ati-maternal-newborn-ati-extra-study-guide

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ATI Maternal Newborn Nursing Contraception Barrier Methods - Condoms - Diaphragms – must be refitted for every 2 years by a provider or if you have gained more than 15lbs or have had a full ter... m pregnancy or a 2 nd term abortion, you must also use spermicide with every act of sex, must remain in place for 6 hours after sex Oral Birth Control - Hormonal methods, nuva ring, patch, etc. are contraceptive methods that have side effects very similar to all they include; chest pain, SOB, leg pain, HA, vision problems, could mean potential blood clot or stroke, of PE, or HTN. Smokers are at higher risk. Women who smoke are not recommended to take oral birth control. Contraindications include: history of blood clots, stroke, cardiac problems, or estrogen related cancer, or if you are a smoker ***What if I miss a dose?--> the nurse should instruct the pt that if there was only 1 dose missed, take asap, if 2-3 doses missed, go by the manufactures’ instructions. ****EFFECTIVENESS decreases when taking anticonvulsants and ABX.**** (Any medications that affect liver enzymes). lOMoARcPSD|733 121 7 Depo Provera (Injectable Progestins) – can cause decrease in bone density, loss in calcium mineral, will need adequate calcium and vitamin D to protect bones. Should only be used as a long term method of birth method. IUD’s – Intrauterine Devices • can increase risk for pelvic inflammatory disease, and uterine perforation, and will increase risk of ectopic pregnancy. • LOOK for change in string length, foul smelling discharge, painful intercourse, fever, chills, etc Female Sterilization (Bilateral Tubal Litigation Salpingectomy) ➢ Surgical procedure: consisting of severance and/ or burning or blocking the fallopian to prevent fertilization. ➢ Risk of ectopic pregnancy if pregnancy occurs. Infertility – inability to conceive after trying for at least 12 months (1yr) -work up will be done after that, will start with male (usual 40% of time issue is with them) -test on female, any test that has dye ensure no shellfish allergy or iodine. Nursing Interventions: • Any medications that are used to treat infertility may increase the risk of multiple births by more than 25%. • Mothers who are less than 16 years old and older than 35 years old. lOMoARcPSD|733 121 7 Pregnancy Signs-3 Signs 1. Presumptive – can be explained by a reason other than pregnancy a. Amenorrhea b. Fatigue c. N/V d. Urinary Frequency e. Linea nigra f. Cholasma (mask of pregnancy) g. Breast Changes h. Uterine Enlargement 2. Probable – signs can caused by physiological factors other than pregnancy. a. abdominal enlargement b. Cervical Changes c. Hegar’s Sign: softening of lower uterus d. Goodell’s Sign: softening of cervical tip e. Chadwick’s Sign: deepened violet bluish color of vaginal mucosa secondary to increased vascularity of the area. f. Braxton Hicks Contractions g. Positive pregnancy test. 3. Positive – very distinct, fetal heart tones, or fetus on US, feel movement Nageles Rule – tells you when your due date is based on last menstrual cycle (JUST ADD 9 months and 1 week) lOMoARcPSD|733 121 7 GTPAL Gravidity - # of times woman has been pregnant including current pregnancy Term births - # of pregnancies that have gone to 38wks or more Preterm births - # of pregnancies that have gone before 38wks Abortions or miscarriages - # of Living children - # of Weight Gain and Nutrition during Pregnancy - Normal weight gain is 25 to 35lbs - If a patient is already overweight, 15 to 25lbs - If a patient is underweight recommended 28 to 40lbs *during first trimester should not gain more than 2-4lbs, after expect weight gain of 1lb per week Extra Calories per day – 340/day – 2 nd trimester, 450/day – 3 rd trimester *if breast feeding after birth you still need an extra 300-400 a day Folic Acid – prevents neural tube birth defects, sources are dark leafy veggies, orange juice Consume 2-3 liters of water a day Limit caffeine to 200-300 mg a day No ETOH lOMoARcPSD|733 121 7 Diagnostic tests during Pregnancy • Prenatal Care o Majority of birth defects occur between 2-8 weeks of gestation US- you want the bladder to be full, sound waves will resonate better Amniocentesis – you want empty bladder Nonstress Test – not invasive, measures fetal wellbeing within the last trimester and measures response of fetal HR to fetal movement (reactive is normal, HR will increase) (nonreactive is not normal, HR will decrease) 34-37 weeks *if nonreactive may have a CST (contraction stress test) done, contractions brought on by Pitocin/oxytocin/nipple stimulation and during that they will monitor FHR and look for acceleration. [Show More]

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