ATI maternal newborn notes (BEST IN 2021)

ATI PROCTORED MATERNAL­NEWBORN NOTES SPONTANEOUS ABORTION: terminated before 20 weeks or weighs less than 500 grams Risk factors  Chromosomal anomalies  Maternal illness, infection  AMA  Trauma/injuries  Anomalies of the fetus or placenta  Antiphospholipid syndrome Expected findings  Tenderness and backache  ROM  Dilation of cervix  Fever  Signs and symptoms of hemorrhage Diagnostics/therapeutic procedures  Ultrasound  Cervical exam  D&E  D&C  Prostaglandins and oxytocin Patient education  Some vaginal discharge OK for 1­2 wk  NO baths, tampons, or intercourse for 2 wk ECTOPIC PREGNANCY Risk factors  Anything that compromises tubal patency  STIs  IVF  Tubal surgery  IUDs Expected findings  Unilateral pain  Light period that is late  Scant, dark red, brown vaginal spotting  6­8 wks after last normal menses  referred shoulder pain  SHOCK Labs  Elevated hCG and progesterone will rule out ectopic preg DX/therapeutic procedures  Transvaginal US  CAUTION W/ VAGINAL EXAMS TX – rapid treatment necessary  Medical management  If rupture has not occurred and tube preservation is desired  Methotrexate  Inhibits cell division, dissolves pregnancy  Salpingostomy  Fixes the tube  Laproscopic salpingectomy  Removes the tube