Summary RN Maternal Newborn Nursing ATI practice A

Management of Care Establishing Priorities Postpartum Disorders: Priority Intervention for Uterine Atony Disorder Uterine atony results from the inability of the uterine muscle to contract adequately after birth. This can lead to postpartum hemorrhage. 1. Ensure that the urinary bladder is empty 2. Monitor for the following  Fundal height, consistency and location  Lochia for quantity, color and consistency. 3. Perform fundal massage if indicated-  if the uterus becomes firm continue assessing hemodynamic status.  If uterine atony persists, anticipate surgical intervention, such as a hysterectomy Safety and Infection Control Accident/Error/Injury Prevention Medical Conditions: Priority Action for a Client Who Is Having a Seizure 1. Make sure to position that patient to prevent aspiration 2. Make sure the patient doesn’t hurt herself 3. Monitor the FHR checking to see how the fetus is reacting to seizure 4. Wait for the seizure to pass. Health Promotion and Maintenance Ante/Intra/Postpartum and Newborn Care (1 item) Prenatal Care: Reportable Findings 1. Determine the estimated date of birth based on the last menstrual period 2. Obtain medical and nursing history to include social support and review of systems 3. Perform physical assessment to include a client’s baseline weight, vital signs and pelvic examination. Medical Conditions: Risk Factors for Preeclampsia This study source was downloaded by from CourseH on :00:56 GMT -06:00 1. Previous history of preeclampsia 2. Multiple gestation (pregnant with more than one baby 3. History of chronic high blood pressure, diabetes, kidney disease or organ transplant Newborn Assessment: Expected Manifestations 1. Adjustment to extrauterine life occur as a newborns respiratory and circulatory system are required to rapidly adjust to life outside of the uterus. 2. The establishment of respiratory function with the cutting of the umbilical cord is the most critical extrauterine adjustment as air inflates the lungs with the first breath 3. Circulatory changes after birth occur with the expulsion of the placenta and the cutting of the umbilical cord. Pharmacological and Parenteral Therapies (1 item) Adverse Effects/Contraindications/Side Effects/Interactions (1 item) Contraception: Identifying Adverse Effects of Combined Oral Contraceptives 1. Can increase the risk of thromboembolism, stoke, heart attack, hypertension, gallbladder disease, liver tumor 2. Exacerbates conditions affected by fluid retention, such as migraines, epilepsy, asthma, kidney, or heart disease. 3. Adverse effects include headache, nausea, breast tenderness, fluid retention and breakthrough bleeding. Reduction of Risk Potential Diagnostic Tests Bleeding During Pregnancy: Laboratory Testing for Suspected Placental Abruption 1. Hgb and hct 2. Cross and type match for possible blood transfusions 3. Kleihauer-Betke test (used to detect fetal blood in maternal circulation) Labor and Delivery Processes: Rupture of Membranes 1. Spontaneous rupture of membranes can initiate labor and can happen anytime during labor, most commonly during the transition phase. Labor usually occurs 24 hours later. 2. Prolonged rupture greater than 24 hours before delivery may lead to infection. 3. Assess FHR immediately after rupture for abrupt decelerations