ATI Maternal Newborn Nursing study guide (great points to help you attain A+)

ATI Maternal Newborn Nursing Contraception Barrier Methods - Condoms - Diaphragms – must be refitted for one every 2 years by a provider or if you have gained more than 15lbs or have had a full term pregnancy or a 2nd term abortion, you must also use spermicide with every act of sex, must remain in place for 6 hours after sex - Hormone methods, nuva ring, patch, etc. side effects very similar to all they include; chest pain, SOB, leg pain, HA, vision problems, could mean potential blood clot or stroke, of PE, or HTN. Smokers are at higher risk and it is recommended they do not take oral BC Contraindications include: history of blood clots, stroke, cardiac problems, or estrogen related cancer, or if you are a smoker Depo Shot – can cause decrease in bone density, loss in calcium mineral, will need adequate calcium and vitamin D to protect bones. IUD’s – can increase risk for pelvic inflammatory disease, and uterine perforation, and will increase risk of ectopic pregnancy, LOOK for change in string length, foul smelling discharge, painful intercourse, fever, chills, etc Infertility – inability to conceive after trying for at least 12 months (1yr) -work up will be done after that, will start with male (usual 40% of time issue is with them) -test on female, any test that has dye ensure no shellfish allergy or iodine Pregnancy Signs 3 Signs 1. Presumptive – can be explained by a reason other than pregnancy 2. Probable – abd enlargement, etc 3. Positive – very distinct, fetal heart tones, or fetus on US, feel movement Negals Rule – tells you when your due date is based on last menstrual cycle (JUST ADD 9 months and 1 week) GTPAL Gravidity - # of times woman has been pregnant including current pregnancy Term births - # of pregnancies that have gone to 38wks or more Preterm births - # of pregnancies that have gone before 38wks Abortions or miscarriages - # of Living children - # of Weight Gain and Nutrition during Pregnancy - Normal weight gain is 25 to 35lbs - If a patient is already overweight, 15 to 25lbs - If a patient is underweight recommended 28 to 40lbs *during first trimester should not gain more than 2-4lbs, after expect weight gain of 1lb per week Extra Calories per day – 340/day – 2nd trimester, 450/day – 3rd trimester *if breast feeding after birth you still need an extra 300-400 a day Folic Acid – prevents neural tube birth defects, sources are dark leafy veggies, orange juice You need 2-3 liters of water a day Limit caffeine to 200-3—mg a day No ETOH Diagnostic tests during Pregnancy US- you want the bladder to be full, sound waves will resonate better Amniocentesis – you want empty bladder Nonstress Test – not invasive, measures fetal wellbeing within the last trimester and measures response of fetal HR to fetal movement (reactive is normal, HR will increase) (nonreactive is not normal, HR will decrease) *if nonreactive may have a CST (contraction stress test) done, contractions brought on by Pitocin/oxytocin/nipple stimulation and during that they will monitor FHR and look for acceleration. -if no late acceleration you have a negative CST (normal) *it can send the woman into early labor Amniocentesis – empty the bladder, test amniotic fluid for genetic abnormalities, usually done around 14 weeks, check for levels of AFP (alpha feta protein), IF AFP levels are high, it is associated with neural tube defects, if levels are low it is associated with chromosomal disorders such as down syndrome, will also check the LS ratio which checks for fetal lung maturity Risks associated – amniotic fluid emboli, hemorrhaging, infection, leaking of amniotic fluid, ruptured membranes, or even miscarriage. Bleeding during Pregnancy ....................................CONTINUED.............................................