Maternal and Child Health Nursing
Maternal and child health nursing tests safe care of the pregnant woman, fetus, newborn, and child. OMSB-style items emphasize risk recognition, gestational age–specific normal values, fetal surveillance, postpartum complications, pediatric weight-based dosing, and family-centered communication.
Core rules
- GTPAL: gravida includes current pregnancy; para counts births at ≥20 weeks; abortions include miscarriages and induced losses before 20 weeks.
- Category I fetal heart tracing: baseline 110–160, moderate variability, no late or variable decelerations, accelerations present. Category III includes absent variability with recurrent late decelerations, recurrent variable decelerations, bradycardia, or a sinusoidal pattern; act immediately.
- Preeclampsia with severe features includes BP ≥160/110, platelets <100,000, creatinine >1.1 mg/dL, liver enzymes twice normal, pulmonary edema, or new cerebral/visual symptoms. Magnesium sulfate prevents seizures; monitor reflexes, respirations, urine output, and serum magnesium.
- Postpartum hemorrhage: assess tone, tissue, trauma, and thrombin. Uterine atony is most common; massage and uterotonics are first-line while ABC and blood products are arranged.
- Pediatric doses are per kg, and safe range checks are mandatory; a child’s normal BP and heart rate vary by age.
Worked example
A woman at 36 weeks has BP 168/112, headache, and 3+ proteinuria. She receives magnesium sulfate. One hour later respirations are 10/min and reflexes are absent. Reasoning: these are magnesium toxicity signs. Stop the infusion, call for urgent review, give oxygen, monitor, and prepare calcium gluconate as the antidote. Do not give more magnesium or discharge her.
Traps
Do not confuse variable decelerations (cord compression) with late decelerations (uteroplacental insufficiency). Do not treat a category II tracing as normal or category III as observation only. Avoid giving pregnant women live vaccines; inactivated vaccines are generally safe. Do not use adult vital-sign ranges for infants.