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Nursing Care and Management of Pregnant and Postpartum Clients, Study Guides, Projects, Research of Nursing

A.T. Still University of Health Sciences (ATSU)Nursing

Comprehensive nursing care guidelines for pregnant and postpartum clients, covering topics such as infection control, labor and delivery, postpartum care, newborn feeding, and common discomforts of pregnancy. It also includes teaching points for various conditions and procedures, such as gestational diabetes, amniocentesis, and preterm labor.

Typology: Study Guides, Projects, Research

2023/2024

Available from 05/18/2024

LEARNERSTORE
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ATI Nursing Maternity Study Guide
Review Notes
1. Complete an ATI Focused Review® and send me a detailed summary (2-
3 sentences each) of 4 concepts that you learned from the focused
review.
a. Nursing Care of Newborns: Reinforcing teaching about newborn safety
i. Monitor the safety of the newborn’s crib. The space between
the mattress and sides of the crib should be less than 2
fingerbreadths. The slats on the crib should be no more than 5.7
cm (2.25 in) apart.
ii. The newborn’s crib or playpen should be away from window
blinds and drapery cords. Newborns can become strangled
in them.
iii. The bassinet or crib should be placed on an inner wall (not next
to a window) to prevent cold stress by radiation
b. Infection control: isolation precautions for a client who has pertussis
i. Droplet precaution
ii. A private room or a room with other clients who have the same
infectious disease. Ensure that clients have their own
equipment.
iii. Masks for providers and visitors
c. Nursing care of the client in labor: Hydrotherapy during labor
i. Hydrotherapy (whirlpool or shower) increases maternal
endorphin levels
d. Nursing care of the client during the postpartum period: Episiotomy care
i. Inspect episiotomy and lacerations for approximation,
drainage, quantity, and quality. A bright red trickle of blood
from the episiotomy site in the early postpartum period is an
expected finding
2. Answer the following questions and review the suggested learning
activities. Send me your answers here.
● What education should the nurse reinforce to the postpartum client
regarding mastitis? Suggested Maternal Newborn Learning Activity: Newborn
Feeding
○ Improper latch is the most common cause of nipple soreness
and mastitis. -
○ Suckling at both breasts advised
○ Rotate on left or right breast
○ Burp between breasts
○ Check hydration-skin turgor mucous membranes, fontanels soft and flat
○ baby should be gaining app roc 20-30 g/day.6-8 wet diapers per day
after milk comes-three bowel movements per day
● A nurse is reinforcing discharge information to a postpartum client who is
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ATI Nursing Maternity Study Guide

Review Notes

  1. Complete an ATI Focused Review® and send me a detailed summary (2- 3 sentences each) of 4 concepts that you learned from the focused review. a. Nursing Care of Newborns: Reinforcing teaching about newborn safety i. Monitor the safety of the newborn’s crib. The space between the mattress and sides of the crib should be less than 2 fingerbreadths. The slats on the crib should be no more than 5. cm (2.25 in) apart. ii. The newborn’s crib or playpen should be away from window blinds and drapery cords. Newborns can become strangled in them. iii. The bassinet or crib should be placed on an inner wall (not next to a window) to prevent cold stress by radiation b. Infection control: isolation precautions for a client who has pertussis i. Droplet precaution ii. A private room or a room with other clients who have the same infectious disease. Ensure that clients have their own equipment. iii. Masks for providers and visitors c. Nursing care of the client in labor: Hydrotherapy during labor i. Hydrotherapy (whirlpool or shower) increases maternal endorphin levels d. Nursing care of the client during the postpartum period: Episiotomy care i. Inspect episiotomy and lacerations for approximation, drainage, quantity, and quality. A bright red trickle of blood from the episiotomy site in the early postpartum period is an expected finding
  2. Answer the following questions and review the suggested learning activities. Send me your answers here. ● What education should the nurse reinforce to the postpartum client regarding mastitis? Suggested Maternal Newborn Learning Activity: Newborn Feeding ○ Improper latch is the most common cause of nipple soreness and mastitis. - ○ Suckling at both breasts advised ○ Rotate on left or right breast ○ Burp between breasts ○ Check hydration-skin turgor mucous membranes, fontanels soft and flat ○ baby should be gaining app roc 20-30 g/day.6-8 wet diapers per day after milk comes-three bowel movements per day ● A nurse is reinforcing discharge information to a postpartum client who is

breastfeeding. What information should the nurse include? Suggested Maternal Newborn Learning Activity: Newborn Feeding ○ You should have burst of 15 sucks or swallows at a time ● A pregnant client is prescribed iron supplements. Identify two (2) teaching points regarding iron absorption the nurse can reinforce in teaching to facilitate increase in red blood cell production during pregnancy. Suggested Maternal NewbornLearning Activity: Nutrition in Pregnancy ○ Iron is best absorbed between meals and when given with a source of vitamin C. Milk and caffeine interfere with the absorption of iron supplements. ○ Food sources of iron include beef liver, red meat, fish, poultry ● A nurse is reinforcing teaching to a group of pregnant women regarding common discomforts of pregnancy. A woman raises her hand and states ever since she started her iron supplement she has been "experiencing constipation". What are some relief measures for constipation? Suggested Maternal Newborn Learning Activity: Nutrition in Pregnancy ○ A stool softener might need to be added to decrease constipation experienced with iron supplements ● What is preterm labor? What are five (5) risk factors for preterm labor? Suggested Maternal Newborn Learning Activity: Stages and Phases of Labor and Delivery ○ Preterm labor is uterine contractions and cervical changes that occur between 20 and 37 weeks of gestation ■ Infections of the urinary tract, vagina, or chorioamnionitis (infection of the amniotic sac) ■ Previous preterm birth ■ Multifetal pregnancy ■ Hydramnios (excessive amniotic fluid) ■ Age younger than 17 or older than 35 ● What instructions should be given to a client scheduled for an amniocentesis? Suggested Maternal Newborn Learning Activity: Gestational Assessment ○ Empty the bladder prior to the procedure to reduce its size and reduce the risk of inadvertent puncture. ○ Obtain and document baseline vital signs and FHR prior to the procedure. ○ Assist the client into a supine position. Place a wedge under the right hip to displace the uterus off the vena cava. Place a drape over the client, exposing only her abdomen ● A nurse is caring for a newborn with hyperbilirubinemia who has been prescribed phototherapy. Identify five (5) interventions the nurse should institute for this client? ○ Maintain an eye mask over the newborn’s eyes for protection of corneas and retinas. ○ Keep the newborn undressed. For a male newborn, a surgical mask should be placed (like a bikini) over the genitalia to prevent possible testicular damage from heat and light waves. Be sure to remove the

○ Penicillin G or ampicillin are most commonly prescribed for GBS. ■ Ask the charge nurse to administer penicillin 5 million units IV as a loading dose, followed by 2.5 million units via intermittent IV bolus every 4 hrs until delivery. The client can receive ampicillin 2 g IV initially, followed by 1 g every 4 hrs via intermittent IV bolus. ● The nurse is reinforcing teaching about self-administering insulin to a client with

gestational diabetes. What are three (3) points the nurse should reinforce with this client? Suggested Maternal Newborn Learning activity: Gestational Diabetes ○ Use for small doses of non irritating, water-soluble medications, such as insulin and heparin. ○ Use a 3⁄8- to 5⁄8-inch, 25- 27-gauge needle or a 28- 31-gauge insulin syringes. Inject no more than 1.5 mL of solution. ○ Select sites that have an adequate fat-pad size (abdomen, upper hips, lateral upper arms, thighs). ○ For average-size clients, pinch up the skin and inject at a 45° to 90° angle. For clients who are obese, use a 90°angle. ● A pregnant client is preparing for a transvaginal ultrasound. What are two (2) teaching points the nurse will reinforce to the client regarding the purpose for this procedure? Suggested Maternal Newborn Learning activity: Fetal monitoring ○ It is especially useful in clients who are obese and those in the first trimester to detect an ectopic pregnancy, identify abnormalities, and to establish gestational age. ○ A transvaginal ultrasound also can be used in the third trimester in conjunction with abdominal scanning to evaluate for preterm labor ● A nurse is reviewing lab results for a newborn infant born at 38 weeks gestation, born 24 hours ago to an Rh negative mother. Which of the following results should be reported to the care provider? ○ Cord blood is collected at birth. Laboratory tests are conducted to determine ABO blood type and Rh status if the mother’s blood type is O or she is Rh-negative. A CBC can be done by a capillary stick to evaluate for anemia, polycythemia, infection, or clotting problems. Blood glucose is done to evaluate for hypoglycemia. ○ Blood glucose level of 45 mg/dLTotal serum Bilirubin 12 mg/DLBlood type B positiveCoombs Negative Suggested Maternal Newborn Learning Activity: Rh Incompatibility : RhoGAM ● The nurse is caring for a client who had a cesarean section two days ago and is now complaining of gas pain. What are three (3) teaching points the nurse should reinforce to the client to assist in alleviating the discomfort? Suggested Maternal Newborn Learning activity: Normal Postpartum care ○ Do not perform housework requiring heavy lifting for at least 3 weeks. Do not lift anything heavier than the infant. ○ Use good body mechanics and maintain proper posture. ○ Avoid sitting for prolonged periods of time with legs crossed (to prevent thrombophlebitis). ○ Do not drive for the first 2 weeks postpartum or while taking opioids for pain control ● A nurse is performing Leopold maneuvers on a pregnant client presenting to the labor and delivery unit in active labor. The nurse notes the following findings: PMI right upper quadrant above maternal umbilicus. The nurse suspects the infant is in what presenting position? Suggested Maternal

Activity: Fetal Monitoring ○ Prepare the client for labor ● The nurse is caring for a primigravida client in labor. The nurse notes the following findings:Cervix is 5 cm, with contractions every 4 minutes lasting 60 seconds each.The client appears restless and uncomfortable. Which stage of labor is the client in? Suggested Maternal Newborn Learning Activity: Stages and Phases of Labor and Delivery ○ Stage 1 Active labor

  1. Complete the pre-test, tutorial and post-test for the Maternal Newborn Skills Module a. COMPLETED
  2. Complete the following practice assessments and Focused Reviews and send me a detailed summary (2-3 sentences each) of 4 concepts that you learned from the focused review. PN Maternal Newborn 2017 A a. Nursing care of Newborn: Hospital Safety i. Newborn is not to be given to anyone who does not have a photo identification badge that distinguishes that person as a staff member of the maternal- newborn unit. b. Nursing care of newborn: contributing to the plan of care for a newborn following circumcision i. Monitor for bleeding and voiding per facility protocol. Apply gauze lightly to the penis if bleeding or oozing is observed 1. Bleeding every 15 to 30 minutes for the first hour and then hourly for the next 4 to 6 hrs. c. Nursing care of the client during the postpartum period: expected findings 32 hr postpartum i. Decreased estrogen is associated with breast engorgement, diaphoresis, and diuresis and excretion of excess extracellular fluid accumulated during pregnancy d. Nursing care of newborns: Administering phytonadione i. Administer 05. To 1 mg intramuscularly into the vastus lateralis within 1 hr after birth
  3. Complete the following practice assessments and Focused Reviews and send me a detailed summary (2-3 sentences each) of 4 concepts that you learned from the focused review. PN Maternal Newborn 2017 B a. Cultural and spiritual nursing care: kosher diet i. Someone stays with the body

ii. A burial society prepares the body b. Infection: Bacterial Vaginosis i. Avoid alcohol while taking medication due to disulfiram- like reaction ii. Take all medications as prescribed

i. Complete blood count (CBC)

ii. Blood type iii. Urinalysis iv. Urine culture v. Rubella vi. Hepatitis B and hepatitis C vii. Sexually transmitted infections (STIs) viii. Human immunodeficiency virus (HIV) ix. Tuberculosis (TB) f. At the initial prenatal visit what should the client expect? What should the client expect at ongoing prenatal visits? i. Determine est. DOB ii. Obtain medical and nursing hx iii. Physical exam (Assess costovertebral angle tenderness for kidney infection) iv. Labs g. List four common discomforts of pregnancy. i. Nausea and vomiting ii. Fatigue iii. Hemorrhoids iv. Heartburn and indigestion h. Name two potential complications this client should promptly report to the HCP. i. High blood pressure ii. Fetal kicks under 10 i. What is the recommended weight gain during pregnancy? i. Recommended Weight Gain for Underweight Women During Pregnancy: 28 to 40 pounds ii. Recommended Weight Gain for Women of Normal Weight During Pregnancy: 25 to 35 pounds iii. Recommended Weight Gain for Overweight Women During Pregnancy: 15 to 25 pounds iv. Recommended Weight Gain for Obese Women During Pregnancy:

of fetal distress. This is an indication for a CST to evaluate the response of the fetus under stress. ii. Intrauterine growth restriction during pregnancy can be

indicative of fetal distress. This is an indication for a CST to evaluate the response of the fetus under stress. iii. Postmaturity describes a fetus who is at greater than 42 weeks of gestation. This is an indication for a CST to evaluate the response of the fetus under stress. c. A nurse is teaching a client who is pregnant about the variables that are scored during a biophysical profile (BPP). Which of the following variables should the nurse include?(Select all that apply.) i. Fetal breathing movements are included in the scoring for a BPP. The fetus is observed during an ultrasound for 30 min and monitored for one episode of maintained fetal breathing movements of at least 30 seconds. This would receive a score of 2. d. A client at 28 weeks gestation has been admitted to the obstetric unit for preeclampsia. Her blood pressure has been ranging from 140s/100 to 160s/110s. She has 3+ proteinuria and generalized edema, and has been complaining of a headache. Which care environment would be most appropriate for this client? i. Loud noises and bright lights can trigger seizures is a preeclamptic client; these stimuli can be minimized in a private room. The client needs to rest as much as possible and avoid stress. There are no dietary restrictions for a client with PIH or preeclampsia. e. The practical nurse is working in a prenatal clinic. The