ATI Proctored OB Maternal Newborn Study Guide Rated A+

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 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.