NSPN 7200 Final EXAM QUESTIONS
AND WELL VERIFIED ANSWERS
Cultural safety - ANSWER>>: the effective care by someone who has undertaken a
process of reflection on their own cultural identity
○ ensuring that all patients are treated equitably by recognizing power structures
and how our attitudes and beliefs influence our relationships and the care we
provide
Trauma-informed care: - ANSWER>>acknowledge the impact of trauma on health
and health care interactions and to establish safe and trustworthy relationships
and environments that reduce the risk of re-traumatization
Trauma informed care 4 principles - ANSWER>>1. Trauma awareness: awareness
of the commonness of trauma
2. Emphasis on safety and trustworthiness: Trauma survivors often feel unsafe -->
create safety and trustworthiness. Ask before you touch
3. Choice, collaboration, and connection: maintaining a person's dignity by giving
choice. Getting Consent: discussion of risks and benefits, alternatives, and time to
ask questions.
4. Strength-based and skill-building: build off of resiliency.
The 5 Ps of Labour (how they effect GD/PTL) - ANSWER>>Passenger
Passage
Powers
Position
Psyche
Preterm labour - ANSWER>>cervical changes and uterine contractions occurring
between 20 and 37 weeks of pregnancy
,PLT S+S - ANSWER>>● frequent menstrual-like cramps
● suprapubic pain or pressure
● pelvic pressure or heaviness
● change in colour or character or amount of vaginal discharge
urinary frequency
● constant, dull low back pain
● uterine contractions
● mild lower adbo pain cramping w/wo diarrhea
ruptured membranes
Tests to confirm ROM: - ANSWER>>nitrazine, ferning, assess pad
Risk factors for Spontaneous PTL - ANSWER>>Infection
GI organisms present in their amniotic fluid, placenta, and membranes,
periodontal disease,
congenital structural abnormalities of the uterus,
implantation of the placenta ,
unexplained 1st trimester bleeding,
high levels of stress
Risk factors for indicated PTL - ANSWER>>GD
HTN/preclampsia
placental disorders
seizures
obesity
AMA
fetal disorders
oligo/poly
TTTS
Threshold of viability?
Factors that influence survival and long-term outcomes? - ANSWER>>22-25wks.
,gestational age, estimated fetal weight, receipt of antenatal corticosteroids,
singleton versus multiple pregnancy, fetal status, and place of birth
Indications for fetal fibronectin testing include: - ANSWER>>● threatened PTL
between 24 and 34 weeks gestation
● intact amniotic membranes
● cervix less than 3 cm dilated
● established fetal well-being
fetal fibronectine Contraindications include: - ANSWER>>ROM, active vaginal
bleeding, vaginal exam or vaginal intercourse in the past 24 hours
what are you looking for when you Palpate contractions - ANSWER>>frequency,
duration, intensity and resting tone
positive result FFN
Neg result FFN - ANSWER>>POSITIVE: 33% chance pt will deliver in next 2 weeks
IF NEGATIVE: has a strong negative predictive value 99% chance pt will NOT
deliver in next 2 weeks
Medications + uses in PTL: - ANSWER>>o
Tocolytics: medications used to slow down or suppress uterine activity.
(Indomethacin or Nifedipine)
Magnesium Sulphate : neuroprotective agent for imminent preterm birth ( <34)
Corticosteroids: (Betamethasone) are used to accelerate fetal lung maturity by
stimulating fetal surfactant.
Abx: for gbs + or infection / Prolonged ROM
Differences seen in Preterm Baby
, - HR , EFM, cord? - ANSWER>>has higher HR bc The sympathetic nervous system,
matures before the parasympathetic system
decreased HR variability
More cord compression: bc less Wharton's jelly protecting the umbilical cord
Preterm baby Potential health consequences : - ANSWER>>● asphyxia
● ineffective thermoregulation
● feeding problems
● respiratory distress
infection
● hyperbili
● metabolic disturbances
fluid and electrolyte imbalance neurologic and behavioral problems
● nutritional deficits
● chronic respiratory disease
● cardiovascular disturbances
hematological disturbances
Preterm infant Physiologic functions: PWSOAC
Think Challenge and response: - ANSWER>>Pink, Warm, Sweet, Organized,
Attached, Clean
ANSWER on back of PTL notes
how is Preterm Breastmilk different - ANSWER>>different from the milk a mom
produces for a term infant. Preterm breast milk has increased protein content,
lipid content that is more specific for a preterm infant, and higher IgA
concentration. The predominant whey protein of preterm breast milk has many
anti-infective properties and the lactose has increased absorption in preterm
infants
Benefits of BF a preterm bb: - ANSWER>>● protection from infection
AND WELL VERIFIED ANSWERS
Cultural safety - ANSWER>>: the effective care by someone who has undertaken a
process of reflection on their own cultural identity
○ ensuring that all patients are treated equitably by recognizing power structures
and how our attitudes and beliefs influence our relationships and the care we
provide
Trauma-informed care: - ANSWER>>acknowledge the impact of trauma on health
and health care interactions and to establish safe and trustworthy relationships
and environments that reduce the risk of re-traumatization
Trauma informed care 4 principles - ANSWER>>1. Trauma awareness: awareness
of the commonness of trauma
2. Emphasis on safety and trustworthiness: Trauma survivors often feel unsafe -->
create safety and trustworthiness. Ask before you touch
3. Choice, collaboration, and connection: maintaining a person's dignity by giving
choice. Getting Consent: discussion of risks and benefits, alternatives, and time to
ask questions.
4. Strength-based and skill-building: build off of resiliency.
The 5 Ps of Labour (how they effect GD/PTL) - ANSWER>>Passenger
Passage
Powers
Position
Psyche
Preterm labour - ANSWER>>cervical changes and uterine contractions occurring
between 20 and 37 weeks of pregnancy
,PLT S+S - ANSWER>>● frequent menstrual-like cramps
● suprapubic pain or pressure
● pelvic pressure or heaviness
● change in colour or character or amount of vaginal discharge
urinary frequency
● constant, dull low back pain
● uterine contractions
● mild lower adbo pain cramping w/wo diarrhea
ruptured membranes
Tests to confirm ROM: - ANSWER>>nitrazine, ferning, assess pad
Risk factors for Spontaneous PTL - ANSWER>>Infection
GI organisms present in their amniotic fluid, placenta, and membranes,
periodontal disease,
congenital structural abnormalities of the uterus,
implantation of the placenta ,
unexplained 1st trimester bleeding,
high levels of stress
Risk factors for indicated PTL - ANSWER>>GD
HTN/preclampsia
placental disorders
seizures
obesity
AMA
fetal disorders
oligo/poly
TTTS
Threshold of viability?
Factors that influence survival and long-term outcomes? - ANSWER>>22-25wks.
,gestational age, estimated fetal weight, receipt of antenatal corticosteroids,
singleton versus multiple pregnancy, fetal status, and place of birth
Indications for fetal fibronectin testing include: - ANSWER>>● threatened PTL
between 24 and 34 weeks gestation
● intact amniotic membranes
● cervix less than 3 cm dilated
● established fetal well-being
fetal fibronectine Contraindications include: - ANSWER>>ROM, active vaginal
bleeding, vaginal exam or vaginal intercourse in the past 24 hours
what are you looking for when you Palpate contractions - ANSWER>>frequency,
duration, intensity and resting tone
positive result FFN
Neg result FFN - ANSWER>>POSITIVE: 33% chance pt will deliver in next 2 weeks
IF NEGATIVE: has a strong negative predictive value 99% chance pt will NOT
deliver in next 2 weeks
Medications + uses in PTL: - ANSWER>>o
Tocolytics: medications used to slow down or suppress uterine activity.
(Indomethacin or Nifedipine)
Magnesium Sulphate : neuroprotective agent for imminent preterm birth ( <34)
Corticosteroids: (Betamethasone) are used to accelerate fetal lung maturity by
stimulating fetal surfactant.
Abx: for gbs + or infection / Prolonged ROM
Differences seen in Preterm Baby
, - HR , EFM, cord? - ANSWER>>has higher HR bc The sympathetic nervous system,
matures before the parasympathetic system
decreased HR variability
More cord compression: bc less Wharton's jelly protecting the umbilical cord
Preterm baby Potential health consequences : - ANSWER>>● asphyxia
● ineffective thermoregulation
● feeding problems
● respiratory distress
infection
● hyperbili
● metabolic disturbances
fluid and electrolyte imbalance neurologic and behavioral problems
● nutritional deficits
● chronic respiratory disease
● cardiovascular disturbances
hematological disturbances
Preterm infant Physiologic functions: PWSOAC
Think Challenge and response: - ANSWER>>Pink, Warm, Sweet, Organized,
Attached, Clean
ANSWER on back of PTL notes
how is Preterm Breastmilk different - ANSWER>>different from the milk a mom
produces for a term infant. Preterm breast milk has increased protein content,
lipid content that is more specific for a preterm infant, and higher IgA
concentration. The predominant whey protein of preterm breast milk has many
anti-infective properties and the lactose has increased absorption in preterm
infants
Benefits of BF a preterm bb: - ANSWER>>● protection from infection
