NURS 551 ATI Maternal Newborn Proctored Study Guide( Complete Solution Rated A)

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ATI Maternal Newborn Proctored Study Guide Ch.1 Oral Contraceptives • Chest pain, SOB, leg pain (clot), headache, eye problems • Can cause blood clots • Hypertension • Do not use with s ... mokers • Hx of blood clots, stroke, cardiac, breast or estrogen • Depro-provera calcium and vitamin D • IUD= increased risk of pelvic inflammatory disease, ectopic pregnancy o Change in string length, foul smell, fever/chills, pain with intercourse  notify provider Ch.2 Infertility • Inability for at least 12 months • Male first (sperm analysis), then the woman (no hx of dye for test or seafood) Ch.3 • Presumptive sign: things that can be explained by other means o Nausea, amenorrhea, N/V, Fatigue • Probable signs o Abdominal enlargements, Hagar sign, chad wicks sign, goodwill sign, ballottement, Braxton hick contractions, positive pregnancy test, fetal outline • Positive sign o FHR • Nagele’s rule: add 9 months and a week • GTPAl: Gravidity (# of times of pregnancy), Term births (38 weeks or more), Preterm births, Abortions/miscarriages, Living children Ch. 5 Nutrition During Pregnancy • Normal: 25-30 pounds • Overweight: 15-25 pounds • Underweight: 28-40 pounds • First trimester: no more than 2-4 pounds for entire trimesters.. then 1 lb/week • 340 calories/day for second trimester…450 for third trimester (even during breastfeeding) • Folic acid (dark leafy green veggies)  fetal neuro tube defects • 2-3 L of water, limit amount of caffeine Ch.6 Assessment of Fetal Well being • Ultrasound  want bladder full **non-invasive** • When poking stomach  empty bladder (amniocenteses) • Biophysical profile: 0-10 score, 8-10 is normal o Reactive HR (0-2) o Breathing o Body movement o Fetal tone o Amniotic fluid volume • Nonstress test: measures fetal well-being in last trimester, response to FHR to fetal movement; reactive if FHR accelerates; non reactive if no FHR acceleration o YOU WANT REACTIVE • Contraction stress test o Want a contraction to occur  ocycotcin, nipple stimulation; monitor FHR to see if decelerations occur o You want late decelerations • Amniocentesis o You want an empty bladder o AT 14 WEEKS o Levels of AFP (high  nuero tube defects; low down syndrome) o L/S ratio: 2:1 ratio is fetal lung maturity (2:5:1 or 3:1 for a client who has diabetes mellitus) o Complications: amniotic fluid emboli, hemorrhage, infection • Chorionic callus sampling o Taking a piece of placenta o Can be done earlier to identify abnormalities ( 11 WEEKS) Ch. 7 Bleeding During Pregnancy • Ectopic: Unilateral stabbing pain; Lower abdominal quadrant pain • Molar: bleeding that resembles prune juice • Placenta previa: lower segment of uterus instead of fundus; PAINLESS bright red during 2nd or 3rd trimester  may hemorrhage o Complete: cervical is completely covered by placental attachment o Partial o Incomplete • Abruptio placentae: sudden onset of intense localized pain with dark red vaginal bleeding Ch. 8 Infections • Yeast infection pretty common Ch. 9 Medical Conditions • Incompetent cervix  cervical cerclage (placed at 12-14 weeks & removed at 37 weeks) • Hyperemesis: excessive N/V past 12 weeks; IV fluids, pyridoaxine (B6) administrations, antiemetic meds (Zofran) • Iron deficiency anemia: iron supplements with food rick in vitamin C (orange juice) • Gestational diabetes: higher risk for developing diabetes after pregnancy, (will likely do biophysiol profile and non-stress test) o Insulin to control sugar levels o Test b/w 24-28 wks  one-hour glucose (no fasting required) over 140 will proceed with next test OTGG (requires fasting) 3 hours • Gestational hypertension: caused by vasospasm  poor tissue perfusion o After 20 week; 0ber 140/90  positive o No protein in the urine o Mild preeclampsia: 1+ o Severe preeclampsia: 3+ o Eclampsia: seizures o HELLP syndrome: o Antihypertensive meds: methyldopa, nifedipine, hydralazine, labetalol o Magnesium!!  to prevent seizures (monitor mg toxicity  no reflexes, low urine output, low level of consciousness, low resp) ▪ Magnesium toxicity  calcium gluconate (antidote) Ch. 10 Early onset of Labor • Preterm labor: 20-37 weeks o Swab of vaginal secretions (fetal fibronectin) o Administer nifidepine (calcium channel blocker) block calcium to suppress contractions o Magnesium sulfate- relax smooth muscle (watch for mg toxicity) o Indomethacin o Betamethasone (steroids) promote fetal lung maturity • Premature rupture of membrane o Nitrazine paper test (should turn blue) *yellow would be just urine* o Positive ferning test to conduct on amniotic fluid to verify rupture o May put on an antiobiotic (infection can cause rupture) (betamethasone) Ch.11 Labor and Delivery Processes • Back ache, weight loss (1-3 lbs), lightening (fetal to pelvis), contractions (Braxton hicks), increased vaginal discharge or bloody show, energy burst, GI changes • Labs: Group B streptococcus, urinalysis • Stages of labor: o Onset-complete dilation (10 cm): ▪ Latent: irregular (mild-moderate); every 5-30 min lasting 30-45 sec ▪ Active: regular (moderate-strong); every 3-5 min lasting 40-70 sec ▪ Transition: (strong-very strong); every 2-3 min lasting 45-90 sec (feeling of needing to poop) o Fully dilates-birth: o Birth-delivery of placenta: o Delivery to placenta-normal vital signs: [Show More]

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