The investigation included in the routine antenatal assessment includes all of the following EXCEPT?

Appeared in: UPUMS Nsg officer-2023

Explanation

Blood urea and creatinine are tests for renal (kidney) function.
These tests are not performed routinely on every pregnant woman as part of the standard antenatal screening.
They are indicated only for high-risk pregnancies, such as those complicated by hypertension, pre-eclampsia, or known kidney problems.
The goal of routine screening is to test for common, widespread conditions, whereas renal function tests are more specific diagnostic tools.

Option A: Haemoglobin estimation is a fundamental and mandatory part of routine antenatal care.
Option B: Random Blood Sugar (RBS) or other forms of glucose testing are standard procedures to screen for Gestational Diabetes Mellitus (GDM).
Option C: HIV screening is recommended universally for all pregnant women as part of routine antenatal care.

Clinical Relevance

Nursing practice connection: Use the key finding related to Routine Antenatal Investigations to guide bedside assessment, documentation, and the next nursing action.
Distinguishing between routine and indicated tests is crucial for cost-effective and patient-centered care. Ordering unnecessary tests can cause undue anxiety and financial burden.
A nurse's role includes identifying risk factors from the patient's history (like a history of hypertension) that would warrant special investigations beyond the routine panel.
Patient education is key. Nurses must explain the purpose of each routine test and why certain other tests may or may not be necessary for their specific pregnancy.

How to Approach the Question

First, identify the keyword 'EXCEPT' in the question. This means you are looking for the option that does not belong with the others.
The question asks about 'routine' antenatal assessments. This implies tests that are done for every pregnant woman, regardless of her specific risk factors.
Review each option and ask: 'Is this test a standard part of care for all pregnancies?'
Haemoglobin (for anaemia), RBS (for gestational diabetes), and HIV (for infection) are well-known universal screening tests in pregnancy.
Consider 'Blood urea, creatinine'. These are kidney function tests. Think about when these would be ordered. They are typically for patients with specific problems like high blood pressure or known kidney disease, not for everyone.
Therefore, the kidney function tests are the exception to the 'routine' list.

Concept Tested & Keywords

Concept Tested: Routine Antenatal Investigations
Stem keywords: antenatal assessment, investigation, routine
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks to identify the investigation that is NOT part of the routine antenatal assessment.

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 20-22

E6 Medicine Macleod Clinical Examination 15e p. 261-263

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 18-26

Practise the full UPUMS Nsg officer-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.