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RNC NIC Review by Me-Maternal Hx & Risk Factors Questions and Answers 100% solved
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RNC NIC Review by Me-Maternal Hx & Risk Factors
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RNC NIC Review by Me-Maternal Hx &Risk Factors
Infants born to Mothers who receive no prenatal care are at increased risk of what? -
answer Prematurity
Low Birth Weight
Maternal iron deficiency anemia
Neonatal mortality
Explain in 5 steps why does an IDM presents with hypoglycemia at birth? - answer1.
Glucose crosses the placenta whereas insulin doesn't.
2. When Mom has elevated insulin, the fetus also has elevated insulin
3. The fetus produces insulin starting at 20 weeks of Gestation
4. After 20 weeks the fetus produces high level of insulin in response to hyperglycemia.
5. Sudden glucose's withdrawal from glucose at birth paired with high insulin production
results in Hypoglycemia
When does the fetus start producing insulin - answer At 20 weeks of gestation
Why does IDM are often LGA - answerThe combo of elevated maternal glucose and
elevated fetal insulin triggers rapid growth
6 Indications for routine blood glucose monitoring in the neonate - answer1. Prematurity
2. IUGR
3. Sepsis
4. Hypothermia
5. Congénital Cardiac Malformation
6. Endocrine Disorder
IDM often presents with these 8 issues - answer1. Birth trauma due to LGA
2. Hypoglycemia
3. RDS because high insulin level inhibits surfactant production
4. Polycythemia because high insulin and glucose increase metabolic rate & O2
consumption, so the infant produces more RBCs to compensate
5. Iron deficiency due to Polycythemia
6. Hyperbili because increased RBC destruction after birth
7. Congenital Malformations
8. Electrolyte Imbalances (low ca and mg)
What is Oligohydramnious? - answerDecreased amount of amniotic fluid
, How is the amniotic fluid produced - answerAfter 20 weeks the fluid is mainly made by
the fetus' excreted urine
What is the amniotic fluid necessary for? - answerCushion and lung development
What are the 7 conditions associated with Oligohydramnious? - answer1. Urinary tract
anomalies
2. Pulmonary Hypoplasia
3. Cord Compression (Variable Decels.)
4. Meconium Staining
5. Post term gestation
6. Pressure Deformities (clubbed feet)
7. PROM which can lead to infections
What is Polyhydramnious? - answerIncreased amount of amniotic fluid
What is the most common endocrine disorder affecting Pregnancy - answerDiabetes
How does sulfonylurea such as Glyburide and Metformin affect the fetus? - answerThey
can cross the placenta and may cause Neonatal jaundice, but they are considered safe
during lactation.
How soon does the fetal thyroid gland synthesizes its own hormones - answerAt 10 to
12 weeks' gestation
What is Phenylketonuria (PKU)? - answerAn inherited disorder in which an enzyme
defect makes impossible to convert the AA phenylalanine into tyrosine
What is the problem with PKU? - answerThe accumulation of excessive amount of
phenylalanine is toxic to the CNS
Maternal phenylalanine Level affects neonatal outcomes
When is PKU screened? - answerWithin 24 hours of life
What are the 3 consequences of maternal renal diseases? - answerMay Cause IUGR
Preterm Delivery
and Perinatal Loss
What is Pre Eclampsia? - answerA pregnancy complication with Hypertension and
increased protein in the urine
Early onset (prior to 32wks) is associated with increased mortality and morbidity
Give 3 Neonatal complications of Pre Eclampsia? - answer1. Increased risk of placenta
abruption
2. Poor Growth
3. Prémature birth
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