ATI-RN Maternal Newborn Study Guide 2026-2027
Damaged Blood Vessel Blood will spurt out of the vagina, and the flow will not slow.
Lochia Flow: will steadily decrease during postpartum period.
Gomco Clamp Circumcision -Pressure of clamp for 3-5 minutes, then slit/cut away excess skin
-Petroleum gauze strips to site after to prevent sticking to diaper
-Apply petroleum jelly to the penis with each diaper change to protect incision
from contact with urine and feces.
- No towelettes
- Do not remove and yellow exudate (can cause pain and bleeding - part of
healing process)
- Do not wrap penis with dry gauze (can adhere and cause pain and bleeding
at removal).
Psychological Task: Accepting the Pregnancy - First Trimester
Accepting the baby
- Second Trimester
Preparing for Parenthood & Preparing for End of Pregnancy
-Third Trimester
Terbutaline (Brethine) Uses to relax uterine smooth muscle to inhibit uterine activity.
- Involves bronchodilation
Adverse Reaction:
Tachycardia (if pulse is greater than 130/min, the medication needs to be held
until HCP is notified.)
Terbutaline is a tocolytic medication that causes uterine relaxation and is used
to treat preterm labor. It is not an appropriate medication to treat uterine atony.
Postpartum Care Client w/Cardiac Disease: Weight the Client Daily for Fluid Overload
Monitor I/O (blood flow to and from heart increases for atleast the first 24
hours after delivery) this places the client at high risk of cardiac
decompensation and fluid overload.
Follow a high-fiber diet to prevent straining with bowl movements because the
pushing effort (valsalva maneuver) can result in cardiac stress.
Initiate bedrest with the hob elevated to promote rest and decrease the clients
oxygen consumption.
, ATI-RN Maternal Newborn Study Guide 2026-2027
Preventing Mastitis: Use finger to release suction on nipple after feeding.
Galactagogue Medications and Herbs can increase the clients milk supply. This
INCREASES the risk of mastitis, if the infant does not empty the breast.
Waiting too long between feedings can result in clogging or plugging of
nipples, this can INCREASE the risk of mastitis.
Wearing underwire bra is associated with increased risk for mastitis due to
blocking the breast from emptying completely.
Development of Hyperbilirubinemia in Newborns: Blood Group Incompatibilities
Maternal Infection
Maternal Diabetes
Administration of Oxytocin during Labor
Delivery of a Stillborn Child: -Unrestricted Access to Childs Body. (process traumatic event)
If the parents express a desire to see an anomaly, the nurse should allow it and
explain what they are viewing.
Allow Privacy and Holding of Child.
Physical Assessment of Newborn following Vaginal Report small, pinpoint, reddish-purple spots on the chest (petechiae) -
Birth: commonly found above the neck if the umbilical cord was around the
newborns neck at birth. This can indicate Infection or Low Platelet Count.
Bluish Feet and hands (acrocyanosis) - often present in newborns is an
expected finding.
Overlapping Suture Lines (Cranial Bones Overlap) also called molding. - this
helps the fetal head move through the canal and is an expected finding.
After 35 weeks a White, cheese-like substance covering skin (vernix caseosa) -
helps hydrate and protect newborns skin after birth. This is an expected finding.
Milia are whiteheads on the face and forehead and are a normal variation.
Epstein pearls are white nodules on the gums and are a normal variation.
Meconium stools are an expected finding within the first 12 to 48 hours after
birth. (Meconium is a newborn's first poop. This sticky, thick, dark green poop is
made up of cells, protein, fats, and intestinal secretions, like bile. Babies
typically pass meconium (mih-KOH-nee-em) in the first few hours and days
after birth.)
, ATI-RN Maternal Newborn Study Guide 2026-2027
Morning Sickness Caused by the buildup of human chorionic gonadotropin (hCG) in the mothers
system.
Dry foods eaten before rising in the morning tend to reduce the risk of nausea.
(crackers)
Eat foods served at cool temps.
Decrease Fluid Intake during meals to prevent overdistention of the stomach.
this reduces nausea and vomiting.
Teach to Avoid brush teeth immediately after meals to decrease nausea and
vomiting.
Gonorrhea A sexually transmitted bacterial disease caused by a gonococcus bacterium
that causes inflammation of the genital mucous membrane, burning pain when
urinating, and a discharge.
Often asymptomatic
Nationally Notifiable Disease
bacterial vaginosis An overgrowth of bacteria in the vagina; characterized by itching, burning, or
pain, and possibly a "fishy" smelling discharge that appears thin, watery, gray,
white, or milky.
Might also report pruritus.
Treated with Metronidazole or Clindamycin Cream.
Trichomoniasis an STD caused by a microscopic protozoan that results in infections of the
vagina, urethra, and bladder.
can be asymptomatic.
Manifestations:
Greenish Yellow Mucopurulent, frothy malodorus discharge.
Treatment of male partner is done WITHOUT a culture if female partner has it.
Easily treated with Metronidazole. Avoid intercourse while being treated or use
a condom.
Unless both partners are treated the male can reinfect the female.
Candidiasis infection of the skin, mouth, or vagina caused by the yeast-type fungus.
second most common vaginal infection.
Manifestations:
thick cottage cheese discharge and vaginal itching.
, ATI-RN Maternal Newborn Study Guide 2026-2027
Routine Medication Administration Following Birth: Administer Vitamin K in the Vastus Lateralis Muscle in Newborns Thigh.
Administer Vitamin K (1mg) intramuscularly.
Administer Erythromycin Eye Ointment Bilaterally within 1 - 2 hours after birth.
Can administer the medication after the initial breastfeeding. Administer a thin
ribbon starting at the inner canthus toward the outer.
Newborn Delivered at 32 Weeks Anticipated Findings: Poorly Developed Muscle Tone and Unable to Maintain the Flexed Position
Seen in Infants at Full Term. (extended extremities)
- will have few creases present on sole of the foot
- testes only partially descended into the sac and only a few rugae (folds in the
stomach lining) present. (completes process of descending by week 40)
Leathery Cracked Skin: Characteristic of newborn born after 42 weeks of gestation. The lack of vernix
in-utero causes a dry, peeling appearance of the skin.
Vacuum-Assisted Vaginal Delivery: Inceases the risk of jaundice as the bruises caused by device dissipate.
will result in caput succedaneum, which is swelling of the scalp that generally
resolves without treatment in 3 - 4 days.
providers choose this when a client has a prolonged second stage of labor or
when the fetus is in distress. the client must be fully dilated before undergoing
a vaginal birth.
Abdominal Trauma Uterine Contractions
Increased Heart Rate for Trauma or Blood Loss
Increased Respiratory Rate
Food that help increase iron intake: High in Vitamin C increase absorption of Iron.
Citrus Fruits
Strawberries
Melons
Tomatoes
Foods that DECREASE:
Oxalates, found in spinach, swiss chard.
Coffee, tea, milk, whole grains, bran.
Damaged Blood Vessel Blood will spurt out of the vagina, and the flow will not slow.
Lochia Flow: will steadily decrease during postpartum period.
Gomco Clamp Circumcision -Pressure of clamp for 3-5 minutes, then slit/cut away excess skin
-Petroleum gauze strips to site after to prevent sticking to diaper
-Apply petroleum jelly to the penis with each diaper change to protect incision
from contact with urine and feces.
- No towelettes
- Do not remove and yellow exudate (can cause pain and bleeding - part of
healing process)
- Do not wrap penis with dry gauze (can adhere and cause pain and bleeding
at removal).
Psychological Task: Accepting the Pregnancy - First Trimester
Accepting the baby
- Second Trimester
Preparing for Parenthood & Preparing for End of Pregnancy
-Third Trimester
Terbutaline (Brethine) Uses to relax uterine smooth muscle to inhibit uterine activity.
- Involves bronchodilation
Adverse Reaction:
Tachycardia (if pulse is greater than 130/min, the medication needs to be held
until HCP is notified.)
Terbutaline is a tocolytic medication that causes uterine relaxation and is used
to treat preterm labor. It is not an appropriate medication to treat uterine atony.
Postpartum Care Client w/Cardiac Disease: Weight the Client Daily for Fluid Overload
Monitor I/O (blood flow to and from heart increases for atleast the first 24
hours after delivery) this places the client at high risk of cardiac
decompensation and fluid overload.
Follow a high-fiber diet to prevent straining with bowl movements because the
pushing effort (valsalva maneuver) can result in cardiac stress.
Initiate bedrest with the hob elevated to promote rest and decrease the clients
oxygen consumption.
, ATI-RN Maternal Newborn Study Guide 2026-2027
Preventing Mastitis: Use finger to release suction on nipple after feeding.
Galactagogue Medications and Herbs can increase the clients milk supply. This
INCREASES the risk of mastitis, if the infant does not empty the breast.
Waiting too long between feedings can result in clogging or plugging of
nipples, this can INCREASE the risk of mastitis.
Wearing underwire bra is associated with increased risk for mastitis due to
blocking the breast from emptying completely.
Development of Hyperbilirubinemia in Newborns: Blood Group Incompatibilities
Maternal Infection
Maternal Diabetes
Administration of Oxytocin during Labor
Delivery of a Stillborn Child: -Unrestricted Access to Childs Body. (process traumatic event)
If the parents express a desire to see an anomaly, the nurse should allow it and
explain what they are viewing.
Allow Privacy and Holding of Child.
Physical Assessment of Newborn following Vaginal Report small, pinpoint, reddish-purple spots on the chest (petechiae) -
Birth: commonly found above the neck if the umbilical cord was around the
newborns neck at birth. This can indicate Infection or Low Platelet Count.
Bluish Feet and hands (acrocyanosis) - often present in newborns is an
expected finding.
Overlapping Suture Lines (Cranial Bones Overlap) also called molding. - this
helps the fetal head move through the canal and is an expected finding.
After 35 weeks a White, cheese-like substance covering skin (vernix caseosa) -
helps hydrate and protect newborns skin after birth. This is an expected finding.
Milia are whiteheads on the face and forehead and are a normal variation.
Epstein pearls are white nodules on the gums and are a normal variation.
Meconium stools are an expected finding within the first 12 to 48 hours after
birth. (Meconium is a newborn's first poop. This sticky, thick, dark green poop is
made up of cells, protein, fats, and intestinal secretions, like bile. Babies
typically pass meconium (mih-KOH-nee-em) in the first few hours and days
after birth.)
, ATI-RN Maternal Newborn Study Guide 2026-2027
Morning Sickness Caused by the buildup of human chorionic gonadotropin (hCG) in the mothers
system.
Dry foods eaten before rising in the morning tend to reduce the risk of nausea.
(crackers)
Eat foods served at cool temps.
Decrease Fluid Intake during meals to prevent overdistention of the stomach.
this reduces nausea and vomiting.
Teach to Avoid brush teeth immediately after meals to decrease nausea and
vomiting.
Gonorrhea A sexually transmitted bacterial disease caused by a gonococcus bacterium
that causes inflammation of the genital mucous membrane, burning pain when
urinating, and a discharge.
Often asymptomatic
Nationally Notifiable Disease
bacterial vaginosis An overgrowth of bacteria in the vagina; characterized by itching, burning, or
pain, and possibly a "fishy" smelling discharge that appears thin, watery, gray,
white, or milky.
Might also report pruritus.
Treated with Metronidazole or Clindamycin Cream.
Trichomoniasis an STD caused by a microscopic protozoan that results in infections of the
vagina, urethra, and bladder.
can be asymptomatic.
Manifestations:
Greenish Yellow Mucopurulent, frothy malodorus discharge.
Treatment of male partner is done WITHOUT a culture if female partner has it.
Easily treated with Metronidazole. Avoid intercourse while being treated or use
a condom.
Unless both partners are treated the male can reinfect the female.
Candidiasis infection of the skin, mouth, or vagina caused by the yeast-type fungus.
second most common vaginal infection.
Manifestations:
thick cottage cheese discharge and vaginal itching.
, ATI-RN Maternal Newborn Study Guide 2026-2027
Routine Medication Administration Following Birth: Administer Vitamin K in the Vastus Lateralis Muscle in Newborns Thigh.
Administer Vitamin K (1mg) intramuscularly.
Administer Erythromycin Eye Ointment Bilaterally within 1 - 2 hours after birth.
Can administer the medication after the initial breastfeeding. Administer a thin
ribbon starting at the inner canthus toward the outer.
Newborn Delivered at 32 Weeks Anticipated Findings: Poorly Developed Muscle Tone and Unable to Maintain the Flexed Position
Seen in Infants at Full Term. (extended extremities)
- will have few creases present on sole of the foot
- testes only partially descended into the sac and only a few rugae (folds in the
stomach lining) present. (completes process of descending by week 40)
Leathery Cracked Skin: Characteristic of newborn born after 42 weeks of gestation. The lack of vernix
in-utero causes a dry, peeling appearance of the skin.
Vacuum-Assisted Vaginal Delivery: Inceases the risk of jaundice as the bruises caused by device dissipate.
will result in caput succedaneum, which is swelling of the scalp that generally
resolves without treatment in 3 - 4 days.
providers choose this when a client has a prolonged second stage of labor or
when the fetus is in distress. the client must be fully dilated before undergoing
a vaginal birth.
Abdominal Trauma Uterine Contractions
Increased Heart Rate for Trauma or Blood Loss
Increased Respiratory Rate
Food that help increase iron intake: High in Vitamin C increase absorption of Iron.
Citrus Fruits
Strawberries
Melons
Tomatoes
Foods that DECREASE:
Oxalates, found in spinach, swiss chard.
Coffee, tea, milk, whole grains, bran.
