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 smokers • 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)