ATI Proctored OB Maternal Newborn Study Guide.

OB MATERNAL NEWBORN ATI
EXAM STUDY GUIDE

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OB Maternal Newborn ATI Exam Study Guide
Video #1: Contraception & Infertility
 Diaphragms: client must be refitted for a diaphragm for the following conditions:
1. It’s been 2 years since she has been fitted
2. Gained more than 15 pounds (7kg)
3. Had a full-term pregnancy
4. Had a second term abortion
o When you use a diaphragm, you need to use spermicide with every act of coitus
(withdrawal of penis from vagina prior to ejaculation). Every time you withdrawal, instill
more spermicide.
o Diaphragm must stay inserted for 6hrs after act of coitus.
 Hormonal Contraceptives (Oral)
o Side effects: Chest pain, SOB, Leg pain (from a possible clot), headache or eye problems
(from a stroke or hypertension)
o Contraindications: Women with a history of blood clots, stroke, cardiac problems,
smoker, breast or estrogen related cancers (pill contains estrogen)
 Depo-Provera/Medroxyprogesterone
o Injectable progestin
o Can cause decreased bone mineral density or loss of calcium
 Nursing action: Ensure patient has adequate intake of calcium and vitamin D
 IUD
o Increase risk for PID
o Can cause uterine perforation or ectopic pregnancy (increases risk for ectopic pregnancy)
o Look out for/Notify PCP:
 Change in string length IUD is moving and not in the right place
 Foul smelling vaginal discharge
 Pain with intercourse
 Fever/Chills (infection)
Infertility is defined as an inability to conceive desire engaging in unprotected sexual intercourse for a
prolonged period of time or at least 12 months.
 Common factors associated with infertility include:
o Decreased sperm production (Sperm analysis)
o Endometriosis
o Ovulation disorders
o Tubal occlusions If you test and use DYE (used in the fallopian tubes), make sure the
woman is not allergic to iodine or shellfish/seafood
Video #2: Signs of Pregnancy
Presumptive: Can be defined by things/reasons other than pregnancy
 Amenorrhea  Can be anorexic or exercising too much
 Fatigue  Didn’t sleep well
 Nausea/Vomiting  Sick
 Urinary Frequency  UTI
 Quickening/Fluttering in stomach  Gas



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Probable: Changes that make the examiner suspect a woman is pregnant (primarily related to physical
changes of the uterus).
Abdominal enlargement: Related to changes in uterine size, shape, and position
Hegar’s Sign: Softening and compressibility of the lower uterus
Chadwick’s Sign: Deepend violet bluish color of cervix and vaginal mucosa
Goodell’s Sign: Softening of cervical tip
Ballottement: Rebound of unengaged uterus
Braxton Hicks Contractions: False contractions that are painless, irregular, and usually relieved
by walking
Positive Pregnancy Test: Woman’s hormonal level may not be normal
Fetal Outline:
Positive: Very distinct things.

 Fetal Heart Sounds
 Fetal Heartbeat can be heard
 Can see the baby with ultrasound
 Can feel movement in the uterus
Naegele’s Rule: Last menstrual period minus (– ) 3 months + 7 days + 1-year ;Cathy’s Rule: + 9
months + 1 week
Gravidity and Parity:
 Gravida: a woman who is pregnant
 Gravidity: number of pregnancies
o Nulligravida: a woman who has never been pregnant
o Primigravida: a woman who is pregnant for the first time
o Multigravida: a woman in at least her second pregnancy.
 Parity: the number of births (not the number of fetuses [ex: twins]) carried pat 20 weeks
gestation, whether or not the fetus was born alive.
o Nullipara: a woman who has not had a birth at more than 20 weeks of gestation.
o Primipara: a woman who has had one birth that occurred after 20 weeks of gestation.
o Multipara: a woman who has had two or more pregnancies to the stage of fetal viability.
Know how to find out GTPAL numbers:
 G= Gravidity (# of times a woman has been pregnant PLUS current pregnancy)
 T= Term Births (How many babies were delivered at term 38 WEEKS OR MORE)
 P= Preterm Births (Below 38 weeks)
 A= Abortion (spontaneous or not) or miscarriages L= Living children


Fundal height:

 Measured to evaluate the gestational age of the fetus.
 During the second and third trimesters (weeks 18-30), the fundal height in centimeters
approximately equals the fetus’s age in weeks, plus or minus 2 cm.
 At 16 weeks, the fundus can be found approximately halfway between the symphysis pubis and
the umbilicus.


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