ATI Maternal Newborn Proctored Study Guide 2019/2020

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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 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 Reactive HR (0-2) Breathing Body movement Fetal tone 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 YOU WANT REACTIVE Contraction stress test Want a contraction to occur ocycotcin, nipple stimulation; monitor FHR to see if decelerations occur You want late decelerations Amniocentesis You want an empty bladder AT 14 WEEKS Levels of AFP (high nuero tube defects; low down syndrome) L/S ratio: 2:1 ratio is fetal lung maturity (2:5:1 or 3:1 for a client who has diabetes mellitus) Complications: amniotic fluid emboli, hemorrhage, infection Chorionic callus sampling Taking a piece of placenta 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 Complete: cervical is completely covered by placental attachment Partial 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) Insulin to control sugar levels Test b/w 24-28 wks one-hour glucose (no fasting required) over 140 will proceed with next test OTGG (requires fasting) 3 hours Gestational hypertension: caused by vasospasm poor tissue perfusion After 20 week; 0ber 140/90 positive No protein in the urine Mild preeclampsia: 1+ Severe preeclampsia: 3+ Eclampsia: seizures HELLP syndrome: Antihypertensive meds: methyldopa, nifedipine, hydralazine, labetalol Magnesium!! to prevent seizures (monitor mg toxicity no reflexes, low urine output, low level of consciousness, low resp) Magnesium toxicity calcium gluconate (antidote) [Show More]

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