Maternal and Child Health Nursing (Obstetrics and Paediatrics)
Maternal and Child Health Nursing covers antenatal, intranatal, postnatal and newborn care, together with child growth, development and immunisation.
Core rules
- Gravida is the number of pregnancies; para is the number of births after 28 weeks. A third pregnancy with two living children is G3 P2 L2.
- Naegele's rule: expected date of delivery = last menstrual period + 7 days − 3 months + 1 year.
- Antenatal care includes folic acid and iron, tetanus–diphtheria immunisation, blood pressure and urine albumin at every visit, haemoglobin, blood group, and screening for HIV, hepatitis B and syphilis.
- The first stage of labour runs from 0 to 10 cm dilatation; the partograph plots dilatation, descent, contractions, fetal heart rate and maternal vitals.
- APGAR at 1 and 5 minutes: Appearance, Pulse, Grimace, Activity, Respiration, each scored 0–2. A score of 7–10 is normal; below 7 requires assessment.
- Exclusive breastfeeding for 6 months; oral rehydration salts plus zinc for 14 days in diarrhoea.
- Danger signs: bleeding, severe headache or blurred vision, convulsions, high fever, reduced fetal movement, no urine for 6 hours.
Worked example
Last menstrual period 10 April 2024. Add 7 days = 17 April; subtract 3 months = 17 January; add 1 year = 17 January 2025. Reasoning: subtracting 3 months carries the date into the following calendar year, which is exactly why the year must be added back.
Traps that cost marks
- Reversing gravida and para.
- Using APGAR to decide whether to resuscitate - resuscitation begins on clinical grounds.
- Introducing complementary feeds before 6 months.