Maternal and Child Health Nursing
Maternal and Child Health Nursing - what the exam tests
This domain tests antenatal, intranatal, postnatal and newborn care, family planning, and recognition and referral of obstetric and neonatal danger signs.
Core rules
- Antenatal care: minimum four visits; weight, BP, haemoglobin, urine albumin and sugar, fundal height; iron-folic acid and calcium supplementation; TT/Td immunisation; danger-sign education.
- Naegele's rule: EDD = first day of LMP + 9 months − 7 days.
- Stages of labour: first (cervical dilatation to 10 cm), second (full dilatation to birth), third (birth to delivery of placenta, usually 5–15 minutes), fourth (first 2 hours - watch for postpartum haemorrhage).
- Newborn care: dry, warm, stimulate, assess breathing; vitamin K 1 mg IM; breastfeeding within one hour with colostrum given; exclusive breastfeeding for 6 months; kangaroo mother care for low birth weight.
- APGAR at 1 and 5 minutes: appearance, pulse, grimace, activity, respiration; 7–10 is normal.
Worked example
A woman's last menstrual period began on 1 March 2024. EDD = 1 March + 9 months = 1 December; then − 7 days = 24 November 2024. Reasoning: Naegele's rule assumes a 28-day cycle with ovulation on day 14; if cycles are irregular or the date is uncertain, an early ultrasound scan is more reliable, but the EDD must still be written on the antenatal card.
Traps that cost marks
- Adding 7 days to the last day of bleeding instead of the first day of the LMP.
- Confusing the first and second stages of labour.
- Discarding colostrum or giving prelacteal feeds such as honey or water.
- Missing danger signs: bleeding, severe headache with blurred vision, reduced fetal movement, fever, convulsions.