RNC NIC EXAM COMPREHENSIVE STUDY
GUIDE
◉ thrombocytopenia (maternal).
Answer: - a generally benign maternal medical complication that is
due to hemodilution (increased RBCs)
- may be associated with hypertensive conditions r/t pregnancy
- may be associated with s/s of bleeding in the infant
◉ risks of maternal thrombocytopenia.
Answer: can result in:
- increased risk of bleeding in the mother, especially during the
delivery
- **bleeding in the infant (oozing from umbilical cord, prolonged
bleeding from heel sticks, bruising, **petechiae
◉ neonatal petechiae.
Answer: - must consider hyperbilirubinemia/jaundice (breakdown
of RBCs)
- also associated with maternal thrombocytopenia
◉ cytomegalovirus (CMV).
,Answer: - **most common intrauterine infection**
- transmitted by exposure to infected blood or body fluids
- majority of infants asymptomatic at birth, but 5-15% have later
sequelae (most commonly hearing and vision loss)
◉ contraindication for breastfeeding.
Answer: - maternal HIV/AIDS infection
- **HIV/AIDS can be spread through breastfeeding**
◉ signs of HIV in newborn.
Answer: - poor weight gain
- **repeated fungal mouth infections** (thrush)
- enlarged lymph nodes
- enlarged liver/spleen
- neurologic problems
- multiple bacterial infections, including pneumonia
◉ chlamydia.
Answer: - **most common bacterial sexually transmitted infection**
- *treatment: erythromycin*
◉ signs/symptoms of neonatal chlamydia.
,Answer: - conjunctivitis in first few weeks
- late-onset: pneumonia at 3-4 months
- otitis media
- gastroenteritis
◉ oligohydramnios.
Answer: - AF volume <1 L at 36 weeks, <800 mL at term
- can lead to pulmonary hypoplasia d/t amniotic fluid's role in fetal
pulmonary development
- **may be related to Potter sequence/renal agenesis** because AF
is largely made up of fetal urine (no urine if the baby has no kidneys)
- **can lead to hypoplastic lungs**
- can also lead to IUGR and positional deformities (baby can't move
well)
◉ Potter sequence (renal agenesis).
Answer: - **Renal agenesis -> oligohydramnios -> severe pulmonary
hypoplasia**
- association of defects beginning w/ bilateral renal agenesis d/t
failure of the ureteric bud to divide
- urine formation does not occur --> low or absent amniotic fluid
volumes
- fetal structures are compressed
, - associated defects: abnormal genital dev., leg deformities, GI
defects, arthrohyposis, pulmonary hypoplasia
- *most infants will die within the first several days; often d/t
associated lung hypoplasia*
◉ hydramnios or polyhydramnios.
Answer: - AF volume >2L
- **may be due to GI obstructions (e.g. esophageal atresia, duodenal
to anal atresia) d/t the baby being unable to swallow amniotic fluid,
so the AF keeps building up in utero **
- also can be d/t tight nuchal cord or neurologic defects which may
also obstruct or impair fetal swallowing
◉ PROM.
Answer: - premature rupture of membranes, before the onset of
labor
- **risk of infection if directly proportional to the duration of ROM**
- **after 24 hours of ROM, the risk of infection escalates
significantly**
◉ PPROM.
Answer: - preterm premature rupture of membranes, PROM
occurring before 37 weeks
GUIDE
◉ thrombocytopenia (maternal).
Answer: - a generally benign maternal medical complication that is
due to hemodilution (increased RBCs)
- may be associated with hypertensive conditions r/t pregnancy
- may be associated with s/s of bleeding in the infant
◉ risks of maternal thrombocytopenia.
Answer: can result in:
- increased risk of bleeding in the mother, especially during the
delivery
- **bleeding in the infant (oozing from umbilical cord, prolonged
bleeding from heel sticks, bruising, **petechiae
◉ neonatal petechiae.
Answer: - must consider hyperbilirubinemia/jaundice (breakdown
of RBCs)
- also associated with maternal thrombocytopenia
◉ cytomegalovirus (CMV).
,Answer: - **most common intrauterine infection**
- transmitted by exposure to infected blood or body fluids
- majority of infants asymptomatic at birth, but 5-15% have later
sequelae (most commonly hearing and vision loss)
◉ contraindication for breastfeeding.
Answer: - maternal HIV/AIDS infection
- **HIV/AIDS can be spread through breastfeeding**
◉ signs of HIV in newborn.
Answer: - poor weight gain
- **repeated fungal mouth infections** (thrush)
- enlarged lymph nodes
- enlarged liver/spleen
- neurologic problems
- multiple bacterial infections, including pneumonia
◉ chlamydia.
Answer: - **most common bacterial sexually transmitted infection**
- *treatment: erythromycin*
◉ signs/symptoms of neonatal chlamydia.
,Answer: - conjunctivitis in first few weeks
- late-onset: pneumonia at 3-4 months
- otitis media
- gastroenteritis
◉ oligohydramnios.
Answer: - AF volume <1 L at 36 weeks, <800 mL at term
- can lead to pulmonary hypoplasia d/t amniotic fluid's role in fetal
pulmonary development
- **may be related to Potter sequence/renal agenesis** because AF
is largely made up of fetal urine (no urine if the baby has no kidneys)
- **can lead to hypoplastic lungs**
- can also lead to IUGR and positional deformities (baby can't move
well)
◉ Potter sequence (renal agenesis).
Answer: - **Renal agenesis -> oligohydramnios -> severe pulmonary
hypoplasia**
- association of defects beginning w/ bilateral renal agenesis d/t
failure of the ureteric bud to divide
- urine formation does not occur --> low or absent amniotic fluid
volumes
- fetal structures are compressed
, - associated defects: abnormal genital dev., leg deformities, GI
defects, arthrohyposis, pulmonary hypoplasia
- *most infants will die within the first several days; often d/t
associated lung hypoplasia*
◉ hydramnios or polyhydramnios.
Answer: - AF volume >2L
- **may be due to GI obstructions (e.g. esophageal atresia, duodenal
to anal atresia) d/t the baby being unable to swallow amniotic fluid,
so the AF keeps building up in utero **
- also can be d/t tight nuchal cord or neurologic defects which may
also obstruct or impair fetal swallowing
◉ PROM.
Answer: - premature rupture of membranes, before the onset of
labor
- **risk of infection if directly proportional to the duration of ROM**
- **after 24 hours of ROM, the risk of infection escalates
significantly**
◉ PPROM.
Answer: - preterm premature rupture of membranes, PROM
occurring before 37 weeks
