ATI MATERNAL NEWBORN REMEDIATION
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Medical Conditions: Priority Postpartum Client (RN QSEN - Safety, Active Learning
Template - Basic Concept, RM MNRN 10.0 Chap 9)
-monitor vitals
-provide education on pregnancy medical condition and what it means now that pt is
postpartum
-do all necessary lab tests to see if labs have returned to normal
-provide medications if needed
-maintain patient comfort
-provide medications to baby if needed
Infections: Caring for a Newborn Whose Mother Has HIV (Active Learning Template -
System Disorder, RM MN RN 10.0 Chp 8)
-Provide counseling prior to and after testing
-Refer client for a mental health consultation, legal assistance, and financial resources
-administer antiviral prophylaxis, triple-drug antiviral, or highly active antiretroviral
therapy (HAART) as prescribed
-encourage vaccination against hepatitis B, pneumococcal infection, Haemophilius
influenzae type B and viral influenza
-Infant should be bathed after birth before remaining with mother
Infections: Prophylaxis Treatment for a Newborn Whose Mother is HBsAg-Positive
Mothers (RN QSEN - Safety, Active Learning Template - Basic Concept, RM MN RN 10.0
Chp 8)
-information for immunization
--infants get their first dose as infants
--completes over a period of 6 months (at birth, 1 month, and 6 months)
--given as an injection
--usually 0.5ml for a newborn dosage
--know how many mLs you need to draw up
--know how to do dosage calculations based on information given in the question
--it is recommended to be administered to all newborns
--informed consent must be obtained
-info about immune globulin
--know how to do dosage calculations based on info given in the question
--for moms who are infected with hep B, the hep B immunoglobulin and the hep B
vaccine is given within 12 hours of birth
--vaccine is then given at 1 month, 2 months, and 12 months
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The first hepatitis B vaccine is given at the birth facility to infants of uninfected mothers
as well as to those whose mothers are positive for hepatitis B. Hepatitis B immune
globulin is also given to infants of infected mothers.
The hepatitis B vaccine should be administered with a 25-gauge, 5/8-inch needle.
Hepatitis B vaccination is recommended for all infants. If the infant is born to an infected
mother who is a chronic carrier, hepatitis vaccine and hepatitis B immune globulin should
be administered within 12 hours of birth. Hepatitis B vaccine should be given in the
vastus lateralis muscle. Hepatitis B vaccine can be given at birth.
Assessment of Fetal Well-Being: Contraindications for a Contraction Stress Test (Active
Learning Template – Diagnostic Procedure, RM MN RN 10.0 Chp 6)
-contraindications for oxytocin stimulation
-can be difficult to stop and could lead to preterm labor!
-only used this method when nipple stimulation fails
-contradictions are placenta previa, bass previa, preterm labor, multiple gestation,
previous classic incision from a cesarean birth, and reduced cervical competence
Infections: Expected Findings of Trichomoniasis (Active Learning Template - System
Disorder, RM MN RN 10.0 Chp 8)
-Males: Penile itching or irritation, dysuria, and urethral discharge
-Females: Yellow-green, frothy vaginal discharge with foul odor, dyspareunia and
itching, dysuria
-Females (physical findings): Discharge in the vaginal vault, which can be sampled for
microscopy, strawberry spots on the cervix (tiny petechiae), a cervix that bleeds easily
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,Therapeutic Communication: Supporting a Client in Early Pregnancy (RN QSEN - Patient-
centered Care, Active Learning Template - Basic Concept, RM FUND 9.0 Ch 32)
Postpartum Physiological Adaptations: Client Teaching for Postpartum Rubella
Vaccination (Active Learning Template - Basic Concept, RM MN RN 10.0 Chp 17)
-A client who has a titer of less than 1:8 is administered a subcutaneous injection of
rubella vaccine or a measles, mumps, and rubella (MMR) vaccine during the postpartum
period
-Protects a subsequent fetus from malformations.
-The client should not get pregnant for 1 month following the immunization
Prenatal Care: Immunizations during Pregnancy (Active Learning Template - Basic
Concept, RM MN RN 10.0 Chp 4)
-live vaccines cannot be given during pregnancy therefore rubella cannot be given.
Recommended immunizations include tetanus-diphtheria pertussis, measles, mumps,
rubella, hep A, hep B, and influenza
Pain Management: Nonpharmacological Methods (RN QSEN - Patient-centered Care,
Active Learning Template -Therapeutic Procedure, RM MN RN 10.0 Chp 12)
-Effleurage: Light, gentle circular stroking of the client's abdomen with the fingertips in
rhythm with breathing during contractions
-Sacral counterpressure: Consistent pressure is applied by the support person using the
heel of the hand or fist against the client's sacral area to counteract pain in the lower back
-Transcutaneous electrical nerve stimulation (TENS)therapy
-Hydrotherapy (whirlpool or shower) increases maternal endorphin levels
-Frequent maternal position changes to promote relaxation and pain relief
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, Patterned breathing, aromatherapy, music, low lighting, massage, walking, effleurage
(light, gentle circular stroking of the client's abdomen with the fingertips in rhythm with
breathing during contractions), sacral counter pressure, heat or cold application,
hydrotherapy, semi-sitting, squatting, kneeling, supine position with wedge under one of
the client's hips to tilt the uterus and avoid supine hypotension syndrome
Assessment and Management of Newborn Complications: Cocaine Use Disorder (Active
Learning Template – System Disorder, RM MN RN 10.0 Chp 27)
Newborn Complications
o neonatal substance withdrawal
hypoglycemia
respiratory distress syndrome/ asphyxia/ meconium aspiration
preterm newborn
small for gestational age
large for gestational age/ macrocosmic newborn
post term newborn
neonatal infection/ sepsis
birth trauma/ injury
hyperbilirubinemia
congenital anomalies
Neonatal Substance Withdrawal
o maternal substance use during pregnancy causing anomalies, neuro behavioral
changes and withdrawal
-mom uses drugs with addictive properties
-Fetal alcohol syndrome: results from intake of alcohol during pregnancy
Assessment of Withdrawal
o -Assessment: withdrawal and wakefulness by using neonatal abstinence scoring:
CNS (wakefulness, high pitched cry, shrill cry, incessant crying, irritable, tremors,
hyperactive w. increased Moro reflex, and muscle tone, abrasions on face knees
and convulsions)
metabolic, vasomotor and reap findings (nasal congestions, flaring, skin mottling,
tachypnea >60 & temp >99
-GI regurg, diarrhea and sucking
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