation of fetal organs - occurs primarily during the first trimester. Teratogenic exposures in this period carry the highest risk of congenital malformations. Later trimesters focus on growth and maturation. For specifics, see MedlinePlus: Fetal Development.
What is the purpose of measuring fundal height in centimeters after 20 weeks' gestation?
Assess fetal growth
Estimate maternal weight gain
Detect preeclampsia
Measure amniotic fluid index
Fundal height in centimeters approximates gestational age after 20 weeks and serves as a quick screen for fetal growth. A measurement more than 2 cm off expected may indicate growth restriction or polyhydramnios, prompting ultrasound evaluation. More at ACOG Prenatal Development FAQ.
Which blood pressure reading is considered normal during pregnancy?
140/95 mm Hg
150/100 mm Hg
90/60 mm Hg
130/90 mm Hg
A blood pressure around 90/60 to 120/80 mm Hg is considered normal in pregnancy. Values consistently above 140/90 mm Hg after 20 weeks may indicate gestational hypertension or preeclampsia. Low readings around 90/60 often reflect normal hemodynamic changes. See ACOG Hypertension in Pregnancy FAQ.
When is the oral glucose tolerance screening typically performed for gestational diabetes?
30 - 34 weeks
18 - 20 weeks
24 - 28 weeks
12 - 16 weeks
Screening for gestational diabetes using the glucose challenge test is recommended between 24 and 28 weeks' gestation for average-risk women. Early screening may be indicated for high-risk populations. Diagnosis and treatment reduce perinatal complications. For guidelines, see ADA Gestational Diabetes Guidelines.
Rho(D) immune globulin is routinely administered to unsensitized Rh-negative mothers at what gestational age to prevent isoimmunization?
28 weeks
36 weeks
12 weeks
16 weeks
Routine antenatal Rho(D) immune globulin at 28 weeks helps prevent maternal sensitization to fetal Rh-positive red blood cells. Additional dosing is given after delivery if the newborn is Rh-positive. This practice has significantly reduced hemolytic disease of the newborn. More at CDC Rho(D) Immune Globulin Guidelines.
Which laboratory value indicates gestational anemia requiring intervention?
Hemoglobin 9.5 g/dL
Hemoglobin 10.2 g/dL
Hemoglobin 10.8 g/dL
Hemoglobin 11.5 g/dL
Anemia in pregnancy is defined as hemoglobin <11.0 g/dL in the first and third trimesters and <10.5 g/dL in the second trimester. Both 10.2 and 9.5 g/dL indicate anemia; however, 9.5 represents more severe anemia. Appropriate iron supplementation and diet counseling are recommended. See ACOG Anemia in Pregnancy.
Which sign is considered a probable (not positive) sign of pregnancy?
Palpable fetal movement by examiner
Positive home urine pregnancy test
Auscultation of fetal heart tones
Ultrasound visualization of the embryo
Probable signs of pregnancy include objective findings such as positive hCG tests, uterine enlargement, and softening of cervical tissues. Positive signs - like fetal heart tone auscultation or ultrasound - confirm fetal presence. Always corroborate probable signs with positive signs or laboratory testing. More at NCBI Signs of Pregnancy.
Which of the following measures amniotic fluid volume most directly during prenatal care?
Group B strep culture
Measurement of fundal height
Non-stress test
Biophysical profile
The biophysical profile uses ultrasound to assess fetal breathing, movements, tone, amniotic fluid volume, and NST results. Amniotic fluid index within the profile quantifies fluid pockets for assessment of oligohydramnios or polyhydramnios. This helps evaluate fetal well-being. Details at ACOG Biophysical Profile.
A pregnant client at 32 weeks' gestation presents with 3+ pitting edema of the lower extremities but normal blood pressure. How should the nurse interpret this finding?
Sign of deep vein thrombosis
Emergency requiring immediate hospitalization
Indicative of preeclampsia
Normal finding due to increased plasma volume
Mild to moderate edema in late pregnancy often reflects increased plasma volume and venous stasis. Without hypertension or proteinuria, it is typically a normal change. Elevating the legs and avoiding prolonged standing can help. If edema is sudden or accompanied by other symptoms, further evaluation is needed. See ACOG Hypertension in Pregnancy FAQ.
Which level of proteinuria is diagnostic of preeclampsia when accompanied by hypertension after 20 weeks' gestation?
1+ on dipstick
4+ on dipstick
Trace on dipstick
2+ on dipstick (?300 mg/24 hr)
Preeclampsia is diagnosed when hypertension occurs after 20 weeks plus proteinuria ?300 mg in a 24-hour urine collection or ?2+ on a dipstick test. Trace or 1+ dipstick readings are not diagnostic without quantification. Severe preeclampsia involves higher thresholds. Details at ACOG Preeclampsia Practice Bulletin.
A nonreactive non-stress test (NST) for a fetus at 34 weeks gestation suggests which of the following?
Possible fetal compromise requiring further assessment
Adequate fetal oxygenation
Normal finding in late pregnancy
Immediate need for cesarean section
A nonreactive NST - fewer than two accelerations of 15 bpm lasting 15 seconds within 20 minutes - may indicate fetal hypoxia or sleep cycle. Further testing (biophysical profile or contraction stress test) is needed. It is not an immediate indication for cesarean without additional data. For guidelines, see ACOG Fetal Monitoring Practice Bulletin.
Which finding is most consistent with hyperemesis gravidarum rather than typical morning sickness?
Nausea without dehydration
Vomiting once daily
Weight loss exceeding 5% of prepregnancy weight
Mild nausea relieved by eating
Hyperemesis gravidarum is characterized by severe, persistent nausea and vomiting leading to weight loss of >5% of prepregnancy weight, dehydration, and electrolyte imbalances. Morning sickness is milder, with minimal weight loss and no significant lab abnormalities. Early intervention is essential. See NIH: Hyperemesis Gravidarum.
An oral glucose tolerance test shows a 1-hour glucose level of 210 mg/dL during pregnancy screening. What is the appropriate next step?
Diagnose gestational diabetes immediately
No further testing needed; normal
Perform 3-hour glucose tolerance test
Repeat 1-hour test next visit
A 1-hour glucose screen ? 130 - 140 mg/dL is considered abnormal depending on criteria; 210 mg/dL definitely exceeds thresholds, warranting a diagnostic 3-hour oral glucose tolerance test. Immediate diagnosis requires confirmation. See ADA guidelines at ADA Gestational Diabetes.
Which presentation is most likely associated with a soft, non-tender, midline fundal height discrepancy at 36 weeks?
Cephalic presentation
Occiput posterior
Breech presentation
Transverse lie
Breech presentation often results in a softer, lower fundal contour and more irregular palpation. A cephalic fetal head fills the fundus firmly. Transverse lie produces a firm transverse mass. Leopold's maneuvers help differentiate presentations. See ACOG Breech Presentation FAQ.
A maternal blood pressure of 150/100 mm Hg at 30 weeks without proteinuria is classified as:
Chronic hypertension
Gestational hypertension
Preeclampsia
Normal pregnancy BP
Gestational hypertension is new-onset hypertension (?140/90 mm Hg) after 20 weeks without proteinuria or end-organ damage. If proteinuria or other signs develop, it becomes preeclampsia. Chronic hypertension exists before 20 weeks. Refer to ACOG Chronic Hypertension Guidance.
Which laboratory finding is most indicative of iron-deficiency anemia in mid-pregnancy?
High MCV and low ferritin
Low MCV and low ferritin
Normal MCV and normal ferritin
High MCV and high ferritin
Iron-deficiency anemia typically shows microcytic (low mean corpuscular volume) anemia and low serum ferritin. Ferritin <30 ng/mL confirms iron deficiency. Normal or high ferritin suggests other causes. Management includes iron supplementation. More at ACOG Anemia in Pregnancy.
Which symptom in the third trimester is most suggestive of placenta previa?
Severe abdominal pain with bleeding
Painless bright red vaginal bleeding
Contractions every 5 minutes
Grayish discharge with odor
Painless, bright red bleeding in the second half of pregnancy suggests placenta previa, where the placenta overlies or is near the cervical os. Painful bleeding more often indicates placental abruption. Ultrasound diagnosis is definitive. See ACOG Placenta Previa FAQ.
Which medication is first-line for managing gestational hypertension?
Enalapril
Atenolol
Hydrochlorothiazide
Labetalol
Labetalol is a preferred first-line agent for gestational hypertension and preeclampsia without severe features. It effectively lowers blood pressure without significant fetal effects. ACE inhibitors like enalapril are contraindicated. More info at ACOG Hypertension Practice Bulletin.
A biophysical profile score of 6/10 in a term pregnancy indicates:
Immediate delivery indicated
Equivocal - repeat or further testing
Unsatisfactory - disregard result
Normal fetal status
A BPP score of 8 - 10 is reassuring; 6 is equivocal and often prompts repeat testing or extended monitoring. Scores ?4 indicate fetal compromise and usually require delivery. Components include NST, breathing, movements, tone, and fluid volume. See ACOG Biophysical Profile FAQ.
Which finding on a contraction stress test (CST) is considered negative (reassuring)?
Bradycardia without contractions
Late decelerations with every contraction
No late decelerations in 10 minutes
Variable decelerations every other contraction
A negative CST shows no late decelerations with at least three contractions in 10 minutes, indicating adequate uteroplacental function. Late decelerations signal fetal hypoxia. Variable decelerations are common but require context. See UpToDate: Contraction Stress Test.
Which prenatal finding should prompt evaluation for gestational cholestasis?
Right lower quadrant pain
Headache and visual changes
Edema of hands and feet
Pruritus of palms and soles with normal labs
Intense itching of the palms and soles, especially at night, with elevated bile acids suggests intrahepatic cholestasis of pregnancy. Prompt diagnosis reduces fetal risks. Evaluate liver function tests and bile acids. More at ACOG Cholestasis FAQ.
A 28-week pregnant client has a positive indirect Coombs test. Which finding is most likely in the newborn?
Neural tube defects
Hypoglycemia
Erythroblastosis fetalis (hemolytic disease)
Macrosomia
A positive indirect Coombs test indicates maternal antibodies against fetal red blood cells, risking hemolytic disease (erythroblastosis fetalis) in the newborn. This can cause anemia, jaundice, and hydrops fetalis. Administration of Rho(D) immune globulin reduces sensitization. See CDC Hemolytic Disease of the Fetus and Newborn.
Which amniotic fluid index (AFI) value indicates oligohydramnios?
AFI > 25 cm
AFI 8 - 12 cm
AFI 12 - 25 cm
AFI 5 - 8 cm
Oligohydramnios is defined as an AFI ?5 cm, though some use ?8 cm. AFI of 5 - 8 cm suggests mild to moderate oligohydramnios, which can indicate fetal renal issues or placental insufficiency and warrants further evaluation. See ACOG Amniotic Fluid FAQ.
Which delivery complication is most associated with polyhydramnios?
Shoulder dystocia
Uterine rupture
Postpartum hemorrhage due to retained placenta
Prolapsed cord
Excess amniotic fluid can lead to uterine overdistention, resulting in malpresentation and increased risk of umbilical cord prolapse upon membrane rupture. Shoulder dystocia is more related to macrosomia. Polyhydramnios also increases risk of preterm labor. For details, see NCBI Polyhydramnios Review.
Which TORCH infection poses the greatest risk of congenital sensorineural hearing loss?
Other (syphilis)
Cytomegalovirus (CMV)
Rubella
Toxoplasmosis
Congenital CMV is the most common non-genetic cause of sensorineural hearing loss in children. While rubella also causes hearing loss, CMV has a higher incidence in developed countries. Early detection can guide interventions. See CDC CMV Clinical Overview.
Which maternal serum marker is most sensitive for neural tube defect screening?
Estriol
Alpha-fetoprotein (AFP)
hCG
Inhibin A
Elevated maternal serum AFP between 16 and 18 weeks suggests open neural tube defects or abdominal wall defects. Other markers in the quad screen help assess trisomy risks. Abnormal AFP warrants ultrasound and possibly amniocentesis. For guidelines, see ACOG Genetic Screening FAQ.
Which finding on fetal ultrasound at 20 weeks suggests spina bifida?
Elevated anterior placenta
Normal cerebellar images (banana sign)
Lemon-shaped skull and banana sign
Absence of nasal bone
The ‚lemon sign' (scalloping of frontal bones) and ‚banana sign' (curved cerebellum) on second-trimester ultrasound are sonographic markers for open spina bifida. These findings prompt detailed neural axis evaluation. See NIH Spina Bifida Sonography.
In a woman with suspected HELLP syndrome, which lab finding is most characteristic?
Elevated platelets
Hyperglycemia
Elevated liver enzymes and low platelets
Low uric acid
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe form of preeclampsia. Lab findings include AST/ALT elevation and platelet count <100,000/mm³. Hemolysis markers (LDH, bilirubin) are also increased. Prompt recognition and delivery are critical. See ACOG HELLP Syndrome FAQ.
Which maternal condition increases risk of oligohydramnios due to decreased fetal urine output?
Gestational diabetes
Chronic hypertension with uteroplacental insufficiency
Polyhydramnios
Multiple gestation
Chronic hypertension can lead to uteroplacental insufficiency, reducing fetal perfusion and urine output, which is the major contributor to amniotic fluid. This results in oligohydramnios. Gestational diabetes more often causes polyhydramnios. For reference, see NCBI Oligohydramnios.
Which fetal movement pattern is most reassuring on ultrasound at term?
Only breathing movements without limb motion
One movement every 30 minutes
No movements for 2 hours
Four or more movements in 30 minutes
Four or more gross body movements or limb movements within 30 minutes is reassuring and indicates good fetal central nervous system function and oxygenation. Decreased movements warrant non-stress testing or biophysical profile. See ACOG Fetal Movement Counts FAQ.
Which finding on a non-stress test indicates fetal compromise?
Two accelerations in 20 minutes
Accelerations with maternal repositioning
Variable decelerations with movement
Late decelerations with contractions
Late decelerations are uniform downward deflections occurring after the peak of contractions, indicating uteroplacental insufficiency and fetal hypoxia. Late decelerations require prompt assessment and intervention. Accelerations are reassuring. See UpToDate: FHR Monitoring.
Which maternal laboratory test at 28 weeks helps assess iron stores?
Alkaline phosphatase
Serum ferritin
Serum albumin
Total protein
Serum ferritin reflects iron stores and is the best indicator of iron deficiency in pregnancy. Levels <30 ng/mL suggest depleted iron stores. Hemoglobin and hematocrit indicate anemia but not specific etiology. See ACOG Anemia in Pregnancy.
A reactive NST with no fetal breathing movements on ultrasound yields what biophysical profile score component value?
2 for amniotic fluid index
2 for fetal breathing
0 for fetal tone
0 for fetal breathing
Each BPP component scores 0 or 2. If no fetal breathing movements are seen in 30 minutes, breathing scores 0, even if NST is reactive. Reactive NST scores 2. The total BPP score integrates all five components. See ACOG Biophysical Profile.
Which maternal condition is most likely to cause late decelerations on fetal monitoring?
Fetal head compression
Early labor contractions
Umbilical cord compression
Hypotension from epidural anesthesia
Maternal hypotension, such as after epidural placement, can reduce uteroplacental perfusion and cause late decelerations. Cord compression yields variable decelerations, and head compression causes early decelerations. Maintaining maternal blood pressure is crucial. See ACOG FHR Monitoring FAQ.
Which feature on a prenatal ultrasound suggests intrauterine growth restriction (IUGR)?
Femur length above 90th percentile
Abdominal circumference below 10th percentile
Fundal height 2 cm greater than gestational age
Amniotic fluid index of 15 cm
Abdominal circumference <10th percentile is a key ultrasound marker for IUGR, reflecting reduced fetal liver size and subcutaneous fat. It warrants close surveillance for fetal well-being. Discrepancies in biparietal diameter or femur length may also appear. See ACOG Ultrasound in Pregnancy.
Which prenatal finding is most indicative of vasa previa?
Severe abdominal pain with contractions
Polyhydramnios on ultrasound
Painless vaginal bleeding and fetal bradycardia upon rupture of membranes
High AFP on maternal serum screen
Vasa previa involves fetal vessels crossing or near the internal cervical os, leading to vessel rupture on membrane rupture and painless bleeding plus fetal bradycardia. Early ultrasound with color Doppler can diagnose before labor. Rapid cesarean delivery is lifesaving. See ACOG Vasa Previa Bulletin.
In a contraction stress test, what does a positive result imply, and what is the next step?
Variable decelerations only; hydrate mother and repeat
Late decelerations present; consider immediate delivery
Accelerations only; perform biophysical profile
No late decelerations; continue routine monitoring
A positive contraction stress test shows persistent late decelerations, indicating uteroplacental insufficiency and high risk of fetal compromise. Immediate evaluation and often delivery planning are required based on gestational age and clinical status. See UpToDate: CST Indications.
Which management step is critical after diagnosing severe preeclampsia at 34 weeks' gestation?
Immediate induction of labor regardless of cervical favorability
Start high-dose diuretics
Administer magnesium sulfate for seizure prophylaxis
Delay delivery until 37 weeks
Magnesium sulfate is indicated in severe preeclampsia to prevent eclamptic seizures. Delivery planning depends on maternal and fetal stability; immediate induction or cesarean may follow. Diuretics are not first-line, and delaying past 37 weeks may risk maternal complications. See ACOG Preeclampsia/Eclampsia.
When should Rho(D) immune globulin be administered after a procedure such as chorionic villus sampling in an Rh-negative, unsensitized pregnant woman?
At 28 weeks only
At 36 weeks only
Only if the baby is Rh-positive
Within 72 hours of the procedure
Rho(D) immune globulin should be given within 72 hours after any sensitizing event such as CVS in Rh-negative unsensitized mothers. This prevents maternal antibody formation. Antepartum dosing at 28 weeks and postpartum dosing if the newborn is Rh-positive are also recommended. Details at CDC Immune Globulin Guidelines.
How is a biophysical profile score of 4/10 at 37 weeks best managed?
Administer tocolytics and observe
Reassure and repeat in one week
Immediate induction of labor or cesarean delivery
Perform amniocentesis for lung maturity
A BPP score ?4 is non-reassuring, indicating significant fetal compromise. At 37 weeks, the fetus is considered term, so delivery - typically induction or cesarean - is recommended. Tocolytics and amniocentesis are not indicated at term with poor BPP scores. For recommendations, see ACOG Biophysical Profile.
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Study Outcomes
Identify Critical Maternal and Child Findings -
Recognize the five client findings that require further evaluation by assessing vital signs and reported symptoms during prenatal and postpartum care.
Differentiate Pregnancy Complication Indicators -
Distinguish normal from abnormal signs in pregnancy complications assessment, ensuring timely referrals for conditions like preeclampsia and gestational diabetes.
Apply Labor Management Nursing Principles -
Implement best practices from a labor management nursing test to manage labor progression and detect deviations from expected patterns.
Interpret Pediatric Client Data -
Analyze child care intervention indicators to spot signs of neonatal distress and growth issues during postpartum follow-up.
Evaluate Community Health Nursing Scenarios -
Solve maternal child nursing quiz cases that mirror real-world community health nursing questions to prioritize care needs and resources.
Formulate Evidence-Based Interventions -
Develop appropriate nursing interventions based on quiz outcomes, leveraging clinical guidelines for both maternal and child health.
Cheat Sheet
Preeclampsia Red Flags -
Assess blood pressure readings >140/90 mm Hg after 20 weeks gestation and screen for proteinuria ≥300 mg/24 hr, per ACOG guidelines. Use the mnemonic "HELLP" (Hemolysis, Elevated Liver enzymes, Low Platelets) to recall severe features that demand urgent evaluation. Early detection of these 5 client findings that require further evaluation can reduce eclampsia risk by up to 15% (WHO, 2022).
Abnormal Fetal Heart Rate Patterns -
Monitor fetal heart rate tracings for late decelerations, variable decelerations, and tachycardia as detailed in the NICE intrapartum care protocol. Remember "VEAL CHOP": Variable - Cord, Early - Head, Accelerations - Okay, Late - Placental insufficiency. Prompt recognition of non-reassuring patterns guides timely interventions, improving perinatal outcomes (Journal of Obstetric Anesthesia, 2021).
Signs of Postpartum Hemorrhage -
Track cumulative blood loss exceeding 500 mL after vaginal birth (or 1,000 mL after cesarean) alongside symptoms such as tachycardia and hypotension, following CDC recommendations. Quantify using gravimetric methods (drape weight) and hemoglobin drop formulas (ΔHb = Hb admission - Hb postpartum). Rapid identification allows administration of uterotonics, minimizing morbidity.
Neonatal Respiratory Distress Indicators -
Spot grunting, nasal flaring, and retractions within the first hours of life, per AAP newborn guidelines. Apply the Silverman - Andersen Score (0 - 10 scale) to quantify distress severity: a score ≥5 triggers CPAP or intubation readiness. Early support reduces risk of bronchopulmonary dysplasia.
Infection Markers in Pregnancy -
Screen for fever >38 °C, tachycardia >100 bpm, and elevated WBC count >15,000/mm³ as potential chorioamnionitis, based on UpToDate protocols. Use the mnemonic "MATT HILL": Maternal fever, Abdominal pain, Tachycardia (maternal/fetal), Tender uterus, High WBC, Increased CRP, Leukocytosis, and Labour signs. Prompt antibiotic therapy per CDC reduces neonatal sepsis rates significantly.
