ATI MATERNITY
Intro, Chap 1, Chap 2
• Know that a pt must be refitted by the provider q2yrs for a diaphragm OR if they've gained >15lb (7kg) OR if they've had a full term pregnancy/2nd term abortion
• When using a d
...
ATI MATERNITY
Intro, Chap 1, Chap 2
• Know that a pt must be refitted by the provider q2yrs for a diaphragm OR if they've gained >15lb (7kg) OR if they've had a full term pregnancy/2nd term abortion
• When using a diaphragm, spermicide must be used for EACH act of coitus
• Diaphragm must remain in place 6h after coitus (intercourse)
• When using a hormonal method of contraception the S/E are chest pain, SOB, leg pain (possible clot), HA, eye problem, stroke, HTN
• Hormonal contraception blood clots!
• If pt is a smoker, do not use hormonal oral contraceptive!
• CONTRAINDICATION (oral pill): hx of blood clot/stroke/cardiac problem, breast/estrogen related cancers, smoker
• Depo-Provera = injectable progestin
o Can cause bone mineral density/loss of calcium
o Make sure to have adequate Ca/vit D intake!
• IUD can ?risk of pelvic inflammatory disease/uterine perforation/ectopic pregnancy
o Monitor for change in string length (indicates IUD dislocation), foul-smelling vaginal discharge, pain with intercourse, fever, chills
• Infertility = inability to conceive for at least 12mo
o Sperm analysis (cost-effective; check men first)
o Any test requiring dye in fallopian tube, make sure that the pt has no allergy to iodine/seafood
Chap 3
• Signs of Pregnancy (KNOW PRESUMPTIVE/POSITIVE; everything else probable)
o Presumptive (signs can be explained other than pregnancy)
▪ Amenorrhea, fatigue, cant sleep well, N/V, urinary frequency, breast changes, quickening
o Probable
▪ Abdominal enlargement, Hegar sign (softening/compressibility of uterus), Chadwick’s (bluish color of cervix), Goddell’s (softening of cervical tip), Bolutment (rebound of unengaged fetus), Braxton Hicks, + pregnancy test (?HcG), fetal outline felt by examiner
o Positive (no doubt; can feel/hear baby)
▪ Fetal HR, US, can feel movement in uterus
• Nagel’s Rule
o Estimates due date based on LMP
o EDD = LMP + 9mo + 1wk
• GTPAL
o G = gravidity (# of times pregnant; incl. current pregnancy)
o T = term (# of term births; >38wks)
o P = pre-term (# of preterm births; <38wks)
o A = abortion/miscarriage
o L = living children
Chap 5
• Norm weight gain = +25-35lb
• If overweight = +15-25lb
• If underweight = +28-40lb
• During 1st trimester, should not gain more than 1-2kg
• After 1st trimester, should gain 1lb/wk (for the last 2 trimesters)
• +340cal/day (2nd trimester)
• +450cal/day (3rd trimester)
• If breastfeeding, need +300-400cal/day
• Folic acid = important for pregnant woman! (prevents fetal neural tube defects)
o Sources of folic acid = OJ, green leafy vegetables
• Should drink 2-3L H20/day
• Limit caffeine to 300mg/day
• NO ETOH
Chap 6
• If having an US (anything non-invasive), make sure that the bladder is full
• If poking into the patient’s stomach (ex. Amniocentesis – anything invasive), make sure that the bladder is EMPTY
• Biophysical profile (BPP) = given score 0-10
o 8-10 = norm (baby is healthy!)
o measures reactive HR, breathing, body movement, fetal tone, amniotic fluid vol
o score of 2 = norm; 0 = abnormal
• Non-stress test
o Non-invasive
o Measures fetal well-being within the last trimester of pregnancy
o Measures response of fetal HR to fetal movement
o Mother presses button when she feels fetal movement
o Reactive = normal = fetal HR accelerates with fetal movement
o Nonreactive =abnormal = fetal HR did not accelerate with fetal movement
need further testing (BPP, contraction stress test)
• Contraction stress test (CST)
o Bring on a contraction through pitocin/oxytocin/nipple stimulation
o During contraction, measure fetal HR to see if late decelerations occur (bad!)
o Negative CST result = no late decelerations = good!
o Positive CST results = late decelerations occur = bad!
o RISKS = can send mother into pre-term labor
........................................CONTINUED.......................................
[Show More]
