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MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY GUIDE-URINARY FREQUENCY
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MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDYGUIDE-URINARY FREQUENCY
- Presumptive Signs and Symptoms of Pregnancy
o Urinary frequency occurs between 6 to 12 weeks.
- Common in the first trimmest because the growing uterus compresses the bladder; it is
also common during the third trimester, especially when the fetal head settles into the
pelvis.
- Hegar’s sign- softening and compressibility of the lower uterine segment which results in
exaggerated uterine anteflexion during the early months of pregnancy—this adds to
urinary frequency.
- Teaching to Manage the Discomforts of Urinary Frequency in Pregnancy
o Try pelvic floor exercises to increase control over leakage
o Empty your bladder when you first feel a full sensation.
o Avoid caffeinated drinks, which stimulate voiding
o Reduce your fluid intake after dinner to reduce nighttime urination.
- Urinary frequency and urgency during the second trimester should be reported to the provider.
ATI Question
1. A nurse is caring for a client in the prenatal clinic who is at 7 weeks of gestation. The
client reports urinary frequency and asks the nurse if this will continue throughout her
pregnancy. Which of the following is an appropriate response?
a. “No. it should only last until about your 12th week, but it will return near the end of
the pregnancy.”
Appropriate time to administer Rubella
- The Rubella titer detects antibodies for the virus that causes German measles; if titer is 1:8 or
less, the woman is not immune; requires immunization after birth, and the woman is advised
to avoid people with undiagnosed rashes.
- Prior to discharge, check the immunity status for rubella for all mothers and give a
subcutaneous injection of rubella vaccine if they are not serologically immune (titer is less than
1:8).
- Make sure that the client signs a consent form to receive the vaccine.
- Contracting Rubella and effects on fetus
o Cataracts, heart defects (patent ductus arteriosus and pulmonary stenosis are the
most common), deafness, mental and motor retardation, growth retardation and
clotting disorders.
ATI Question
2. A nurse is reinforcing teaching about immunizations with a woman in her first trimester of
pregnancy whose diagnostic testing indicates she does not have an immunity to rubella. The
nurse should recommend that the client receives a measles, mumps, rubella (MMR) vaccine at
which of the following times?
a. Prior to discharge from the hospital after giving birth.
3. A nurse is reviewing lab results for a client who is at 37 weeks of gestation. The nurse notes that
the client is rubella non-immune, positive for group A beta-hemolytic strep, and has a blood
type of O negative. Which action should the nurse take?
a. Instruct the client to obtain a rubella immunization after delivery
4. The nurse midwife is concerned about a pregnant client who is suspected of having a
TORCH infection. Which is the main reason TORCH infections are grouped together? They
are:
MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
GUIDE-URINARY FREQUENCY
,MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
GUIDE-URINARY FREQUENCY
a. All TORCH infections have the capability of infecting the fetus or causing serious
effects to the newborn.
5. A woman in her first trimester contracts rubella. How is the fetus likely to be affected?
a. The rubella virus usually causes mild illness in the mother, but has devastating effects
on the fetus, including cataracts, heart defects (patent ductus arteriosus and pulmonary
stenosis are the most common), deafness, mental and motor retardation, growth
retardation and clotting disorders.
6. A nurse is administering a rubella immunization to a client who is 2 days postpartum.
What statement indicates to the nurse the client needs further instruction?
a. “I can conceive anytime I want after 10 days.”
Most Reliable Contraception in preventing pregnancy
- Contraception refers to strategies or devices used to reduce the risk of fertilization or
implantation in an attempt to prevent pregnancy.
- Intrauterine device (IUD)- a chemically activated T-shaped device that is inserted through the
cervix and placed in the uterus by the provider. Releases a chemical substance that damages
sperm in transit to the uterine tubes and prevents fertilization. The most effective contraceptive
methods at preventing pregnancy are the long-acting reversible contraceptive (LARC)
methods: implant and IUDs. IUDs can be used by nulliparous and multiparous female clients.
- IUD can maintain effectiveness for 3-10 years.
- Hormonal IUD’s 3-5 years
- Copper IUD- 10 years
- Copper IUD’s do not contain hormones, so it is safe for patients cautioned against hormonal
birth control methods.
- IUD Contraindications
o Active pelvic infection
o Abnormal uterine bleeding
o Severe uterine distortion
ATI Question
7. A nurse is providing teaching to a client who has come to the family-planning clinic requesting
an intrauterine device (IUD). Which of the following pieces of information should the nurse
provide to the client?
a. “Your risk for ectopic pregnancy increased with an IUD.”
8. A nurse is reinforcing teaching with a client who has an intrauterine device (IUD). Which of
the following statements by the client indicates an understanding of the teaching?
a. If I have pain during intercourse, I will notify my doctor.
Newborn Eye Assessment
- Eyeball movement will demonstrate random, jerky movements.
- To strengthen the weak eye muscle, parents should patch the unaffected eye.
- Many newborns have transient strabismus (deviation or wandering of eyes independently)
and searching nystagmus (involuntary repetitive eye movement), which is caused by
immature muscular control. These are normal for the first 3 to 6 months of age.
ATI Question
9. A nurse is caring for a new mother who is concerned that her infant’s eyes cross. Which of
the following statements is a therapeutic response by the nurse?
MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
GUIDE-URINARY FREQUENCY
,MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
GUIDE-URINARY FREQUENCY
a. “This is normal because newborns lack the muscle control necessary to regulate
eye movement.”
10. A nurse is providing teaching to the parents of a child who has strabismus. Which of the
following instructions should the nurse include to prevent the development of
amblyopia?
a. Patch the unaffected eye
Epidural block
- Consists of a local anesthetic, bupivacaine, along with an analgesic, morphine, or
fentanyl, injected into the epidural space at the level of the fourth or fifth vertebrae.
- This eliminates pain from the level of the umbilicus to the thighs, relieving the discomfort
of uterine contractions, fetal descent, and stretching of the perineum.
- Administered during active labor and when the patient has dilated to at least 4 cm.
- Adverse effects
o Maternal hypotension, fetal bradycardia, fever, itching, inability to feel the urge to
void, urinary retention, loss of the bearing down reflex.
- Nursing actions
o Encourage the client to remain in the side-lying position after insertion of the
epidural catheter to avoid supine hypotension syndrome with compression of the
vena cava.
o Side lying:
▪ Is a very good position for resting and convenient for many kinds of
medical interventions.
▪ May promote progress of labor when alternated with walking
▪ Is useful to slow a very rapid second stage
▪ Avoids vena cava syndrome
▪ May offer increased control of pushing efforts
▪ Takes pressure off hemorrhoids
▪ Facilitates relaxation between contractions
ATI Question
11. A nurse on a labor unit is caring for a patient who just received an epidural. The nurse
determines that the contractions have a duration of 1 min and a frequency of 3 min. The nurse
obtains the following vital signs: FHR 130/min, maternal HR 128/min and maternal blood
pressure 92/54. Which of the following is the priority action for the nurse to take?
a. Position the client on her side
Primigravida
- Primigravida- a woman pregnant for the first time.
- True Labor
o Contraction timing- regular, becoming closer together, usually 4-6 min apart, lasting
30- 60 s.
o Contraction strength- become stronger with time, vaginal pressure is usually felt.
o Contraction discomfort- starts in the back and radiates around toward the front of
the abdomen.
o Any change in activity- Contractions continue no matter what positional change is made.
o Contractions that occur during true labor increase in intensity and become more
regular with a change in activity.
o True labor cannot be suppressed by using comfort measures, and the pain is felt in
the lower back and lower abdomen.
- Signs of true labor
MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
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, MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
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o The nurse should inform the client that a sign of true labor is the bloody show, which is
a blood-tinged discharge from the vagina that occurs when the cervix begins to efface
and dilate.
o This is an indication that the client should go to the hospital
o Contractions: become regular in frequency
o Stronger, lasts longer, and more frequent
o Felt in lower back radiating to abdomen
o Walking can increase contraction intensity
o Continue despite comfort measures
o Progressive change in dilation & effacement
o Moves to anterior position
o Bloody show
o Fetus: presenting part engages in pelvis
ATI Question
12. A nurse midwife is examining a client who is a primigravida at 42 weeks of gestation and
states that she believes she is in labor. Which of the following findings confirm to the nurse
that the client is in true labor?
a. Cervical dilation
13. A client who is at 34 weeks gestation asks the nurse how she will know when she is in labor
and should go to the hospital. Which of the following responses should the nurse make?
a. You will notice blood-tinged discharge from your vagina.
14. A nurse is discussing the differences between true labor and false labor with a group of
expectant parents. Which of the following characteristics should the nurse include when
discussing true labor?
a. Contractions become stronger with walking
15. A client who is 37 weeks gestation comes to the office for a routine visit. This is the client's first
baby, and she asks the nurse how she will know when labor begins. Which signs indicate that
true labor has begun?
a. Expulsion of pink-tinged mucous and contractions that start in the lower back
16. A client reports awaking from sleep by contractions that are occurring every five minutes and
lasting 30-40 seconds. Which of the following questions should the nurse ask to assess for
true labor versus false labor?
a. “Have you noticed any bloody show or fluid coming from your vagina?”
17. The client asks the nurse to explain the difference between true and false labor. Which of
the following is an example of true labor?
a. In true labor the cervix will dilate and efface
Magnesium Sulfate Administration
- Magnesium sulfate is infused to prevent any seizure activity, along with antihypertensives
if blood pressure values begin to rise.
- Calcium gluconate is kept at the bedside in case the magnesium level becomes toxic.
- Continued close monitoring of neurologic status is warranted to detect any signs or symptoms
of hypoxemia, impending seizure activity, or increased intracranial pressure.
- If the patient is sleepy and difficult to rouse, she may be experiencing symptoms of
magnesium sulfate toxicity. This should be immediately reported to the provider.
- A newborn whose mother received high doses of magnesium sulfate needs to be monitored
for respiratory depression, hypocalcemia, and hypotonia.
- Nursing Actions
MATERNAL NEWBORN ATI FINAL EXAM 2022 LATEST UPDATE STUDY
GUIDE-URINARY FREQUENCY
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