Prepare for your exams
Get points
Guidelines and tips

Prepare for your exams

Study with the several resources on Docsity

Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips

Sell on Docsity

Log in Sign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search Store documents

The best documents sold by students who completed their studies

Search through all study resources

Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents

20 Points

For each uploaded document

Answer questions

5 Points

For each given answer (max 1 per day)

All the ways to get free points

Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

University Rankings

Discover the best universities in your country according to Docsity users

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

From our blog

Exams and Study

Go to the blog

Maternal/Newborn ATI Final REVIEW, Exams of Nursing

University of Colorado - Colorado Springs (UCCS)Nursing

Maternal/Newborn ATI Final REVIEW

Typology: Exams

2024/2025

Available from 07/03/2025

houenoume-houenoume 🇺🇸

16 documents

1 / 20

This page cannot be seen from the preview

Don't miss anything!

Maternal/Newborn ATI Final REVIEW

What is the fourth stage of labor and when does it start?

- Postpartum period- starts after the delivery of the placenta

What are the greatest risks during the postpartum period?

- Hemorrhage

Shock

Infection

When is RH immune globulin (RhoGAM) administered to post partum women?

- Administered 72 hours for women who are Rh-negative and gave birth to infants who

are Rh-positive

This prevents sensitization to Rh in future pregnancies

What is included in the postpartum nursing assessment?

- Monitoring vital signs

Assessing uterine firmness & location in relation to umbilicus

Uterine position in relation to midline (if deviated, assist mom in emptying bladder)

Amount of vaginal bleeding (lochia)

How often should vitals be monitored after delivery?

- Every 15 min for the first hour

Every 30 minutes for second hour

Every 4-8 hr depending on remaining medication regimen

This occurs with contractions of the uterine smooth muscle, whereby the uterus returns

to its pre-pregnant state

- Involution

Defined as blood flow from the uterus during postpartum period

- Lochia

This type of lochia is bright red in color, bloody consistency, fleshy odor, may contain

small clots

- Lochia rubra

This type of lochia is pinkish brown in color & serosanguineous consistency

- Lochia serosa

This type of lochia is yellowish, white creamy color, fleshy odor

- Lochia alba

When is colostrum present in the new mother's breasts?

Partial preview of the text

Download Maternal/Newborn ATI Final REVIEW and more Exams Nursing in PDF only on Docsity!

Maternal/Newborn ATI Final REVIEW

What is the fourth stage of labor and when does it start?

Postpartum period- starts after the delivery of the placenta What are the greatest risks during the postpartum period?
Hemorrhage Shock Infection When is RH immune globulin (RhoGAM) administered to post partum women?
Administered 72 hours for women who are Rh-negative and gave birth to infants who are Rh-positive This prevents sensitization to Rh in future pregnancies What is included in the postpartum nursing assessment?
Monitoring vital signs Assessing uterine firmness & location in relation to umbilicus Uterine position in relation to midline (if deviated, assist mom in emptying bladder) Amount of vaginal bleeding (lochia) How often should vitals be monitored after delivery?
Every 15 min for the first hour Every 30 minutes for second hour Every 4-8 hr depending on remaining medication regimen This occurs with contractions of the uterine smooth muscle, whereby the uterus returns to its pre-pregnant state
Involution Defined as blood flow from the uterus during postpartum period
Lochia This type of lochia is bright red in color, bloody consistency, fleshy odor, may contain small clots
Lochia rubra This type of lochia is pinkish brown in color & serosanguineous consistency
Lochia serosa This type of lochia is yellowish, white creamy color, fleshy odor
Lochia alba When is colostrum present in the new mother's breasts?

During pregnancy and 2-3 days immediately after birth Defined as an infection in a milk duct of the breast with concurrent flulike symptoms
Mastitis What are therapeutic and approved holding positions when breast feeding?
Cradle hold Side-lying hold Football hold What does breast feeding cause the release of? What does this prevent?
Breast feeding causes the release of oxytocin which stimulates uterine contractions (will prevent hemorrhage) What are normal lab values in the post partum period?
Increased Hct & Hgb up to 72 hours Leukocytosis (WBC count up to 20,000-25,000 for the first 10-14 days, without presence of infection) Increased coagulation factors Increased fibrinogen A medical condition during pregnancy defined as excessive nausea and vomiting that is prolonged past 12 weeks of gestation. Results in weight loss & electrolyte imbalance
Hyperemesis gravidarum What are nursing responsibilities when caring for a patient diagnosed with hyperemesis gravidarum?
Monitor client's I&O Assess client's skin turgor/mucous membranes Monitor vital signs Monitor client's weight Have client remain NPO for 24-48 hours This medical condition occurs during pregnancy due to inadequacy in maternal iron stores and consuming insufficient amounts of dietary iron
Anemia This medical condition is defined as an impaired tolerance to glucose with the first onset or recognition during pregnancy
Gestational diabetes mellitus What is the ideal blood glucose level during pregnancy?
70 - 110mg/dL What are the clinical manifestations of hypoglycemia?
Nervousness

Methyldopa (Aldomet) Nifedipine (Adalat, Procardia) Hydralazine (Apresoline, Nesopresol) Labetalol (Normodyne) AVOID ACE INHIBITORS & ARBs What is an anticonvulsant medication used during pregnancy?
Magnesium sulfate What are signs of magnesium sulfate toxicity?
Absence of patellar deep tendon reflexes Urine output less than 30mL/hr Respirations less than 12/min Decreased LOC Cardiac dysrhythmias If magnesium sulfate toxicity is suspected, what is the priority nursing action?
Discontinue infusion & administer antidote CALCIUM GLUCONATE. Also, prepare to prevent respiratory/cardiac arrest Including what vitamin in the diet will increase absorption of iron supplementation?
Vitamin C This syndrome results from the chronic or periodic intake of alcohol during pregnancy; Alcohol is considered teratogenic
Fetal alcohol syndrome Defined as a serum glucose level of less than 40mg/dL
Hypoglycemia in full term newborn Defined as a serum glucose level of less than 25 mg/dL
Hypoglycemia in pre-term newborn This syndrome is defined as surfactant deficiency in the lungs and is characterized by poor gas exchange and ventilatory failure
Respiratory distress syndrome (RDS) Produced by the body, it is a phospholipid that assists in alveoli expansion & allows gas exchange to occur
Surfactant What are assessment findings of respiratory distress syndrome in a newborn?
Tachypnea (greater than 60/min) Nasal flaring Expiratory grunting Retractions (abdominal)

Labored breathing Fine crackles upon auscultation Cyanosis What weeks gestation defines a pre-term newborn?

Between 20-37 weeks gestation Defined as a newborn whose birth weight is at or below the 10th percentile and who has intrauterine growth restriction
SGA- Small for gestational age Defined as a newborn who's weight is above the 90th percentile or more than 8 lb 12 oz
LGA- large for gestational age Defined as a newborn who is born after the completion of 42 weeks of gestation
Post-term infant What do post-term infants have an increased risk for in utero?
Aspirating meconium This disorder is a complication that can result from meconium aspiration; Ductus arteriosus & foramen ovale remain open
Persistent pulmonary hypertension of the newborn Defined as an elevation of serum bilirubin levels resulting in jaundice (especially sclera and mucous membranes)
Hyperbilirubinemia (Hyperbili) What can result from untreated hyperbilirubinemia of levels higher than 25 mg/dL?
Kernicterus (bilirubin encephalopathy)- caused by bilirubin depositing into brain cells What is the treatment for hyperbili?
Phototherapy What are nursing responsibilities when caring for a newborn receiving phototherapy?
Maintain eye mask over newborn's eyes for protection of corneas and retinas Keep newborn undressed, surgical mask placed over genitalia Avoid motioning skin (can cause burns) Remove newborn from phototherapy q4hr assessing accordingly Reposition newborn q2hr What are signs that phototherapy is working?
Bronze discoloration Maculopapular skin rash Dehydration Elevated temperature

Spring activated lancet used on outer aspect of heel After puncture, apply pressure with gauze until bleeding stops Cuddle/comfort newborn after completion of procedure to promote feelings of safety How is the newborn identified after birth?

Using two identifiers; Arm band is applied immediately after birth to both mom and father baby to prevent newborn from being given to wrong parents How should newborns be positioned during sleep to prevent SIDS?
Supine "safe sleep" How might stools of breast fed newborns appear?
Yellow and seedy What is mandatory post birth to prevent opthalmia neconatorum?
Erythromycin (Roycin) - Prophylactic eye care What organisms is opthalmia neconatorum caused by?
Neisseria gonorrhoeae or Chlaymdia trachomatis - can cause blindness if left untreated Why is vitamin K administered to newborn within 1 hour after birth?
To prevent hemorrhagic disorders; Because vitamin K into produced in the GI tract of the newborn until day 8, it is administered at birth How should you care an infant while umbilical cord is healing?
Keep clean and dry to prevent infection What type of bathing should be avoided while umbilical cord is still healing?
Bathing infant by submersion in water; Should be avoided until cord has fallen off If an infant is not dried completely at birth, by what mechanism will the infant lose heat?
Evaporation - loss of heat that occurs when a liquid is converted to a vapor What does performing Leopold's maneuvers determine?
Number of fetuses Presenting part (cephalic/breech Fetal lie (longitudinal/transverse) Fetal attitude Degree of descent into mom's pelvis Location of PMI - fetal back How and in what order are contractions rated?
Frequency, Duration, Intensity What is a normal fetal heart rate (FHR)?

110 - 160bpm with increases/decreases from baseline What are advantages of external fetal monitoring?
Noninvasive- reduces risk for infection Membranes do not have to be punctured Cervix does not have to be dilated What are disadvantages of external fetal monitoring?
Contraction intensity is not measurable Requires frequent repositioning of client Quality of recording is affected by client obesity/fetal position Defined as FHR less than 110/min
Fetal bradycardia What are nursing interventions required when FHR is 110bpm or less?
Discontinue oxytocin Assist client to side-lying position Administer o2 at 8-10L/min Insert IV catheter w/tocolytic medication Notify provider Defined as FHR greater than 160 bpm for 10 min or more
Fetal tachycardia What are nursing interventions required when FHR is 160bpm or more?
Administer prescribed antipyretics for maternal fever (if present) Administer o2 by mask at 8-10 L/min Administer IV fluid bolus What nursing intervention is required for early decelerations of FHR?
No intervention required - expected finding Cause: Compression of fetal head resulting from uterine contraction What are late decelerations of FHR caused by?
Uteroplacental insufficiency causing inadequate fetal oxygenation What are nursing interventions required for late decelerations of FHR?
Place client in side-lying position Insert IV catheter and increase fluids Discontinue oxytocin if being infused Administer o2 by mask 8-10 L/min Notify provider Prepare for emergency c-section or assisted vaginal birth What are variable decelerations of FHR caused by?

Uterine enlargement Quickening Signs that make the medical examiner suspect a woman is pregnant

Probable signs of pregnancy What are examples of probable signs of pregnancy?
Abdominal enlargement Hegar's sign (softening of lower uterus) Chadwick's sign (Deepened violet-blue color of cervix/vaginal mucosa Goodell's sign (softening of cervical tip Braxton hicks contractions Positive pregnancy test (Testing for hcg) What are examples of positive signs of pregnancy?
Fetal heart sounds Visualization of fetus by ultrasound Fetal movement palpated by experienced examiner What do at-home pregnancy tests detect in urine?
hCG- human chorionic gonadotropin What do higher levels of hCG indicate?
Multifetal pregnancy Ectopic pregnancy Genetic abnormality- Down syndrome What do lower levels of hCG indicate?
Possible misscarriage How do you determine an estimated delivery date using Nagele's rule?
Take the first day of the woman's LMP, subtract 3 months, add 7 days and add 1 year Defined as the number of pregnancies
Gravidity Defined as a woman in her first pregnancy
Primagravida Defined as a woman who has had two or more pregnancies
Multigravida Defined as the number of pregnancies in which the fetus or fetuses reach viability ( weeks) regardless of whether the fetus is born alive
Parity

What does the GTPAL acronym stand for?

Gravidity Term births (38+ weeks) Preterm births Abortions/miscarriages Living children What is supine hypotension syndrome?
Pressure of the uterus on the vena cava, decreasing venous blood flow to the heart What is chloasma?
Pigmentation increases on the face, normal during pregnancy What is line nigra?
Dark line of pigmentation from the umbilicus extending to the pubic area Approximately how long should a mother spend breastfeeding on each breast?
15 - 20 minutes per breast & 30- 40 minutes total feeding Before a circumcision is performed, what does a nurse need to assess?
History of bleeding tendencies in family (hemophilia, clotting disorders) Hypospadias/epispadias Ambiguous genitalia (have both male/female characteristics) Illness/infection Post a circumcision, what does a nurse need to assess?
Bleeding q15min for first hour & a1hr for 12 hours Assess for first voiding by newborn post procedure What is recommended exercise type and amount of time during pregnancy?
Exercise during pregnancy yields positive benefits and should consist of 30 minutes moderate exercise (walking/swimming) For the expectant mother experiencing nausea/vomiting, what should the nurse recommend when it comes to eating in the morning?
Eat crackers or plain toast before getting out of bed How is an apgar score made?
Perfect score: 10 5 categories, each worth points each Categories: HR, RR, Muscle tone, Reflex irritability, Color How many veins/arteries should the umbilical cord have?
1 vein 2 arteries

Qualitative amniotic fluid volume This type of stress test consists of a woman brushing her palm across her nipple for 2 minutes, which causes the pituitary to release endogenous oxytocin

Nipple stimulated CST (Contraction stress test) Defined as the aspiration of amniotic fluid for analysis by insertion of a needle transabdnominally into a client's uterus and amniotic sac under direct ultrasound guidance
Amniocentesis High levels of what protein (examined during an amniocentesis) is associated with neural tube defects?
Alpha-fetoprotein (AFP) What are low levels of Alpha-fetoprotein (AFP) associated with?
Down Syndrome What are high levels of Alpha-fetoprotein (AFP) associated with?
Neutal tube defects What are nursing responsibilities following an amniocentesis?
Monitor vital signs, FHR, uterine contractions for 30 minutes following procedure Have client rest for 30 minutes Administer Rh immune globulin (RhoGAM) to the client if she is Rh-negative to protect against Rh isoimmunization (If fetus has different Rh) This type of diagnostic procedure is an assessment of a portion of the developing placenta (chorionic villi) which is aspirated through a thin sterile catheter or syringe through the abdominal wall
Chorionic villi sampling A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis to assess fetal lung maturity. What is the test for fetal lung maturity during an amniocentesis?
Lecithin/sphingomyelin (L/S) ratio What is an acoustic vibration device & why is it used during a non stress test (NST)?
It is a vibrato device that is used to awaken a fetus from sleeping What are some contraindications for oxytocin therapy during labor?
Sepsis Unripe cervix Genital herpes History of multiple births Uterine surgery

What is terbutaline (Brethine) used for?

To stop uterine contractions- causes uterine smooth muscle relaxation Defined as the artificial rupture of membranes (AROM) by provider using an Amnihook or other sharp instrument
Amniotomy Defined as scant amount or absence of amniotic fluid
Oligohydramnios This type of delivery assistance involves using a cup like suction device that is attached to the head
Vacuum-assisted delivery This type of assisted birth is using an instrument with two curved spoon like blades to assist in the delivery of the fetal head
Forceps-assisted birth Defined as an incision made into the perineum to enlarge the vaginal opening to facilitate delivery and minimize soft tissue damage
Episiotomy What are indications for cesarean birth?
Malpresentation (breech) Fetal distress Placental abnormalities High risk pregnancy (HIV+, Hypertensive disorders, diabetes mellitus, active genital herpes lesions) Previous c-section Multiple gestations Umbilical cord prolapse What are nursing responsibilities after a c-section?
Monitor for bleeding (internal, external) Assess lochia Monitor I&O Monitor vitals Give pain medication as prescribed Encourage ambulation to prevent thrombus Assess client for UTI When is an amnioinfusion indicated?
Oligohydraminios (scant/absent amniotic fluid) Fetal cord compression

Defined as the abnormal implantation of a fertilized ovum outside of the uterine cavity, usually in the fallopian tube, which can result in a tubal rupture causing a fatal hemorrhage

Ectopic pregnancy This occurs when the placenta abnormally implants in the lower segment of the uterus near or over the cervical os instead of attaching to the fundus
Placenta previa Defined as the premature separation of the placenta from the uterus, which can be partial or complete detachment
Abruptio placenta What are risk factors associated with abrupt placenta?
Maternal HTN Blunt abdominal trauma Cocaine use Cigarette smoking Refers to a thrombus that is associated with inflammation, occurs postpartum
Thrombophlebitis If a client reports leg pain & tenderness, what should the nurse suspect?
Possible DVT What are nursing responsibilities when educating client about preventing thrombophlebitis?
Maintain antiembolism stockings until ambulation established Perform active/passive ROM if on bed rest Avoid prolonged periods of standing, sitting or immobility Have client elevate legs when sitting Maintain adequate fluid intake Tell client to discontinue smoking What are nursing responsibilities when caring for a patient with thrombophlebitis?
Encourage rest Facilitate bed rest DO NOT massage affected area to prevent thrombus from dislodging and becoming an embolus Administer analgesics (NSAIDs) Administer anticoagulants for DVT When administering IV heparin, what lab value should the nurse particularly monitor?
apTT What is the antidote for PO warfarin?

Vitamin K When administering PO warfarin, what lab value should the nurse particularly monitor?
PT and INR Defined as a coagulopathy that is an autoimmune disorder in which the life span of platelets is decreased by anti platelet antibodies
Idiopathic thrombocytopenic purpura (ITP) Defined as a coagulopathy in which clotting and anticlotting mechanisms occur at the same time
Disseminated intravascular coagulation (DIC) Defined as more than 500mL blood loss after a vaginal birth or more than 1000 mL blood loss after a cesarean birth
Postpartum hemorrhage What are nursing responsibilities if post partum hemorrhage is suspected?
Monitor vital signs Assess for source of bleeding Assess bladder for distention Maintain/initiate IV fluids to replace blood loss Provide o2 at 2-3 L/min via NC Elevate client's legs to increase venous return What is methylergonovine (Methergine) used for?
Controls postpartum hemorrhage What drugs control postpartum hemorrhage?
Methylergonovine (Methergine) Misoprostol (Cytotec) Carboprost tromethamine (Hemabate) Defined as inability of the uterine muscle to contract adequately after birth
Uterine atony Defined as when the uterus remains enlarged with continued local discharge and may result in a post partum hemorrhage
Subinvolution of the uterus Defined as turning inside out of the uterus and may be partial or complete
Inversion of the uterus Defined when fragments of the placenta remain in the uterus and prevents the uterus from contracting, which can lead to uterine atony or subinvolution
Retained placenta

Avoid bathing the new infant daily because it can cause dryness and alters the acid mantle of the newborn's skin What should the temperature of the water approximately be to prevent injury to newborns?
36.6-37.2 (98-99F) If a client tests positive for a 1-hour glucose tolerance test, what test will confirm/deny a diagnosis of gestational diabetes?
3 - hr glucose tolerance test What is the main clinical finding that indicates magnesium sulfate toxicity?
Absence of deep tendon reflexes How long should a child be back facing in car seat while riding in a vehicle?
Until age 2 What is unilateral breast pain a symptom of?
Mastitis What are traditional hispanic practices post partum?
Protecting the newborn's head/feet from cold air; Delaying bath for 14 days following delivery; Bed rest for mom for 3 days & drinking warm beverages following birth What is irritability during phototherapy a sign of?
Acute bilirubin and encephalopathy When should oxytocin be administered?
Flaccid uterus Excess vaginal bleeding To enhance contractions What should an expectant mother do after exercising?
Side-lie for 10 minutes to promote circulation to fetus At what minutes are apgar scores taken?
1 & 5 minutes What does a feeling of tightness following an amniocentesis indicate?
Onset of uterine contractions What does dull, intermittent back pain indicate?
Preterm labor, needs to be reported to provider What is a non-pharmacological method for lactation suppression?
Cabbage leaves:

Plant sterols and salicylates from cabbage leaves can help relieve swelling What are sub-sternal retractions in a newborn a sign of?

Respiratory distress During the immediate postpartum period, what is the new mom at greatest risk for?
Post partum hemorrhage What does a mom's subjective report of "tingling fingers" during labor indicate?
Hyperventilation

Maternal/Newborn ATI Final REVIEW, Exams of Nursing

Related documents

Partial preview of the text

Download Maternal/Newborn ATI Final REVIEW and more Exams Nursing in PDF only on Docsity!

Maternal/Newborn ATI Final REVIEW