MATERNITY ATI REVIEW GOOD

Document Content and Description Below

ATI MATERNITY Intro, Chap 1, Chap 2 • Know that a pt must be refitted by the provider q2yrs for a diaphragm OR if they've gained >15lb (7kg) OR if they've had a full term pregnancy/2nd term abor... tion • When using a diaphragm, spermicide must be used for EACH act of coitus • Diaphragm must remain in place 6h after coitus (intercourse) • When using a hormonal method of contraception the S/E are chest pain, SOB, leg pain (possible clot), HA, eye problem, stroke, HTN • Hormonal contraception  blood clots! • If pt is a smoker, do not use hormonal oral contraceptive! • CONTRAINDICATION (oral pill): hx of blood clot/stroke/cardiac problem, breast/estrogen related cancers, smoker • Depo-Provera = injectable progestin o Can cause bone mineral density/loss of calcium o Make sure to have adequate Ca/vit D intake! • IUD can ?risk of pelvic inflammatory disease/uterine perforation/ectopic pregnancy o Monitor for change in string length (indicates IUD dislocation), foul-smelling vaginal discharge, pain with intercourse, fever, chills • Infertility = inability to conceive for at least 12mo o Sperm analysis (cost-effective; check men first) o Any test requiring dye in fallopian tube, make sure that the pt has no allergy to iodine/seafood Chap 3 • Signs of Pregnancy (KNOW PRESUMPTIVE/POSITIVE; everything else probable) o Presumptive (signs can be explained other than pregnancy) ▪ Amenorrhea, fatigue, cant sleep well, N/V, urinary frequency, breast changes, quickening o Probable ▪ Abdominal enlargement, Hegar sign (softening/compressibility of uterus), Chadwick’s (bluish color of cervix), Goddell’s (softening of cervical tip), Bolutment (rebound of unengaged fetus), Braxton Hicks, + pregnancy test (?HcG), fetal outline felt by examiner o Positive (no doubt; can feel/hear baby) ▪ Fetal HR, US, can feel movement in uterus • Nagel’s Rule o Estimates due date based on LMP o EDD = LMP + 9mo + 1wk • GTPAL o G = gravidity (# of times pregnant; incl. current pregnancy) o T = term (# of term births; >38wks) o P = pre-term (# of preterm births; <38wks) o A = abortion/miscarriage o L = living children Chap 5 • Norm weight gain = +25-35lb • If overweight = +15-25lb • If underweight = +28-40lb • During 1st trimester, should not gain more than 1-2kg • After 1st trimester, should gain 1lb/wk (for the last 2 trimesters) • +340cal/day (2nd trimester) • +450cal/day (3rd trimester) • If breastfeeding, need +300-400cal/day • Folic acid = important for pregnant woman! (prevents fetal neural tube defects) o Sources of folic acid = OJ, green leafy vegetables • Should drink 2-3L H20/day • Limit caffeine to 300mg/day • NO ETOH Chap 6 • If having an US (anything non-invasive), make sure that the bladder is full • If poking into the patient’s stomach (ex. Amniocentesis – anything invasive), make sure that the bladder is EMPTY • Biophysical profile (BPP) = given score 0-10 o 8-10 = norm (baby is healthy!) o measures reactive HR, breathing, body movement, fetal tone, amniotic fluid vol o score of 2 = norm; 0 = abnormal • Non-stress test o Non-invasive o Measures fetal well-being within the last trimester of pregnancy o Measures response of fetal HR to fetal movement o Mother presses button when she feels fetal movement o Reactive = normal = fetal HR accelerates with fetal movement o Nonreactive =abnormal = fetal HR did not accelerate with fetal movement  need further testing (BPP, contraction stress test) • Contraction stress test (CST) o Bring on a contraction through pitocin/oxytocin/nipple stimulation o During contraction, measure fetal HR to see if late decelerations occur (bad!) o Negative CST result = no late decelerations = good! o Positive CST results = late decelerations occur = bad! o RISKS = can send mother into pre-term labor ........................................CONTINUED....................................... [Show More]

Last updated: 1 year ago

Preview 1 out of 12 pages