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Running Head: PRENATAL CARE The Clinical Issue and Research Questions Developed Using PICOT

Prenatal Care – Background, Significance in Nursing, and PICOT questions West Coast University – Ontario Professor Dr. Shiva Metghalchi June 27, 2020

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Prenatal Care: The Clinical Issue and Research Questions Developed Using PICOT Background Prenatal is a term refers to the entire period when a woman is pregnant, including antepartum and intrapartum periods; prenatal care or antepartum care is defined as the health care associating to pregnancy that a woman receives during the gestation and before the onset of labor (Durham & Chapman, 2019). According to the Centers for Disease Control and Prevention, approximately 210 million women become pregnant and 130 million births take place each year, however, approximately 10 million women experience related pregnancy complications every year and 800 women die from complications every day (Rosenberg, 2002). The death rate is highly related to lack or no prenatal care during women’s pregnancy period. Many of these lifethreatening complications are preventable if detected and managed early through prenatal care. Without prenatal care, the risk for neonatal death increases to 40% for wellbeing women, and up to 80% for pregnant women that are in high-risk categories such as advanced maternal age over 35, hypertension, diabetes, smokers, alcoholics, illicit drug users, ectopic pregnancy, and Rhnegative blood (Finnegan & Sheffield, 2004). Infection, genetic disorders, abortion, hemorrhage, miscarriages, and obstructed labor complications can be reduced if treatments are made during prenatal and intrapartum visits; the infectious disease that can affect fetus overall conditions including HIV, pneumonia, herpesvirus, rubella, and tuberculosis, which are preventable if proper actions are taken (Finnegan & Sheffield, 2004). Obstetric visit during prenatal care benefit both maternal and fetal wellbeing as early detection of diseases and infections can facilitate the medical professions to prompt appropriate interventions; additionally, provides counseling and answers inquiries such as diet, exercise, birth plans, and breastfeeding, for potential mothers to prepare for labor and postpartum periods.

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Prenatal Care: The Clinical Issue and Research Questions Developed Using PICOT Significance in Nursing Prenatal visits to a health care physician often include a well-women physical exam, weight checks, and providing a urine sample to check for glucose and protein levels; the initial visit will have provider to confirm pregnancy and estimated due date for the birth (Durham & Chapman, 2019). Furthermore, depending on maternal conditions, certain blood tests, and screening, such as ultrasonography and Alpha-fetoprotein AFP, will be ordered to check maternal and fetus’s health. Prenatal care in nursing involves patient assessments, health promotions, and education for expectant mothers. Patient assessments are essential to obtain a patient’s medical and nursing history that might interfere with the current pregnancy and to determine the patient’s current knowledge or readiness for childbirth. Nurses’ roles in prenatal care often include promoting a safe outcome to pregnancy, assisting the mothers in self-care of the discomforts during pregnancy, establishing a trusting relationship, and fostering positive feelings by the pregnant woman and her family involving the childbearing experience (ICNP, 2017). Discomforts are common during pregnancy and it is the nurse’s responsibility to recognize abnormal signs and symptoms to report to the physician immediately for further investigation. Failure in completing nursing prenatal care will highly increase the risk related to maternal and/or neonatal complications and mortality. PICOT Questions 1. In pregnant women who are 25 years old or older, how does early prenatal care as compared to late/no prenatal care increases the chances for the successful delivery of the fetus in 10 months?

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Prenatal Care: The Clinical Issue and Research Questions Developed Using PICOT 2. In pregnant women who are 25 years old or older, how does following prenatal recommended diets as compare to taking marketed prenatal vitamins decreases the chances for neonatal neural tube defect in the antepartum period? 3. In pregnant women who are 25 years old or older, how does prenatal suggested daily exercise/activity as compare to a sedentary lifestyle reduce pregnancy complications in the antepartum period?

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Prenatal Care: The Clinical Issue and Research Questions Developed Using PICOT References Durham, R. and Chapman, L. (2019). Maternal-Newborn Nursing: The Critical Components of Nursing Care. 3rd edition. F.A. Davis: Philadelphia. Finnegan, L. and Sheffield, J. (2004). Infectious Disease and Maternal Morbidity and Mortality. Emerging Infectious Diseases. Retrieved from: https://wwwnc.cdc.gov/eid/article/10/11/04-0624_05_article#suggestedcitation ICNP, International Council of Nurses. (2017). Prenatal Nursing Care. Retrieved from: https://www.icn.ch/sites/default/files/inlinefiles/ICNP_Catalogue_Prenatal_Nursing_Care.pdf Rosenberg, J. (2002). Neonatal Death Risk: Effect of Prenatal Care Is Most Evident After Term Birth. Perspectives on Sexual and Reproductive Health. Retrieved from: https://www.guttmacher.org/journals/psrh/2002/09/neonatal-death-risk-effect-prenatalcare-most-evident-after-term-birth...