Nursing Midwifery and Babies: Comprehensive Healthcare Assignment

This assignment addresses key concepts in nursing, midwifery, and newborn care. It begins with definitions of terms such as Gravida and Para, and then explores prenatal care, including glucose tolerance tests and fundal height measurements. The assignment defines spontaneous labor and describes the stages of labor. It also covers complications such as meconium stained liquor and shoulder dystocia, and the Apgar score assessment. Finally, it examines antenatal and postnatal care, including blood glucose level control, medication management, and psychological support for mothers. The assignment references several studies and provides a comprehensive overview of the topics.

Running Head: Nursing Midwifery and Babies 1
Nursing midwifery and babies
Name
Institution
1. Karen has Gravida 2 and Para 1. Gravida 2 means that she had 2 pregnancies regardless of
whether they were interrupted or relented to a live birth, Para one means she has ever had one
pregnancy which reached viability i.e. above 20 weeks’ gestation.

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2. Prenatal glucose tolerance tests helps to diagnose gestational diabetes in order to provide early
treatment and prenatal care of gestational diabetic mothers (Sosa, Kennell, Klaus, Robertson &
Urrutia, 2008). This is done to ensure normal baby and good maternal health after the pregnancy.
Normal rages are 7.8mmol/l or less but not excess after drinking the glucose solution. Glucose
test after fasting should be 5.3mmol/l one hour after taking sugar solution less than
10.0mmol/l ,2 hours after glucose solution less than 8.6mmol/l and 3hours after glucose solution
less than 7.8mmol/l.
3.Fundal height during pregnancy is used to measure the size of the uterus. This is done to be
able to asses fetal growth sand and development during pregnancy (Barclay et al., 2009). This
measurement should correspond to gestational age in weeks between 16 and 36 weeks for a
vertex fetus. Fundal height is also used in determining descend of the fetus especially from 36
weeks.
4.Spontaneous labour is the labour that begins and progresses without pharmacological,
mechanical or operative interventions, leading to delivery of a normal baby without
complications to the mother.
5. The first stage of labour is usually the longest (Salariya, 2010). It could even last for more
than 20 hours. to some women who are prim gravida but short hours to some women, cervix
starts to soften and open up or dilate with regular rhythmic contractions, preparing to push the
baby via the birth canal.
6. The meconium stained liqar can lead to infant respiratory distress and syndrome (Renfrew et
al., 2014). This is a respiratory distress which occurs within 4 hours of birth. It becomes worse in
48 to 72 hours. If not fat, it resolves within 72hours. Meconium stained liqar also leads to

Nursing Midwifery and Babies 3
persistence pulmonary hypertension of the new born. This occurs where the fetal circulation
resists, with blood being shunted away from the lungs through the foramen ovale and the patent
ductus arteriosus. Meconium stained liqar also leads to chronic lung disease. This is as a result of
intense pulmonary intervention. These infants with meconium aspiration have a slightly
increased incidence of infection in the first year of life. This is because lungs are still in
recovery.
7. Shoulder dystocia is a case of obstructed labour which occurs after delivery of the head. the
anterior shoulder of the infant cannot pass below, hence requiring significant manipulation to
pass (McCormick, 2014). The pubis symphysis, diagnosed when shoulders delays to deliver after
the fetal head is delivered, is grouped in obstetric emergency case and death of the fetus can
occur if not delivered and compresses on umbilical cord.
8. Apgar score is a standardized way of evaluation, assessing and recording the condition of a
new born baby. It is done within one to five minutes after birth. Apgar score is done by a
multiple of doctors or midwife. The vital signs assessed includes; skin colour which should be
pink or according to the tribe. If the colour is blue the baby scores zero. If the skin is pink and
extremities are blue, the baby scores one.
Pulse / heartbeat is evaluated using a stethoscope. if there is no heart pulse or heartbeat, the baby
scores are zero. If the heart rate is less than a hundred beats per minute the baby score one
(Salariya et al., 2011). If heart rate is greater than a hundred, the baby scores two. If there is
grimacing the score is one, and if there is grimacing and cough, sneeze or vigorous cry, the score

Nursing Midwifery and Babies 4
is two for reflex irritability. Activity or muscle tone activity are loose and flappy, the baby scores
zero. If there is muscle tone the score is one. If there is active motion the infant scores two.
Respiratory effort. If the baby is not breathing he or she scores zero. Respiratory rate slow or
irregular the baby scores one (Leahy‐Warren et al., 2012). If he or she cries well, the score is
two. Classification according to total scores, if Apgar is between 7-10, the baby is said to be
normal. If Apgar is 4-6, the baby is moderate asphyxia and Apgar 0-3 is severe asphyxia and it
requires resuscitation.
9. Antenatal care aims at monitoring the health of both mother and baby (Leahy Warren, 2010).
This is achieved through monitoring blood glucose level, which is done by advising the mother
to test through fasting, premeal, post meal and also bedtime levels of glucose. This is done daily
during pregnancy in order to develop a baseline on how to control the sugars. If the mother is on
multiple daily injection regimen to test the glucose level through developing targets for self-
monitoring. This also helps in taking risks of hypoglycemia.
Antenatal care is also achieved through monitoring HbA1c which is hemoglobin A1c (Kirkham,
2010). it is used to test the amount of glucose in blood over a period of one month to pregnant
mothers. It determines the level of risk of the pregnancy. It is mostly considered during second
and third trimester of pregnancy. prevents insulin treatment risks to hypoglycemia by using
short acting analogous, which have advantage over soluble human insulin. Mothers are also
advised to keep fast acting form of glucose like juices. They are also taught on signs and
symptoms of hypoglycemia for early interventions.
Antenatal care also involves monitoring of well-being of the fetus before 38 weeks. It is also
done especially when there is risk of fetal growth restrictions.

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Postnatal care included blood glucose level control, medicines and breastfeeding. insulin should
be reduced immediately after birth and monitor glucose levels accurately to adjust the dose. The
mother should be informed that she is at a risk of hypoglycemia (McInnes & Chambers, 2008).
The should therefore take meals or snacks with every breastfeeding. She is also advised to
discontinue blood glucose lowering therapy after birth. Mothers should also avoid any medicine
for treatment of diabetes complications which were discontinued for safety reasons in the
preconception period.
Giving psychological care concerning diabetes, which may resolve after delivery. Some
medications should also be stopped immediately after birth. Mother is also informed that she is
at risk of developing gestational diabetes with other pregnancies.

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References
Barclay, L., Everitt, L., Rogan, F., Schmied, V., & Wyllie, A. (2009). Becoming a mother
—an analysis of women's experience of early motherhood. Journal of advanced nursing, 25(4),
719-728.
Kirkham, M. (Ed.). (2010). The midwife-mother relationship. Palgrave Macmillan.
Leahy Warren, P. (2010). First‐time mothers: Social support and confidence in infant
care. Journal of advanced nursing, 50(5), 479-488.
Leahy‐Warren, P., McCarthy, G., & Corcoran, P. (2012). First‐time mothers: social
support, maternal parental self‐efficacy and postnatal depression. Journal of clinical
nursing, 21(3‐4), 388-397.
McInnes, R. J., & Chambers, J. A. (2008). Supporting breastfeeding mothers: qualitative
synthesis. Journal of advanced nursing, 62(4), 407-427.
Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N.
F., ... & McCormick, F. (2014). Midwifery and quality care: findings from a new evidence-
informed framework for maternal and newborn care. The Lancet, 384(9948), 1129-1145.
Salariya, E. M., Easton, P. M., & Cater, J. I. (2011). Duration of breast-feeding after early
initiation and frequent feeding. The Lancet, 312(8100), 1141-1143.
Sosa, R., Kennell, J., Klaus, M., Robertson, S., & Urrutia, J. (2008). The effect of a
supportive companion on perinatal problems, length of labor, and mother-infant interaction. New
England Journal of Medicine, 303(11), 597-600.