Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

• Do you agree with your peers’ assessment?
• Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.

Please be sure to validate your opinions and ideas with in text-citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. Be respectful and thoughtful.This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Minimum of 100 words.

Charli”response

1. Access a nationally recognized professional practice resource such as AAP, AAFP, AWHONN, March of Dimes, CDC, etc. Review guidelines for prenatal testing, prenatal assessments, or maternal fetal outcomes related to prenatal care. What information did you find that influenced your awareness of prenatal testing and prenatal care? What information will you utilize when you provide care for a woman who is pregnant or planning a pregnancy?

Preconception care and prenatal care builds a solid foundation that will set the plan for the pregnancy. There are numerous testing and educational opportunities during this process that may or may not occur during this phase. According to the American Academy of Family Physicians (AAFP) (2016), preconception care is not always able to be addressed as most pregnancies are unintended. Guidelines to manage preconception or prenatal care include managing chronic disease such as HTN, diabetes, and psychiatric disorders, genetic testing and family testing, obstetrics history, maternal and prenatal health, folic acid supplements, STI history, social history, and BMI (AAFP, 2016).

During preconception care, carrier screening or genetic testing should be offered to every woman. This testing is done on any individual that does not have any overt phenotype for a specific genetic disorder, but possibly has one variant allele within a gene(s) that is related to a diagnosis (Rink, Romero, Biggio, Saller, & Giardine, 2019). This is still offered to pregnant women, but it is ideal to be offered in the preconception stage to determine if the parents should reconsider producing or not. It also opens doors for parents to know what to expect and how this pregnancy will go. If any conditions or diagnoses are made, counseling for the parents can then be provided to further guide decisions related to conception or pregnancy (Rink et al., 2019).

One important statement that I read is that genetic testing that is positive only tells you that there is a higher risk for that child to have that condition occur. There needs to be further testing to verify if the genetic testing is leading to something or if that fetus is in fact, not at risk (ACOG, 2019). Not all women want to have genetic testing done or have further testing that is invasive if something abnormal is found. Women should be educated and informed before they make a decision. Some women will decline many of these testing options or only want noninvasive options. Ultimately, the decision is up to the expectant mother and their wishes should be respected.

References

AAFP releases position paper on preconception care. (2016). AAFP. Retrieved from https://www.aafp.org/afp/2016/0915/p508.html

Rink, B., Romero, S., Biggio, J., Saller, D., & Giardine, R. (2019). Carrier screening for genetic conditions. The American College of Obstetricians and Gynecologists. Retrieved from https://www.acog.org/-/media/Committee-Opinions/Co…

Prenatal genetic screening tests. (2017). ACOG. Retrieved from (Links to an external site.)Links to an external site.https://www.acog.org/Patients/FAQs/Prenatal-geneti…

Tracies Response’

1. Review the essential elements of a fetal assessment during the last trimester of pregnancy. What are the clinical indicators of fetal well being (normal findings) and what steps would you take if findings are not reassuring?

During the last trimester, women go to weekly obgyn visits. During this time, the doctor is getting the women prepared for childbirth and checking to see how close she may be to labor. During this trimester, the doctor will check the baby’s position in the uterus and estimate the baby’s weight. An ultrasound may be done to confirm the baby’s position and to determine the amount of amniotic fluid around the baby (American College of Obstetricians and Gynecologists, 2017). The mother is also screened for group B streptococcus at this time. This is an intestinal and lower genital tract bacteria that can harm the baby during delivery (American College of Obstetricians and Gynecologists, 2017). Babies who become infected can become very ill. As the body prepares itself for birth, the doctor can do a pelvic exam to detect cervical changes and softening. The cervix will start to dilate, open, and thin. If any of these tests are abnormal, the patient should come more often during her last trimester to be checked. If the baby is malpositioned in the uterus, this will need be monitored closely to prevent complications such as nuchal cord. If the baby is found to be excessively large, special preparations may need to be made to accommodate the large baby, such as a possible C-section. When the baby has macrosomia, a vaginal birth poses risks for birth injuries such as shoulder injuries (Wilson, 2018).

References

American College of Obstetricians and Gynecologists. (2017, September). Group B Strep and Pregnancy. Retrieved from https://www.acog.org/Patients/FAQs/Group-B-Strep-a…

Wilson, D. (2018). What Might Go Wrong in the Third Trimester? Healthline. Retrieved from https://www.healthline.com/health/pregnancy/third-…