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ATI Maternal Newborn Proctored Study Guide Latest update 2021(100% Tool for success)

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Ch. 12 Pain management • Effleurage: light gentle circular stroking of the clients abdomen with fingertips in rhythm with breathing during contractions (cutaneous stimulation) • Resp. depression, decreased FHR, hypote ...

Ch. 12 Pain management • Effleurage: light gentle circular stroking of the clients abdomen with fingertips in rhythm with breathing during contractions (cutaneous stimulation) • Resp. depression, decreased FHR, hypotension, sedation with opioid or sedative • Epidural: lack of sensations from umbilicus to thighs; dilated to 4cm or aboce; AE: hypotension fetal bradycardia, (IV bolus to counteract) avoid supine hypotension **do not lay on back Ch. 13 Fetal Assessment During Labor • 110-160 BPM; want moderate variability (NO LATE DECELERATIONS) **early ones are ok • Fetal bradycardia (due to epidural) disco oxytocin, place on side, provide oxygen • Fetal tachycardia (over 160) maternal infection (antipyretic and oxygen) • Late declaration (uteral placental insufficiency): side lying position, increase fluid, admin oxygen, disco oxytocin • Variable decelerations (umbilical cord compression): reposition clients side to side, knee chest position Ch. 16 Complications related to labor process • Prolapsed umbilical cord: displaced preceding the presenting part of the fetus or through the cervix o Use a sterile-gloved hand, insert two fingers into the vagina and apply finger pressure on either side of the cord to the fetal presenting part to elevate it off the cord o Reposition in a knee-chest, Trendelenburg or a side lying position with a rolled towel under the clients right or left hip to relive the cord o Apply warm sterile saline soaked towel to the visible cord Ch.17 Postpartum physiological adaptions • RhoGaM admin 72 hours after giving birth who are RH neg and baby is RH positive to prevent issues with next pregnancy • Fundus o 3rd stage of labor: palpable at midline and 2cm below to halfway b/w umbilicus and symphysis pubis o 12 hr postpartum: 1 cm above umbilicus o Every 24 hours after should descend 1-2 cm o 6 post partum halfway o By 10 day you shouldn’t be able to palpate • Lochia: discharge after birth o Rubra bright red color, some clot (1-3 days) o Serosa pinkish brown color (4-10 days) o Alba yellowish white creamy discharge with flush order (4-8 weeks) • Ice packs at perineum for first 24 to 48 hr, sitz baths at 100-104 degrees at least 2x a day • Milk 2-3 days after birth (before that is the colostrum)

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